- •English for medical students
- •Preface
- •Medicine as a science. Branches of medicine
- •Branches of medicine
- •Basic sciences
- •Diagnostic specialties
- •Clinical disciplines
- •Human organism human anatomy
- •The cell
- •Properties of cells:
- •Cell membrane: a cell's protective coat
- •Cytoskeleton: a cell's scaffold
- •Genetic material
- •Organelles
- •Cell nucleus (a cell's information center)
- •Ribosomes (the protein production machine)
- •Mitochondria and Chloroplasts (the power generators)
- •Endoplasmic reticulum and Golgi apparatus (macromolecule managers)
- •Lysosomes and Peroxisomes (the cellular digestive system)
- •Centrioles
- •Vacuoles
- •The tissue
- •Human organ systems
- •The anatomical position
- •Relative directions
- •Median and sagittal plane
- •Coronal plane
- •Transverse plane
- •Special cases
- •Body cavities
- •Digestive system
- •Introduction
- •Ingestion
- •Digestion: stomach
- •Digestion and absorption: small intestine
- •Absorption: large intestine
- •Answer the questions
- •Ulcerative colitis
- •Urinary system
- •Introduction
- •Kidneys: location and structure
- •Kidneys: function
- •Urine production
- •Answer the questions
- •Cystitis
- •Reproductive system
- •Introduction
- •Male reproductive organs
- •Female reproductive organs
- •Development of sex cells
- •Answer the questions
- •Vaginismus
- •Prostatitis
- •Nervous system
- •Introduction
- •Cns: neurons, brain, spinal cord
- •Pns: somatic (voluntary) nervous system, autonomic (involuntary) nervous system
- •Sense organs
- •Answer the questions
- •Ischemic stroke
- •Immediate treatment
- •Cardiovascular system
- •Introduction
- •Components of blood
- •How blood clots
- •How red blood cells carry oxygen
- •Blood pressure
- •The heart (the pump)
- •Answer the questions
- •Mitral stenosis
- •Respiratory system
- •Introduction
- •Lungs and air passages
- •Gas exchange
- •Respiration
- •Answer the questions
- •Lymphatic system
- •Introduction
- •Capillary hydrostatic pressure: fluid diffusion and reabsorption
- •Lymph vessels
- •Lymph organs: nodes, nodules, spleen, thymus gland, tonsils
- •Answer the questions
- •Lymphadenitis and lymphangitis
- •Skeletal system
- •Introduction
- •Axial skeleton
- •Appendicular skeleton
- •Ossification and reconstruction
- •Bone marrow
- •Answer the questions
- •Osteoarthritis
- •Muscular system
- •Introduction
- •Cardiac muscle
- •Smooth muscle
- •Skeletal muscle
- •Muscle fibers and exercise
- •Answer the questions
- •Myasthenia gravis
- •Skin (integumentary system)
- •Introduction
- •Skin: epidermal layers
- •Skin: dermal layers
- •Sudoriferous (sweat) and sebaceous (oil) glands
- •Hair and nails
- •Skin color
- •Answer the questions
- •Endocrine system
- •Introduction
- •Glands and neural components
- •Homeostatic feedback mechanisms
- •Pituitary gland
- •Thyroid gland
- •Adrenal glands
- •Ovaries and testes
- •Answer the questions
- •Type 1 diabetes
- •Insulin
- •Vascular disease
- •I. What is cancer?
