Diagnosis of the formula + + treatment principles auxiliary examinationdiagnosis of digestive diseases formula
common symptoms: abdominal pain, diarrhea, nausea, vomiting, mass
1. acute and chronic gastritis = eating unclean or irritants + abdominal pain, bloating, nausea and vomiting
2. gastroesophageal reflux disease = acid reflux burning sensation + + retrosternal esophageal endoscopy red erosion zone transects (heartburn, acid reflux, back to food)
3.
ulcer = chronic peptic ulcer disease on regular abdominal pain (pain after a meal) + duodenal ulcer hematemesis melena
= hunger, pain (more than 4 hours after meals) or melena night pain + vomiting =
sudden severe abdominal pain, peptic ulcer perforation (peritonitis signs) + X ray of free gas below the diaphragm have
4. esophageal and gastric veins variceal upper gastrointestinal bleeding + = past history of liver disease
5. bacillary dysentery = dirty + eating + abdominal sepsis will mucin + tenesmus
6. ulcerative colitis = left lower abdominal pain, pus and blood will mucin + + (will be Italy, and after remission) + 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) = edema symptoms + purple + Cullen waist and abdomen or belly meat and water to wash through like liquid sugar + high + 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 on + + + subphrenic peritoneal irritation free gas
(4) Ectopic Pregnancy = postmenopausal vaginal bleeding + History + abdominal pain (cervical pain held) + human chorionic gonadotropin
( 5), ovarian cyst torsion = pain + sudden position changes and a cystic mass
(6) history of acute pelvic inflammatory disease = curettage surgery + + abnormal vaginal discharge lower abdominal pain + abdominal pain (cervical pain held) + purulent secretion material
14. digestive system tumors
(1) gastric = old + black + it + Kanying law change + chronic ulcer pain, abdominal mass, upper abdominal pain + weight loss + + the left supraclavicular lymph nodes
(2) = progressive dysphagia of esophageal cancer (the late) + retrosternal burning pain (early) + food choking feeling (early)
(3) liver: a history of hepatitis + liver pain increased + liver + AFP Great quality hardware + ascites, jaundice + B super-placeholder
(4) = rectum rectal irritation + DRE + blood + pus and blood will thin + stool deformation
(5) pancreatic cancer (pancreatic cancer, ampullary around the cancer) = old + pain + jaundice aggravated sexual clay color stool + skin itching
(6) colon cancer: old + weight loss + change in bowel habit + CEA + abdominal mass
15. anus, rectum, benign
(1) painless hemorrhoid = + it with bloody vein-like mass of blood +
(2) external hemorrhoids = anal pain + blood + anus tender will be mass
(3) anal fissure = anal pain when it will be after + anal fissure
16.
renal injury blunt abdominal trauma injury + hematuria
= waist = right hepatic rupture of peritoneal irritation abdominal trauma + + shifting dullness
spleen rupture = left abdominal pain + abdominal injury + All
intestinal rupture = abdominal bleeding abdomen trauma + peritoneal irritation sign + puncture pale yellow liquid
17. abdominal hernia (inguinal hernia) = elderly men increases abdominal pressure + right + the lower abdomen into the scrotum tumor +
digestive diseases further examination
1. endoscopy, colonoscopy, colonoscopy
2. gastroenterography
3. Abdominal B-, CT
4. upright abdominal plain film
5. stool: General Inspection , occult blood, culture and parasite examination
6.HP 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, etc.
