Bartholin Cyst:
Patho: Bartholin glands are two small glands located on each side of the vaginal opening. These
glands secrete fluid that helps lubricate the vagina. When the ducts of these glands become
blocked, fluid accumulates in the gland, forming a cyst.
Diagnostics: usually made based on physical exam and medical history. Ultrasound or MRI may
be used to confirm the diagnosis.
Signs and Symptoms: May cause swelling and discomfort near the vaginal opening. The cyst
may be painless or cause pain during sex or other activities that put pressure on the area. If the
cyst becomes infected, it may become red, swollen, and painful.
Education & Interventions: Treatment depends on the size and severity of the cyst. Small cysts
that do not cause symptoms may not require treatment. Warm compresses or sitz baths may
help relieve discomfort. If the cyst is large or causes pain or discomfort, it may need to be
drained or surgically removed. Antibiotic may be prescribed if the cyst becomes infected.
Vulvitis: inflammation of the vulva, the external female genitalia. It may be caused by irritants,
such as soaps or perfumes, or by an infection.
Diagnosis: usually made based on physical exam and medical history. If an infection is
suspected, a swab of the area may be taken and sent for testing.
S/S: may cause itching, burning, redness, and swelling or the vulva. Discharge and pain during
sex or urination may also occur.
Education & Interventions: Treatment depends on the cause of vulvitis. Avoiding irritants and
practicing good hygiene may help relieve symptoms. If an infection is present, it may be treated
with antifungal or antibacterial medication. Topical creams or ointments may also be
prescribed to help relieve symptoms.
Vaginal yeast infection: a type of fungal infection that occurs when there is an overgrowth of
yeast in the vagina.
Diagnostics: usually made based on physical exam and medical history. A sample of vaginal
discharge may be taken and sent for testing to confirm the dx.
S/S: may cause itching, burning, and redness of the vulva. Thick, white, odorless discharge may
also occur.
Education & Interventions: Treatment usually involves antifungal medication, either as a cream
or pill. Avoiding irritants, wearing loose clothing, and practicing good hygiene may also help
prevent yeast infections.
Polyps: noncancerous growths that can develop in the uterus, cervix, or vagina.
Diagnostics: usually made based on physical exam and medical history. Ultrasound or MRI may
be used to confirm the dx.
S/S: may not cause any symptoms. If symptoms do occur, they may include irregular menstrual
bleeding, bleeding after sex, or vaginal discharge.
Education & Interventions: May involve monitoring the polyp to ensure it does not grow or
become cancerous. If the polyp is causing symptoms or is at risk for becoming cancerous, it may
need to be removed surgically. Hormonal medication may also be prescribed to help prevent
the growth of new polyps.
Gynecologic Cancers: Are cancers that affect the female reproductive system, including the
vulva, cervix, endometrium(lining of the uterus), and ovaries. These cancers occur when
abnormal cells in these tissue grow and divide uncontrollably, forming tumors.
Diagnostics: may include physical exam, imaging tests( such as CT scans or MRIs) and/or
biopsies (tissue samples that are examined under a microscope).
S/S: can vary depending on the type and stage of the cancer, but may include abnormal vaginal
bleeding, pain or discomfort in the pelvic area, changes in bowel or bladder habits, and/or
unexplained weight loss.
Education & Interventions: may depend on the type, stage, and location of the cancer. Tx
options may include surgery, radiation therapy, chemotherapy, targeted therapy, or a
combination of these. Education about prevention and early detection may also be important,
including regular gynecologic exams and cancer screening tests.
Stages: stages of gynecologic cancer refer to how advanced the cancer is and how far it has
spread. The stages are typically categorized using the TNM system, which stands for Tumor,
Nodes, and Metastasis. The stages range from I to IV being the most advanced and indicating
that the cancer has spread to other parts of the body.
Types:
Vulva CA: is a rare type of cancer that affects the external female genitalia, including the labia
and clitoris. If is often caused by the human papillomavirus (HPV) or long-term irritation of the
vulva.
Diagnostics: may include a physical exam, biopsy, and/or imaging tests.
S/S: may include itching, burning, or bleeding in the genital area, changes in the color or
thickness of the skin, and/or lump or bump in the vulva.
Education & Interventions: may include surgery, radiation therapy, chemotherapy, or a
combination of these. Prevention measures may include practicing safe sex and avoiding
exposure to irritants or chemicals.
Cervical Cancer: cancer that affects the cervix, which is the lower part of the uterus that
connects to the vagina. It is often caused by HPV.
Diagnostics: may include a Pap smear test, HPV test, colposcopy, and/or biopsy.
S/S: may include abnormal vaginal bleeding, pain during sex, and/or unusual vaginal discharge.
Education & Interventions: may include surgery, radiation therapy, chemotherapy, or a
combination of these. Prevention measures may include HPV vaccination and regular cervical
cancer screening. New guidelines are allowing the vaccine to be provided up to the age of 45.
Endometrial Cancer: is a type of cancer that affects the lining of the uterus.
Diagnostics: may include a biopsy, imaging tests, and/or hysteroscopy ( a procedure to
examine the inside of the uterus).
S/S: may include abnormal vaginal bleeding, pelvic pain, or pressure, and/or changes in bowel
or bladder habits.
Education & Interventions: may include surgery, radiation therapy, hormone therapy, or a
combination of these. Prevention measures may include maintaining a healthy weight.
Ovarian CA: affects the ovaries, which are the female reproductive organs that produce eggs.
It can occur when abnormal cells in the ovaries grow and divide uncontrollably.
Diagnostics: physical exam, imaging tests (such as ultrasound or CT scans) and/or a biopsy.
S/.S: may include abdominal swelling or bloating, pelvic pain, or discomfort, and/or changes in
bowel or bladder habits.
Education &Interventions: may include surgery, chemotherapy, targeted therapy, or a
combination of these. Prevention measures may include using oral contraceptives, having
multiple pregnancies, and undergoing prophylactic (preventive) surgery for women with a high
risk of ovarian cancer. Early detection is also important, so women with a family history of
ovarian cancer or other risk factors should discuss screening options with their healthcare
provider.
Endometriosis: a condition in which the tissue that normally lines the inside of the uterus
(the endometrium) grows outside of the uterus, such as on the ovaries, fallopian tubes, or other
organs in the pelvis. This can cause inflammation, scaring, and pain.
Diagnostics: may include a physical exam, imaging tests ( such as ultrasound or MRI) and/or
laparoscopic surgery to visualize and biopsy the tissue.
S/S: may include pelvic pain or cramping, painful periods, pain during sex, and/or infertility.
Education & Interventions: may include pain relief medications, hormonal therapies (such as
birth control pills or gonadotropin-releasing hormone agonists), and/or surgery. Education
about managing symptoms and fertility options may also be important.
Fibroids (Leiomyomas): non-cancerous growths that develop in the muscle tissue of the
uterus. The exact cause of fibroids is unknown, but they are more common in women of
reproductive age and may be influenced by hormones.
Diagnostics: may include a physical exam, imaging tests (such as ultrasound or MRI), and/or
biopsy.
