1 symptoms. 2 symptomatology imaging doctor,i feel bad! what ’ s the bad? discomfortfever?...
TRANSCRIPT
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SYMPTOMS
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Symptomatology imaging
Doctor,I feel bad!
What’s the bad?
DiscomfortFever?Headache? Dyspnea?
Chest pain?……
symptoms
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Symptom: Subjective disturbances that
arise from diseases.
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Symptoms General symptoms Respiratory system Circulatory system Digestive system Kidney and urinary system Hematologic system Endocrine system
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General Symptoms Fever Edema Fatigue Weight reduction 。。。。
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Fever Upward shift of temperature.
Normal body temperature: Axilla,rectal,oral
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Fever How it happens?
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Etiology Infective fever
Viruses,bacteria,fungi,parasite
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Non-infective fever Connective tissue disorders Hypersensitive reaction Endocrinologic disease Neoplasms Hemorrhage or thromboembolic disease Central fever Others
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Physiology: Activity,ovulation,smoking,……
In the morning,elder,……
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Clinical manifestation
Low:37.4-38℃ Middle:38.1-39℃ High:39.1-41℃ Excessively high: > 41℃
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Fever type Type of temperature curve
1. Continuous feverT 39-40℃ continue for days and fluctuation < 1℃
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2. Remittent FeverFever continue for days, fluctuation >
2℃,does not fall to normal.& Rheumatic fever
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3. Intermittent (Periodic ) Fever
T rises for several hrs and fall to normal or below
& Malaria
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4.Undulant fever
T rises last for 7-14 days and falling to normal,recurring over weeks or months.
& Brucella infection
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5.Relapsing fever
T rises abruptly for days and falls abruptly to normal.
& Lymphoma
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6.Irregular feverIrregular curve& Bronchopneumonia
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Fever
Accompany symptoms Rigor or shivering attack Rash Tachycadia Splenomegaly or
lymphadenopathy Facial feature
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Inquiry???
Fever of unknown origin, FUO
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Edema Defination: Excessive collection of
fluid in the interstitial space.
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Mechanism of edema Hydrostatic pressure Oncotic pressure Disrupted capillary permeability
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Etiology Localized edema & Deep vein thrombophlebitis
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Generalized edema Congestive heart failure Liver disease Kidney Idiopathic
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心原性水肿与肾原性水肿的鉴别 肾原性水肿 心原性水肿
──── ———————————— ——————————
开始部位 从眼睑、颜面开始 从足部开始 发展快慢 发展常迅速 发展较缓慢 水肿性质 软而移动性大 比较坚实 移动性较小 伴随病征 伴有其他肾脏病病征 伴有心功能不全病征 ( 高血压、蛋白尿、血尿、管型 ) 心脏增大、心杂音、肝肿
大 ——————————————————
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水肿的诊断
1. 是否水肿 2. 全身性 or 局限性 3. 压陷性 or 非压陷性 4. 炎症性 or 非炎症性 5. 水肿的程度
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Pulmonary system Cough and expectoration Wheezing Hemoptysis Cyanosis Dyspnea Chest pain
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Cough The most commom symptom of lung
disease The cough reflex is a normal defense
mechanism of lungs that protects them from foreign bodies and excessive secretions.
Coughing may be voluntary or involuntary, productive or nonproductive.
Smoking :the most common cause of the chronic caugh
Coughing may be psychogenic
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Expectoration(sputum production) Normally approximately 75-100ml of
sputum is secreted by the bronchi daily An increase in the quantity of sputum
production: early manifestation of bronchitis
Sputum should be described according to color, consistency, quantity, number of times daily, and the presence of blood.
Mucoid and purulent
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Dyspnea Subjective sensation of shortness
of breath Important manifestation of
cardiopulmonary disease
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Acute dyspnea Pulmonary diseases: pneumonia,
asthma, pulmonary embolus, spontaneous pneumothorax
Cardiopumonary edema Acute hyperventilation syndrome is a
relatively frequent neuropsychiatric cause of dyspnea
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Chronic dyspnea Chronic obstructive airway disease
Chronic bronchitis,… Restrictive lung disease
Interstitial lung disease,… Nonpulmonary disease
Congestive heart failure Anemia Hyperthyroidism …
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Some types of dyspnea Exertional dyspnea Acute pulmonary edema Orthopnea Paroxysmal nocturnal dyspnea Cardiac asthma
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Hemoptysis It is the expectoration of blood or
bloody sputum. The most common cause: Bronchitis,bronchiectasis and
bronchogenic carcinoma
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Differentiation of hemoptysis and hematemesis
-------------------------------------------------------------- hemoptysis
hematemesis-------- ------------------------------------------------------History respiratory disease indigestionPresymptoms cough nausea
Color bright red dark red or brown
Contents alveolar macrophages food particlepH high lowHematochezia (-) (+)Postproduction stained for days noConfirmed by bronchoscopy gastroscopy----------------------------------------------------------------------
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Hemoptysis Accompany findings Fever Chest pain Cough Purulent sputum Skin or mucosal hemorrhage LHF ?
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Cyanosis A bluish color of the skin and
mucous membranes
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Central cyanosis: It results from arterial hypoxemia
caused by right-to-left cardiac shunt,pulmonary arteriovenous fistula,or acute or chronic pulmonary disease.
Peripheral cyanosis: It is caused by stagnant
circulation through the peripheral vascular bed.
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Cardiovascular system Palpitation Chest pain Dyspnea Cyanosis Fatigue Syncope
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Chest pain A common symptom of many diseases Different causes of chest pain
Pulmonary disease Pheumothorax,pneumomia,pulmonary embolism,
Musculoskeletal disease Rib fracture,osteoarthritis,herpes zoster
Esophageal and other gastrointestinal disease
esophagitis,esophageal spasm
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Chest pain Cardiovascular disease
Angina pectoris Acute myocardial infarction Pericarditis Dissecting hematoma of the aorta
The most important symptom of cardiac diseaseAngina pectoris is the true symptom of CHD.
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Chest pain
Angina for example Onset:typically builds up over a few
minutes,and may be brought on by exercise, emotion, or cold weather
Duraton:2 to 10 minutes Site and radiation: retrosternal pain, often
radiates to the left shoulder or arms especially
Intensity: moderate
Always ask the patient what they were doing when the pain came
on.
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Chest pain Progression:resolves on resting or
with sublingual nitroglycerin Associated symptoms:dispnea risk factors:smoking,family
history,diabetes,hypertension, Examination
Electrocardiogram(ECG) Chest x-ray
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Thanks for your attention!