Clincial Manifestations of disease Flashcards
What is WHO’s definition of Health?
A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
what is Homeostasis?
The purposeful maintenance of a stable internal environment maintained by coordinated physiological processes that oppose change.
What is pathophysiology?
Altered health
What is the definiton of pathology?
study of the structure and functional changes in cells, tissues, and organs caused by disease
What is the defintion of a disease state?
Any deviation from or interruption of the normal structure ore function of a part, organ or system of the body manifested by a characteristic set of symptoms or signs
What is disease and what are the two groups its divided into?
3
- Does not allow the body to function normally
- Can affect individual organs or an entire body system
- Divided into two groups
- Infectious
- Non Infectious
What are the different categories of infectious disease and what are some examples?
4
How are they transmitted?
Bacterial: Cholera
Viral: Chicken pox (varicella)
Fungal: Tinea
Parasitic: Malaria
Transmitted by a microorganism
What are the different categories of non-infectious disease and what are some examples?
3
How are they tranmitted?
Genetic or hereditary: Down Syndrome
Congenital: Fetal alcohol syndrome
Environmental: Lung CA (Cancer)
Not transmitted by a microorganism
How are pathogens transmitted?
6
In the air In water In food In body fluids like saliva, blood, semen By touching By another organism like the mosquito These transmitters are called vectors
Name the ways that bacteria can interact in the human body. Remember that these can be overlapping.
4
- Some bacteria are entirely adapted to the pathogenic way of life in humans. They are never part of the normal flora but may cause subclinical infection (not part of the body and come in just to be infectious)
- Some bacteria which are part of the normal flora acquire extra virulence factors making them pathogenic (something makes normal floura infectious)
- Some bacteria from the normal flora can cause disease if they gain access to deep tissues by trauma, surgery, lines especially if associated with a foreign body (bacteria get to parts of the body they arent supposed to be through trauma)
- In immuno-crompromised patients many free-living bacteria and components of the normal flora can cause disease (overgrowth) especially if introduced into deep tissues
(overgrowth of normal bacteria in immunocomprimised patients)
4 ways pathogens make us sick?
- Bacteria produce poisons that cause cell death
- Viruses use our cells to reproduce and then cause cell death
- Fungi grow and produce toxins
- Parasites live and grow in our body destroying tissue
What is the definition of a diagnoses?
The designation as to the nature or cause of a health problem.
What does the diagnostic processs include?
2
The diagnostic process includes the history (symptoms) and the physical exam (signs)
What is the definition of a differential diagnoses?
Weighing competing possibilities and selecting the most likely one but listing in order of likelihood
What is the defintion of a working diagnosis?
Based on information so far: history, physical exam, and diagnostic testing results currently available
What is the defintion of headaches or (cephalgia)?
How is the brain involved in headaches?
Is a pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. –The brain tissue itself is not sensitive to pain because it lacks pain receptors.
Types of Headaches general classifications?
2
Primary
Secondary
Types of primary headaches (the most common kind)?
Tension
Migraine
Cluster
Types of secondary headaches?
What are these based on?
- Cervicogenic (whiplash)
- Medication overuse (rebound)
- Birth Control changes
- Sinus symptoms
- TMJ pain (Temporomandibular Joint)
Based on etiology, not symptoms
What do you need to ask all patients with a chief complaint of headache?
And what do you do if yes?
Is this the worst headache of your life?
Red Flag!!! Subarachnoid hemorrhage
Send to the Emergency Department immediately
Other red flags for headaches
5
- Fever associated with headache (menigitis)
- Sudden onset of headache (less than 5 = lesions in the brain
Over 65 = cancers or tumors) - Absence of similar headaches in the past
- Worsening pattern
- Change in mental status, personality or change in level of consciousness
What questions should you ask for the systemic case history of headaches?
7
- Age at onset
- Presence or absence of aura and prodrome
- Frequency, intensity and duration of attack
- Number of headache days per month
- Time and mode of onset
- Quality, site and radiation of pain
- Family history of migraine
In review of systems what questions do we want to ask a patient with a headache?
6
- Head trauma
- Dizziness/vertigo
- Syncope/LOC (Loss of Consciousness)
- Earaches/drainage/discharge
- Vision status. Eye pain/redness/tearing
- Toothaches
What should the physical exam include with your headache patient?
10
- Obtain blood pressure and pulse
- Listen for bruit (stenosis in the carotid arteries) at neck
- Inspect the head for any trauma, swelling or asymmetry
- Examine the ears for any erythema, swelling, discharge
- Look up the nose for any swelling of the turbinate’s, bleeding, masses
- Tap on the sinuses for any tenderness
- Check for lymphadenopathy,
- Palpate for tenderness of head, neck and shoulder regions
- PERRLA- pupils equal, round, react to light, accommodation
- Good neurological exam
Other features suggesting a specific headache source?
6
- Chronic nasal stuffiness or chronic respiratory suggests diagnosis of sinusitis
- Impaired vision or seeing “holes” around light suggests the presence of glaucoma
- Visual field defects suggest the presence of a lesion of the optic pathway
- Sudden, severe, unilateral vision loss suggests the presence of optic neuritis
- Headache, fatigue, generalized aches and pains, and night sweats in subjects age 55 yo or older suggest presence of temporal arteritis
- Intermittent headaches with high blood pressure are suggestive of pheochromocytoma (tumor in the adrenal medulla = irregular epi and norepi)
Danger signs in physical examination of headaches?
3
- Neck stiffness and especially meningismus (resistance to passive neck flexion) suggests meningitis
- Papilledema (optic disc swelling caused by increased intracranial pressure)
- Focal neurologic signs suggest an intracranial mass lesion
Fever ranges in:
anus
oral
arm and ear
Temperature in the anus (rectal) ≥ 37.5-38.3 °C (99.5-100.9 °F)
Temperature in the mouth (oral) ≥ 37.7 °C (99.9 °F)
Temperature in the arm (axilla) or ear (otic) ≥ 37.2 °C (99.0 °F)
In differential diagnoses of fever what could be some infectious causes?
5
Influenza HIV UTI Infectious mononucleosis Gastroenteritis
What are some skin inflammations that could causes fever?
2
Boils (Furuncle or Carbuncle)
Abscess
What are some immunilogical diseases that could cause fever?
4
Lupus erythematosis
Sarcoidosis
Inflammatory bowel diseases
Kawasaki disease
What are fever causes that are related to tissue destruction?
4
Hemolysis
Surgery
Infarction
Rhabdomyolysis
Drug reactions to fever?
Reactions to incompatible blood products/Drugs
What are cancers that can cause fever?
3
Kidney cancer
Leukemia
Lymphomas
Metabolic disorders that can cause fever?
2
Gout (build up of crystals in a joint)
Porphyria (inherited)