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SYMPTOMS
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Symptomatology
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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
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General symptoms
Respiratory system
Circulatory system
Digestive system
Kidney and urinary system
Hematologic system
Endocrine system
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General Symptoms
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Fever
Edema
Fatigue
Weight reduction
。。。。
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Fever
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Upward shift of temperature.
Normal body temperature:
Axilla,rectal,oral
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Fever
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How it happens?
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Etiology
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Infective fever
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Viruses,bacteria,fungi,parasite
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Non-infective fever
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Connective tissue disorders
Hypersensitive reaction
Endocrinologic disease
Neoplasms
Hemorrhage or thromboembolic disease
Central fever
Others
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Physiology:
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Activity,ovulation,smoking,……
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In the morning,elder,……
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Clinical manifestation
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Low:37.4-38℃
Middle:38.1-39℃
High:39.1-41℃
Excessively high:＞41℃
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Fever type
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Type of temperature curve
1. Continuous fever
T 39-40℃ continue for days and fluctuation ＜
1℃
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2. Remittent Fever
Fever 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
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T rises abruptly for days and falls abruptly to normal.
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& Lymphoma
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6.Irregular fever
Irregular curve
& Bronchopneumonia
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Fever
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Accompany symptoms
Rigor or shivering attack
Rash
Tachycadia
Splenomegaly or lymphadenopathy
Facial feature
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Inquiry???
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Fever of unknown origin, FUO
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Edema
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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
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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
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开始部位
从眼睑、颜面开始
心原性水肿
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从足部开始
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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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——————————————————
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水肿的诊断
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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
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Cough and expectoration
Wheezing
Hemoptysis
Cyanosis
Dyspnea
Chest pain
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Cough
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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)
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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
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Subjective sensation of shortness of
breath
Important manifestation of
cardiopulmonary disease
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Acute dyspnea
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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
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Chronic obstructive airway disease
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Restrictive lung disease
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Chronic bronchitis,…
Interstitial lung disease,…
Nonpulmonary disease
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Congestive heart failure
Anemia
Hyperthyroidism
…
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Some types of dyspnea
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Exertional dyspnea
Acute pulmonary edema
Orthopnea
Paroxysmal nocturnal dyspnea
Cardiac asthma
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Hemoptysis
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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
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
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Hemoptysis
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Accompany findings
Fever
Chest pain
Cough
Purulent sputum
Skin or mucosal hemorrhage
LHF？
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Cyanosis
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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
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Palpitation
Chest pain
Dyspnea
Cyanosis
Fatigue
Syncope
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Chest pain
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A common symptom of many diseases
Different causes of chest pain
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Pulmonary disease
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Musculoskeletal disease
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Pheumothorax,pneumomia,pulmonary embolism,
Rib fracture,osteoarthritis,herpes zoster
Esophageal and other gastrointestinal disease
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esophagitis,esophageal spasm
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Chest pain
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Cardiovascular disease
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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.
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Chest pain
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Angina for example
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Always ask the
patient what
they were
doing when the
pain came on.
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
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Chest pain
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Progression:resolves on resting or with
sublingual nitroglycerin
Associated symptoms:dispnea
risk factors:smoking,family
history,diabetes,hypertension,
Examination
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Electrocardiogram(ECG)
Chest x-ray
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Thanks for your attention!
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