digestive treatment principles
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 any, Helicobacter 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 Treatment
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) g Reber bacillus pneumonia = cough brick-red sputum + X-ray cavities
(3) Mycoplasma pneumonia = cough + children + irritating + joint pain antibiotics ineffective
(4) bronchial pneumonia = infant + fever + symptoms of breathing difficulties (nose 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, night sweats low heat + + antibiotic treatment had no significant effect
(2) = TB + TB pleurisy signs of pleural effusion (chest pain disappeared + percussion + fremitus real audio / breath sounds disappear)
(3) tuberculosis pericarditis, pericardial effusion = TB + signs (+ precordial pain, shortness of breath + nausea upper abdominal bulge + lower extremity edema)
(4) intestinal tuberculosis = TB + abdominal symptoms (abdominal pain, diarrhea, right lower abdominal mass) < br> (5) = TB + TB peritonitis inflammation of the abdomen (abdominal pain, diarrhea, abdominal wall flexibility and a sense of)
(6) renal tuberculosis = TB + + bladder irritation, thinning of the renal parenchyma and destructive
4. bronchus expand = childhood whooping cough or measles history of delayed healing of bronchial pneumonia + cough + purulent + hemoptysis
5.COPD = old (smoking) + sputum + asthma + barrel chest pulmonary function tests, a second rate FEV1/FVC% less than 70%
6. abscess = smelly pus sputum + heat + X-ray films / CT shows fluid level
7. lung cancer =, the old + blood + irritating cough + sputum weight loss + X ray burr
8. pulmonary heart disease = 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. = chronic lung disease, respiratory failure, cyanosis history + + blood gas analysis
I type: PaO2 <60mmHg PaCO2 normal - severe pneumonia induced
II-type : PaO2 <60mmHg PaCO2> 50mmHg-COPD induced
11. chest blunt trauma
(1) tension pneumothorax chest trauma history + = extensive subcutaneous emphysema (grip snow flu) + tracheal deviation + Shift + percussion drum sound breath sounds disappeared
(2) history of chest trauma hemothorax + = offset + percussion dullness tracheal breath sounds decreased + X + ray costophrenic angle disappeared, curved high density
(3) History of chest trauma rib fractures = + bone fricative
Check the items respiratory diseases
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 count, electrolyte
treatment of respiratory diseases principles
1. General treatment: rest, nutrition, prevention of infection / oxygen
2. symptomatic treatment / drug treatment
(1) anti-infective therapy: use of broad-spectrum antibiotic or combination
(2 ) anti-tuberculosis treatment: early, regular, joint, rules, full
(3) anti-shock: expansion, the use of vasoactive drugs
(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, + rest or mouth with nitroglycerin can mitigation + 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 arched Up elevation
V1-6 extensive anterior wall myocardial infarction
V1-3 anteroseptal myocardial infarction
V3-5 limited 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 pulmonary tone and 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)
1 级 140-159 or 90-99 below 160/100
2 160-179 or 100-109 lower than the 180/110
3 级 ≥ 180 or ≥ 110
risk stratification
low risk: 1. Lifestyle.
in crisis: 1 + 2 factors; two are not associated with, or less than 2 factors. 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 slightly restricted
III Activity was limited
IV class symptoms at rest
right heart failure left ventricular failure + = Full HF
4. arrhythmia:
(1) AF = absolute rhythm shortage ranging from + pulse wave + f + ECG 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 / min)
(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 / ventricular fusion wave
(4) Other: See some of the third leg of electrocardiographic
5. valvular heart disease
(1) mitral stenosis = dyspnea (exertional, paroxysmal, night, orthopnea , acute 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 All hair samples rough systolic murmur, left subscapular angle to the armpit or conduction
(3) aortic stenosis = breathing difficulties + angina + syncope + ejection murmur to the neck conduction
(4 ) = aortic insufficiency of paroxysmal nocturnal palpitations + angina + noise + breathing + AustinFliht peripheral vascular symptoms (flush pulse, Mussctz sign, significant fluctuations in carotid artery, capillary pulsation Zheng, arterial tone and Durozicz shooting levy)
major flap valve murmurs occur during the switching nature of
mitral stenosis murmur ; diastolic rumble open like
Systolic mitral regurgitation off hair-like
open systolic aortic stenosis jet-like
diastolic aortic insufficiency related sigh like
6. shock signs = P ↑ + Bp ↓ + speed + pulse fine cold limbs, hair
(1) signs of hemorrhagic shock + Hemorrhage off
(2) signs of cardiogenic shock = shock + left heart failure
cardiovascular system to further examine
1. electrocardiogram, Holter
2. echocardiography
3. chest X ray
4. fundus examination (hypertension), radionuclide
5. myocardial enzymes
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 protein, troponin, creatine kinase 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 receptor blockers, calcium channel blockers, ACEI (angiotensin converting enzyme inhibitors), angiotensin II receptor blockers
(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, etc.
