Pathophysiology

Upper UTI affecting cortex and medulla of kidney and renal pelvis. More common in people with diabetes and reduced immune response to infections.
Presents with chills, fever, nausea, vomitting, dysuria (pain when urinating), and abdominal pain

Progressive procress, of scarring and deformation of renal calyces (cortex?) and pelvis due to bacterial infection, chronic obstructio or reflux.  Can develop into acute pyelonephritis
Loose functio to concentrate urine, polyuria, nocturia, hypertension, fever, nausea, vomitting, abdominal pain

Poor blood flow to the brain due to a vascular disorder. Result in injury of brain tissues

Risk factors are age, sex (higer in males), family history, cardiac disease, previous histories of stroke, blood disorders, hypertension, diabetes mellitus, smoking, or hypercoagulopathy.Atrial fibrilation froms blood cloths and thus also risk factor.
Obesity, physical inactivity, oral contraceptive, hormone replacement therapy, alcohol and drugs

Ischemic stroke: caused by cerebrovascular obstruction (thrombosis or emboli)

Transient Ischemic attack (TIAs): temporal disturbance of cerebral blood flow that reverses before infarction occurs

Hemorrhagic stroke: Most frequent and fatal. Rupture of cerebral blood vessel -> edema

Hemorrhagic stroke caused by cerebral aneurysm which leads to bleeding in subarachnoid space

Before rupture/bleeding: Asymptomatic, headaches, nausea, vomitting and dizziness.

After: Same as before, If severe bleeding, collaps and loss of consciousness. neck stiffness, motor and sensory deficits

Determined by the artery affected/area of brain without O2. Symptoms often sudden and one-sided!

facial droop, arm weakness, slurred speach, imbalance, Language deficits, sensation and cognition deficites.

Spasticity due to increased muscle tone

Abnormal discharge of neurons. Can occure during all serious illnesses that affect the brain and metabolism of it (tumor, infections, drug abuse,...)

Seizure is a single event, epilipsy is a chronic disorder

Birth injury, or congenital malformation.

Head trauma, drugs, stroke or tumor can cause it

Abnormal, and excess excitation of some cortical neurons (due to altered membrane permeability or distribution of ions)

Focal seizure (specific area of brain): With or without impaired awareness. (without: no symptoms or movement when motor area involved. With: Confusion, hallucinations, Illusions, lip smacking, grimacing,..)

Generalised seizures (simultaneusly in both hemispheres): Motor (contraction of muscles with loss of awareness) or non-motor (brief loss of contact with environment)

Non-epileptic seizures and status epilepticus (does not stop spontaneously -> can lead to death because respiratory failure ect.)

Impaired motor function or loss of awareness (depends on type of seizure)

Can be primary or secondary to other disease, like meningitsi, brain tumor, cerebral aneurysm, hemorrage,...

Migraine headache: tends to run in families

Cluster headache: occurs frequently in a month then not (in clusters)

Tension-type headache: most common type

Runs in families, may be inherited. Hormonal variations play a level (woman) but also dietary substances

Patophysiology is not fully understood. Neurogenic inflammation

Without aura: Pulsating, thorbbing, lasts 1-2 days, more serious with physical ativity, nausea, vomiting, sensitivity to light

With aura: Additionally reversible visual, sensory symptoms or speech disturbances (develops over few minutes and lasts up to 1h)

More frequent in men. Most uncommon type of headache.

Patophysiology not fully understood. Interplay of vascular, neurogenic, metabolic and hormonal factors and or autosomal dominant gene.

Rapid onset pain, peaks in 10-15 min. Pain behind eye, restlesness, tears on one side, eyelid edema, swating on forhead and face

Most common type, usually not severe enough to interfere with daily activities.

Mechanism is unknown. May result from sustained tension of mscles (neck, scalp) or migraines that slowly transform to chronic. Also caused by stress, anxiety and depression, caffein overuse

Dull, aching, diffuse headaches, around the head. NOT associated with nausea, vomitting or worsening with physical acitivity

Chronic Daily Headache (CDH)

Cause is unknown, but hypothesis assumes transformed migraine, or posttraumatic headaches. Sometimes related to medication overuse

Certain characteristics of migraine, others resemble chronic tension type headaches.

Responsiveness to painful stimuly begins in newborn period. Pain response evolves with maturation and cognitive development. Neurons in neonates have wider receptive field and lower treshold

Frequently underrecognized and underrated. Williness to report differs with age.

Difficulty locating pain and assess intensity

Usually in contex with injury or inflammation. Can be chamical (tissue trauma or ischemia) thermal, mechanical

Tissue injury leads to release of inflammatory mediators. Nocirepors respond to chemical, thermal, mechanical changes and Thalamus stimulates hypothalamus (endocrine response), emotional experience (limbic cortex) and locatio of intesity and location.

Acute pain: duration <6 months, Increased autonomic response (Hear rate, Blood Pressure, muscle tension,..). associated with anxiety
Chronic pain duration >6 months, absence of autonomic response but increased irritability, depression, loss of appetite, sleep disorders
Deep somatic pain: Strong pressure on bone, muscle ischemia, dissue damage
Referred pain: Pain in different site than original (e.g Myocardial infarct)
Visceral pain: Commonly produced by diseases. Contractions, ischemia of visceral wall

Age (onset usually at around 56 years).

Believed to be caused by interaction of environmental and genetic factors. Oxidative stress and mitochondrial disorders.

Contact with pesticides, or rural living increases (while coffe and smoking lowers) risk.

Degenerative disorder of basal ganglia function. Destroys nigrostriatal pathways progressively and reduces striatal dopamine. Some residual neurons are atrophic, few contain Lewy bodies (spherical eosinophilic inclusions)

Loss of dopamine nerve cells, leads to:

Tremor (Involuntary oscilating contractions of hands, feet, neck, tongue, jaw) resembles movement of rolling pill between fingers.
Rigidity: resistance to full range of movement -> leads to jerks/ratchet-like movements
Bradykinesia: Slowness in initiating and performing movements. People freeze in place when walking, higher risk to fall, loss of blinking reflex, tongue and throat muscles become rigid -> speed becomes slow....
 

Neurological disorder that selectively affects motor function (upper motor neuron disease).

People in their 50s, Males and with family history

Affects the lower motor neurons of the spinal cord and upper motor neurons of the cerebral cortex. Undergo degeneration of distal terminals until cell dies. Sensory system remains intact.

Can be caused by gene mutation or a suggested exotoxic injury. Autoimmunity has also be suggested

Due to UMN or LMN (lower motor neurons) involvement:
UMN: weakness, stiffness, impaired fine motor control
LMN: weakness, muscle fiber atrophy, muscle cramps

Speech, chewing, swallowing is impaired because muscles are involved. No cure for ALS, results in death (respiratory muscles)

Multiple Sclerosis

Inflammation and destruction of the CNS myelin (PNS usually spared)