Diagnosis of the formula + + treatment principles auxiliary examination ... ...diagnosis of the common formula
digestive symptoms: abdominal pain, diarrhea, nausea, vomiting, mass
1. acute and chronic gastritis = eating unclean or irritants + abdominal pain, bloating, nausea, vomiting
2. gastroesophageal reflux disease = acid reflux burning sensation + + retrosternal esophageal endoscopy erosion with a red strip (heartburn, acid reflux, back to food)
3. peptic ulcer disease
= chronic gastric ulcer on a regular abdominal pain (pain after a meal) + hematemesis melena
duodenal ulcer = hunger pain (more than 4 hours after the meal), or night pain + melena
peptic ulcer hematemesis perforation = sudden severe abdominal pain (peritonitis signs) + X ray of free gas below the diaphragm have
4. esophageal varices = upper gastrointestinal bleeding + past liver disease history
5. bacillary dysentery = unclean diet + abdominal pain + mucus pus and blood will + tenesmus
6. ulcerative colitis = left lower abdominal pain, pus and blood will mucin + + (will be Italy, and after mitigation) + antibiotics ineffective
therapy: sulfasalazine (SASP)
7. Acute pancreatitis (edema) = binge eating / history of chronic biliary abdominal pain + bend + sustained pain relief + amylase test
acute pancreatitis (hemorrhagic necrosis) = + waist and abdomen symptoms of edema or Cullen purple + paracentesis + washing liquid in water samples of meat with high glucose + low
hemorrhagic necrotizing calcium: urine amylase value is not necessarily high, sometimes it decreased. Select CT
week when diagnosed measured serum amylase, lipase measured more than a week
8. Pyloric obstruction = vomiting Sushi + vibration of water sounds
9. Cirrhotic portal hypertension + = history of hepatitis (spleen Big + ascites + spider) + ultrasound (liver shrink)
10. cholecystitis = paroxysmal and positive signs of right upper quadrant colic + Could + nausea and vomiting
11. cholelithiasis = paroxysmal right upper quadrant colic + Could + B Super echo the positive sign of light group, shadowing
12. Acute obstructive suppurative cholangitis = triad under the Ke (abdominal pain + fever + chills, jaundice) + performance + shock psychiatric symptoms (such as the look of indifference, coma) in five of the levy
13. abdomen
(1) appendicitis, right lower abdominal pain + = metastatic Maxwell point tenderness (pain, men Tong) + WBC increased
(2) intestinal obstruction: abdominal pain + vomiting + Expansion + closed + X line (Banana / fluid level)
causes: mechanical and dynamic
revascularization: simple and strangulated
level: complete and incomplete
parts: high and low
(3) history of gastrointestinal ulcer perforation = + sudden severe abdominal pain with peritoneal irritation + + subdiaphragmatic free gas
(4) Ectopic Pregnancy = postmenopausal vaginal bleeding + History + abdominal pain (cervical pain held) + human chorionic gonadotropin
(5) of ovarian cyst torsion = pain + sudden position changes and a cystic mass
(6) = curettage surgery of acute pelvic inflammatory disease + abnormal vaginal discharge lower abdominal pain + abdominal + pain (cervical pain held) + purulent discharge
14. digestive system tumors
(1) gastric = old + black + it + Kanying law change + chronic ulcer pain upper abdominal pain + abdominal mass + weight loss + left supraclavicular lymph nodes
(2) = progressive dysphagia of esophageal cancer (the late) + retrosternal burning pain (early) + food choking feeling (early)
(5) pancreatic cancer (pancreatic cancer, periampullary cancer) = old + pain + jaundice aggravated sexual clay color stool + skin itching
(6) colon cancer: old + change in bowel habits weight loss + + CEA + abdominal mass
15. anus, rectum benign lesions
(1) painless hemorrhoid = + it with bloody vein-like mass of blood +
(2) external hemorrhoids = anal pain + anus blood + tender will be mass
(3) when it will be after anal fissure = pain + anal anal fissure
16.
renal injury blunt abdominal trauma injury + hematuria
= waist traumatic hepatic rupture = right abdominal peritoneal irritation + + shifting dullness
rupture = left abdominal pain + abdominal injury + All
intestinal rupture = abdominal bleeding abdomen trauma + peritoneal irritation yellow liquid
+ puncture 17. hernia (inguinal hernia) = increased abdominal pressure elderly men + + + right lower abdomen into the scrotum tumor
digestive diseases for further examination
1. stomach Mirror, colonoscopy, colonoscopy
2. gastroenterography
3. Abdominal B-, CT
4. upright abdominal plain film
5. stool: routine examination, occult blood, culture and parasitic Check
6.HP worm detection
7. peritoneal puncture
8. lymph node biopsy or liver biopsy (case monitoring)
9. laboratory:
(1) urine amylase
(2) AFP, CEA, CA19-9 carbohydrate antigen
(3) urine routine examination, liver and kidney function, electrolytes, blood gas analysis
digestive treatment principles < br>
a general treatment: attention to rest, diet / fasting, life guidance
Second, the cause of treatment
(1) ulcer: PPI class of acid-suppressing drugs of choice can be added with mucosal protective agent, If H. pylori infection should be treated with combined sterilization, commonly used triple therapy or quadruple therapy: PPI, colloidal bismuth combined two antibiotics
(2) application of broad-spectrum antibiotics, anti-infection treatment, anti-shock
( 3) obstruction / peritonitis: fasting, gastrointestinal decompression
(4) to maintain water and electrolyte acid-base balance
three, four
symptomatic treatment, surgical: resection or repair
five tumors: 1 ) surgery
2) radiotherapy + chemotherapy + immunotherapy + Chinese medicine treatment
diagnosis of respiratory diseases formula
1. acute upper respiratory tract infection = sore throat + cough + fever
2. pneumonia
(1) Lobar = adult + cold + fever + cough rusty sputum
(2) Klebsiella pneumonia = cough brick-red sputum + X-ray film empty
(3) Mycoplasma pneumonia = cough + children + irritating + joint pain antibiotics ineffective
(4) = infants and young children with bronchial pneumonia breathing difficulties + fever + symptoms (nasal flap, three depressions sign positive)
(5), Staphylococcus aureus pneumonia, sepsis = heat + chest pain + sputum + X ray sheet film
3. Tuberculosis
(1) TB = young + hemoptysis + Afternoon + fever + night sweats antibiotic treatment had no significant effect < br> (2) = TB + TB pleurisy signs of pleural effusion (chest pain disappeared + percussion + fremitus real audio / breath sounds disappear)
(3) tuberculous pericarditis, pericardial effusion = TB + signs (heart before District pain + abdominal breathing difficulties Fullness + + lower extremity edema)
