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Basics of Theoretical and Experimental Medicine by Peter Celec

Learn about common diseases, their causes, symptoms, and treatment approaches in biomedicine. Covers cardiovascular, respiratory, gastrointestinal, and more. Examination includes oral test and seminar paper. Study physiology vs. pathophysiology, and explore Latin medical terms.

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Basics of Theoretical and Experimental Medicine by Peter Celec

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  1. Základ teoretickej a experimentálnej medicíny Peter Celec Ústav molekulárnej biomedicíny, LF UK www.imbm.sk petercelec@gmail.com

  2. Basics of theoretical and experimental medicine Peter Celec Institute of Molecular Biomedicine, LF UK www.imbm.sk petercelec@gmail.com

  3. Who? MUDr. RNDr. Roman Gardlík, PhD. h-index: 12 RNDr. Barbora Vlková, PhD. h-index: 8 Mgr. Barbora Konečná, PhD. h-index: 2 Mgr. Veronika Borbélyová, PhD. h-index: 2 MUDr. Mgr. Július Hodosy, PhD., MPH. h-index: 14 3

  4. Why? • Biomedical research • biology and medicine • Future career • Master theses • PhD • IMBM, BMC • Bidirectional 4

  5. What? • Principles of common diseases • Etiology • Pathogenesis • Symptoms & signs • Treatment approaches • Models 5

  6. Syllabus • Introduction • Syllabus, motivation, examination • Cardiovascular diseases • Heart failure, hypertension, atherosclerosis, coronary artery disease, shock • Respiratory diseases • Asthma, COPD, emphysema, pulmonary edema, acid base balance • Gastrointestinal diseases • Ulcers, diarrhea, constipation, icterus, pancreatitis, portal hypertension, liver failure • Nephrology and disorders of the genitourinary tract • Renal failure, glomerulonephritis, preeclampsia, urinary tract infection, amenorrhea • Blood and immune disorders • Anemia, inflammation, immunosuppression, autoimmune diseases, allergy, leukemia, lymphoma • Cancer diseases • Carcinogenesis, Paraneoplastic syndrome, • Neuropsychiatric disorders • Stroke, multiple sclerosis, epilepsy, migraine, autism, depression, schizophrenia, neurodegeneration • Metabolic diseases • Diabetes mellitus, gout, hemochromatosis • Endocrine diseases • Disorders of the thyroid, adrenal and pituitary gland, hypogonadism, hypergonadism • Musculoskeletal diseases • Osteoporosis, carpal tunnel syndrome, rheumatoid arthritis, osteoarthrosis, psoriasis 6

  7. Information sources • Lectures • www.imbm.sk • Textbooks • Wikipedia • Pathophysiology, internal medicine • Review articles • Pubmed • CVTI • www.cvtisr.sk 7

  8. Examination • Oral exam • Questions according to the syllabus • Seminar paper • 1.12. • One disease reviewed in detail • Tasks to solve • Questions every week 8

  9. Basic terms • Physiology vs. Pathophysiology • Pathology vs. Pathophysiology • Etiology vs Pathogenesis • Symptoms vs Signs • Syndrome • Health vs Disease • Latin terms 9

  10. 10

  11. Latin I. • -brady – bradypnoe, bradykardia • -tachy – tachypnoe, tachykardia • -hypo – hypopnoe, hypoglycemia • -hyper – hyperpnoe, hyperglycemia • -poly – polydipsia, polyphagia • -oligo – oliguria, oligofrénia • -a/an – apnoe, anuria • -pseudo – pseudocyst • -endo – endoscopy • -ekto – ectopic 11

  12. Latin II. • -osis – degeneration - arthrosis • -itis – inflammation - hepatitis • -oma – tumor - myoma • -algia – pain - artralgia • -stenosis – narrowing - pylorostenosis • -pathia – disease - hepatopatia • -lithiasis – stone - nephrolithiasis • -rrhagia – bleeding - metrorrhagia • -emia – blood - glycemia, natriemia, kaliemia • -uria – urine - glykosuria, natriuria 12

