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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!