Introduction to General

Medical Conditions
Introduction to General
Medical Conditions
Genevieve Ludwig and
Megan Streveler-Lundstrom

MOMENTUM PRESS, LLC, NEW YORK

Introduction to General Medical Conditions

Copyright Momentum Press, LLC, 2017.

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First published in 2017 by

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ISBN-13: 978-1-94561-292-3 (paperback)

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Momentum Press Health, Wellness, and Exercise Science Collection

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 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 complica-
tions that may arise in each system. Common conditions and illnesses
of the respiratory, cardiovascular, digestive, urinary, reproductive, neuro-
logical, 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
Prefaceix

Part I Introduction to General Medical Concepts 1

Chapter 1 Introduction to Clinical Pathology3
Chapter 2 Common Medical Procedures11
Chapter 3 Pharmacology Basics17
Chapter 4 Common Contagious Illnesses25

Part II Conditions by Body System 31

Chapter 5 Respiratory System Conditions33
Chapter 6 Cardiovascular Conditions41
Chapter 7 Digestive System Conditions51
Chapter 8 Urinary System Conditions57
Chapter 9 Reproductive System Conditions61
Chapter 10 Neurological System Conditions69
Chapter 11 Endocrine System Conditions77
Chapter 12 Dermatological Conditions83
Chapter 13 Eye Conditions99
Chapter 14 Ear Conditions107

About the Authors111

Index113
 Preface
Introduction to General Medical Conditions includes some of the most com-
mon 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 gen-
eral 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 systems 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 musculoskele-
tal 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 athletes 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 progres-
sion of signs and symptoms over time as well as the nature of the disease
4 INTRODUCTION TO GENERAL MEDICAL CONDITIONS

(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 individuals
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 ques-
tions that address any past medical conditions and if any contraindi-
cations are present, as these responses may aid in treatment decisions
 Introduction to Clinical Pathology 5

(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 athletes 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, uri-
nary, 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. Condi-
tions 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 athletes 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 athletes vital signs should be
monitored every 15 minutes. It is also helpful to be able to compare an
6 INTRODUCTION TO GENERAL MEDICAL CONDITIONS

athletes vitals to a set of baseline values taken during a preparticipation

physical examination.
Neurological conditions that present with symptoms associated with
changes to a persons brain stem function, such as cranial nerve alter-
ations, 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 persons weight, changes in a persons 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 persons 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
 Introduction to Clinical Pathology 7

Severe or progressive dizziness

Severe malaise or fatigue

In general, symptoms that are not well localized, have no injury asso-
ciated 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 recommenda-
tions indicating which conditions should disqualify an athlete from par-
ticipation, each athlete as well as their guardian(s) should work closely
with a physician to make an educated and informed decision on an indi-
vidual 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 par-
ticipate 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
8 INTRODUCTION TO GENERAL MEDICAL CONDITIONS

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
 Introduction to Clinical Pathology 9