S/S: may include heavy or prolonged menstrual bleeding, pelvic pressure, or pain, and/or
urinary or bowel problems.
Education & Interventions: Tx may depend on the size, location, and symptoms associated with
the fibroids. Tx options may include medication, non-invasive procedures ( such as uterine
artery embolization) or surgery. Education about symptom management and fertility options
may also be important.
Pelvic Inflammatory Disease (PID): an infection of the female reproductive organs,
including the uterus, ovaries, and fallopian tubes. It is often caused by sexually transmitted
infections (STIs), such as chlamydia or gonorrhea.
Diagnostics: may include a physical exam, blood tests, pelvic ultrasound, and/or cervical culture
to test for STIs.
S/S: may include lower abdominal pain, fever, abnormal vaginal discharge, painful sex, and/or
irregular periods.
Education & Interventions: Tx may include antibiotics to treat the underlying infection, as well
as pain relief medication. Education about preventing and treating STIs, as well as practicing
safe sex, may also be important. Untreated PID can lead to serious complication, such as
infertility and chronic pelvic pain.
Polycystic Ovary Syndrome (PCOS): is a hormonal disorder that affects women of the
reproductive age. It is characterized by an imbalance of reproductive hormones that can lead to
the formation of small cysts on the ovaries.
Diagnostics: may include a physical exam, blood tests (to measure hormone levels), and/or
pelvic ultrasound (to look for cysts on the ovaries).
S/S: may include irregular periods, excessive hair growth (hirsutism), acne, weight gain, and/or
infertility.
Education & Interventions: Tx may include lifestyle changes (such as diet and exercise) to
manage weight and reduce insulin resistance, which is often associated with PCOS. Hormonal
therapies, such as birth control pills or anti-androgen medications, may also be used to regulate
periods and manage symptom. Education about managing symptoms and fertility options may
also be important. PCOS can increase the risk for other health problems, such as diabetes and
heart disease, so monitoring and managing these risks may also be important.
Cystocele: also known as a bladder prolapse, is a condition in which the bladder bulges into
the vagina due to weakened pelvic muscles and ligaments.
Diagnostics: may include physical exam, pelvic exam, and/or urodynamic testing to assess the
bladder function.
S/S: may include a bulge or pressure sensation in the vagina, difficulty emptying the bladder,
and/or urinary incontinence.
Education & Interventions: Tx may include pelvic floor exercises (such as Kegels, pessary ( a
device inserted into the vagina to support the bladder), and/or surgery. Education about
managing symptoms and preventing reoccurrence may also be important.
Rectocele: a condition in which the rectum bulges into the vagina due to weakened pelvic
muscles and ligaments.
Diagnostics: may include physical exam, pelvic exam, and/or defecography ( a test to assess
rectal function).
S/s: may include bulge or pressure sensation in the vagina, difficulty passing stool, and/or fecal
incontinence.
Education & Interventions: Tx may include pelvic floor exercises, stool softeners, and/or
surgery. Education about managing symptoms and preventing recurrence may also be
important.
Enterocele: a condition in which the small intestine bulges into the vagina due to weakened
pelvic muscles and ligaments.
Diagnostics: may include a physical exam, pelvic exam, and/or imaging tests( such as MRI or
ultrasound).
S/S: may include a bilge or pressure sensation in the vagina, lower abdominal pain, and/or
difficulty passing stool.
Education Interventions: Tx for enterocele may include pelvic floor exercises, a pessary, and/or
surgery. Education about managing symptoms and preventing recurrence may also be
important.
Uterine Prolapse: a condition in which the uterus descends into or protrudes out of the vagina
due to weakened pelvic muscles and ligaments.
Diagnostics: may include a physical exam, pelvic exam, and/or imaging tests (such as
ultrasound).
S/S: may include a feeling of heaviness or pressure in the pelvic area, a bulge or protrusion from
the vagina, and/or urinary or bowel problems.
Education & Interventions: Treatment for uterine prolapse may include pelvic floor exercises,
pessary, and/or surgery. Education about managing symptoms and preventing recurrence may
also be important.
Menstrual Cycle Dysfunctions:
Terms for different dysfunctions of the menstrual cycle include:
 Amenorrhea: absence of menstruation
 Dysmenorrhea: heavy menstrual bleeding
 Menorrhagia: heavy menstrual bleeding
 Metrorrhagia: irregular or unpredictable menstrual bleeding
 Oligomenorrhea: infrequent or light menstrual periods.
Premenstrual Syndrome (PMS): is a group of symptoms that occur before menstruation and
can be caused by hormonal changes.
Diagnostics: typically diagnosed based on a history of symptoms.
S/S: may include mood changes, irritability, fatigue, bloating, and/or breast tenderness.
Education & Interventions: Tx may include lifestyle changes ( such as diet and exercise),
medication, and/or therapy. Educating about managing symptoms and coping strategies may
also be important.
Preeclampsia/Eclampsia/HELLP:
Preeclampsia and eclampsia are conditions that can occur during pregnancy and are
characterized by high blood pressure and damage to multiple organ systems. HELLP syndrome
is a severe form of preeclampsia that can cause additional complications. Preeclampsia occurs
in 5-8% of pregnancies, and typically presents after 20 weeks gestation. The exact cause is
unknown, but it is believed to be related to problems with blood vessel function in the
placenta. The placenta is an organ that connects the developing fetus to the mother’s blood
supply, and when it is not functioning properly, it can lead to a decrease in blood flow to the
fetus and the development of preeclampsia.
Symptoms of preeclampsia can include high blood pressure, protein in the urine, swelling
(edema) in the hands and feet, severe headaches, and visual changes. Left untreated,
preeclampsia can lead to eclampsia, which is characterized by seizures in a woman with
preeclampsia.
HELLP syndrome is a severe form of preeclampsia that can lead to liver damage and low
platelet count. The acronym HELLP stands for: Hemolysis (breakdown of RBCs) Elevated liver
enzymes (evidence of liver damage), Low platelet count( thrombocytopenia). Symptoms of
HELLP syndrome can include those of preeclampsia, as well as nausea and vomiting, upper
abdominal pain, and fatigue.
Tx for both preeclampsia and HELLP syndrome typically involves closely monitoring the mother
and fetus, as well as delivery of the baby, which can be induced early if the conditions are
severe enough. In some cases, medication may also be used to control blood pressure and
prevent seizures.
Breast Cancer
A type of cancer that forms in the breast tissue.
S/S: may include lump or thickening in the breast tissue, changes in the size or shape of the
breast, nipple discharge, and/or skin changes (such as redness or dimpling).
Hypospadias/Epispadias: are congenital abnormalities of the penis in which the urethral
opening is not located at the tip of the penis. Physical exam and imaging such as ultrasound
used to diagnosis.
S/S: may include a curved or angled penis, difficulty urinating, and/or problems with sexual
function. Tx may include surgery.
Phimosis/ Paraphimosis: conditions that involve the foreskin of the penis.
S/S may include pain, swelling, and/or difficulty retracting the foreskin.
Tx. May include topical medications, stretching exercises, and/or circumcision.