(4) intestinal tuberculosis = TB + abdominal symptoms (abdominal pain, diarrhea, right lower abdominal mass)
(5) TB = TB + abdominal peritonitis inflammation (abdominal pain, diarrhea, abdominal wall flexibility and a sense of)
(6) renal tuberculosis = TB + + bladder irritation, thinning of the renal parenchyma and destructive
4. bronchiectasis = childhood whooping cough or measles delayed healing of bronchial pneumonia purulent cough + history + + hemoptysis
5.COPD = old (smoking) + sputum + asthma + barrel chest pulmonary function tests, FEV1/FVC% less than a second rate of 70%
6 . abscess = smelly pus sputum + heat + X-ray films / CT shows fluid level
7. lung cancer = in + elderly + irritating cough, bloody sputum + weight loss + X ray burr
8. Cor = history of chronic lung disease + enlarged heart
Evolution order: chronic bronchitis - Emphysema - Pulmonary Heart Disease
9. paroxysmal bronchial asthma or recurrent wheezing + = auscultation wheezing allergy
10 + . respiratory failure, chronic lung disease = history of cyanosis + + blood gas analysis
I type: PaO2 <60mmHg PaCO2 normal - severe pneumonia induced
II Type: PaO2 <60mmHg PaCO2> 50mmHg-induced chronic obstructive pulmonary disease
11. chest blunt trauma
(1) tension pneumothorax chest trauma history + = extensive subcutaneous emphysema (grip snow flu) + offset + tracheal breath sound percussion drum sound + disappear
(2) = hemothorax tracheal trauma history + chest percussion dullness + offset + + X ray decreased breath sounds costophrenic angle disappeared, curved high density
(3) history of chest trauma and rib fractures = + bone fricative
respiratory disease surveillance project
1. chest X films, chest CT
2.PPD, ESR
3. sputum culture + sensitivity test, sputum Mycobacterium tuberculosis
find 4. lung function
5. liver and kidney function
6. Blood gas analysis
7. bronchoscopy
8. sputum cytology testing
9. lymph node biopsy
10. blood Conventional electrolyte
respiratory diseases treatment principles
1. General treatment: rest, nutrition, prevention of infection / oxygen
2. symptomatic treatment / drug treatment
(1) anti-infective therapy: use of broad spectrum antibiotics or combination therapy
(2) anti-TB treatment: early, regular, joint, rules, full
(3) anti-shock: expansion, the use of vascular active drug
(4) Control of hemoptysis: pituitrin
(5) fever, cough, asthma, expectorant
(6) correct the acid-base balance
3. tumors ( lung cancer)
(1) surgery
(2) radiotherapy + chemotherapy + immunotherapy + Chinese medicine treatment
diagnosis of circulatory system diseases formula
1 . coronary heart disease = chest pain narrowing
(1) = chest narrowing angina pain <30 minutes, 3-5-minute / second, + with rest or nitroglycerin can relieve mouth + ECG: ST segment horizontal depression
(2) MI = chest pain, narrowing of> 30 minutes, rest or mouth can not be relieved with nitroglycerin sense of impending doom + sweating + + ECG: ST segment elevation arched up < br> V1-6 extensive anterior wall myocardial infarction
V1-3 anteroseptal myocardial infarction
V3-5 limitations of anterior myocardial infarction
V5-6 anterolateral myocardial infarction
Ⅱ, Ⅲ, aVF inferior myocardial infarction
I, aVL high lateral myocardial infarction
Killip classification of cardiac function: acute myocardial infarction patients to assess heart function
I Class: No sound and lungs The third heart sound
II level: the lungs are sound, but the sound range is less than 1 / 2 lung field
III level: the extent of lung sounds is greater than 1 / 2 lung field (pulmonary edema)
IV Grade: cardiogenic shock
2.
hypertension patients by absolute level of cardiovascular risk stratification (normal 140/90) < br> 1 级 140-159 or 90-99 below 160/100
2 级 160-179 or 100-109 lower than the 180/110
3 级 ≥ 180 or ≥ 110
risk The degree of
low risk: a. Lifestyle.
in crisis: 1 + 2 factors; 2 is not accompanied by factors of 2 or lower. Drug treatment.
risk :1-2 + at least three factors, target organ damage. Rules of drug treatment.
very high risk: 3; 1-2 level + of target organ damage, there are complications. Intensive treatment as soon as possible.
3. CHF = left lung (cycle) the right body (circulation)
left heart failure = pink foamy sputum cough + shortness of breath (at night can not be supine, orthopnea, after the event)
right heart failure = jugular vein engorgement + lower extremity edema, hepatomegaly +
I
NYHA class daily activities are not limited
II Class-level activity with mild limitation
III obviously limited
IV class symptoms at rest
right heart failure left ventricular failure + = Full HF
4. arrhythmia:
(1) the absolute heart rate ranging from + AF = short pulse constraints + ECG + f wave strength of the first heart sound varies
(2) = paroxysmal supraventricular tachycardia paroxysmal palpitation + sudden sudden stop + ECG (no P waves, heart rate 160-250 beats / points)
(3) = paroxysmal ventricular tachycardia of sudden onset of palpitation + History + ECG past more than 3 consecutive fast wide QRS wave + cardiac malformations have been won / Room fusion wave
( 4) Other: See some of the third leg of electrocardiographic
5. valvular heart disease
(1) mitral stenosis = dyspnea (exertional, paroxysmal, night, orthopnea, pulmonary edema) + acute massive hemoptysis, sputum + pear-shaped pink bubble-like heart + rumbling noise
(2) = mitral regurgitation in acute left heart failure / chronic advanced stage failure or total failure + left apical systolic all rough hair-like noise, to the armpit or the left subscapular angle conduction
(3) aortic stenosis = breathing difficulties + angina + syncope + ejection murmur to the neck conduction
(4) aortic valve palpitations + angina + incomplete = paroxysmal nocturnal dyspnea + AustinFliht noise + peripheral vascular symptoms (flush pulse, Mussctz symptoms, carotid fluctuates significantly, and capillary pulsation Zheng, arterial tone and Durozicz shooting levy)
noise occurs mainly during the switch flap valve noise properties
opening rumble of mitral stenosis and diastolic mitral regurgitation like
off hair-like
systolic aortic stenosis systolic jet-like
open aortic insufficiency diastolic related sigh like
6. shock signs = P ↑ + Bp ↓ + speed + pulse cold limbs, hair thin
(1) hemorrhagic Hugh shock signs + bleeding
(2) signs of cardiogenic shock = shock + left heart failure
cardiovascular system to further examine
1. electrocardiogram, dynamic ECG
2. echocardiography
3. chest X ray
4. fundus examination (hypertension), radionuclide
5. myocardial enzyme
6.