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).
OConnor, D.P., and A.L. Fincher. 2015. Clinical Pathology for Athletic Trainers:
Recognizing Systemic Disease. 3rd ed. Thorofare, NJ: Slack.
 Index
abdominal pain, 51
abdominal problems, 8
abdominal trauma, digestive system,
52
acetaminophen, pain relievers, 22
acne, dermatology, 84
acute erosive gastritis (AEG), 54
acute pancreatitis, endocrine system,
81
Addisons disease, endocrine system,
78
adenoma, endocrine system, 78
airway obstruction, asthma, 34
Alzheimers disease, 70
allergic rhinitis. See hay fever
amenorrhea, reproductive system, 62
amyotrophic lateral sclerosis (ALS),
71
anisocoria, eye, 100
anti-anxiety, pharmacology, 17
antibiotics, pharmacology, 18
antidepressants, pharmacology, 18
antifungals, pharmacology, 19
antihistamines, pharmacology, 19
antivirals, pharmacology, 1920
aortic valve stenosis, cardiovascular
condition, 43
appendicitis, digestive system, 5253
arthrogram, 11
asthma, respiratory system, 3435
atopic dermatitis, 86
basal cell carcinoma, dermatology,
8485
bladder infections (cystitis), 58
boils. See carbuncles/furuncles
body systems. See also specific
conditions
cardiovascular conditions, 41
integumentary (skin) system, 83
bone densitometry (DXA scan), 13
bone scan (scintigraphy), 12
breast injuries, reproductive system,
63
bronchitis, respiratory system, 35
candidiasis, reproductive system, 63
carbuncle/furuncle, dermatology, 86
cardiac arrhythmias, cardiovascular
condition, 43
cardiovascular conditions, 7, 4142
anatomy, 42
aortic valve stenosis, 43
cardiac arrhythmias, 43
commotio cordis, 44
congenital coronary artery
abnormalities, 44
coronary artery disease, 45
HCM, 46
hypertension, 4546
hypotension, 4647
Marfan syndrome, 47
myocardial infarction, 48
shock, 49
stroke, 49
syncope, 48
cauliflower ear. See hematoma auris
causalgia, 72
cellulitis, dermatology, 85
central nervous system conditions, 8
cerebral palsy (CP), 71
cerebral vascular accident (CVA), 49
chief complaint, medical history, 5
chronic erosive gastritis (CEG), 54
chronic pancreatitis, endocrine
system, 81
circulatory shock, 49
clinical diagnoses, 4
clinical pathology
defined, 34
medical disqualifications, 79
medical history, 47
closed head injury/concussion,
neurological system, 7172
114 Index