Peyronie’s Disease: a condition in which scar tissue forms inside the penis, causing it to curve
or bend.
S.s: may include a curved or bent penis, pain, or discomfort during erections, and/or difficulty
with sexual function.
Tx may include medication, injection therapy, or surgery.
Erectile Dysfunction: a condition in which a man has difficulty achieving or maintaining an
erection sufficient for sexual intercourse. PE, blood test, or imaging.
S.S may include difficulty achieving or maintaining an erection, reduced sexual desire, and/or
premature ejaculation.
Tx includes medications, lifestyle changes, or psychological counseling.
Priapism: a condition in which an erection last longer than four hours and is not related to
sexual stimulation.
S/S may include a painful and prolonged erection that does not go away on its on.
Tx may include medications, aspiration, or drainage of blood from the penis, or surgery.
Balanitis/Balanoposthitis: balanitis a condition in which the head of the penis becomes
inflamed, while balanoposthitis is a condition in which both the head of the penis and the
foreskin become inflamed.
S/s may include redness, swelling, itching, and/or pain in the affected area.
Tx may include topical medications, oral antibiotics, and/or circumcision.
Cryptorchidism: a condition in which one or both testicles fail to descend into the scrotum
during fetal development.
S/S may include an absent or undescended testicle, infertility, and/or increased risk of
testicular cancer.
Tx may include surgery to bring the testicle(s) into the scrotum.
Hydrocele: a condition in which fluid accumulates in the sac surrounding the testicle, causing
swelling and discomfort.
S/S may include swelling, discomfort, and/or a feeling of heaviness in the scrotum.
Tx may include observation, medications, or surgery.
Hematocele: a condition in which blood accumulates in the sac surrounding the testicle,
causing swelling and discomfort. S/S swelling, discomfort, and/or feeling of heaviness in the
scrotum.
Spermatocele: a condition in which a fluid-filled cyst in the epididymis, the coiled tube located
on the back of the testicle that stores and transport sperm.
S/s may include a painless lump or swelling on the testicle.
Varicocele: a condition in which the veins in the scrotum become enlarged and twisted causing
pain and discomfort.
S/S may include pain, discomfort, and/or swelling in the scrotum.
Testicular torsion: a condition in which the testicle twists on its spermatic cord, causing a loss
of blood flow to the testicle and potentially leading to permanent damage.
S/S may include sudden, severe pain in the scrotum, swelling, and/or nausea/vomiting.
Testicular torsion is a medical emergency and requires surgery to restore blood flow to the
affected testicle.
Education about seeking prompt medical attention is crucial.
Orchitis: a condition in which one or both testicles become inflamed, usually as a result of a
bacterial or viral infection.
S/s: may include pain, swelling, and/or redness in the affected testicle(s), as well as fever and
other flu.
Prostate: a small, walnut-sized gland located below the bladder in men. It produces seminal
fluid that nourishes and transports sperm during ejaculation. Two common prostate conditions
are acute/chronic prostatitis and benign prostatic hyperplasia (BPH).
Acute prostatitis is a sudden inflammation of the prostate gland caused by a bacterial
infection.
Symptoms may include fever, chills, painful urination, urinary frequency and urgency, lower
back pain, and pain in the groin and genital area.
Diagnosis is typically made through a physical exam, urine, and blood test, and imaging studies
such as US or MRI.
Tx usually involves a course of antibiotics.
Chronic prostatitis is a long-term inflammation of the prostate gland, which may be caused
by a bacterial infection, an autoimmune disorder, or another underlying condition, and sexual
dysfunction.
Diagnosis is typically made through a physical exam, urine, and blood tests; and imaging studies
such as ultrasound or MRI.
Tx may involve antibiotic, anti-inflammatory medications, or other medications to manage
symptoms.
BPH is a non-cancerous enlargement of the prostate gland, which can cause difficulty
urinating, frequent urination, weak urine flow, and other urinary symptoms. It is common in
older men and is caused by changes in hormone levels.
Diagnosis is typically made through a physical exam, urine and blood tests, and imaging studies
such as a US or MRI.
Tx may involve medications to relax the muscles of the prostate and bladder, or surgery to
remove part of the prostate gland.
Cancer can occur in various parts of the male reproductive system, including the penis,
scrotum, prostate, and testicles.
Penile cancer is a rare form of cancer that typically affects older men. It may present as a
lump or sore of the penis and may cause pain or bleeding during urination or sexual
intercourse.
Diagnosis is typically made through a physical exam, biopsy, and imaging studies such as MRI or
CT scan.
Tx may involve surgery to remove the cancerous tissue, radiation therapy, or chemotherapy.
Scrotal cancer is also rare and may present as a lump or sore on the scrotum. Diagnosis and
treatment are similar to those for penile cancer.
Prostate cancer is the most common type of cancer in men, and typically affects older men. It
may not cause symptoms in its early stages, but may present as difficulty urinating, blood in the
urine or semen, or pain in the back, hips, or pelvis.
Diagnosis is typically made through a physical exam, blood tests, and imaging studies such as
MRI or ultrasound.
Treatment may involve surgery, radiation therapy, or other therapies to remove or destroy the
cancerous tissue.
Testicular cancer is relatively rare but is the most common cancer in younger men between
the ages of 15 and 44. It may present as a lump or swelling in one or both testicles, or as pain or
discomfort in the scrotum.
Diagnosis is typically made through a physical exam, ultrasound, and blood tests.
Treatment may involve surgery to remove the affected testicle, followed by radiation therapy
or chemotherapy.
STIs can be caused by a variety of agents, including bacteria, viruses, fungi, protozoa, and
parasites. Some examples of STIs that can infect the external genitalia include:



Genital warts (Condyloma acuminatum) caused by the human papillomavirus
(HPV) which can be transmitted through skin-to- skin contact during sexual activity.
Genital warts appear as small, raised bumps or clusters of bumps on the genitals, anus,
or surrounding skin. There is no cure for HPV, but the warts can be removed through
various treatments.
Genital Herpes: caused by the herpes simplex virus (HSV), which can be transmitted
through sexual contact. There are two types of HSV: type 1 (HSV-1) which typically
causes cold sores on the mouth but can also cause genital herpes; and type 2 (HSV-2)
which is most common cause of genital herpes. Genital herpes can cause painful blisters
or sores on or around the genitals or anus. There is no cure for herpes, but antiviral
medications can help to manage symptoms and reduce the risk of transmission to
others.
Chancroid: is caused by the bacterium Haemophilus ducreyi, which is transmitted
through sexual contact. Chancroid causes painful, open sores on the genitals or anus. It
is rare in developed countries but is more common in areas with poor sanitation and
high rates or other STIs. Treatment usually involves a course of antibiotics.
Vaginal Infections
 Candidiasis (yeast infection) caused by an overgrowth of the fungus candida, which is
normally present in the vagina in small amounts. Candidiasis can cause itching, burning,
and thick, white discharge. It is not always associated with sexual activity but can be
more common in women who are pregnant, taking antibiotics, or have a weakened
immune systems. Treatment typically involves antifungal medication.