blood gas analysis 7. blood, blood lipids, blood glucose, serum potassium, liver and kidney function
8. cardiac catheterization
9. coronary angiography
10. myocardial necrosis markers (myoglobin, troponin, creatine kinase isoenzyme CK-MB)
cardiovascular treatment principles
1. General treatment: attention to rest, lifestyle changes (such as smoking cessation alcohol, low sodium low-fat diet, moderate exercise) , testing, care
2. Hypertension:
(1) diuretics, B blockers, calcium channel blockers, ACEI (angiotensin converting enzyme inhibitors), angiotensin II by Inhibitor
(2) control of complications. Such as heart failure, diabetes, cerebrovascular disease, renal failure, coronary heart disease
3. Coronary heart disease:
symptomatic treatment: control of arrhythmias, improve cardiac function, myocardial infarction II thrombolytic or interventional therapy to prevent
< br> control of shock, heart failure
correct anticoagulant and antiplatelet therapy: aspirin, heparin
4. fibrillation:
drugs cardioversion, use of amiodarone
slow ventricular rate, the choice of cedilanid
5. heart failure:
diuretic, ACEI, B blockers, inotropic drugs (digitalis: to Xin high cedilanid. non-digitalis : dopamine, milrinone), cardiac pacemakers
6. valvular heart disease:
cause of treatment, valve replacement, urinary system diseases such as diagnostic
formula
1. Renal glomerulonephritis: eyelid / facial edema and history of streptococcal infection + young + + C3 + hematuria and proteinuria decreased blood pressure
2. urinary tract infection
(1) = Female + pyelonephritis back pain + fever + pyuria , WBC tube
(2) acute exacerbation of chronic pyelonephritis = urinary bladder irritation, injury history + + recurrent low back pain + fever + pain + WBC knocked on kidney area increased
(3) lower urinary tract infection = Married women + hot + bladder irritation
3. hematuria after kidney stones = activities waist colic + B + X-over or
4. ureteral stones = activity after lumbar colic hematuria + + X-ray examination
5. RCC = old + (painless) gross hematuria
6. nephritis, renal failure = years of history of hypertension hematuria and proteinuria + + serum creatinine (compensation of 133, 442 decompensated , failure of 707, uremia) increased
7. prostatic hyperplasia = elderly + urinary + progressive dysuria
further examination of urinary system diseases
1. Abdominal B- plain film
2. urine routine, ESR, renal function, blood gas analysis
3. pyelography
4. biopsies
5. gynecologic examination
6. creatinine, glomerular filtration rate
7. renal function
8. radionuclide renography
9. cystoscopic treatment of urinary system
principles
1. General treatment: attention to rest , low sodium / low protein diet
2. symptomatic treatment
(1) anti-infective
(2) diuretic antihypertensive
(3) dialysis
(4) to correct fluid and electrolyte acid-base disorders
3. surgical treatment: surgical resection or incision
4. Tumor (kidney cancer)
5. hemodialysis
1. hyperthyroidism = sudden palpitations + eye (eyes bulging) + emotional + sweating + goiter
check: T3/T4/TSH 131I radionuclide thyroid
2. Thyroid cancer Thyroid + B = Super nodules
3. Diabetes = a little more than three, blood glucose: fasting 7.0, meal 11.1, OGTT
(1) 1 = more than three a diabetes incidence of acute + low + young + rotten apple
(2) 2 = middle-aged diabetic slow onset + + easy to ketoacidosis diabetic ketoacidosis and hyperosmolar
difference: the limit of blood sugar with 33.3
check: fructosamine, insulin release experiments, C peptide release assay, glycosylated hemoglobin
general treatment : life guidance, diet, physical exercise, disease monitoring, drug treatment to prevent complications
:
promote secretagogues, sulfonylurea -2 type of non-obese, diet and exercise control is not ideal
biguanide - Obesity who
insulin and Type 2 -1 complications
a glucosidase inhibitor - postprandial hyperglycemia diagnosis of blood diseases
formula
1. leukemic = heat + sternal tenderness, bleeding tendency + + pancytopenia
2. aplastic anemia = appearance + + three-line to reduce bleeding tendency
3. autoimmune hemolytic anemia, anemia = appearance + Coombs (antiglobulin test) Positive + splenomegaly
4. Serum iron deficiency anemia = down + anemic appearance (pale skin and mucous membranes) + women menorrhagia or digestive system tumors
5. idiopathic thrombocytopenic purpura = Women + bleeding tendency + thrombocytopenia (less than 100-109), red white blood cell count normal
6.DIC = extended multi-site bleeding + PT +3 P test positive blood diseases
further examination
1. Bone marrow biopsy
2. cell morphology
3. liver and kidney function, abdominal B-
4.
