Download General Medicine Conditions

 100+
strains
 Most common communicable disease
 Upper respiratory infection
 Self-limiting…lasts 5-10 days regardless
of tx
 Acute
infectious respiratory viral disease
 Types:
• Type A: assoc w/ worldwide epidemics (most
common)
• Type B: geographic epidemics
• Type C: mild flu
 Recovery
in about 7-10 days
 Fever, chills, headache, myalgia, loss of
appetite
 Avoid aspirin in children – Reye’s syndrome
Acute infection caused by Ebstein-Barr virus
 Typically found in young adults

• Mild when it occurs in young children
• Older adults are typically immune
Transmitted by respiratory secretions
 Sx:

• Fever, sore throat, swollen lymph nodes, malaise,
hepatomegaly, splenomegaly(50-70% have enlarged
spleen)

Infection usually ensures permanent immunity
• You carry virus, but typically don’t get symptoms when
virus occasionally becomes active (you can give it to
others when active & asymptomatic)
 90%
of acute bronchitis = viral infection of
the lungs
 Lasts 1-3wks
• Typically doesn’t need tx unless you have severe or
persistent sx
 Sy: SOB, chest
pain/tightness, fatigue,
muscle aches
 Sx: Possible fever, difficulty breathing,
coughing (possibly w/ mucus)
 Lung
infection caused by bacteria or virus
 Sx:
• Chest pain, spitting up blood, fever, difficulty
breathing, coughing up yellow/greenish sputum
 Tx:
• Antibiotics for bacteria (sometimes viral to
prevent complications)
• Most can be treated at home with lots of rest
• It often clears up in 2 to 3 weeks
 Constriction
of air passages in the lungs
 Causes: cold, smoke, allergic
reaction/allergies, exercise
 Sy: Tightness in the chest, SOB
 Sx: Trouble breathing, increased RR,
wheezing, bluish skin, increased pulse,
tingling?
 Tx: Inhaler, monitor, calm the athlete down,
EMS?
Inflammation of the coverings around brain & spinal
cord
 Usually caused by a bacterial or viral infection

• Viral: most common, usually not as serious
 Can cause prolonged fever & seizures
• Bacterial: not as common, but very serious
 Can cause brain damage & death
Typically seen in children, teens, and young adults
Contagious – passed via coughing, sneezing, & close
contact
 Sx:


•
•
•
•
A stiff & painful neck, especially w/ neck flexion
Fever
Headache
Seizures
 Causes:
• Excessive loss of blood (can be seen w/ menstrual
cycles)
• Deficient intake of iron
• Poor absorption of iron
 Sx:
• Weakness/Feeling tired
• Feeling grumpy
• Headaches
• Difficulty concentrating
• Light-headedness
• Difficulty breathing
 Physical
findings or changes in behavior
that occur after an episode of abnormal
electrical activity in the brain
 Often used interchangeably w/
"convulsions"
• Convulsions are uncontrollable body
• shaking/contracting & relaxing of muscles
 There
are many types of seizures…not all
have convulsions








Remain calm
Cushion fall
Clear area
Loosen restrictive clothing
Place soft cloth between teeth
Allow patient to awaken normally
Do not restrain patient during seizure
Call 911 if:
•
•
•
•
•
•
First seizure
Lasts more than 2 to 5 min
The person remains unconscious
More then one seizure
Caused by head injury or has diabetes
Atypical seizure for them
Due to rapid breathing, levels of carbon dioxide
are low (compared to O2) in bloodstream
 Body responds to lower CO2 by constricting
blood vessels in brain
 Sx:

•
•
•
•

Lightheaded, headache
Rapid heartbeat & RR
Numbness or tingling in hands, feet, or mouth
Shaking/seizures
Tx: Slow respiratory rate
• Breath in through nose & out through mouth
• Inhale/exhale through one nostril w/ the other pinched
and mouth closed
• Breath into a paper or plastic bag
 Severe
allergic reaction
 Sy: Chest tightness, difficulty breathing,
dizziness
 Sx:Wheezing, swollen tongue/lips/throat,
bluish skin, hives, nausea, vomiting,
confusion
 Tx: Epi-pen, monitor, activate EMS
 Prevention: Know athletes’ Hx
 Stones
may form in any part of UT, most
occur in kidney
 Dissolved urine salts begin to solidify
 May increase in size & result in
obstruction
 Intense radiating pain from kidney area
to groin
 Tx: US waves, ureteroscopic removal,
allow to pass on own
 UTI
or Kidney Infection
• Caused by bacteria
 Obstruction
or ‘holding it’ paves way for
infection due to stagnation of urine
 Sx: pain w/ urination, increased urgency
& frequency, fever & chills possible
 Tx: antibiotics
 Inflammation
of the appendix
 Not sure what it does & we can live without it
 Medical emergency - requires prompt
surgery to remove the appendix
 Will eventually burst, or perforate, spilling
infectious materials into abdominal cavity
 In U.S. – affects 1:15, usually between 10-30
y/o
 Sx: Pain in LR abdomen, fever, loss of
appetite, nausea or vomiting
 Protrusion
of any organ or tissue through
the wall of the cavity that contains it