 Trichomoniasis: This is caused by the parasite Trichomonas vaginalis and is the only
vaginal infection known to be exclusively sexually transmitted. Trichomoniasis can cause
itching, burning, and frothy, green, or yellow discharge with a foul odor. Treatment
typically involves antibiotics.
 Bacterial vaginosis: this is caused by an overgrowth of bacteria in the vagina and can
cause a thin, gray, or white discharge with a fishy odor. It is not always associated with
sexual activity and may occur in women who are pregnant, using intrauterine devices
(IUDs) or have multiple sexual partners. Treatment typically involves antibiotics.
Vaginal-urogenital systemic infections are infections that can affect both the vaginal
and urogenital areas, as well as potentially spreading to other parts of the body. Here
are some examples:
 Chlamydial infections: these are caused by the bacteria Chlamydia trachomatis and
can affect both men and women.

S.s may include vaginal discharge, pain during sex or urination, and lower abdominal
pain. If left untreated, chlamydia can lead to serious complications such as infertility or
pelvic inflammatory disease.
 Treatment typically involves antibiotics.
 Gonorrhea: caused by the bacteria Neisseria gonorrhoeae and can affect both men
and women. Symptoms may include painful urination, discharge from the penis or
vagina, and pelvic pain. If left untreated, gonorrhea can lead to serious complication
such as infertility or pelvic inflammatory disease. Treatment typically involves
antibiotics.
 Syphilis: caused by the bacteria Treponema pallidum and can progress through several
stages if left untreated. The primary stage is characterized by the appearance of a
painless sore(chancre) at the site of infection. The secondary stage may cause a rash and
flu-like symptoms, while the tertiary stage can lead to serious complications such as
heart disease and neurological problems. Treatment typically involves antibiotics.
It is important to note that all of these infections can have serious health consequences if left
untreated and may require medical intervention. Additionally, practicing safe sex by using
condoms and getting regular STI testing can help prevent the spread of these infections.
Wk. 8 Objectives
I.
Oral Cavity
A. Mouth
1. Aphthous ulcers (canker sores): are small, painful sores that develop on the
inside of the mouth, on the gums, or on the tongue. The exact cause is
unknown, but they may be triggered by stress, injury to the mouth, or
certain foods. Clinical presentation and history are diagnostic bases. S/s
painful sores in the mouth that may last up to 2 weeks, may recur. Avoid
trigger foods, maintain good oral hygiene, and use over-the-counter pain
relief medications if needed. Topical corticosteroids or other topical
medications to relieve pain can be used.
2. Herpes simplex virus infection (HSV): is a viral infection that can cause cold
sores or blisters on the lips, mouth, or tongue. It is highly contagious and can
be spread through close contact with someone who has the virus. Usually
diagnosed through clinical presentation and history but can also be
confirmed through a blood test or culture of the lesion. S/s painful blisters or
sores in the mouth that may last for up to 2 wks., may recur. Avoid close
contact with others during outbreaks, maintain good oral hygiene, and use
antiviral medications to reduce the severity and duration of symptoms.
Antiviral medications such as acyclovir, famciclovir, or valacyclovir can be
used to reduce symptoms.
3. Oral candidiasis (thrush): oral candidiasis is a fungal infection caused by
Candida albicans. It typically occurs in individuals with weakened immune
systems or those taking antibiotic, corticosteroids, or chemotherapy. Usually
diagnosed based on clinical presentation or history but can be confirmed
through a swab culture of the lesion. S/S white patches or plagues on the
tongue, gums, or rook of the mouth that may be painful or cause discomfort.
Maintain good oral hygiene, avoid smoking and excessive alcohol
consumption, and treat underlying medical conditions that may contribute
to thrush. Antifungal medications such as nystatin, fluconazole, or
clotrimazole can be used to treat thrush.
B. Teeth
1. Dental Caries: aka cavities, are caused by bacteria in the mouth that
produced acid and erode tooth enamel over time. They can lead to tooth
pain sensitivity, and decay. Usually diagnosed based on clinical presentation
and history but can also be confirmed through a dental x-ray. Tooth pain or
sensitivity, visible pits or holes in the teeth, tooth decay. Maintain good oral
hygiene, limit sugary and acidic foods, and see a dentist regularly for
cleanings and checkups. Fillings, crowns, or root canal therapy may be
necessary to treat dental caries.
2. Gingivitis: is a mild form of gum disease that is caused by bacteria in the
mouth that produce toxins and cause inflammation of the gums. It can lead
to gum recession, tooth loss, and other complication if left untreated. Can
be confirmed through a periodontal exam or dental x-ray. S/S red, swollen,
or bleeding gums, bad breath, and receding gums.
3. Periodontitis is an inflammatory condition that affects the tissue
surrounding and supporting the teeth, including the gums, periodontal
ligaments, and alveolar bone. It is caused by the accumulation of bacteria in
the dental plaque, which triggers an immune response that leads to
inflammation and destruction of the periodontal tissues. The symptoms of
periodontitis include swollen, red, and bleeding gums, bad breath, receding
gums, and loosening of teeth. The diagnosis is based on clinical signs, such as
probing depth and attachment loss, and radiographic examination.
Treatment includes scaling and root planning to remove plaque and tartar
from the teeth and smooth the root. Brushing and flossing regularly to
remove plaque buildup, regular dental check-ups, and cleanings. Use of
antimicrobial mouthwash to reduce bacterial load. Quitting smoking, as it is
a significant risk factor for periodontitis. Scaling and root planning to remove
plaque and tartar from the teeth and smooth the root surface. Surgical
intervention may be necessary in severe cases.
4. Oral Squamous Cell CA: is a type of cancer that affects the cells lining the
oral cavity and oropharynx. Is often associated with chronic tobacco and
alcohol use, as well as infection with human papillomavirus (HPV). Clinical
examination, biopsy, imaging studies such as CT scans or MRI. S/S: pain or
discomfort in the mouth or throat, difficulty swallowing or speaking, swelling
or lumps in the mouth or neck, white or red patched in the mouth or throat,
unexplained weight loss. Smoking cessation and limiting alcohol
consumption can decrease the risk of oral cancer. Regular dental check-ups
and oral cancer screenings can aid in early detection and treatments.
Salivary Glands:
1. Xerostomia: also known as dry mouth, is a condition where the salivary glands do not
produce enough saliva. It can be caused by medications, radiation therapy, autoimmune
diseases such as Sjogren’s syndrome, or aging.
S/S: dry or sticky feeling in the mouth, difficulty chewing, swallowing, or speaking.
Increased risk of dental caries or oral infections. Sore throat or hoarseness. Altered
tasted sensation. Patients should drink plenty of water and avoid alcohol and caffeine.
Sugar-free gum or candy can help stimulate saliva production. Artificial saliva substitutes
or prescription medications may be recommended for severe cases.
2. Sialadenitis & Sialolithiasis: Sialadenitis is an inflammation of the salivary gland, usually
caused by a bacterial infection. Most common form of viral infection- mumps.
Sialolithiasis is a condition where a stone, or calculus, forms within the salivary gland or
duct, leading to blockage and inflammation.