blood blood disease therapy
general treatment: Closed infection control, use of broad spectrum antibiotics
leukemia: chemotherapy and bone marrow transplantation
chemotherapy:
acute leukemia, acute lymphoblastic-DVLP program
(daunorubicin, vincristine, L-aspartate lactamases, prednisone)
acute Fei Lin-DA program
(daunorubicin, cytarabine)
promyelocytic - RA
autoimmune chronic leukemia
hemolytic anemia: glucocorticoids, splenectomy
TTP: corticosteroids, splenectomy
aplastic anemia: male hormones, immune agents, bone marrow transplantation
anemia: iron supplements + VC, severe anemia before surgery can be RBC
women with systemic lupus erythematosus = erythema + butterfly + photosensitivity + ulcer positive
+ arthritis + ANA + RA = single large joint
rheumatoid joints Yan = middle-aged women + + RF-positive symmetrical small joint septic arthritis
= Youth + heat =
osteoarthritis bone fricative / bone rubbing sense + activity after the increase, pain relief after the break
formula
poisoning diagnosis of carbon monoxide poisoning = coal stove + Cherry + COHB
increased exposure to organophosphorus pesticide poisoning = needle-like changes history + pupil + garlic + audio + bile wet lung auscultation alkaline esterase activity was reduced cerebral vascular disease diagnosis
formula
1. intracerebral hemorrhage = + hypertension in elderly patients with acute onset of + consciousness + + Location signs
2. thrombosis = resting state disease (coronary heart disease, hyperlipidemia)
3. pathogenesis of acute cerebral embolism = + heart emboli (subacute endocarditis)
pulmonary dyspnea + chest pain + = hemoptysis, leg bolt son (varicose veins / lower limb gangrene)
4. pathogenesis of acute subarachnoid hemorrhage = + meningeal irritation + CT
5. infarction = hypertension + paralysis + CT
no lesions meningitis diagnosis of tuberculous meningitis formula
+ = meningeal irritation with symptoms (fever night sweats)
disease brain = meningeal irritation + virus infection (fever)
of meningeal irritation + Brain = purulent ( heat)
ECM = meningeal irritation + + skin in winter and spring ecchymosis
mucosa petechia meningeal irritation JE = + + respiratory failure, brain injury
summer and autumn the Diagnosis formula
1. concussion = transient loss of consciousness (coma a few minutes) + retrograde amnesia
2. acute epidural hematoma = + intermediate wake of traumatic brain injury (coma - conscious - unconscious) + CT shuttle shaped hematoma
3. subdural hematoma = persistent coma
4. herniation = mydriasis + cardiopulmonary arrest
diagnosis of infectious diseases formula
1. HAV = fever + jaundice + HAV (+) + fecal-oral transmission
2. Hepatitis B = fever + jaundice + HBV (+) + body fluids
3. Hepatitis C = fever + jaundice + HCV (+) + blood-borne
4. AIDS = contact history + fever + weight loss + HIV (+)
diagnosis of gynecological diseases formula
1. ectopic pregnancy, menopause, history + = severe abdominal pain + abdominal mass, vaginal bleeding + + cervical lifting pain
2. ovarian tumor torsion = acute lower abdominal pain + mass + no shock without anemia, HCG (-), no history of postmenopausal vaginal bleeding and
3. acute pelvic inflammatory disease = abdominal pain (cervical give pain) + heat + vaginal discharge
4. cervical cancer = contact bleeding or irregular vaginal bleeding + cauliflower excrescence (Ib of limited cervical, Ib1 of longitude <= 4cm)
5 . Ovarian cancer = older women + + bloating + abdominal mass, weight loss
6. Uterine fibroids = women of childbearing age as excessive + + + anemia increase the appearance of uterine pediatric diagnosis
formula
1. infants and children with diarrhea (rotavirus infections)
= season (autumn and winter) + stool samples dilute water + heat
dehydrated egg drop soup indexing (1) mild:
( 2) Moderate: small limbs, oliguria cold tears
(3) severe: no urine of blood pressure lowering
dehydration properties of cold extremities: diagnostic serum sodium level of 130-150
: 1. rotary virus enteritis (heavy / light)
2. severe (moderate / mild) hypertonic (isotonic / hypotonic) dehydration
3. Others, such as metabolic acidosis
rehydration therapy:
1. Principle:
2. the first day of infusion volume, speed and type of
(1) Total
(2) speed
(3) types of
3. The next day rehydration
4. Drug treatment: infection control, protection of intestinal
2. eruptive diseases in children with
(1) measles = fever + flu + body on the mucosal papules + measles spots
(2 ) rubella = fever + flu + red papules on the ear lymph nodes + tender
(3) Emergency = protruding heat + hot back rash
(4) RV = herpes low heat + water + to itchy Mind distribution
(5) scarlet = fever + sore throat + strawberry tongue + rash in skin folds more vulnerable to friction parts densely
3. Nutritional vitamin D deficiency rickets = irritable temperament in children fed properly + + bone changes (costophrenic sulcus, frog belly, O-leg) + serum calcium + phosphorus
lower limb fracture and dislocation of large joints proprietary fracture diagnostic formula
signs: unusual activity / sense of bones rub / abnormalities
1. humerus surgical neck fracture of the shoulder injury + = arm movement disorder
2. humeral fracture = history of trauma disorder + down + upper arm wrist
3. humerus fractures = pediatric + + with hands palm down after elbow triangle of elbow pain in the normal +
4. fractures of the distal radius = wrist injury + + front side silver fork-like spear-like
5. = radial head subluxation in children + strong stretch upper
6. = posterior dislocation of hip pain in his legs + + side of the lower extremity hip shorten + limb adduction internal rotation deformity
7. = palm of your hand with anterior shoulder dislocation in the contralateral injured + hand care and positive signs ipsilateral elbow + CJR
8. femoral neck fracture = hip external rotation of limb deformities trauma + + trochanter Move
+ Pauwels angle
acute purulent soft tissue painful swelling of infection =
1. carbuncle = middle-aged + fever chills swollen knot + + skin ulceration after hard honeycomb sores
2. subcutaneous cellulitis = acute painful swelling of traumatic + + skin temperature fluctuation of + swelling sense, ill + a pus
3. erysipelas = limbs or facial flaky skin erythema + + bulge + recur clear boundary
4. Acute lymphangitis / lymphadenitis = subcutaneous red lines + local lymph nodes of breast disease diagnosis tenderness
formula
1. Acute mastitis = breast tenderness pregnant women + + hot + WBC increased
acute mastitis + floating feeling = abscess formation
2. breast cystic hyperplasia = cyclical breast tenderness + + tired after the palpable mass increased
3. breast cancer risk factors + = quality hard painless lump + axillary lymph node is not smooth swelling
treatment principles:
1. General treatment: rest, nutrition, health and other
2. symptomatic therapy / drug therapy / etiology treatment
3. surgical treatment
4. Tumor Treatment < / p>.
digestive symptoms: abdominal pain, diarrhea, nausea, vomiting, mass
1. acute and chronic gastritis = eating unclean or irritants + abdominal pain, bloating, nausea, vomiting
2. gastroesophageal reflux disease = acid reflux burning sensation + + retrosternal esophageal endoscopy erosion with a red strip (heartburn, acid reflux, back to food)
3. peptic ulcer disease
= chronic gastric ulcer on a regular abdominal pain (pain after a meal) + hematemesis melena
duodenal ulcer = hunger pain (more than 4 hours after the meal), or night pain + melena
peptic ulcer hematemesis perforation = sudden severe abdominal pain (peritonitis signs) + X ray of free gas below the diaphragm have
4. esophageal varices = upper gastrointestinal bleeding + past liver disease history
5. bacillary dysentery = unclean diet + abdominal pain + mucus pus and blood will + tenesmus
6. ulcerative colitis = left lower abdominal pain, pus and blood will mucin + + (will be Italy, and after mitigation) + antibiotics ineffective
therapy: sulfasalazine (SASP)
7. Acute pancreatitis (edema) = binge eating / history of chronic biliary abdominal pain + bend + sustained pain relief + amylase test
acute pancreatitis (hemorrhagic necrosis) = + waist and abdomen symptoms of edema or Cullen purple + paracentesis + washing liquid in water samples of meat with high glucose + low
hemorrhagic necrotizing calcium: urine amylase value is not necessarily high, sometimes it decreased. Select CT
week when diagnosed measured serum amylase, lipase measured more than a week
8. Pyloric obstruction = vomiting Sushi + vibration of water sounds
9. Cirrhotic portal hypertension + = history of hepatitis (spleen Big + ascites + spider) + ultrasound (liver shrink)
10. cholecystitis = paroxysmal and positive signs of right upper quadrant colic + Could + nausea and vomiting
11. cholelithiasis = paroxysmal right upper quadrant colic + Could + B Super echo the positive sign of light group, shadowing
12. Acute obstructive suppurative cholangitis = triad under the Ke (abdominal pain + fever + chills, jaundice) + performance + shock psychiatric symptoms (such as the look of indifference, coma) in five of the levy
13. abdomen
(1) appendicitis, right lower abdominal pain + = metastatic Maxwell point tenderness (pain, men Tong) + WBC increased
(2) intestinal obstruction: abdominal pain + vomiting + Expansion + closed + X line (Banana / fluid level)
causes: mechanical and dynamic
revascularization: simple and strangulated
level: complete and incomplete
parts: high and low
(3) history of gastrointestinal ulcer perforation = + sudden severe abdominal pain with peritoneal irritation + + subdiaphragmatic free gas
(4) Ectopic Pregnancy = postmenopausal vaginal bleeding + History + abdominal pain (cervical pain held) + human chorionic gonadotropin
(5) of ovarian cyst torsion = pain + sudden position changes and a cystic mass
(6) = curettage surgery of acute pelvic inflammatory disease + abnormal vaginal discharge lower abdominal pain + abdominal + pain (cervical pain held) + purulent discharge
14. digestive system tumors
(1) gastric = old + black + it + Kanying law change + chronic ulcer pain upper abdominal pain + abdominal mass + weight loss + left supraclavicular lymph nodes
(2) = progressive dysphagia of esophageal cancer (the late) + retrosternal burning pain (early) + food choking feeling (early)
(5) pancreatic cancer (pancreatic cancer, periampullary cancer) = old + pain + jaundice aggravated sexual clay color stool + skin itching
(6) colon cancer: old + change in bowel habits weight loss + + CEA + abdominal mass
15. anus, rectum benign lesions
(1) painless hemorrhoid = + it with bloody vein-like mass of blood +
(2) external hemorrhoids = anal pain + anus blood + tender will be mass
(3) when it will be after anal fissure = pain + anal anal fissure
16.
renal injury blunt abdominal trauma injury + hematuria
= waist traumatic hepatic rupture = right abdominal peritoneal irritation + + shifting dullness
rupture = left abdominal pain + abdominal injury + All
intestinal rupture = abdominal bleeding abdomen trauma + peritoneal irritation yellow liquid
+ puncture 17. hernia (inguinal hernia) = increased abdominal pressure elderly men + + + right lower abdomen into the scrotum tumor
digestive diseases for further examination
1. stomach Mirror, colonoscopy, colonoscopy
2. gastroenterography
3. Abdominal B-, CT
4. upright abdominal plain film
5. stool: routine examination, occult blood, culture and parasitic Check
6.HP worm detection
7. peritoneal puncture
8. lymph node biopsy or liver biopsy (case monitoring)
9. laboratory:
(1) urine amylase
(2) AFP, CEA, CA19-9 carbohydrate antigen
(3) urine routine examination, liver and kidney function, electrolytes, blood gas analysis
digestive treatment principles < br>
a general treatment: attention to rest, diet / fasting, life guidance
Second, the cause of treatment
(1) ulcer: PPI class of acid-suppressing drugs of choice can be added with mucosal protective agent, If H. pylori infection should be treated with combined sterilization, commonly used triple therapy or quadruple therapy: PPI, colloidal bismuth combined two antibiotics
(2) application of broad-spectrum antibiotics, anti-infection treatment, anti-shock
( 3) obstruction / peritonitis: fasting, gastrointestinal decompression
(4) to maintain water and electrolyte acid-base balance
three, four
symptomatic treatment, surgical: resection or repair
five tumors: 1 ) surgery
2) radiotherapy + chemotherapy + immunotherapy + Chinese medicine treatment
diagnosis of respiratory diseases formula
1. acute upper respiratory tract infection = sore throat + cough + fever
2. pneumonia
(1) Lobar = adult + cold + fever + cough rusty sputum
(2) Klebsiella pneumonia = cough brick-red sputum + X-ray film empty
(3) Mycoplasma pneumonia = cough + children + irritating + joint pain antibiotics ineffective
(4) = infants and young children with bronchial pneumonia breathing difficulties + fever + symptoms (nasal flap, three depressions sign positive)
(5), Staphylococcus aureus pneumonia, sepsis = heat + chest pain + sputum + X ray sheet film
3. Tuberculosis
(1) TB = young + hemoptysis + Afternoon + fever + night sweats antibiotic treatment had no significant effect < br> (2) = TB + TB pleurisy signs of pleural effusion (chest pain disappeared + percussion + fremitus real audio / breath sounds disappear)