- •II. Terminology of cancer
- •III. History of oncology
- •IV. Oncological diseases
- •1. Laryngeal cancer
- •Symptoms:
- •Diagnosis:
- •Treatment:
- •2. Lung cancer
- •Causes:
- •Symptoms:
- •Diagnosis:
- •Treatment:
- •3. Colon cancer
- •Causes, incidence, and risk factors:
- •Symptoms:
- •Signs and tests:
- •Treatment:
- •4. Brain tumor
- •Causes, incidence, and risk factors:
- •Symptoms:
- •Signs and tests:
- •Treatment :
- •Wilhelm Conrad Roentgen
- •I. Diagnostic radiology
- •II. Therapeutic radiology
- •III. Interventional radiology
- •Answer the questions
- •Pharmacology
- •For the gastrointestinal tract or digestive system
- •For the cardiovascular system
- •For the central nervous system
- •For musculo-skeletal disorders
- •Why we need vitamins
- •Vitamin deficiencies
- •Analgesics
- •Paracetamol and nsaiDs
- •Opiates and morphinomimetics
- •Combinations
- •Topical or systemic
- •Psychotropic agents
- •Addiction
- •Antibiotics
- •Side effects
- •Antibiotic resistance
- •Vaccines
- •Origin of vaccines
- •Developing immunity
- •Potential for adverse side effects in general
- •Answer the questions
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 1
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 2
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 3
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 4
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 5
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 6
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 7
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 8
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 9
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 10
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 11
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 12
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 13
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 14
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 15
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 16
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 17
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 18
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 19
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 20
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 21
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 22
- •I. Learn new combining forms and their meanings
- •II. Do basic exercises
- •III. Do additional exercises
- •IV. Get ready for the test
- •V. Write test 23
Paracetamol and nsaiDs
The exact mechanism of action of paracetamol is uncertain, but it appears to be acting centrally. Aspirin and the NSAIDs inhibit cyclooxygenase, leading to a decrease in prostaglandin production; this improves pain and also inflammation (in contrast to paracetamol and the opioids).
Paracetamol has few side effects, but dosing is limited by possible hepatotoxicity (potential for liver damage). NSAIDs may predispose to peptic ulcers, renal failure, allergic reactions, and hearing loss. They may also increase the risk of hemorrhage.
Opiates and morphinomimetics
Tramadol and buprenorphine are thought to be partial agonists of the opioid receptors. Morphine, the archetypal opioid, and various other substances (e.g. pethidine, oxycodone, hydrocodone, diamorphine) all exert a similar influence on the cerebral opioid system. Dosing may be limited by opioid toxicity (confusion, myoclonic jerks and pinpoint pupils), but there is no dose ceiling in patients who tolerate this.
Opioids, while very effective analgesics, may have some unpleasant side-effects. Up to 1 in 3 patients starting morphine may experience nausea and vomiting (generally relieved by a short course of antiemetics). Pruritus (itching) may require switching to a different opioid. Constipation occurs in almost all patients on opioids, and laxatives (lactulose, macrogol-containing or co-danthramer) are typically co-prescribed.
When used appropriately, opioids and similar narcotic analgesics are safe and effective, carrying relatively little risk of addiction. Occasionally, gradual tapering of the dose is required to avoid withdrawal symptoms.
Combinations
Analgesics are frequently used in combination, such as the paracetamol and codeine preparations found in many non-prescription pain relievers. They can also be found in combination with vasoconstrictor drugs such as pseudoephedrine for sinus-related preparations, or with antihistamine drugs for allergy sufferers.
Topical or systemic
Topical analgesia is generally recommended to avoid systemic side-effects. Painful joints, for example, may be treated with an ibuprofen- or diclofenac-containing gel; capsaicin also is used topically. Lidocaine and steroids may be injected into painful joints for longer-term pain relief. Lidocaine is also used for painful mouth sores and to numb areas for dental work and minor medical procedures.
Psychotropic agents
Tetrahydrocannabinol and some other cannabinoids, either from the Cannabis sativa plant or synthetic, have analgesic properties, although the use of cannabis derivatives is illegal in many countries. Other analgesic agents include ketamine (an NMDA receptor antagonist), clonidine and other α2-adrenoreceptor agonists, and mexiletine and other local anaesthetic analogues.
Addiction
In the United States in recent years, however, there has been a wave of new addictions to prescription painkillers such as oxycodone (OxyContin, Percocet etc.) and hydrocodone (Vicodin, Lortab etc.). The U.S. Government is now taking steps to reverse this epidemic, which it has blamed on easy access to prescription drugs over the Internet. The bigger problem however is doctors overprescribing these drugs.