S/S: pain and swelling in the affected gland, difficulty opening the mouth or swallowing,
fever, chills, pus or discharge from the gland, dry mouth, or xerostomia. Antibiotics are
the first-line treatment for sialadenitis. Warm compresses and massage can help relieve
symptoms. In severe cases, surgical intervention may be necessary to remove the stone
or gland.
Esophagus
Esophagus is a muscular tube that connects the mouth to the stomach. It has a sphincter
muscle at the bottom, which controls the flow of food and stomach acid into the stomach.
Disorders of the esophagus can cause difficulty in swallowing, chest pain, and other symptoms.
Esophageal Varices: occur when there is an increased pressure in the veins of the esophagus
due to liver disease, specifically cirrhosis. As a result, the veins can become swollen and may
burst, leading to life-threatening bleeding. Endoscopy is the gold standard for diagnosis of
esophageal varices. S/S may not have any symptoms until they burst and cause bleeding.
Symptoms of bleeding include vomiting blood, black stools, and shock. Treatment may involve
medications to reduce the risk of bleeding, endoscopic therapy, and surgery in severe cases.
Barrett Esophagus: a condition in which the cells in the lower part of the esophagus change to
resemble those found in the intestine. Often caused by chronic gastroesophageal reflux disease
(GERD). Greatest concern has a higher risk for development of esophageal adenocarcinoma.
Diagnosis is made through endoscopy and biopsy.
S./S are not usually present. However, it increases the risk of developing esophageal cancer.
Treatment may involve medications to reduce acid reflux and surveillance endoscopy to
monitor for cancer development.
Mallory-Weiss Syndrome(Tear): is a tear in the lining of the esophagus or stomach, usually
caused by severe vomiting or retching. It is often associated with alcoholism.
Diagnose made through endoscopy.
S/s include chest pain, vomiting blood, and shock.
Treatment usually involves supportive care such as fluids and blood transfusions. Endoscopic
therapy may be used in severe cases.
GI Tract Structure and Function: The gastrointestinal (GI) tract is a long tube that extends from
the mouth to the anus and is responsible for the digestion and absorption of nutrients, water,
and electrolytes. The GI tract is divided into several regions, including the oral cavity, pharynx,
esophagus, stomach, small intestine, large intestine, rectum, and anus. Each region has its
unique anatomical structure and function.
Gi Motility: the movement of food through the GI tract via contraction and relaxation of
smooth muscle.
Basic mechanisms of GI motility: peristalsis and segmentation.
Disorders of GI motility: dysmotility, such as achalasia and gastroparesis.
Gastric Secretions: the production of gastric juice in the stomach.
Basic components of gastric juice: hydrochloric acid (HCI), pepsinogen, and intrinsic factor.
Role of gastric juice in digestion: HCI aids in protein digestion, pepsinogen is converted to
pepsin for protein digestion, and intrinsic factor aids in vitamin B12 absorption.
Intestinal Flora: is the microorganisms that live in the GI tract. The role of the intestinal flora is
aiding in digestion and absorption, produce vitamins, prevent growth or harmful bacteria, and
stimulate immune system. The disruption of intestinal flora can cause various GI disorders, such
as inflammatory bowel disease (IBD) and Clostridium difficile infection.
Digestion and Absorption: Carbohydrate digestion and absorption begins in the mouth with
salivary amylase, continues in the small intestine with pancreatic amylase, and is absorbed as
glucose.
Fat digestion and absorption: Bile from the liver emulsifies fat, pancreatic lipase breaks it down
into fatty acids and glycerol and is absorbed as chylomicrons.
Protein digestion and absorption: Begins in the stomach with pepsin, continues in the small
intestine with pancreatic proteases, and is absorbed as amino acids.
Small Intestine: Function is for digestion and absorption of nutrients. Anatomy consists of
duodenum, jejunum, and ileum.
Disorders are Celiac, inflammatory bowel disease (IBD), and small intestinal bacterial
overgrowth (SIBO).
Large Intestine:
Function is absorption of water and electrolytes, and formation and storage of feces.
Anatomy consists of cecum, colon, rectum, and anus.
Disorders are diverticulitis, inflammatory bowel disease (IBD), and colorectal cancer.
Gallbladder:
function is stores and concentrates bile produced by the liver, and releases it into the small
intestine.
Disorders include cholecystitis, cholelithiasis(gallstones), and biliary colic.
Diagnostic tests include: upper GI series- x-rays to examine esophagus, stomach, and small
intestine. Colonoscopy uses a flexible tube with a camera to examine the colon and rectum.
Endoscopy uses a flexible tube with a camera to examine the esophagus, stomach, and small
intestine. Stool tests can detect blood, infections, another abnormalities in the feces.
Disorders of GI Function can affect various parts of the GI tract and can manifest in several
ways, including anorexia, nausea and vomiting, and difficulty swallowing. Common disorders
that can affect the esophagus include dysphagia, hiatal hernia, gastroesophageal reflux disease
(GERD), and an increased risk of esophageal cancer.
Common Manifestation:
Anorexia: loss of appetite or desire to eat
Nausea and vomiting
Retching: the involuntary attempt to vomit, but without bringing up any stomach contents
DO Esophagus
Dysphagia: difficulty or discomfort in swallowing, can be caused by various factors including
neurological disorders, tumors, and structural abnormalities of the esophagus.
Hiatal hernia: a condition in which a portion of the stomach protrudes through the diaphragm
into the chest cavity, causing discomfort and increasing the risk of GERD
GERD: a chronic condition in which stomach acid and contents backflow into the esophagus,
causing heartburn, regurgitation, and damage to the esophageal lining. Risk factors for
esophageal cancer: GERD, smoking, alcohol consumption, obesity, and poor nutrition.
Diagnostic tests:
Endoscopy a procedure in which a thin, flexible tube with a camera is inserted into the
esophagus to visualize the area and take biopsies if necessary.
Esophageal manometry: a test to measure the strength and coordination of the esophagus
muscles during swallowing.
pH monitoring: a test to measure the acidity of the esophagus over a 24-hour period
Barium swallow: a test in which the patient drinks a liquid containing barium, which allows for
visualization of the esophagus on an X-ray
Interventions:
Lifestyle modifications: weight loss, smoking cessation, avoiding trigger foods (e.g. spicy foods,
alcohol, caffeine) elevating the head of the bed
Medications: antacids, H2 blockers, proton pump inhibitors, prokinetics, and pain relief
medications
Surgery: fundoplication or repair of a hiatal hernia may be necessary in severe cases of GERD or
dysphagia.
Nutritional support: in cases of severe dysphagia or anorexia, patients may require enteral or
parenteral nutrition support.
Early diagnosis and management of GI disorders can help prevent complications and improve
quality of life for affected patients.
DO’s Stomach
The gastric mucosal barrier is a protective layer of the stomach lining that helps prevent
stomach acid and other digestive enzymes from damaging the stomach wall. This barrier is
made up of a layer of mucus, bicarbonate, and tight junctions between the cells of the stomach
lining.
