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SYMPTOMS

SYMPTOMS. Symptomatology. imaging. What ’ s the bad? DiscomfortFever? Headache? Dyspnea? Chest pain? …… symptoms. Doctor,I feel bad!. Symptom: Subjective disturbances that arise from diseases. . Symptoms . General symptoms Respiratory system Circulatory system

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SYMPTOMS

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  1. SYMPTOMS

  2. Symptomatology • imaging What’s the bad? DiscomfortFever? Headache? Dyspnea? Chest pain? …… symptoms Doctor,I feel bad!

  3. Symptom: Subjective disturbances that arise from diseases.

  4. Symptoms • General symptoms • Respiratory system • Circulatory system • Digestive system • Kidney and urinary system • Hematologic system • Endocrine system

  5. General Symptoms • Fever • Edema • Fatigue • Weight reduction • 。。。。

  6. Fever • Upward shift of temperature. • Normal body temperature: • Axilla,rectal,oral

  7. Fever • How it happens?

  8. Etiology • Infective fever • Viruses,bacteria,fungi,parasite

  9. Non-infective fever • Connective tissue disorders • Hypersensitive reaction • Endocrinologic disease • Neoplasms • Hemorrhage or thromboembolic disease • Central fever • Others

  10. Physiology: • Activity,ovulation,smoking,…… • In the morning,elder,……

  11. Clinical manifestation • Low:37.4-38℃ • Middle:38.1-39℃ • High:39.1-41℃ • Excessively high:＞41℃

  12. Fever type • Type of temperature curve 1. Continuous fever T 39-40℃ continue for days and fluctuation ＜1℃

  13. 2. Remittent Fever Fever continue for days, fluctuation ＞2℃,does not fall to normal. & Rheumatic fever

  14. 3. Intermittent (Periodic )Fever T rises for several hrs and fall to normal or below & Malaria

  15. 4.Undulant fever • T rises last for 7-14 days and falling to normal,recurring over weeks or months. • & Brucella infection

  16. 5.Relapsing fever • T rises abruptly for days and falls abruptly to normal. • & Lymphoma

  17. 6.Irregular fever Irregular curve & Bronchopneumonia

  18. Fever • Accompany symptoms • Rigor or shivering attack • Rash • Tachycadia • Splenomegaly or lymphadenopathy • Facial feature

  19. Inquiry??? • Fever of unknown origin, FUO

  20. Edema • Defination: Excessive collection of fluid in the interstitial space.

  21. Mechanism of edema • Hydrostatic pressure • Oncotic pressure • Disrupted capillary permeability

  22. Etiology • Localized edema • & Deep vein thrombophlebitis

  23. Generalized edema • Congestive heart failure • Liver disease • Kidney • Idiopathic

  24. 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 • ——————————————————

  25. 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

  26. Pulmonary system • Cough and expectoration • Wheezing • Hemoptysis • Cyanosis • Dyspnea • Chest pain

  27. 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

  28. 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

  29. Dyspnea • Subjective sensation of shortness of breath • Important manifestation of cardiopulmonary disease

  30. Acute dyspnea • Pulmonary diseases: pneumonia, asthma, pulmonary embolus, spontaneous pneumothorax • Cardiopumonary edema • Acute hyperventilation syndrome is a relatively frequent neuropsychiatric cause of dyspnea

  31. Chronic dyspnea • Chronic obstructive airway disease • Chronic bronchitis,… • Restrictive lung disease • Interstitial lung disease,… • Nonpulmonary disease • Congestive heart failure • Anemia • Hyperthyroidism • …

  32. Some types of dyspnea • Exertional dyspnea • Acute pulmonary edema • Orthopnea • Paroxysmal nocturnal dyspnea • Cardiac asthma

  33. Hemoptysis • It is the expectoration of blood or bloody sputum. • The most common cause: • Bronchitis,bronchiectasis and bronchogenic carcinoma

  34. Differentiation of hemoptysis and hematemesis -------------------------------------------------------------- hemoptysis hematemesis -------- ------------------------------------------------------ History respiratory disease indigestion Presymptoms cough nausea Color bright red dark red or brown Contents alveolar macrophages food particle pH high low Hematochezia (-) (+) Postproduction stained for days no Confirmed by bronchoscopy gastroscopy ----------------------------------------------------------------------

  35. Hemoptysis • Accompany findings • Fever • Chest pain • Cough • Purulent sputum • Skin or mucosal hemorrhage • LHF？

  36. Cyanosis • A bluish color of the skin and mucous membranes

  37. 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.

  38. Cardiovascular system • Palpitation • Chest pain • Dyspnea • Cyanosis • Fatigue • Syncope

  39. 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

  40. Chest pain • Cardiovascular disease • Angina pectoris • Acute myocardial infarction • Pericarditis • Dissecting hematoma of the aorta • The most important symptom of cardiac disease • Angina pectoris is the true symptom of CHD.

  41. Always ask the patient what they were doing when the pain came on. 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

  42. 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

  43. Thanks for your attention!

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