(3) tuberculous pericarditis, pericardial effusion = TB + signs (heart before District pain + abdominal breathing difficulties Fullness + + lower extremity edema)
(4) intestinal tuberculosis = TB + abdominal symptoms (abdominal pain, diarrhea, right lower abdominal mass)
(5) TB = TB + abdominal peritonitis inflammation (abdominal pain, diarrhea, abdominal wall flexibility and a sense of)
(6) renal tuberculosis = TB + + bladder irritation, thinning of the renal parenchyma and destructive
4. bronchiectasis = childhood whooping cough or measles delayed healing of bronchial pneumonia purulent cough + history + + hemoptysis
5.COPD = old (smoking) + sputum + asthma + barrel chest pulmonary function tests, FEV1/FVC% less than a second rate of 70%
6 . abscess = smelly pus sputum + heat + X-ray films / CT shows fluid level
7. lung cancer = in + elderly + irritating cough, bloody sputum + weight loss + X ray burr
8. Cor = history of chronic lung disease + enlarged heart
Evolution order: chronic bronchitis - Emphysema - Pulmonary Heart Disease
9. paroxysmal bronchial asthma or recurrent wheezing + = auscultation wheezing allergy
10 + . respiratory failure, chronic lung disease = history of cyanosis + + blood gas analysis
I type: PaO2 <60mmHg PaCO2 normal - severe pneumonia induced
II Type: PaO2 <60mmHg PaCO2> 50mmHg-induced chronic obstructive pulmonary disease
11. chest blunt trauma
(1) tension pneumothorax chest trauma history + = extensive subcutaneous emphysema (grip snow flu) + offset + tracheal breath sound percussion drum sound + disappear
(2) = hemothorax tracheal trauma history + chest percussion dullness + offset + + X ray decreased breath sounds costophrenic angle disappeared, curved high density
(3) history of chest trauma and rib fractures = + bone fricative
respiratory disease surveillance project
1. chest X films, chest CT
2.PPD, ESR
3. sputum culture + sensitivity test, sputum Mycobacterium tuberculosis
find 4. lung function
5. liver and kidney function
6. Blood gas analysis
7. bronchoscopy
8. sputum cytology testing
9. lymph node biopsy
10. blood Conventional electrolyte
respiratory diseases treatment principles
1. General treatment: rest, nutrition, prevention of infection / oxygen
2. symptomatic treatment / drug treatment
(1) anti-infective therapy: use of broad spectrum antibiotics or combination therapy
(2) anti-TB treatment: early, regular, joint, rules, full
(3) anti-shock: expansion, the use of vascular active drug
(4) Control of hemoptysis: pituitrin
(5) fever, cough, asthma, expectorant
(6) correct the acid-base balance
3. tumors ( lung cancer)
(1) surgery
(2) radiotherapy + chemotherapy + immunotherapy + Chinese medicine treatment
diagnosis of circulatory system diseases formula
1 . coronary heart disease = chest pain narrowing
(1) = chest narrowing angina pain <30 minutes, 3-5-minute / second, + with rest or nitroglycerin can relieve mouth + ECG: ST segment horizontal depression
(2) MI = chest pain, narrowing of> 30 minutes, rest or mouth can not be relieved with nitroglycerin sense of impending doom + sweating + + ECG: ST segment elevation arched up < br> V1-6 extensive anterior wall myocardial infarction
V1-3 anteroseptal myocardial infarction
V3-5 limitations of anterior myocardial infarction
V5-6 anterolateral myocardial infarction
Ⅱ, Ⅲ, aVF inferior myocardial infarction
I, aVL high lateral myocardial infarction
Killip classification of cardiac function: acute myocardial infarction patients to assess heart function
I Class: No sound and lungs The third heart sound
II level: the lungs are sound, but the sound range is less than 1 / 2 lung field
III level: the extent of lung sounds is greater than 1 / 2 lung field (pulmonary edema)
IV Grade: cardiogenic shock
2.
hypertension patients by absolute level of cardiovascular risk stratification (normal 140/90) < br> 1 级 140-159 or 90-99 below 160/100
2 级 160-179 or 100-109 lower than the 180/110
3 级 ≥ 180 or ≥ 110
risk The degree of
low risk: a. Lifestyle.
in crisis: 1 + 2 factors; 2 is not accompanied by factors of 2 or lower. Drug treatment.
risk :1-2 + at least three factors, target organ damage. Rules of drug treatment.
very high risk: 3; 1-2 level + of target organ damage, there are complications. Intensive treatment as soon as possible.
3. CHF = left lung (cycle) the right body (circulation)
left heart failure = pink foamy sputum cough + shortness of breath (at night can not be supine, orthopnea, after the event)
right heart failure = jugular vein engorgement + lower extremity edema, hepatomegaly +
I
NYHA class daily activities are not limited
II Class-level activity with mild limitation
III obviously limited
IV class symptoms at rest
right heart failure left ventricular failure + = Full HF
4. arrhythmia:
(1) the absolute heart rate ranging from + AF = short pulse constraints + ECG + f wave strength of the first heart sound varies
(2) = paroxysmal supraventricular tachycardia paroxysmal palpitation + sudden sudden stop + ECG (no P waves, heart rate 160-250 beats / points)
(3) = paroxysmal ventricular tachycardia of sudden onset of palpitation + History + ECG past more than 3 consecutive fast wide QRS wave + cardiac malformations have been won / Room fusion wave
( 4) Other: See some of the third leg of electrocardiographic
5. valvular heart disease
(1) mitral stenosis = dyspnea (exertional, paroxysmal, night, orthopnea, pulmonary edema) + acute massive hemoptysis, sputum + pear-shaped pink bubble-like heart + rumbling noise
(2) = mitral regurgitation in acute left heart failure / chronic advanced stage failure or total failure + left apical systolic all rough hair-like noise, to the armpit or the left subscapular angle conduction
(3) aortic stenosis = breathing difficulties + angina + syncope + ejection murmur to the neck conduction
(4) aortic valve palpitations + angina + incomplete = paroxysmal nocturnal dyspnea + AustinFliht noise + peripheral vascular symptoms (flush pulse, Mussctz symptoms, carotid fluctuates significantly, and capillary pulsation Zheng, arterial tone and Durozicz shooting levy)
noise occurs mainly during the switch flap valve noise properties
opening rumble of mitral stenosis and diastolic mitral regurgitation like
off hair-like
systolic aortic stenosis systolic jet-like
open aortic insufficiency diastolic related sigh like
6. shock signs = P ↑ + Bp ↓ + speed + pulse cold limbs, hair thin
(1) hemorrhagic Hugh shock signs + bleeding
(2) signs of cardiogenic shock = shock + left heart failure
cardiovascular system to further examine
1. electrocardiogram, dynamic ECG
2. echocardiography
3. chest X ray
4. fundus examination (hypertension), radionuclide
5. myocardial enzyme
6.
