Introduction to General Medical Conditions
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Introduction to General Medical Conditions
Copyright © Momentum Press, LLC, 2017.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means—electronic, mechanical, photocopy, recording, or any other
except for brief quotations, not to exceed 400 words, without the prior permission of the publisher.
First published in 2017 by
Momentum Press, LLC
222 East 46th Street, New York, NY 10017
www.momentumpress.net
ISBN-13: 978-1-94561-292-3 (paperback)
ISBN-13: 978-1-94561-293-0 (e-book)
Momentum Press Health, Wellness, and Exercise Science Collection
Cover and interior design by Exeter Premedia Services Private Ltd., Chennai, India
First edition: 2017
10 9 8 7 6 5 4 3 2 1
Printed in the United States of America.
Abstract
Introduction to General Medical Conditions explains the most common
non-orthopedic maladies seen in the active population. The text is designed
to be a reference tool for students and professionals who work with athletes
or a physically active population. Each chapter covers a specific body part
or system. Also discussed are preventative measures to avoid developing
these conditions. Coaches, students in allied health professions, physical
education teachers, parents, and athletes will benefit from reading this text.
The first unit of the text gives an introduction to general medicine
concepts. It starts by providing an introduction to clinical pathology,
common medical procedures, the basics of pharmacology, and lastly,
introduces common contagious illnesses.
The second unit of the text discusses body systems and complications
that may arise in each system. Common conditions and illnesses of the
respiratory, cardiovascular, digestive, urinary, reproductive, neurological,
and endocrine systems are introduced. Additionally, the second unit covers
dermatological conditions and issues that may arise in the eyes or ears.
Each illness and condition in the text provides the associated signs and
symptoms, most common treatment plan and recommended preventative
measures.
Keywords
body systems, clinical pathology, common illnesses, dermatological
conditions, ear conditions, eye conditions, medical procedures
Contents
Preface
Part I Introduction to General Medical Concepts
Chapter 1 Introduction to Clinical Pathology
Chapter 2 Common Medical Procedures
Chapter 3 Pharmacology Basics
Chapter 4 Common Contagious Illnesses
Part II Conditions by Body System
Chapter 5 Respiratory System Conditions
Chapter 6 Cardiovascular Conditions
Chapter 7 Digestive System Conditions
Chapter 8 Urinary System Conditions
Chapter 9 Reproductive System Conditions
Chapter 10 Neurological System Conditions
Chapter 11 Endocrine System Conditions
Chapter 12 Dermatological Conditions
Chapter 13 Eye Conditions
Chapter 14 Ear Conditions
About the Authors
Index
Preface
Introduction to General Medical Conditions includes some of the most
common illnesses and conditions of the body systems. The text is designed
as a reference tool for students and professionals who work with athletes or
any physically active population. The reader will be introduced to basic
general medical concepts, common medical procedures, basic
pharmacology, and common infectious illnesses. Individual chapters will
cover specific body systems and will include a brief review of the system’s
anatomy, the introduction to each condition, the common signs and
symptoms for easy recognition, and the most commonly prescribed
treatments. Lastly, preventative measures will be discussed to help patients
avoid obtaining these common illnesses or conditions. Coaches, allied
health students, physical education teachers, parents, and the physically
active will benefit from reading this text. Several texts exist for
understanding musculoskeletal injuries, but few quick reference tools are
available for general medical concepts and conditions.
PART I
Introduction to General
Medical Concepts
CHAPTER 1
Introduction to Clinical Pathology
Chapter 1 provides an introduction to the basic principles of clinical
pathology and provides the reader with an explanation as to why having a
foundation in general medical condition and treatment is vital when serving
as a parent, coach, personal trainer, instructor, or athletic trainer. This
chapter will start by providing several definitions and a basic guide to
general medical evaluation techniques, as well as how these techniques
differs from orthopedic joint evaluations.