Diagnosis of urinary system diseases
formula
1. glomerular nephritis: the eyelid / facial edema and history of streptococcal infection + young + + C3 + hematuria and proteinuria decreased blood pressure
2. urinary tract infection
(1) = pyelonephritis women + back pain + fever + pyuria, WBC casts
(2) acute exacerbation of chronic pyelonephritis = urinary bladder irritation, injury history + + recurrent low back pain + fever + pain + WBC knocked on kidney area increased
(3) married women with lower urinary tract infection = + hot + bladder irritation
3. hematuria after kidney stones = activities + colic + B over the waist or the X-
4. ureteral stones = activities of hematuria after + + X-ray lumbar colic
5. RCC = old + (painless) gross hematuria
6. nephritis, renal failure = years of history of hypertension hematuria and proteinuria + + serum creatinine (decompensated 133, 442 decompensated, failure of 707, uremia) increased
7. prostatic hyperplasia = elderly + urinary + for voiding difficulty
further examination of urinary system diseases
1. abdominal B ultrasound, plain film
2. urine routine, ESR, renal function, blood gas analysis
3. pyelography
4. biopsies
5. gynecological examination
6. creatinine, glomerular filtration rate
7. renal function
8. radionuclide renography
9. cystoscopy
principles of treatment of urinary system
1. General treatment: attention to rest, low sodium / low protein diet
2. symptomatic treatment
(1) anti-infective
(2) diuretic antihypertensive
(3) dialysis
1. hyperthyroidism = sudden palpitations + eye (eyes bulging) + emotional + sweating + goiter
check: T3/T4/TSH 131I radionuclide thyroid
2. thyroid cancer = thyroid nodules + B Super
3. Diabetes = more than three a little blood glucose: fasting 7.0, meal 11.1, OGTT
(1) 1 = more than three a diabetes incidence of acute + low + Green Junior + rotten apple
(2) 2 = middle-aged diabetic + hard + slow onset of ketoacidosis diabetic ketoacidosis and hyperosmolar
differences: 33.3 for the glycemic index to check the limits of
: fructosamine, insulin release test, C peptide release assay, glycosylated hemoglobin
General treatment: life guidance, diet, physical exercise, disease monitoring, drug treatment to prevent complications
:
secretagogues agents, sulfur Urea -2 Non obesity, diet and exercise control is not ideal
biguanide -
obese and type 2 insulin -1 complications
a glucosidase inhibitor - postprandial hyperglycemia
diagnosis of blood diseases formula
1. leukemic = heat + Bleeding + sternum tenderness + pancytopenia
2. aplastic anemia = appearance + + three-line to reduce bleeding tendency
3. = autoimmune hemolytic anemia anemia Maung + 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 + thrombocytopenia (less than 100-109), red white blood cell count normal
6.DIC = extended multi-site bleeding + PT +3 P test positive
further examination of blood system diseases
1. Bone marrow biopsy
2. cell morphology
3. liver and kidney function, abdominal B-
4. blood
blood system diseases treatment
general treatment: rest, infection control, use of broad spectrum antibiotics
leukemia: chemotherapy and bone marrow transplantation
chemotherapy:
acute leukemia, acute lymphoblastic-DVLP program
(daunorubicin, Changchun new base, L-asparaginase, prednisone)
acute Fei Lin-DA program
(daunorubicin, cytarabine)
promyelocytic - chronic RA
Leukemia
autoimmune hemolytic anemia: glucocorticoids, splenectomy
TTP: corticosteroids, splenectomy
AA: male hormones, immune agents, bone marrow transplantation
anemia: iron supplementation + VC, preoperative anemia, a serious infusion of red blood cells
women with systemic lupus erythematosus = erythema + butterfly + photosensitivity + ulcer positive
+ arthritis + ANA + RA = Single = rheumatoid arthritis in large joints
older 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 = history + + garlic pupil pinpoint changes in taste + wet lung auscultation Sound + cholinesterase activity decreased
diagnosis of cerebral vascular disease formula
1. intracerebral hemorrhage = + hypertension in elderly patients with acute onset of + consciousness + + Location signs