Sports Hernia: “Athletic Pubalgia”
 Typically no lump felt on exam, will worsen if not properly
treated
 Tx: PT, Surgery?
 Strangulated
Hernia:
• Blood supply to hernia is cut off, can lead to
necrosis/gangrene (tissue death)
 Direct
blow to left side
 Mono may enlarge the spleen, making
contact sports extremely risky
 Profuse internal bleeding
 Early stage: pain in upper left quadrant,
tenderness, bruising
 Life threatening stage: Pain in left
neck/shoulder, faintness, dizziness, pale
skin, rapid pulse, vomiting, low BP, SOB,
rigid abdominal muscles
 Blow
to flank/mid back
 Early stage: Pain at site, bruising
 Advanced stage: faintness, dizziness,
increased HR, bloody or cloudy urine,
vomiting, rigid back muscles, pale and
cool skin, frequent and burning urination
 Diabetes
Mellitus (DM):
• Most common pancreatic disorder
• Type I
• Type II
• Gestational
 7th
leading cause of death in U.S. in 2006
 23.6
million children & adults in US
(7.8%)
• Diagnosed: 17.9 million people
• Undiagnosed: 5.7 million people
• Pre-diabetes: 57 million people
• New Cases: 1.6 million adults each year
 22%
of all people <20 y/o have diabetes
• Recent estimates put this closer to 1/3
 About
2 million adolescents aged 12-19
are considered pre-diabetic
 20+
y/o:
• 6.6% of non-Hispanic whites
• 7.5% of Asian Americans
• 11.8% of non-Hispanic blacks
• 10.4% of Hispanics
 Heart
disease and stroke
• 2 to 4 x’s higher risk than adults w/o diabetes.
 High
blood pressure
• 75% of adults had BP > 130/80 or used meds
 Blindness
• Leading cause of new cases of blindness among
adults 20–74 y/o
 Kidney disease
• Leading cause of kidney failure, accounting for
44% of new cases
 Amputation
• >60% of non-traumatic lower-limb amputations
occur in people with diabetes
• From poor wound healing and poor circulation
 High
cholesterol
 Erectile dysfunction
 $174
billion: Total costs of diagnosed
diabetes in US
 Medical
expenses were 2.3x’s higher
than people s diabetes
 $218
billion: Factoring costs of
undiagnosed diabetes, pre-diabetes, and
gestational diabetes
 Body
cannot effectively regulate blood glucose
• Characterized by hyperglycemia
 Type
1: body’s failure to produce insulin due to
autoimmune pathology (5-10%)
 Type 2: cell insulin resistance or failure of the
pancreas to produce enough insulin (90-95%)
 Gestational: glucose intolerance during
pregnancy
 Pre-Diabetic: blood glucose levels are higher
than normal but not high enough for a
diagnosis
Body
converts food to glucose, if not
used it is stored as glycogen in the liver
& muscles
Insulin
produced in the pancreas,
facilitates glucose transport in the cells
for energy metabolism & storage
“Autoimmune” –
Juvenile
body fights itself
onset
5-10% of diabetes incidence
Underweight or normal
Low insulin levels
FHx usually negative
 Usually
diagnosed in children and young
adults
 Previously known as juvenile diabetes
 Only 5% of people with diabetes have
this form of the disease
 In type 1 diabetes, the body does not
produce insulin, a hormone that is
needed to convert sugar, starches & other
food into energy
“Insulin
resistant”
Adult onset (typically)
90-95% of diabetes incidence
Risk factors:
• Overweight
• Sedentary lifestyle
• Poor diet
• FHx
 Most
common form of diabetes
 Previously known as ‘adult onset’
 The body does not use insulin properly
 Initially the pancreas makes extra insulin
to make up for it, but over time the body
can’t make enough to keep your blood
glucose at normal levels
Fasting
plasma glucose - p 8hr fast
• Normal = 100 mg/dL
• Pre-diabetic = 100-126 mg/dL
• Diabetic = >126 mg/dL
Casual
plasma glucose
• > 200 mg/dL
Increased
thirst
Increased urination (polyuria)
Unexplained weight loss
Increased hunger
Tingling in hands and feet
Blurry vision
Glucose in the urine
Type 1:
Type 2:
 Diet
 Diet
 Exercise
 Exercise
 Insulin
 Oral
 Regular
blood sugar
monitoring
anti-diabetic
agents
 Regular blood sugar
monitoring
 Insulin???
 Pre-meal
blood sugar: <100 mg/dL
 Post-meal blood sugar: <180mg/dL
