week 05 - pathology internal 3

7/30/2019 Week 05 - Pathology Internal 3

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Pathology

Internal and Pediatric Disease

Surgical and Dermatologic Disease

Headache

Wind , Heat,

Excessive Liver Yang

Phlegm , Dampness

KI qi deficiency


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1. Tension Headache

:,,


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Tension Headache

Tight feeling in head or neck muscles

A tightening band-like sensation around the neckand/or head

A constant dull, achy feeling on both sides of the head

Pain that primarily occurs in the forehead, temples orthe back of the head and/or neck

Chronic tension-type headacheschanges in sleeppatterns or insomnia

early morning or late day headache

fatigue, nausea.

Tension Headache

()


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Migraine Headache

Migraine w/o aura

Attacks lasting 4-72

hours

At least 2 of

- unilateral

- pulsating

- moderate to severe

- aggravated by

movement

At least one of

- Nausea

- Photophobia

- Phonophobia

(

)


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A temporary blind spot

Blurred vision

Eye pain

Seeing stars or zigzag

lines

Tunnel vision

.

.

Aura


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Cluster Headache

> ()

Hypothalamus


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Sinus Headache

,,

Yang Ming

Shao yang

Tai Yang

Jue Yin


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Headache

GB 20

Vertex headache : + Du 20 , LV3

Temporal headache : + Tai Yang, GB8, SJ3

Frontal headache : + GB14, UB2, LI4

Occipital headache : + UB10, SI3

Erysipelas

Blisters

Fever, shaking, and chills

Painful, very red, swollen,and warm skinunderneath the sore(lesion)

Skin lesion with a raisedborder

Sores (erysipelas lesions)on the cheeks and bridgeof the nose


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Erysipelas

Group A (or rarely group C or G) -hemolytic

streptococci

shiny, raised, indurated, and tender plaque-

like lesions with distinct margins.

Herpes Zoster

Angioedema

Contact Dermatitis


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Cupping and Letting blood

.

Furuncle (Boil),

TCM

1.

Heat toxin

2.


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Furuncles

Carbuncles

Furuncle

Merck

staphylococcal infection

Both furuncles and carbuncles may affect

healthy young people but are more common

in the obese, the immunocompromised

(including those with neutrophil defects), the

elderly, and possibly those with diabetes.


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(2010 Feb.)

Impetigo- Infectious eruptions offlaccid pustules, which rupture to form a thick

honey-colored to brow crust. staphylococcus

Acute Mastitis

Baby blowing wind against the breast

Or heat collecting

LV qi stagnation Blood stagnation

Damp Heat collect


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Acute Mastitis

Staphylococcal species are the most common 1

s/s

high fever

Erythema

Tenderness

Pain swelling, and warmth to the touch

Acute Mastitis

Staphylococcal infections

usually produce a

localized area of acute

inflammation that may

progress to the formationof single or multiple

abscesses.

Streptococcal infections

tend to cause a diffuse

spreading infection that

eventually involves the

entire breast. The involved breast tissue

is infiltrated by

neutrophils and may be

necrotic.


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Tetanus Lockjaw

Tetanus

S/S

Jaw stiffness (mostfrequent)

Difficulty swallowing

Restlessness

Irritability Stiff neck, arms, or legs

Headache

Sore throat

Tonic spasms

Opisthotonos opistho "behind

tonos "tension

Hyperextension


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Tetanus

Clostridium tetani.

exotoxin(tetanospasmin)

-

PNSCNS

DTaP vaccine is a "3-in-

1" vaccine that protects

against

Diphtheria

Pertussis

Tetanus


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Acute Appendicitis

S/S Chills

Constipation

Diarrhea

Fever

Loss of appetite

Nausea

Shaking Vomiting

Acute appendicitis

CT scan : B- appendicitis


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McBurney Point

ASIS (anterior superior

iliac spine) to the

umbilicus (the belly

button).

ASIS 1/3

reffered pain

Obstruction - appendiceal lumen

mucus production intraluminal pressure

Bacteria trapped within the lumen

multiply and the appendix becomes distended

Venous congestion and edema

12 hours after onset, the inflammatory process

may spread through the wall of the VA.