2. thrombosis = quiet state disease (coronary heart disease, hyperlipidemia)
3. Brain = incidence of acute cardiac embolism + thrombosis (subacute endocarditis)
pulmonary dyspnea + chest pain + = hemoptysis, lower extremity embolus (varicose veins / lower limb gangrene)
4. subarachnoid hemorrhage = incidence of acute + meningeal irritation + CT
5. infarction = hypertension + paralysis + CT no lesions
meningitis diagnosis formula
tuberculous meningitis = + with meningeal irritation symptoms (fever night sweats)
disease brain = meningeal irritation + virus infection (fever)
of the brain = + purulent meningeal irritation (heat)
ECM = meningeal irritation + + skin in winter and spring ecchymosis
mucosal petechia meningeal irritation + JE = respiratory failure + summer and autumn
diagnosis of traumatic brain injury disease 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 spindle hematoma < br> 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 + + + cervical lifting pain vaginal bleeding
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 pain held) + heat + vaginal discharge
4. cervical cancer = contact bleeding or irregular vaginal bleeding + food vegetation patterns (Ib of limited cervical, Ib1 of longitude <= 4cm)
5. Ovarian cancer = older women + + bloating + abdominal mass, weight loss
6. Uterine fibroids = + The amount of women of childbearing age uterus increases too much + + anemia appearance
Diagnosis of pediatric diseases 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: Cool
tear limbs less oliguria ; (3) severe: no blood in urine reduced
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 < br> 4. Drug treatment: infection control, protection of intestinal mucosa
2. eruptive diseases in children with
(1) measles = fever + flu + body on the mucosal papules + measles spots
(2) RV = fever + flu + on + red papules tender lymph nodes behind the ear
(3) Emergency = protruding heat + hot back rash
(4) RV = fever + herpes + itchy concentric water 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) + low serum calcium + phosphate
limb fracture and dislocation of large joints proprietary fracture diagnostic formula
signs: unusual activity / feeling of bone rubbing / 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. humeral fractures = + children + with hands palm down posterior 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 + hip + limb + shorter side of the lower extremity internal rotation and adduction deformity
7. = palm of your hand with anterior shoulder dislocation to injury + elbow + ipsilateral contralateral hand care CJR sign positive
8. femoral neck fracture = hip external rotation of limb deformities trauma + + trochanter Move
+ Pauwels angle
acute purulent infection of soft tissue swelling = pain
1. carbuncle = middle-aged + fever chills swollen knot + + skin ulceration after hard honeycomb sores
2. subcutaneous acute cellulitis = trauma + pain + swelling + swollen skin temperature fluctuations in the high sense of ill-defined + the pus
3. erysipelas = flaky skin, limb or facial erythema + + bulge + recur clear boundary
4. Acute lymphangitis / lymphadenitis red line + = skin contact local lymph nodes pain
diagnosis of breast disease formula
1. Acute mastitis = breast tenderness pregnant women + + hot + WBC increased
floating sense of acute mastitis + = abscess formation
2. breast cystic hyperplasia = cyclic breast swelling + + tired after the palpable mass increased
3. breast cancer risk factors + = quality hard not smooth painless lump + axillary lymph nodes
treatment principles:
1. General treatment: rest, nutrition, health care
2. symptomatic treatment / drug treatment / causes of treatment
3. surgical treatment
4. cancer treatment
common symptoms: abdominal pain, diarrhea, nausea, vomiting, mass
1. acute and chronic gastritis = eating unclean or irritants + abdominal pain, bloating, nausea and vomiting
2. gastroesophageal reflux disease = acid reflux burning sensation + + retrosternal esophageal endoscopy red erosion zone transects (heartburn, acid reflux, back to food)
3.