cold, contagious illness, 2526 herpes simplex, 88

cold remedies, pharmacology, 20 herpes zoster, 8889
colitis, digestive system, 53 hives, 89
common illnesses, 25 impetigo, 8990
commotio cordis, cardiovascular mole, 9192
condition, 44 molluscum contagiosum, 9091
complete blood count (CBC), 12 pediculosis, 92
complex regional pain syndrome, psoriasis, 93
7273 rosacea, 9394
computerized tomography scabies, 94
(CT/CAT), 12 sunburn, 9495
congenital coronary artery tinea pedis, 95
abnormalities, cardiovascular tinea versicolor, 96
condition, 44 verruca (warts), 9697
conjunctivitis, eye, 100 diabetes mellitus, endocrine system,
constipation, digestive system, 5354 7980
contact dermatitis, 86 diagnosis, defined, 4
contagious illness diarrhea, digestive system, 54
cold, 2526 differential diagnoses, 4
influenza, 26 digestive system conditions, 5152
laryngitis, 2627 abdominal trauma, 52
mononucleosis, 27 anatomy, 51
pharyngitis, 27 appendicitis, 5253
rhinitis, 28 colitis, 53
sinusitis, 28 constipation, 5354
tetanus, 29 diarrhea, 54
tonsillitis, 29 gastritis/gastroenteritis, 5455
corneal abrasion, eye, 100101 GERD, 55
coronary artery disease, cardiovascular IBS, 5556
condition, 45 peptic ulcer, 56
corticosteroids, pharmacology, 2021 dry eye, 101
cough, whooping, 38 dysmenorrhea, reproductive system,
cryptorchidism, reproductive system, 64
64 DXA scan (bone densitometry), 13
Cushings syndrome, endocrine
system, 79 ear conditions
cyst, epidermoid, 87 anatomy, 107
cystitis (bladder infections), 58 hematoma auris, 108
labyrinthitis, 108
dermatitis/eczema, dermatology, 8687 Menieres disease, 108109
dermatological conditions otitis externa, 109
acne, 84 otitis media, 109110
anatomy of skin, 83 perforated/ruptured tympanic
basal cell carcinoma, 8485 membrane, 110
carbuncle/furuncle, 86 electrocardiography (EKG/ECG), 13
cellulitis, 85 electromyography (EMG), 13
dermatitis/eczema, 8687 endocrine system conditions, 7778
epidermoid cyst, 87 Addisons disease, 78
folliculitis, 8788 adenoma, 78
 Index 115
anatomy, 77
Cushings syndrome, 79
diabetes mellitus, 7980
hyperthyroidism, 80
hypothyroidism, 8081
pancreatitis, 81
epidermoid cyst, dermatology, 87
epididymitis, reproductive system, 65
epidural hematomas 74
epilepsy, neurological system, 73
etiology, defined, 4
exhalation process, 34
eye conditions
anatomy, 99
anisocoria, 100
conjunctivitis, 100
corneal abrasion, 100101
dry eye, 101
glaucoma, 101102
globe rupture, 102
hyphema, 102103
macular degeneration, 103
orbital fracture, 103
retinal detachment, 104
strabismus, 104
stye, 104105
family history, 5
FAST acronym (stroke), 49
fever, hay, 3536
flu. See influenza
fluoroscopy, 14
folliculitis, dermatology, 8788
furuncle/carbuncle, dermatology, 86
gastritis/gastroenteritis, digestive
system, 5455
gastroesophageal reflux disease
(GERD), digestive system, 55
general illness, 8
glaucoma, eye, 101102
globe rupture, eye, 102
gynecomastia, reproductive system, 65
hay fever, respiratory system, 3536
heart arrhythmia, 43
hematological conditions, 8
hematoma, 7374
hematoma auris, ear, 108
hemorrhaging/bleeding, 73
herpes simplex, dermatology, 88
herpes zoster, dermatology, 8889
hives, dermatology, 89
hydrocele, reproductive system, 65
hyperglycemia, endocrine system, 79
hypertension, cardiovascular
condition, 4546
hyperthyroidism, endocrine system,
80
hypertrophic cardiomyopathy
(HCM), cardiovascular
condition, 46
hyperventilation, respiratory system,
36
hyphema, eye, 102103
hypoglycemia, endocrine system, 79
hypotension, cardiovascular
condition, 4647
hypothyroidism, endocrine system,
8081
impetigo, dermatology, 8990
influenza, contagious illness, 26
insulin dependent, endocrine system,
79
intracranial bleeding, neurological
system, 7374
irritable bowel syndrome (IBS),
digestive system, 5556
labyrinthitis, ear, 108
laryngitis, contagious illness, 2627
lice (pediculosis), 92
lockjaw. See tetanus
Lou Gehrigs disease. See amyotrophic
lateral sclerosis (ALS)
macular degeneration, eye, 103
magnetic resonance imaging (MRI),
14
Marfan syndrome, cardiovascular
condition, 47
medical disqualifications, 79
medical history, 45
components, 5
severity and red flag warnings, 57
medical procedures
arthrogram, 11
116 Index
bone scan, 12
complete blood count, 12
computerized tomography, 12
DXA scan, 13
electrocardiography, 13
electromyography, 13
fluoroscopy, 14
MRI, 14
urinalysis, 1415
X-ray, 15
Menieres disease, ear, 108109
meningitis, neurological system, 74
migraine, neurological system, 75
mild traumatic brain, neurological
system, 7172
mole, dermatology, 9192
molluscum contagiosum,
dermatology, 9091
mononucleosis, contagious illness, 27
multiple sclerosis (MS), neurological
system, 7576
muscle relaxers, pharmacology, 21
myocardial infarction, cardiovascular
condition, 48
neurogenic bladder, urinary system,
5859
neurological conditions, 6
neurological diseases, 69
neurological system conditions
ALS, 71
Alzheimers disease, 70
anatomy, 6970
cerebral palsy, 71
closed head injury/concussion,
7172
complex regional pain syndrome,
7273
epilepsy, 73
intracranial bleeding, 7374
meningitis, 74
migraine, 75
multiple sclerosis, 7576
neurological diseases, 69
Parkinsons disease, 76
non-insulin dependent, endocrine
system, 79
non-steroidal anti-inflammatory drugs
(NSAIDs), pharmacology,
2122
oligomenorrhea, reproductive system,
6667
orbital fracture, eye, 103
otitis externa, ear, 109
otitis media, ear, 109110
pain relievers, pharmacology, 22
pancreatitis, endocrine system, 81
Parkinsons disease, neurological
system, 76
past history, 5
pathogenesis, defined, 34
pathology, defined, 3
pediculosis, dermatology, 92
pelvic inflammatory disease (PID),
reproductive system, 66
penile injuries, reproductive system,
66
peptic ulcer, digestive system, 56
perforated/ruptured tympanic
membrane, ear, 110
peripheral nervous system, 69
pertussis (whooping cough), 38
pharmacology
anti-anxiety, 17
antibiotics, 18
antidepressants, 18
antifungals, 19
antihistamines, 19
antivirals, 1920
cold remedies, 20
corticosteroids, 2021
muscle relaxers, 21
NSAIDs, 2122
pain relievers, 22
stimulants, 23
pharyngitis, contagious illness, 27
pneumonia, respiratory system, 3637
pneumothorax, respiratory system, 37
present history, 5
psoriasis, dermatology, 93
Red Flag, signs and symptoms, 67
reflex sympathetic dystrophy (RSD),
72
reproductive system conditions,
6162
amenorrhea, 62
breast injuries, 63
 Index 117