Peritoneal irritation then develops.
http://en.wikipedia.org/wiki/File:Surface_projections_of_the_organs_of_the_trunk.png


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Acute intestinal obstruction

Stag Qi, blood, cold, heat, or parasitic

organisms collecting in the intestinal tract and

blocking passage

Acute Intestinal Obstruction

: ,,(),,

or,,,,,()

Anticholinergic:The action of certain medications that inhibit thetransmission of parasympathetic nerve impulses and therebyreduce spasms of smooth muscle


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Intestinal strangulation

TCM: Small Intestine Patterns

1. Qi Pain

Acute twisting pain of thelower abdomen

Abdominal distension

Borborygmus

Flatulence

Bearing down pain in thetestes

Referring to the lumbar region

Hernia

2. Qi Tied

Sudden violent abdominalpain

Dislike of pressure

Abdominal distension

Constipation

Borborygmi Flatulence

Vomiting

Appendicitis


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Worms(Small intestine pattern)

Abdominal pain and distension, bad taste in

mouth, shallow complexion

1. roundworm : abdominal pain, vomiting

roundworm, cold limbs

2. hookworm : eat strange objects

3. pinworm : itchy anus, worse in the evening

4. tapeworm : constant hunger

. ^^


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Acute perforation of gastric and duodenal ulcer

,

Phlegm lodging in ST Irregular eating habit

Emotional frustration

Excessive fatigue

Cold excess invading

and the coagulated

blood obstruction MJ

Closure of the interior

and exhaustion of theExterior

,

sudden severe painradiate to the shoulder

Looks very ill

rapid heart rate

Sweating

an abdomen that istender and firm to thetouch


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Acute disease of the biliary tract

Acute cholecystitis

Gall stone

Roundworm

Emotional problem

Irregular eating habits

External excesses

Damp heat

Liver and Gall bladder

Acute cholecystitis

Be sharp, cramping, or

dull

Come and go

Spread to the back or

below the right

shoulder blade

Occur within minutes of

a meal

Abdominal fullness

Clay-colored stools

Fever

Nausea and vomiting

Yellowing of skin andwhites of the eyes

(jaundice)


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Murphy's sign

Pain is felt during

inhalation or coughing

when the physician

palpates your RUQ due

to the inflammation of

the gallbladder. ,


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Clinical Findings Biliary Colic Acute Cholecystitis

Right upper quadrant

pain

Present Present

Abdominal

tenderness

Absent to mild Moderate to severe,

especially over the

liver or gallbladder

(Murphy's sign)

Fever Absent Usually present

Leukocytosis Absent Usually > 11,000/l

Duration of

symptoms

< 4 hr > 6 hr

Ultrasound Gallstones Gallstones,

thickening of the

gallbladder wall

Hemorrhoids

.

UB30 (Bai Huan Shu)

DU1 (Chang qiang)

UB57 (Cheng Shan)


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Buergers disease

TCM

Invasion by cold and dampness

Lodge in the channel and obstruct the passageof Qi and Blood

Tobacco and alcohol

Activating the blood so as to clear the channels

Buergers disease


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Thromboangiitis Obliterans

20~ 40,

claudication of the foot :,

ulcerations
http://www.mayoclinicproceedings.com/content/82/4/448/F1.large.jpg


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1.?

2.

Raynaud's Phenomenon

Emotional Stress

Cold

Vasoconstriction
http://upload.wikimedia.org/wikipedia/commons/f/fc/Raynaud's_Syndrome.jpg


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Scleroderma

Scleroderma

CREST

2010/FEB.