Gastritis- Acute and Chronic
Gastritis refers to inflammation of the stomach lining. Acute gastritis is usually caused by an
infection, certain medications, or alcohol. Chronic gastritis can be caused by long-term use of
certain medications, infection with H. pylori, or an autoimmune disorder.
S/S: N,V, abdominal pain, loss of appetite, feeling full after eating a small amount of food,
belching.
Diagnostics: endoscopy to examine the lining of the stomach and obtain biopsies for analysis.
Blood tests to detect Pylori infection.
Interventions: medications to reduce stomach acid such as proton pump inhibitors), antibiotics
(if Pylori infection is present), avoiding certain foods that irritate the stomach lining (such as
spicy foods, alcohol, and caffeine)
Peptic Ulcer Disease (PUD): are sores that form in the lining of the stomach or the first part of
the small intestine (duodenum). The most common cause of peptic ulcers is infection with H.
pylori bacteria. Other causes include long-term use of nonsteroidal anti-inflammatory drugs
(NSAIDs) and excess stomach acid production.
S/S: Abdominal pain, nausea, vomiting, loss of appetite, feeling full after eating a small amount
of food, dark or tarry stools.
Dx: endoscopy- stool test to detect pylori
Interventions: medications to reduce stomach acid (such as proton pump inhibitors),
antibiotics(if Pylori infection is present), avoiding certain foods that irritate the stomach liningspicy foods, alcohol, and caffeine. Surgery in rare cases.
Awareness of Zollinger-Ellison Syndrome: is a rare disorder that causes tumors to form in the
pancreas or duodenum. These tumors produce large amounts of gastrin, a hormone that
stimulates excess stomach acid production, leading to peptic ulcers.
S/s: abdominal pain, nausea, vomiting, diarrhea, weight loss, heartburn, fatigue
Dx: Blood test to measure gastrin levels, endoscopy, imaging tests to look for tumors.
Interventions: medications to reduce stomach acid ( PPIs) surgery to remove the tumors (in
some cases).
Stress Ulcer: are sores that form in the stomach or duodenum as a result of severe physical
stress, such as major surgery, burns, or trauma. Associated ulcers are given specific names
based on location- stress ulcers affecting critically ill patients with shock, sepsis, or severe
trauma, The exact cause is not fully understood, but it is thought to be related to reduced blood
flow to the stomach lining. S/S; abdominal pain, nausea,
vomiting, loss of appetite, feeling full after eating a meal.
Disorders of Small & Large Intestine
Small Intestine:
Irritable Bowel Syndrome (IBS):
Pathophysiology: The exact cause of IBS is not known, but it is believed to be related to an
altered motility of the bowel and/or hypersensitivity of the intestine.
Symptoms: Abdominal pain, bloating, constipation and/or diarrhea
Diagnosis: Based on symptoms and the absence of other underlying gastrointestinal disorders
Treatment: Dietary changes, medication for symptom relief, stress management, and/or
psychotherapy
Inflammatory Bowel Disease (IBD):
Pathophysiology: Chronic inflammation of the intestinal wall, believed to be caused by an
immune response to the intestinal microbiome.
Two types:
Crohn's Disease: Affects any part of the digestive tract, from the mouth to the anus.
Inflammation can be patchy and involve all layers of the intestinal wall.
Ulcerative Colitis (UC): Involves only the colon and rectum. Inflammation is continuous and
involves only the innermost layer of the intestinal wall.
Symptoms: Abdominal pain, diarrhea, bloody stools, weight loss, and fatigue.
Diagnosis: Colonoscopy with biopsy, imaging studies, blood tests, and stool tests.
Treatment: Medications to control inflammation, surgery in severe cases, and lifestyle
modifications.
Infectious Enterocolitis:
Pathophysiology: Inflammation and irritation of the intestinal wall caused by a bacterial or viral
infection.
Symptoms: Diarrhea, abdominal pain, fever, and vomiting.
Diagnosis: Stool culture, blood tests, and imaging studies.
Treatment: Fluid and electrolyte replacement, antibiotics for bacterial infections, antiviral
medications for viral infections.
Diverticulosis and Diverticulitis:
Pathophysiology: Diverticula are small outpouchings of the intestinal wall. Diverticulosis is the
presence of these pouches, while diverticulitis is the inflammation of these pouches.
Symptoms: Abdominal pain, fever, and change in bowel habits.
Diagnosis: CT scan, colonoscopy, and blood tests.
Treatment: Antibiotics, pain management, and surgery in severe cases.
Appendicitis:
Pathophysiology: Inflammation and infection of the appendix, usually caused by obstruction of
the appendix.
Symptoms: Abdominal pain, fever, nausea, vomiting, and loss of appetite.
Diagnosis: Physical examination, blood tests, and imaging studies.
Treatment: Surgery to remove the appendix.
Large Intestine:
Diarrhea:
Pathophysiology: Increased frequency of bowel movements and/or loose stools.
Acute Diarrhea: Usually caused by a viral or bacterial infection.
Chronic Diarrhea: Can be caused by a variety of factors including IBS, IBD, food intolerance, and
malabsorption syndromes.
Symptoms: Loose stools, abdominal pain, cramping, fever, and dehydration.
Diagnosis: Stool culture, blood tests, and imaging studies.
Treatment: Fluid and electrolyte replacement, antibiotics for bacterial infections, medication
for symptom relief, and dietary changes.
Fecal Impaction:
Pathophysiology: A blockage of the colon by a mass of hardened feces.
Symptoms: Abdominal pain, distension, and constipation.
Diagnosis: Physical examination, imaging studies, and digital rectal exam.
Treatment: Enemas, laxatives, and manual removal of the fecal impaction.
DO’s Small & Large Intestine
Clostridium (C.) difficile Colitis
Pathophysiology: Clostridium difficile (C. diff) is a bacterium that causes inflammation of the
colon. Antibiotics can disrupt the normal balance of bacteria in the gut, allowing C. diff to
overgrow and produce toxins that damage the colon lining.
Basic diagnostics: C. diff is typically diagnosed with a stool test that detects the presence of the
bacterium or its toxins.
Signs & symptoms: Watery diarrhea (often foul-smelling), abdominal pain and cramping, fever,
loss of appetite, nausea.
Education & interventions: Treatment typically involves antibiotics that target C. diff, such as
metronidazole or vancomycin. In severe cases, surgery may be necessary to remove the
affected portion of the colon.
Diverticulosis, Diverticulitis
Pathophysiology: Diverticulosis is the presence of small, bulging pouches (diverticula) in the
wall of the colon. Diverticulitis occurs when these pouches become inflamed or infected.
Basic diagnostics: Diverticulosis is often diagnosed incidentally during a colonoscopy or other
imaging test. Diverticulitis may be diagnosed with a physical exam, blood tests, and imaging
tests such as a CT scan or ultrasound.
Signs & symptoms: Diverticulosis is often asymptomatic. Diverticulitis may cause abdominal
pain (usually in the lower left quadrant), fever, nausea, vomiting, constipation or diarrhea, and
bloating.
Education & interventions: Treatment for mild diverticulitis may involve rest, antibiotics, and a
liquid diet. In more severe cases, hospitalization and surgery may be necessary. Prevention
measures include a high-fiber diet and regular exercise.