blood gas analysis 7. blood, blood lipids, blood glucose, serum potassium, liver and kidney function
8. cardiac catheterization
9. coronary angiography
10. myocardial necrosis markers (myoglobin, troponin, creatine kinase isoenzyme CK-MB)
cardiovascular treatment principles
1. General treatment: attention to rest, lifestyle changes (such as smoking cessation alcohol, low sodium low-fat diet, moderate exercise) , testing, care
2. Hypertension:
(1) diuretics, B blockers, calcium channel blockers, ACEI (angiotensin converting enzyme inhibitors), angiotensin II by Inhibitor
(2) control of complications. Such as heart failure, diabetes, cerebrovascular disease, renal failure, coronary heart disease
3. Coronary heart disease:
symptomatic treatment: control of arrhythmias, improve cardiac function, myocardial infarction II thrombolytic or interventional therapy to prevent
< br> control of shock, heart failure
correct anticoagulant and antiplatelet therapy: aspirin, heparin
4. fibrillation:
drugs cardioversion, use of amiodarone
slow ventricular rate, the choice of cedilanid
5. heart failure:
diuretic, ACEI, B blockers, inotropic drugs (digitalis: to Xin high cedilanid. non-digitalis : dopamine, milrinone), cardiac pacemakers
6. valvular heart disease:
cause of treatment, valve replacement, urinary system diseases such as diagnostic
formula
1. Renal glomerulonephritis: eyelid / facial edema and history of streptococcal infection + young + + C3 + hematuria and proteinuria decreased blood pressure
2. urinary tract infection
(1) = Female + pyelonephritis back pain + fever + pyuria , WBC tube
(2) acute exacerbation of chronic pyelonephritis = urinary bladder irritation, injury history + + recurrent low back pain + fever + pain + WBC knocked on kidney area increased
(3) lower urinary tract infection = Married women + hot + bladder irritation
3. hematuria after kidney stones = activities waist colic + B + X-over or
4. ureteral stones = activity after lumbar colic hematuria + + X-ray examination
5. RCC = old + (painless) gross hematuria
6. nephritis, renal failure = years of history of hypertension hematuria and proteinuria + + serum creatinine (compensation of 133, 442 decompensated , failure of 707, uremia) increased
7. prostatic hyperplasia = elderly + urinary + progressive dysuria
further examination of urinary system diseases
1. Abdominal B- plain film
2. urine routine, ESR, renal function, blood gas analysis
3. pyelography
4. biopsies
5. gynecologic examination
6. creatinine, glomerular filtration rate
7. renal function
8. radionuclide renography
9. cystoscopic treatment of urinary system
principles
1. General treatment: attention to rest , low sodium / low protein diet
2. symptomatic treatment
(1) anti-infective
(2) diuretic antihypertensive
(3) dialysis
(4) to correct fluid and electrolyte acid-base disorders
3. surgical treatment: surgical resection or incision
4. Tumor (kidney cancer)
5. hemodialysis
1. hyperthyroidism = sudden palpitations + eye (eyes bulging) + emotional + sweating + goiter
check: T3/T4/TSH 131I radionuclide thyroid
2. Thyroid cancer Thyroid + B = Super nodules
3. Diabetes = a little more than three, blood glucose: fasting 7.0, meal 11.1, OGTT
(1) 1 = more than three a diabetes incidence of acute + low + young + rotten apple
(2) 2 = middle-aged diabetic slow onset + + easy to ketoacidosis diabetic ketoacidosis and hyperosmolar
difference: the limit of blood sugar with 33.3
check: fructosamine, insulin release experiments, C peptide release assay, glycosylated hemoglobin
general treatment : life guidance, diet, physical exercise, disease monitoring, drug treatment to prevent complications
:
promote secretagogues, sulfonylurea -2 type of non-obese, diet and exercise control is not ideal
biguanide - Obesity who
insulin and Type 2 -1 complications
a glucosidase inhibitor - postprandial hyperglycemia diagnosis of blood diseases
formula
1. leukemic = heat + sternal tenderness, bleeding tendency + + pancytopenia
2. aplastic anemia = appearance + + three-line to reduce bleeding tendency
3. autoimmune hemolytic anemia, anemia = appearance + Coombs (antiglobulin test) Positive + splenomegaly
4. Serum iron deficiency anemia = down + anemic appearance (pale skin and mucous membranes) + women menorrhagia or digestive system tumors
5. idiopathic thrombocytopenic purpura = Women + bleeding tendency + thrombocytopenia (less than 100-109), red white blood cell count normal
6.DIC = extended multi-site bleeding + PT +3 P test positive blood diseases
further examination
1. Bone marrow biopsy
2. cell morphology
3. liver and kidney function, abdominal B-
4.