/

Dry Cough

Shortness of breath Wheezing


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Blanching, blueness, or redness

of fingers and toes in response toheat and cold (Raynaud'sphenomenon)

Hair loss

Skin hardness

Skin is abnormally dark or light

Skin thickening and shiny handsand forearm

Small white lumps beneath theskin

Tight and mask-like facial skin Ulcerations on fingertips or toes

Joint pain

Numbness and pain in the feet

Pain, stiffness, and swelling offingers and joints

Wrist pain

Bloating after meals

Constipation

Diarrhea

Difficulty swallowing

Esophageal reflux or heartburn Weight loss


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3

A, Generalized morphea. B, Diffuse edema of hands. C, Firm, thickened skin. D, Flexion

contractures of fingers. E, Raynaud's phenomenon (pallor phase). F, Ischemic digital ulcer. G,

Telangectasias on the face (a), dorsum of the hand (b), mucosa (c). H, Calcinosis cutis.

Urinary Tract Infection

1. KI def

2. damp heat collect inL.J

- Spreading the UB qiand clearing L.J. of heatand dampness

95% ascending


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3

UTI

Acute Cystitis Pressure in the lower pelvis

Painful urination

Frequent need to urinate

Urgent need to urinate

Decreased ability to holdurine

Need to urinate at night

Abnormal urine color --cloudy

Blood in the urine

Foul or strong urine odor

Pyelonephritis Back pain or flank pain

Chills with shaking

Severe abdominal pain(occurs occasionally)

Fatigue

Fever

General ill feeling

Chills with shaking

Mental changes orconfusion*

Skin changes

Kidneys (acute pyelonephritis)

Upper back and side (flank)

pain

High fever

Shaking and chills

Nausea

Vomiting

Bladder (cystitis)

Pelvic pressure

Lower abdomen discomfort

Frequent, painful urination

Blood in urine

Urethra (urethritis) Burning with urination


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3

Escherichia coli (E. coli) 75%

,,

Cystitis-

Pyelonephritis

TCM : Renal Colic

Stone Urinary dysfunction

- Damp heat collecting forming stone

Spreading and draining the contents of the

water passageways by eliminating Dampness

and Heat


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3

Renal Colic

CT

Renal Stone(renal lithiasis)

1.,.

2. 80%+(calcium oxalate or calciumoxalate mixed with calcium phosphate)

3. ()

4. 50% ()


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3

1. Calcium stones

High oxalate levels in some fruits and vegetables,

in nuts and chocolate.

Your liver also produces oxalate.

Dietary factors, high doses of vitamin D

intestinal bypass surgery

several different metabolic disorders can increase

the concentration of calcium or oxalate in urine. Calcium stones calcium phosphate.

Foods that contain oxalates

Fruits blackberries, blueberries, raspberries, strawberries, currants(),

kiwifruit, concord (purple) grapes, figs, tangerines, plums

Vegetables spinach, Swiss chard(), beet greens(), collards(),

okra, parsley, leeks and quinoa

celery, green beans, rutabagas, and summer squash

Nuts and seeds

almonds, cashews, peanuts Legumes

soybeans, tofu, soy products

Grains wheat bran, wheat germ, quinoa

Other cocoa, chocolate, and black tea

Quinoa

Rutabagas


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3

2. Struvite stones

UTI

.

3. Uric acid stones

Uric acid stones can form in people who are

dehydrated, those who eat a high-protein

diet and those with gout.

Certain genetic factors and disorders of the

blood-producing tissues also may predisposeyou to uric acid stones.


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3

Gout.

Puricil

:
http://4.bp.blogspot.com/_pMxMXFn7L-4/Sdclrps0BjI/AAAAAAAAFec/wKbzeOTdLrQ/s1600-h/gotamao.gifhttp://2.bp.blogspot.com/_pMxMXFn7L-4/Sdc3hDnILpI/AAAAAAAAFe0/252sFtDjwJM/s1600-h/Podagra.jpghttp://4.bp.blogspot.com/_pMxMXFn7L-4/Sdclr0MvB1I/AAAAAAAAFek/hZ917an1Lrw/s1600-h/gout_labeled.jpg


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Severe pain in the side and back, below the ribs

Pain that spreads to the lower abdomen and

groin

Pain on urination

Pink, red or brown urine

Nausea and vomiting

Persistent urge to urinate Fever and chills if an infection is present

TCM

UB 23, SP6

,,

Jumping Exercise

week 05 - pathology internal 3

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