Understanding common medical conditions and how they present is
crucial in any setting. Commonly, coaches, parents, and athletic trainers are
the first to see an athlete when a general medical condition arises. Thus,
having knowledge about common conditions and the ability to recognize
the need for referral to a medical doctor is an important first step in process
of providing care. Understanding clinical pathology is also crucial because
certain conditions may affect an athlete’s ability to participate and the
disease may require certain precautions when the athlete is allowed to play.
Lastly, understanding basic principles of clinical pathology is necessary to
determine if and how a specific condition can affect musculoskeletal
injuries as well as required recovery time before an athlete is allowed to
return to play.
Definitions
Pathology: The study of biological causes, effects, and processes of disease.
Pathogenesis: Refers to the physiological or biological origin that leads to
the diseased state. Commonly noted by the development and progression of
signs and symptoms over time as well as the nature of the disease (acute,
chronic, or recurrent). Commonly thought of as synonymous with etiology.
Etiology: Explains the underlying mechanisms and causes of disease,
studying the development of a disease. Commonly, etiology is explained in
historical terms.
Sign: Observable indication of a pathology. Objective finding that can be
measured. For example, rash, swelling, discoloration, bleeding, changes in
blood pressure or heart rate, temperature, and sweating.
Symptom: Abnormal function, description, appearance, or sensation that a
patient describes. Symptoms are subjective in nature. For example, pain,
nausea, fatigue, dizziness, numbness, and lightheadedness.
Diagnosis: The specific injury, illness, disease, or condition a patient
develops as determined by a medical evaluation. It is considered the “art of
naming a disease.” Clinical diagnoses are based on signs, symptoms, taking
a thorough history from the patient and conducting a physical examination.
Commonly, lab work or imaging studies are also performed to aid in the
decision process. Differential diagnoses are provided when two or more
diseases present with similar signs and symptoms and further evaluation
techniques need to be performed in order to differentiate and determine the
diagnosis.
Medical History
Taking a medical history is the first step in determining an individual’s
potential clinical pathology. The purpose of the medical history is to try and
determine the potential pathogenesis (i.e., how and when the signs and
symptoms presented and progressed) of the disease state. This is a question
and answer time when you gather information from the athlete or individual
to determine the severity of any existing signs and symptoms. During the
history, it is also important to identify whether there are any other co-
existing conditions, and if so, to what extent they may be affecting the
athlete. Lastly, the interviewer should ask questions that address any past
medical conditions and if any contraindications are present, as these
responses may aid in treatment decisions (i.e., allergies to medications). The
information gathered from the history will then be used to guide the
physical examination.
Common Components to a General Medical History
Chief Complaint: Refers to the primary symptom, as stated by the patient,
for seeking medical treatment or medical advice.
Present History: Time of symptom onset and rate of progression since the
onset. How signs or symptoms have changed over time for the current
condition or chief complaint.
Past History: Previously diagnosed conditions, diseases, and illnesses. This
includes any past issues related to heart disease, stroke, cancer, diabetes, or
blood pressure as well as any surgeries or hospitalizations.
Family History: Major health problems within the athlete’s immediate
family.
Social History: Current or past history of usage of alcohol, substance abuse,
stress level, depression, safety in the home or work environments.
Review of Systems: Includes addressing at least one question that screens
each organ system of the body (circulatory, respiratory, endocrine, urinary,
integumentary, reproductive, digestive, nervous, lymphatic, and
musculoskeletal).
Determining the Severity of the Condition and Red Flag Warnings
The severity or seriousness of a general medical condition can be
determined, in part, by the associated signs and symptoms. Conditions that
cause a change in vital signs (heart rate, blood pressure, and respiration
rate) are more severe in nature and can be life threatening. When an illness
or injury causes major changes to any of the vital signs, this is considered
an emergency. In these instances, it is essential to frequently monitor the
athlete’s vital signs at least every 5 minutes. In a non-emergency situation
but where there is potential for the condition to worsen and become life
threatening, the athlete’s vital signs should be monitored every 15 minutes.
It is also helpful to be able to compare an athlete’s vitals to a set of baseline
values taken during a preparticipation physical examination.