 HbA1c
value: <6-7%
• Preferred test – less affected by daily glucose
fluctuations
• Avg glycemic control for 2-3 month period
• Normal range is 4-6%
 Blood
pressure <140/90
 Pay
special attention to Type I athletes
during/after exercise
 Watch for sx’s of hypoglycemia
• Confusion, irritation, pale?, sweating?
 Athlete
will need to experiment w/ proper
levels of insulin & food intake prior to and
during exercise
 Athlete and ATC should have sugar source at
all times
 Athlete may not be able to get sugar source
before its too late, & then they will fight it
 Low
blood sugar
 Mild: Hunger, irritability, weakness
 Moderate: Dilated pupils, sweating,
strong and rapid pulse
 Severe: Confusion, convulsions,
unconsciousness
 Treatment: Give athlete sugar, candy, fruit
juice, or soda
• If athlete does not recover w/in few minutes:
Activate EMS, monitor
 High
blood glucose levels
 Early stage: excessive thirst, dry mouth,
nausea, sweet/fruity breath, excessive
urination
 Advanced stage: Headaches, abdominal
pain, dry/red/warm skin, weak/rapid
pulse, heavy breathing, vomiting
 Treatment: Take insulin (if available),
EMS?, monitor
 Smoking
is leading cause of all types of
lung cancers
 Breast and Testicular Cancer – Selfexams recommended
 Depositories
for cellular debris
 Site of phagocytosis by macrophages, &
lymphocytes (T-cells and B-cells)
• Phagocytosis: digestion of bacteria & other
materials
 During
an infection: due to the number of
bacteria destroyed – node often gets
enlarged & tender
 Caused
by bacteria that can lead to
serious infections & infertility
 It can infect both men & women
 1.4-2.86million cases/year
 Most common in young adults/teenagers
– 1:15 sexually active females aged 14-19
have this disease
 It is easily treatable w/ antibiotics
 Sx: discharge, pain w/ urination
 Caused
by Herpes Simplex Virus 2
 776,000 new infections/year
 In U.S….16% 14 to 49y/o affected
 More common in women 1:5 vs 1:9
 Sx: Blisters, painful sores…not always
symptomatic
• Can be spread while asymptomatic
 No
cure
 If also infected w/ HPV – increased risk of
cervical cancer 2-3x’s
• 14 strains of HPV cause 90% of all cervical cancer
 Caused
by bacteria that affects mucous
membrane of genital & urinary tracts
 Treatable
w/ antibiotics, but can cause
infertility & death if left untreated
 In
U.S. - 820,000 new cases/year
 ~570,000
of them were15-24 y/o
 Sx: discharge
& pain w/ urinating
 Caused
by bacteria that can cause
lesions of CNS & CV system
 Treatable w/ antibiotics, but can cause
long-term complications or death if not
properly treated
 ~55,400 new cases/year
 Sx: Non-painful sore lasting 3-6wks…if
not treated a rash will follow & in 10-30
yrs paralysis & death
 Acquired
immune deficiency syndrome
 Caused by HIV (Human
Immunodeficiency Virus)
• Infects helper T-cells w/ long incubation &
replicates the virus
• Slowly destroys immune system (T-cells)
 AIDS: during
advanced stages of disease
 After immune system destroyed,
opportunistic infections occur
 Cyst: fluid
filled sac that can form
anywhere on body
 When they form on the ovaries, they can
cause pain & affect menstruation
 Under the age of 40, ovarian cancer is
rare
 Most cysts are benign, asymptomatic &
go away on their own in 1-3 months
Disordered eating:
Abnormal eating habits (i.e., crash diets, binge
eating) or excessive exercise keeps the body
from getting enough nutrition
 Amenorrhea:
Poor nutrition, high-energy demands, physical
and emotional stress, or low BF% can lead to
hormonal changes that stop menstrual periods
 Premature osteoporosis (low bone density for
age):
Amenorrhea disrupts the body's bone-building
processes and weakens the skeleton, making
bones more likely to break

 Direct
blow to groin area
 Sx’s: Pain, nausea
 Self-exam:
•
•
•
•
•
Swelling, discoloration, deformity, spasm
Testicles draw up or twist
Bloody or cloudy urine
Vomiting
Tenderness lasting >1hr
 Tx: Place
in most comfortable position
(knees to chest?), ice, refer to physician if
serious sx’s present