candidiasis, 63 Steinberg sign (Marfan syndrome), 47

cryptorchidism, 64 stimulants, pharmacology, 23
dysmenorrhea, 64 strabismus, eye, 104
epididymitis, 65 stroke, cardiovascular condition, 49
female anatomy, 61 stye, eye, 104105
gynecomastia, 65 subdural hematomas 74
hydrocele, 65 sunburn, dermatology, 9495
male anatomy, 62 swimmers ear. See otitis externa
oligomenorrhea, 6667 symptom, defined, 4
penile injuries, 66 syncope, cardiovascular condition, 48
PID, 66
spermatic cord torsion, 67 tetanus, contagious illness, 29
vaginitis, 67 tinea capitis/corporis/tinea cruris/
varicocele, 68 tinea pedis, 95
respiratory system conditions, 8, tinea versicolor, dermatology, 96
3334 tonsillitis, contagious illness, 29
anatomy, 3334 trauma, abdominal, 52
asthma, 3435
bronchitis, 35 ulcer, peptic, 56
hay fever, 3536 upper respiratory tract infection
hyperventilation, 36 (URTI/URI), 37
pertussis, 38 urethritis, urinary system, 59
pneumonia, 3637 urinalysis, 1415
pneumothorax, 37 urinary system conditions, 57
URTI/URI, 37 anatomy, 57
VCD, 38 cystitis/bladder infections, 58
retinal detachment, eye, 104 kidney stones, 58
review of systems, 5 neurogenic bladder, 5859
rhinitis, contagious illness, 28 urethritis, 59
rosacea, dermatology, 9394 UTI, 59
urinary tract infection (UTI), 59
scabies, dermatology, 94
scintigraphy (bone scan), 12 vaginitis, reproductive system, 67
sensory concerns, 8 varicocele, reproductive system, 68
severity/seriousness, medical verruca (warts), dermatology, 9697
condition, 56 viral meningitis 74
shock, cardiovascular condition, 49 vocal cord dysfunction (VCD),
sign, defined, 4 respiratory system, 38
single organ concerns, 9
sinusitis, contagious illness, 28
skin disorders, 9 Walker-Murdoch sign (Marfan
skin system, 83. See also syndrome), 47
dermatological conditions warts (verruca), dermatology, 9697
social history, 5 whooping cough (pertussis), 38
spermatic cord torsion, reproductive
system, 67 X-ray, 15