Appendicitis
Pathophysiology: Appendicitis is inflammation of the appendix, a small, finger-shaped pouch
attached to the large intestine. It is often caused by blockage of the appendix by stool, foreign
objects, or cancer.
Basic diagnostics: Diagnosis is based on a physical exam, blood tests, and imaging tests such as
an ultrasound or CT scan.
Signs & symptoms: Abdominal pain (often starting near the belly button and shifting to the
lower right side), loss of appetite, nausea, vomiting, fever, constipation, or diarrhea.
Education & interventions: Treatment involves surgical removal of the appendix
(appendectomy). If not treated promptly, appendicitis can lead to a ruptured appendix and a
potentially life-threatening infection.
Diarrhea in Children
Pathophysiology: Diarrhea in children is often caused by viral or bacterial infections that affect
the gastrointestinal tract. It can also be caused by certain medications or underlying medical
conditions.
Basic diagnostics: Diagnosis is typically based on symptoms and physical exam. In some cases,
stool tests may be necessary to determine the cause of the diarrhea.
Signs & symptoms: Frequent loose or watery stools, abdominal pain, cramping, fever,
dehydration.
Education & interventions: Treatment typically involves rehydration with fluids and electrolytes
(e.g. oral rehydration solution) and addressing the underlying cause of the diarrhea. In some
cases, antibiotics may be necessary. Prevention measures include good hygiene practices, such
as hand washing.
Intestinal Obstruction:
Pathophysiology: Intestinal obstruction occurs when the normal flow of intestinal contents is
blocked, leading to a buildup of contents proximal to the site of obstruction. The obstruction
can be mechanical (e.g. due to adhesions, hernias, tumors, volvulus) or functional (e.g. due to
decreased motility, as seen in paralytic ileus). The increased pressure and distension can lead to
ischemia, perforation, and even sepsis.
Diagnostics: Physical exam, imaging studies (e.g. abdominal X-ray, CT scan), endoscopy, and
sometimes surgery.
Signs and Symptoms: Abdominal pain, bloating, nausea and vomiting, constipation, and
sometimes diarrhea.
Education and Interventions: Treatment depends on the underlying cause and severity of the
obstruction. Options include bowel rest, nasogastric tube decompression, surgical intervention,
and antibiotics if infection is present.
Hemorrhoids:
Pathophysiology: Hemorrhoids are swollen veins in the rectum or anus that can cause
discomfort, bleeding, and itching. They can be internal (inside the rectum) or external (outside
the anus).
Diagnostics: Physical exam, anoscopy, sigmoidoscopy, colonoscopy.
Signs and Symptoms: Rectal bleeding, pain or discomfort, itching, and sometimes a lump or
swelling near the anus.
Education and Interventions: Treatment options include lifestyle changes (e.g. increased fiber
intake, hydration), topical agents (e.g. creams, ointments), procedures (e.g. rubber band
ligation, sclerotherapy, coagulation), and surgery in severe cases.
Celiac Disease:
Pathophysiology: Celiac disease is an autoimmune disorder in which ingestion of gluten leads to
damage of the small intestine mucosa, resulting in malabsorption of nutrients. The damage is
due to an immune response triggered by gluten, a protein found in wheat, barley, and rye.
Diagnostics: Blood tests (e.g. anti-tissue transglutaminase, anti-endomysial antibodies), small
bowel biopsy.
Signs and Symptoms: Diarrhea, abdominal pain, bloating, weight loss, fatigue, and sometimes
skin rash.
Education and Interventions: Treatment involves strict adherence to a gluten-free diet, which
allows the small intestine to heal and improves symptoms. In severe cases, nutritional
supplements may be needed.
Cystic Fibrosis:
Pathophysiology: Cystic fibrosis is a genetic disorder that affects the respiratory, digestive, and
reproductive systems. The disease is caused by mutations in the CFTR gene, which leads to
abnormal function of chloride channels and a buildup of thick, sticky mucus in the affected
organs.
Diagnostics: Newborn screening, sweat test, genetic testing.
Signs and Symptoms: Respiratory symptoms (e.g. chronic cough, wheezing, frequent
infections), digestive symptoms (e.g. malabsorption, abdominal pain, distension), and
reproductive symptoms (e.g. infertility).
Education and Interventions: Treatment involves a multidisciplinary approach and may include
airway clearance techniques, medications (e.g. bronchodilators, antibiotics), nutritional
support, enzyme replacement therapy, and in some cases, lung transplantation.
Neoplasms-Adenomatous Polyps, Colorectal CA:
Pathophysiology: Colorectal cancer develops from the abnormal growth of cells in the colon or
rectum. Adenomatous polyps, which are precancerous growths, can develop into cancer if left
untreated.
Diagnostics: Screening tests (e.g. colonoscopy, fecal occult blood test), biopsy, imaging studies
(e.g. CT scan, MRI).
Disorders of Hepatobiliary & Exocrine Pancreas Function
Functions of Liver, Bile production & elimination, Jaundice
The liver is responsible for filtering the blood coming from the digestive tract before passing it
to the rest of the body. It also produces bile, which helps in the digestion and absorption of
fats. Jaundice is a condition where there is a buildup of bilirubin in the blood, causing yellowing
of the skin and eyes.
Differentiate Viral Hepatitis: A, B, C, D & E, Chronic Viral Hepatitis
Hepatitis A is transmitted through contaminated food or water. It causes acute inflammation of
the liver.
Hepatitis B is transmitted through bodily fluids, such as blood, semen, and vaginal secretions. It
can cause acute or chronic inflammation of the liver and can lead to liver cirrhosis and cancer.
Hepatitis C is transmitted through blood-to-blood contact, such as sharing needles or receiving
blood transfusions. It can cause chronic inflammation of the liver and lead to cirrhosis and
cancer.
Hepatitis D can only infect people who are already infected with Hepatitis B. It can cause acute
or chronic liver inflammation.
Hepatitis E is transmitted through contaminated food or water. It causes acute inflammation of
the liver.
Awareness of Autoimmune Hepatitis, Primary & Secondary Biliary Cirrhosis
Autoimmune Hepatitis is a condition where the body's immune system attacks the liver cells,
causing inflammation and damage.
Primary Biliary Cirrhosis is a chronic liver disease where the bile ducts in the liver become
damaged, leading to bile buildup and liver damage.
Secondary Biliary Cirrhosis occurs when there is a blockage in the bile ducts outside the liver,
causing bile to accumulate in the liver and leading to liver damage.
Alcohol-Induced Liver Disease/Failure
Alcohol-induced liver disease is caused by excessive alcohol consumption, which can lead to
inflammation and damage to the liver. It can progress to liver cirrhosis and failure if not treated.
Basic Diagnostics, Signs & Symptoms, Education, and Interventions for Hepatobiliary & Exocrine
Pancreas Disorders
Diagnostics
Blood tests to assess liver function and check for viral hepatitis.
Imaging tests, such as ultrasound or MRI, to visualize the liver and bile ducts.
Liver biopsy to check for liver damage or disease.
Signs & Symptoms
Jaundice, or yellowing of the skin and eyes.
