Manifestation of Disease Flashcards
Health Definition
physical, mental, and social well-being
Homeostasis
maintenance of a stable internal environment
Disease State Definition
any deviation from or interruption of the normal structure or function of any part of the body manifested by a set of signs and symptoms
Types of Infectious Diseases and Transmission
Bacterial: Cholera
Viral: Chicken Pox
Fungal: Tinea
Parasitic: Malaria
Transmitted via microorganisms
Contagious
Types of Non-infectious Diseases and Transmission
Genetic/Hereditary: Downs
Congenital: Fetal alcohol syndrome
Environmental: Lung CA
NOT transmitted via microorganism
NOT contagious
How are pathogens transmitted?
air, water, food, bodily fluids(saliva, blood, semen), touching, via another organism (mosquito)
Diagnosis Definition
designation to the cause of a health problem
Differential Diagnosis
Weighing competing possibilities and selecting the most likely cause of disease
*Assume worst and work from there
Working Diagnosis
where you decide which tests you will use to confirm your diagnosis
*Approach: HA
Systemic case history:
- age @ onset
- presence/absence of aura
- frequency/intesity/duration
- # HA/month
- Time and mode of onset
- Quality, site and radiation
- FH of migraines
Types of HA
Primary: tension, migraine, cluster
Secondary: cervicogenic (whiplash), medication overdose (rebound), birth control change, sinus, TMJ pain
Red Flag Symptom of HA
Worst HA of life- - possible subarachnoid hemorrhage
Fever Sudden onset Absence of HA in past Worsening pattern Change in mental status, personality, conciousness
*Differential Diagnosis: HA
Good ROS
- head trauma
- dizziness/vertigo
- syncope/LOC
- Earaches/drainage/discharge
- Vision Status. Eye pain/tearing
- Toothaches
HA Exam
- BP and Pulse
- Bruit in neck
- Look for head trauma/swelling/asymmetry
- Examine ears(blood,swelling,discharge)
- Examine nose (swelling of turbinates, bleeding, masses)
- Tap sinuses (tenderness)
- Check lymphadenopathy
- PERRLA (pupils equal, round, reactive to light, accomadation)
- Good neurological exam
Other HA Sources
- chronic nasal congestion
- impaired vision/seeing holes (glaucoma)
- Visual field defects (lesion of optic pathway)
- Sudden/severe unilateral vision loss (optic neuritis)
- HA, fatigue, general aches, night sweats >55yo (temporal arteritis, may cause blindness)
- Intermittent HA w/ high BP
HA Danger Signs
Neck stiffness (meningitis)
Papilledema (optic disc swelling d/t increased ICP) (Worry about mass)
Focal neurologic signs suggesting an intracranial mass lesion
*Differential Diagnosis: FEVER
Infectious disease;
- influenza
- HIV
- UTI
- Infectious mono
- Gastroenteritis
Skin Inflammation;
-Boils, abscess
Immunological Disease;
-lupus, sarcoidosis, IBS, Kawasaki Disease
Tissue Destruction:
- hemolysis
- surgery
- nfarction
- rhabdomyolysis
Blood transfusion rxn
Drug sensitivity
Cancers
- kidney
- leukemia
- lymphomas
Metabolic Disorder;
-Gout, porphyria
Thrombo-embolytic
-PE, DVT
Unknown
*Approach: FEVER
Good HPI, ROS, and exam
Exam- head to toe look for source
Consider: CBC, BMP(Basic Metabolic Panel), blood cultures, UA
Cough Classification
duration, character, quality, timing
*Differential Diagnosis: COUGH
Infections:
- common cold
- pneuomonia
- pertussis
- TB
Reactive airway disease;
- Cough variant asthma
- Chronic bronchitis
- Long term fume inhalation
GERD- unexplained cough
Air pollution;
- particulate matter
- tobacco smoke
- dampness in home
- irritant gasses
Foreign body- i.e. while eating
ACE inhibitor- used in diabetic, heart disease, and BP pts. Common side effect
Psychogenic:
- most common in kids
- emotional probs
Post nasal drip
*Approach: COUGH
CBC, H. pylori (if h./o gerd), sed rate (inflammation) CXR, Spirometry
Treatment: antibiotics, corticosteroids
*Differential Diagnosis: EDEMA
- Palpable swelling
- Manifestation of heart failure, cirrhosis, nephrotic syndrome, renal failure, medications
Hx very important:
- coronary disease
- ETOH abuse
- HTN
- Hepatic/Renal Disease
- Medications (NSAIDS/Corticosteriods)
*Approach: EDEMA
-Exam:
HEENT (Head, ears, eyes, nose, throat)
Resp.
Cardiovascular
Abdominal
Extremeties
Edema
-CBC, CMP (electrolytes), TSH, EKG, CXR, Duplex US
*Dont miss acute onset unexplained unilateral leg edema»>think DVT
-potential causes
Long drive/flight, tobacco use, birth control, recent surgery
*Differential Diagnosis: WEIGHT LOSS
Hyper/hypothyroidism Dental Problems Gastrointestinal Disease: -anorexia -abd pain -dysphagia -dysmotility -diarrhea -malabsorption -chronic inflamm -obstrucion
Cancer
HIV
Adv. Cardiac, pulm, & renal disease
Drugs:
-OTC/herbal meds
-Prescription drugs
-Substance abuse
*ETOH, cocaine, opiates, amphetamines, tobacco use
*Approach: WEIGHT LOSS
HPI, PMH, FH. PSH, ROS and Head to toe exam:
- appearance
- affect (how they describe pain)
- skin changes
- lymphadenopathy
- cardiopulmonary status
- hematosplenomegaly
- abd mass
- rectal exam w/ + stool hemoccult
CBC, CMP, TSH, Hbg A1C, UA, Stool hemoccult, ESR/CRP, CXR
*Differential Diagnosis: VAGUE NEURO SYMPTOMS
- dizziness
- fainting
- numbness/weakness
- syncope (LOC,h/o heart disease, diabetes, dehydration, stress)
*Approach: VAGUE NEURO SYMPTOMS
HPI, PMH, HF, PSH, SOC, ROS, Vitals (ortho BP)
CBC, CMP, TSH, UA, HgbA1C, HCG (pregnancy), CXR, EKG, Pulse Ox
Physical Exam-
- higher functions (gate, speech, mental status)
- cranial nerves
- sensory system
- motor system
- reflexes
- cerebellum
3 Main processes of Inflamm
arterioles dilate
capillaries become more permeable
neutrophils and Mfs migrate to interstitial fluid
5 Cardinal Signs of Inflamm
Pain Redness Swelling Heat Immobility
*Differential Diagnosis: INFLAMM
Infection vs inflammation
Trauma vs overuse
Unilateral:
-long drive, tobacco use, birth
control–think DVT
-Cellulitis
Bilateral:
- Rhabdomyolysis
- Immune Disorders
*Approach: INFLAMM
HPI, PMH, FH, PSH, ROS
CBC, SED rate/CRP, CMP, UA, Plain films