blood blood disease therapy
general treatment: Closed infection control, use of broad spectrum antibiotics
leukemia: chemotherapy and bone marrow transplantation
chemotherapy:
acute leukemia, acute lymphoblastic-DVLP program
(daunorubicin, vincristine, L-aspartate lactamases, prednisone)
acute Fei Lin-DA program
(daunorubicin, cytarabine)
promyelocytic - RA
autoimmune chronic leukemia
hemolytic anemia: glucocorticoids, splenectomy
TTP: corticosteroids, splenectomy
aplastic anemia: male hormones, immune agents, bone marrow transplantation
anemia: iron supplements + VC, severe anemia before surgery can be RBC
women with systemic lupus erythematosus = erythema + butterfly + photosensitivity + ulcer positive
+ arthritis + ANA + RA = single large joint
rheumatoid joints Yan = middle-aged women + + RF-positive symmetrical small joint septic arthritis
= Youth + heat =
osteoarthritis bone fricative / bone rubbing sense + activity after the increase, pain relief after the break
formula
poisoning diagnosis of carbon monoxide poisoning = coal stove + Cherry + COHB
increased exposure to organophosphorus pesticide poisoning = needle-like changes history + pupil + garlic + audio + bile wet lung auscultation alkaline esterase activity was reduced cerebral vascular disease diagnosis
formula
1. intracerebral hemorrhage = + hypertension in elderly patients with acute onset of + consciousness + + Location signs
2. thrombosis = resting state disease (coronary heart disease, hyperlipidemia)
3. pathogenesis of acute cerebral embolism = + heart emboli (subacute endocarditis)
pulmonary dyspnea + chest pain + = hemoptysis, leg bolt son (varicose veins / lower limb gangrene)
4. pathogenesis of acute subarachnoid hemorrhage = + meningeal irritation + CT
5. infarction = hypertension + paralysis + CT
no lesions meningitis diagnosis of tuberculous meningitis formula
+ = meningeal irritation with symptoms (fever night sweats)
disease brain = meningeal irritation + virus infection (fever)
of meningeal irritation + Brain = purulent ( heat)
ECM = meningeal irritation + + skin in winter and spring ecchymosis
mucosa petechia meningeal irritation JE = + + respiratory failure, brain injury
summer and autumn the Diagnosis formula
1. concussion = transient loss of consciousness (coma a few minutes) + retrograde amnesia
2. acute epidural hematoma = + intermediate wake of traumatic brain injury (coma - conscious - unconscious) + CT shuttle shaped hematoma
3. subdural hematoma = persistent coma
4. herniation = mydriasis + cardiopulmonary arrest
diagnosis of infectious diseases formula
1. HAV = fever + jaundice + HAV (+) + fecal-oral transmission
2. Hepatitis B = fever + jaundice + HBV (+) + body fluids
3. Hepatitis C = fever + jaundice + HCV (+) + blood-borne
4. AIDS = contact history + fever + weight loss + HIV (+)
diagnosis of gynecological diseases formula
1. ectopic pregnancy, menopause, history + = severe abdominal pain + abdominal mass, vaginal bleeding + + cervical lifting pain
2. ovarian tumor torsion = acute lower abdominal pain + mass + no shock without anemia, HCG (-), no history of postmenopausal vaginal bleeding and
3. acute pelvic inflammatory disease = abdominal pain (cervical give pain) + heat + vaginal discharge
4. cervical cancer = contact bleeding or irregular vaginal bleeding + cauliflower excrescence (Ib of limited cervical, Ib1 of longitude <= 4cm)
5 . Ovarian cancer = older women + + bloating + abdominal mass, weight loss
6. Uterine fibroids = women of childbearing age as excessive + + + anemia increase the appearance of uterine pediatric diagnosis
formula
1. infants and children with diarrhea (rotavirus infections)
= season (autumn and winter) + stool samples dilute water + heat
dehydrated egg drop soup indexing (1) mild:
( 2) Moderate: small limbs, oliguria cold tears
(3) severe: no urine of blood pressure lowering
dehydration properties of cold extremities: diagnostic serum sodium level of 130-150
: 1. rotary virus enteritis (heavy / light)
2. severe (moderate / mild) hypertonic (isotonic / hypotonic) dehydration
3. Others, such as metabolic acidosis
rehydration therapy:
1. Principle:
2. the first day of infusion volume, speed and type of
(1) Total
(2) speed
(3) types of
3. The next day rehydration
4. Drug treatment: infection control, protection of intestinal
2. eruptive diseases in children with
(1) measles = fever + flu + body on the mucosal papules + measles spots
(2 ) rubella = fever + flu + red papules on the ear lymph nodes + tender
(3) Emergency = protruding heat + hot back rash
(4) RV = herpes low heat + water + to itchy Mind distribution
(5) scarlet = fever + sore throat + strawberry tongue + rash in skin folds more vulnerable to friction parts densely
3. Nutritional vitamin D deficiency rickets = irritable temperament in children fed properly + + bone changes (costophrenic sulcus, frog belly, O-leg) + serum calcium + phosphorus
lower limb fracture and dislocation of large joints proprietary fracture diagnostic formula
signs: unusual activity / sense of bones rub / abnormalities
1. humerus surgical neck fracture of the shoulder injury + = arm movement disorder
2. humeral fracture = history of trauma disorder + down + upper arm wrist
3. humerus fractures = pediatric + + with hands palm down after elbow triangle of elbow pain in the normal +
4. fractures of the distal radius = wrist injury + + front side silver fork-like spear-like
5. = radial head subluxation in children + strong stretch upper
6. = posterior dislocation of hip pain in his legs + + side of the lower extremity hip shorten + limb adduction internal rotation deformity
7. = palm of your hand with anterior shoulder dislocation in the contralateral injured + hand care and positive signs ipsilateral elbow + CJR
8. femoral neck fracture = hip external rotation of limb deformities trauma + + trochanter Move
+ Pauwels angle
acute purulent soft tissue painful swelling of infection =
1. carbuncle = middle-aged + fever chills swollen knot + + skin ulceration after hard honeycomb sores
2. subcutaneous cellulitis = acute painful swelling of traumatic + + skin temperature fluctuation of + swelling sense, ill + a pus
3. erysipelas = limbs or facial flaky skin erythema + + bulge + recur clear boundary
4. Acute lymphangitis / lymphadenitis = subcutaneous red lines + local lymph nodes of breast disease diagnosis tenderness
formula
1. Acute mastitis = breast tenderness pregnant women + + hot + WBC increased
acute mastitis + floating feeling = abscess formation
2. breast cystic hyperplasia = cyclical breast tenderness + + tired after the palpable mass increased
3. breast cancer risk factors + = quality hard painless lump + axillary lymph node is not smooth swelling
treatment principles:
1. General treatment: rest, nutrition, health and other
2. symptomatic therapy / drug therapy / etiology treatment
3. surgical treatment
4. Tumor Treatment < / p>.
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