Neurological conditions that present with symptoms associated with
changes to a person’s brain stem function, such as cranial nerve alterations,
are also concerning and should be considered a medical emergency. There
are 12 cranial nerves that allow for smell, taste, vision, hearing, facial
movements or sensations, speech, and swallowing. Additionally, changes in
reflexes, coordination, and balance may be a sign of conditions affecting
brain stem function.
Signs and symptoms that appear as a result of endocrine disorders may
present more subtly and develop more slowly than acute conditions and
injuries that abruptly affect cardiovascular and pulmonary function or
neurological function. These conditions commonly present with changes in
a person’s weight, changes in a person’s level of fatigue or changes in body
temperature.
The least severe conditions will present with signs and symptoms that
affect daily function and are slow to develop and may lead to diagnoses of
chronic conditions. These illnesses may alter a person’s sleep pattern,
appetite, urinary or bowel habits, or metabolic health.
The following is a list of “Red Flag” signs and symptoms that would
demand immediate referral to a medical doctor.
• Constant pain
• Severe (incapacitating) pain
• Pulsing pain
• Syncope
• Heart palpitations or flutters
• Night pain or night sweats
• Difficult or painful swallowing
• Visual changes
• Unexplained weight loss or gain
• Insomnia
• Difficulty or painful breathing
• Recurrent nausea or vomiting
• Pain with urination
• Blood in urine
• Severe or progressive dizziness
• Severe malaise or fatigue
In general, symptoms that are not well localized, have no injury
associated with onset, have been worsening, or are unaffected by standard
treatments, are not likely to be caused by musculoskeletal conditions and
should be treated as a general medical condition.
Medical Disqualifications
Many conditions may preclude an athlete from playing competitive sports
for safety and wellbeing of the athlete. Despite published recommendations
indicating which conditions should disqualify an athlete from participation,
each athlete as well as their guardian(s) should work closely with a
physician to make an educated and informed decision on an individual
basis. All effort should be made to allow safe participation and to avoid
increasing risk of life-threatening injury or death. Commonly athletes that
are disqualified from intense sports may be allowed to participate in lower
intensity sports like golf, bowling, cricket, billiards, and curling. The
following is a list of common medical conditions that may preclude an
athlete from playing contact sports or sports requiring intense physical
activity. This is not an all-inclusive list. All diagnoses, as well as physical
activity clearances, should be made by a medical professional.
Cardiovascular Conditions
Hypertrophic cardiomyopathy
Aortic stenosis
Infective carditis
Uncontrolled hypertension
Mitral valve prolapse
Wolff-Parkinson-White syndrome
Ventricular tachycardia, Ventricular flutter, or Ventricular fibrillation
Premature ventricular contractions
Long QT syndrome
Marfan syndrome
Respiratory Conditions
Tuberculosis
Severe or uncontrolled asthma
Pneumothorax
Pulmonary insufficiency
Central Nervous System Conditions
Seizure disorder (uncontrolled)
Concussion
Sensory Concerns
Detached retina
Severe myopia
Severe hearing loss
Abdominal Problems
Hepatomegaly
Splenomegaly
Active hepatitis
Inguinal hernia
General Illness
Infectious mononucleosis
Diabetes mellitus (uncontrolled)
Acute febrile illness
Hyperthyroidism (uncontrolled)
Hematological Conditions
Anemia
Sickle cell trait
Hemophilia
Skin Disorders
Herpes simplex
Impetigo
Tinea corporis
Single Organ Concerns
Eye
Kidney
Testicle
Additional References
Cuppet, M., and K. Walsh. 2012. General Medical Conditions in the Athlete. 2nd ed. St. Louis,
Missouri: Elsevier Mosby.
“Diseases and Conditions.” http://mayoclinic.org/diseases-conditions (accessed March 2017).
O’Connor, D.P., and A.L. Fincher. 2015. Clinical Pathology for Athletic Trainers: Recognizing
Systemic Disease. 3rd ed. Thorofare, NJ: Slack.