Abdominal pain and swelling.
Nausea, vomiting, and loss of appetite.
Fatigue and weakness.
Dark urine and pale stools.
Education
Avoid excessive alcohol consumption.
Practice safe sex to prevent the transmission of viral hepatitis.
Maintain a healthy diet and exercise regularly.
Follow up with healthcare providers regularly for monitoring and management of liver disease.
Interventions
Treatment for viral hepatitis, including antiviral medications.
Medications to manage symptoms and complications of liver disease.
Lifestyle changes, such as dietary modifications and exercise, to improve liver function and
prevent further damage.
Liver transplantation for end-stage liver disease.
Alcohol-Induced Liver Disease/Failure:
Pathophysiology: Chronic excessive alcohol consumption can lead to liver damage and liver
failure. The liver becomes inflamed, leading to alcoholic hepatitis, and eventually cirrhosis,
which is irreversible.
Diagnostics: Physical examination, liver function tests, imaging studies (ultrasound, CT scan,
MRI), liver biopsy.
Signs and Symptoms: Fatigue, jaundice, abdominal pain, weight loss, loss of appetite, ascites
(fluid buildup in the abdomen), easy bruising and bleeding, mental confusion.
Education and Interventions: The primary intervention is to stop consuming alcohol. Treatment
includes supportive care, managing complications (such as ascites and hepatic
encephalopathy), and addressing malnutrition.
Nonalcoholic Fatty Liver Disease (NAFLD):
Pathophysiology: NAFLD is a condition where there is a buildup of fat in the liver, not related to
excessive alcohol consumption. It can progress to nonalcoholic steatohepatitis (NASH),
inflammation and damage to the liver.
Diagnostics: Liver function tests, imaging studies (ultrasound, CT scan, MRI), liver biopsy.
Signs and Symptoms: Often asymptomatic, but can present with fatigue, abdominal discomfort,
and/or elevated liver enzymes.
Education and Interventions: Treatment includes weight loss, dietary changes, and physical
activity. Managing comorbid conditions such as diabetes and high blood pressure can also
improve outcomes.
Portal HTN->Esophageal Varices & Cirrhosis->Hepatic Encephalopathy:
Pathophysiology: Portal hypertension refers to high blood pressure in the portal vein, which
carries blood from the digestive organs to the liver. This can lead to the development of
esophageal varices and cirrhosis, which are complications of chronic liver disease. Hepatic
encephalopathy is a neurological complication of cirrhosis.
Diagnostics: Physical examination, imaging studies (ultrasound, CT scan, MRI), liver function
tests.
Signs and Symptoms: Esophageal varices can present with hematemesis (vomiting blood) or
melena (dark, tarry stools). Cirrhosis can present with fatigue, jaundice, abdominal pain, weight
loss, and confusion. Hepatic encephalopathy can present with altered mental status, confusion,
and coma.
Education and Interventions: Treatment includes managing the underlying liver disease,
treating complications (such as esophageal varices and hepatic encephalopathy), and
preventing further liver damage through lifestyle modifications (such as alcohol cessation and
weight loss).
Liver CA:
Pathophysiology: Liver cancer can arise from primary liver cells (hepatocellular carcinoma) or
from cells in the bile duct (cholangiocarcinoma). Risk factors include chronic liver disease,
alcohol consumption, and viral hepatitis.
Diagnostics: Imaging studies (ultrasound, CT scan, MRI), liver function tests, liver biopsy.
Signs and Symptoms: Often asymptomatic in early stages. Later stages can present with
abdominal pain, weight loss, jaundice, and ascites.
Education and Interventions: Treatment depends on the stage and location of the cancer, and
may include surgery, chemotherapy, and radiation therapy. Prevention through lifestyle
modifications (such as alcohol cessation) and vaccination against hepatitis B can reduce the risk
of developing liver cancer.
Cholelithiasis, Acute vs Chronic Cholecystitis
Pathophysiology: Cholelithiasis refers to the formation of gallstones in the gallbladder. Acute
cholecystitis occurs when there is inflammation of the gallbladder due to obstruction of the
cystic duct by gallstones. Chronic cholecystitis occurs when there is repeated attacks of
inflammation, leading to fibrosis and thickening of the gallbladder wall.
Diagnostics: Ultrasound, CT scan, blood tests (elevated liver enzymes)
Signs and Symptoms: Epigastric or right upper quadrant pain, nausea, vomiting, fever, jaundice
Education and Interventions: Treatment may involve pain management, antibiotics, and
cholecystectomy (surgical removal of the gallbladder).
Biliary Atresia
Pathophysiology: Biliary atresia is a rare disorder that affects infants, in which the bile ducts
outside and inside the liver are inflamed and blocked. This results in impaired bile flow, leading
to liver damage and eventually cirrhosis.
Diagnostics: Blood tests (elevated bilirubin, liver enzymes), ultrasound, liver biopsy
Signs and Symptoms: Jaundice, dark urine, pale stools, poor weight gain, abdominal swelling
Education and Interventions: Treatment typically involves surgery to correct the bile duct
obstruction. In severe cases, a liver transplant may be necessary.
Choledocholithiasis, Cholangitis, Gall Bladder CA
Pathophysiology: Choledocholithiasis refers to the presence of gallstones in the common bile
duct. Cholangitis is inflammation of the bile ducts, often caused by an obstruction due to
gallstones. Gallbladder cancer is a rare but aggressive cancer that originates in the gallbladder.
Diagnostics: Ultrasound, CT scan, ERCP (endoscopic retrograde cholangiopancreatography),
blood tests (elevated liver enzymes)
Signs and Symptoms: Abdominal pain, nausea, vomiting, fever, jaundice, weight loss
Education and Interventions: Treatment for choledocholithiasis and cholangitis may involve
antibiotics, pain management, and ERCP to remove the gallstones. Treatment for gallbladder
cancer may involve surgery, chemotherapy, and radiation therapy.
Pancreatitis (Acute, Chronic)
Pathophysiology: Pancreatitis is inflammation of the pancreas, which can occur acutely or
chronically. Acute pancreatitis is typically caused by gallstones or alcohol abuse, while chronic
pancreatitis is often due to long-term alcohol use or repeated acute attacks.
Diagnostics: Blood tests (elevated amylase and lipase), CT scan, endoscopic ultrasound, MRI
Signs and Symptoms: Abdominal pain, nausea, vomiting, fever, jaundice, weight loss
Education and Interventions: Treatment may involve pain management, fluid, and electrolyte
replacement, and addressing the underlying cause (e.g., alcohol cessation). Severe cases may
require hospitalization and nutritional support.
Pancreatic CA
Pathophysiology: Pancreatic cancer is a cancerous growth in the pancreas, which can be
aggressive and difficult to treat.
Diagnostics: CT scan, MRI, endoscopic ultrasound, biopsy
Signs and Symptoms: Abdominal pain, weight loss, jaundice, poor appetite, nausea, vomiting
Education and Interventions: Treatment may involve surgery, chemotherapy, and radiation
therapy. The prognosis for pancreatic cancer is often poor, so early detection is important.