  13. Selected symptoms & signs • Cyanosis • Dyspnoe • Icterus • Struma • Edema • Palpitations • Syncope • Ascites 13

  14. Syndrome • Anemic syndrome • Paleness • Fatique • Dyspnea 14

  15. Cardiovascular system I

  16. Circulation 16

  17. Conducting system 17

  18. Cardiac output • Preload • Contractility • Afterload • Frequency • Synchronisation 18

  19. Mechanisms of heart • Frank-Starling mechanism • Inotropy – lusitropy 19

  20. Cardiovascular diseases • Hypertension • Atherosclerosis • Coronary artery disease • Angina pectoris • Acute myocardial infarction • Heart failure • Stroke 20

  21. Neurohumoral regulation • Autonomous nervous system • RAAS system • Endothelin • Natriuretic peptides • NO 21

  22. Autonomous nervous system 22

  23. RAAS system 23

  24. Endothelin 24

  25. Natriuretic hormones 25

  26. NO 26

  27. Heart failure • Insufficient perfusion of tissues • Normal filling • Forward failure • Ejection fraction • Backward failure • Edema 27

  28. Heart failure • Systolic • Low ejection fraction • Contraction failure • Diastolic • Normal ejection fraction • Filling failure 28

  29. NYHA classification • Class I • No limitations of physical activity. Dyspnoe with heavy physical exertion. • Class II • Some limitation of physical activity. Dyspnoe with ordinary exertion. • Class III • Definite limitation of physical activity. Dyspnoe with minimal exertion. • Class IV • Severe limitation of physical activity. Dyspnoe at rest. 29

  30. Heart failure • Compensation • Catecholamines • Frank-Starling • Hypertrophy • Decompensation 30

  31. Heart failure • Epidemiology • 20/1000 – adult population • 150/1000 – over 75 years • 5-year mortality 50% • Therapy • ACE-inhibitors • Beta-blockers • Diuretics 31

  32. Symptoms of heart failure Think FACES... • Fatigue • Activities limited • Chest congestion • Edema or ankle swelling • Shortness of breath 32

  33. Decompensation Increased pulmonary venous pressure Insterstitial edema Alveolar edema 33

  34. Acute pulmonary edema 34

  35. Hypertrophy • Overload • Pressure • Afterload • Concentric hypertrophy • Volume • Preload • Excentric hypertrophy 35

  36. Valvular defects • Mitral/Tricuspidal • Stenosis • Insufficiency • Aortal/Pulmonary • Stenosis • Insufficiency 36

  37. Valvular defects 37

  38. Healthy heart Dilation 38

  39. Healthy heart Concentric hypertrophy 39

  40. Healthy heart Excentric hypertrophy 40

  41. Blood pressure • Hypertension • 140/90 mm Hg, but... • Many confounding factors • Hypertrophy, encephalopathy, stroke, hypertensive nephropathy, retinopathy... • Primary – essential • Secondary • Renal • Renovascular • Endocrine • Neural, iatrogenic, gestational... 41

  42. 42

  43. Afterload & blood pressure • BP = CO x SVR • Cardiac output • Systemic vascular resistance • If CO is low, BP is maintained by  SVR •  SVR =  afterload 43

  44. Complications of hypertension • Atherosclerosis • Stroke • AMI • Nephropathy • Blindness 44

  45. Cardiovascular models • Hypertesion • L-NAME, SHR, Dahlsalt-sensitiverats • Atherosclerosis • Highfatdiet, apoEkomice • AMI • Coronarysurgery • Heartfailure • Isoprenalin 45

  46. Questions • Which genetic factors are associated with hypertension? Heritability? • What is the evolutionary origin of the RAAS system? • What is the effect of ACE inhibitors on mortality in hypertension and heart failure? • Which promoters are myocardium-specific? • Why does apoE knock-out leads to atherosclerosis? 46

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