CHAPTER 2
Common Medical Procedures
Chapter 2 presents common medical procedures utilized by practitioners in
order to identify and diagnose specific pathologies. Practitioners diagnose a
disease by conducting laboratory testing of blood, bodily fluids, tissues, and
cells. There are three main reasons that a practitioner will order a
procedure: (1) to diagnose the presence of a condition, (2) to note the
progression of a condition or (3) to see if a patient is free of a condition.
Procedures can be classified as non-invasive, minimally invasive or
invasive. Some tests can be completed directly in the doctor’s exam room
while other take highly specialized equipment and must be performed in a
lab or other facility. This chapter will discuss the various types of testing
used by medical practitioners to diagnose common clinical pathologies in
medicine.
Tables 2.1 to 2.11 discuss common diagnostic procedures used by
medical professionals.
Table 2.1 Arthrogram
Purpose An x-ray after a contrast dye or solution is
administered into the joint allowing the practitioner
the ability to see soft tissue structures. Most
commonly used in the shoulder or hip joint.
Test Procedure The joint is injected with a contrast dye using a long
needle. Once the contrast is in the joint, patients may
then have x-rays, MRI, or CT imaging completed.
Sometimes these x-rays are referred to as fluoroscopy
imaging.
Indications To gain an understanding of what is causing joint
signs and symptoms such as swelling, catching, pain,
or laxity. This procedure also allows for imaging of
ligaments, joints, and cartilage.
Contraindications Pregnancy, allergies to the contrast materials, known
joint infection.
Table 2.2 Bone Scan (Scintigraphy)
Purpose A bone scan is utilized to determine any abnormalities
in bone structure throughout the body. It is commonly
used to look at the health of a bone when a condition
is too early to be detected on x-ray, such as bone stress
reactions/stress fractures, although MRI is the new
gold standard for stress fracture diagnosis. It is also
used for bone cancer diagnoses and monitoring.
Test Procedure A tracer is injected into a vein and after a few hours a
camera scan is conducted to determine any areas of
bony abnormality. Areas of abnormality will be
indicated by the tracer.
Indications Suspected fracture, malignancy, osteoporosis, joint
degeneration.
Contraindications Precautions should be taken for women who are
pregnant or breastfeeding.
Table 2.3 Complete Blood Count (CBC)
Purpose A blood draw used to diagnose a variety of conditions
and evaluate the contents of the plasma and overall
health of the blood cells, including red blood cells,
white blood cells, platelets, hematocrit, and
hemoglobin levels.
Test Procedure A needle is inserted into a vein, usually of the
antecubital space. The phlebotomist fills one or
multiple vials with blood to be analyzed in a lab.
Indications To evaluate overall health, to diagnose, or monitor a
condition.
Contraindications None.
Table 2.4 Computerized Tomography
Purpose A computerized tomography (CT or CAT) scan
utilizes a series of x-rays to produce a cross-sectional
image of bones, blood vessels, the brain, or body
structures. CT scans are beneficial to determine the
extent of trauma to the body after an accident by
providing more detail compared to x-ray alone.
Test Procedure The patient is placed in a closed tube. A series of x-ray
images are collected by using a computer to compile
x-ray views from various angles. This creates the
ability to see cross-sectional views of specific body
structures.
Indications Suspected trauma or damage to specific body
structures. Identification of tumors, or masses evident
in body organs.
Contraindications Pregnancy, claustrophobia, children.
Table 2.5 DXA Scan (Bone Densitometry)
Purpose DXA scans are used to measure bone density to
diagnosis and monitor osteoporosis. The scan used
dual energy x-ray absorptiometry to mainly evaluate
the bones of the hip and spine. The results are
measured in a T-score where your bone density is
compared to that of a 30-year-old person.
Test Procedure Patients lie on an open x-ray table and lie still for 10
to 20 minutes while the scanner moves over the body.
It is pain-free and a low dose of radiation.
Indications Females over age 65. Females over 60 who are at high
risk for bone fractures. Athletes with Female Athletic
Triad.
Contraindications Patients with known fractures, patients younger than
40.