ulcer = chronic peptic ulcer disease on regular abdominal pain (pain after a meal) + duodenal ulcer hematemesis melena
= hunger, pain (more than 4 hours after meals) or melena night pain + vomiting =
sudden severe abdominal pain, peptic ulcer perforation (peritonitis signs) + X ray of free gas below the diaphragm have
4. esophageal and gastric veins variceal upper gastrointestinal bleeding + = past history of liver disease
5. bacillary dysentery = dirty + eating + abdominal sepsis will mucin + tenesmus
6. ulcerative colitis = left lower abdominal pain, pus and blood will mucin + + (will be Italy, and after remission) + 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) = edema symptoms + purple + Cullen waist and abdomen or belly meat and water to wash through like liquid sugar + high + 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 on + + + subphrenic peritoneal irritation free gas
(4) Ectopic Pregnancy = postmenopausal vaginal bleeding + History + abdominal pain (cervical pain held) + human chorionic gonadotropin
( 5), ovarian cyst torsion = pain + sudden position changes and a cystic mass
(6) history of acute pelvic inflammatory disease = curettage surgery + + abnormal vaginal discharge lower abdominal pain + abdominal pain (cervical pain held) + purulent secretion material
14. digestive system tumors
(1) gastric = old + black + it + Kanying law change + chronic ulcer pain, abdominal mass, upper abdominal pain + weight loss + + the left supraclavicular lymph nodes
(2) = progressive dysphagia of esophageal cancer (the late) + retrosternal burning pain (early) + food choking feeling (early)
(3) liver: a history of hepatitis + liver pain increased + liver + AFP Great quality hardware + ascites, jaundice + B super-placeholder
(4) = rectum rectal irritation + DRE + blood + pus and blood will thin + stool deformation
(5) pancreatic cancer (pancreatic cancer, ampullary around the cancer) = old + pain + jaundice aggravated sexual clay color stool + skin itching
(6) colon cancer: old + weight loss + change in bowel habit + CEA + abdominal mass
15. anus, rectum, benign
(1) painless hemorrhoid = + it with bloody vein-like mass of blood +
(2) external hemorrhoids = anal pain + blood + anus tender will be mass
(3) anal fissure = anal pain when it will be after + anal fissure
16.
renal injury blunt abdominal trauma injury + hematuria
= waist = right hepatic rupture of peritoneal irritation abdominal trauma + + shifting dullness
spleen rupture = left abdominal pain + abdominal injury + All
intestinal rupture = abdominal bleeding abdomen trauma + peritoneal irritation sign + puncture pale yellow liquid
17. abdominal hernia (inguinal hernia) = elderly men increases abdominal pressure + right + the lower abdomen into the scrotum tumor +
digestive diseases further examination
1. endoscopy, colonoscopy, colonoscopy
2. gastroenterography
3. Abdominal B-, CT
4. upright abdominal plain film
5. stool: General Inspection , occult blood, culture and parasite examination
6.HP 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, etc.
digestive treatment principles
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 any, Helicobacter 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 Treatment
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) g Reber bacillus pneumonia = cough brick-red sputum + X-ray cavities
(3) Mycoplasma pneumonia = cough + children + irritating + joint pain antibiotics ineffective
(4) bronchial pneumonia = infant + fever + symptoms of breathing difficulties (nose 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, night sweats low heat + + antibiotic treatment had no significant effect
(2) = TB + TB pleurisy signs of pleural effusion (chest pain disappeared + percussion + fremitus real audio / breath sounds disappear)
(3) tuberculosis pericarditis, pericardial effusion = TB + signs (+ precordial pain, shortness of breath + nausea upper abdominal bulge + lower extremity edema)
(4) intestinal tuberculosis = TB + abdominal symptoms (abdominal pain, diarrhea, right lower abdominal mass) < br> (5) = TB + TB peritonitis inflammation of the abdomen (abdominal pain, diarrhea, abdominal wall flexibility and a sense of)
(6) renal tuberculosis = TB + + bladder irritation, thinning of the renal parenchyma and destructive
4. bronchus expand = childhood whooping cough or measles history of delayed healing of bronchial pneumonia + cough + purulent + hemoptysis
5.COPD = old (smoking) + sputum + asthma + barrel chest pulmonary function tests, a second rate FEV1/FVC% less than 70%
6. abscess = smelly pus sputum + heat + X-ray films / CT shows fluid level
7. lung cancer =, the old + blood + irritating cough + sputum weight loss + X ray burr
8. pulmonary heart disease = 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. = chronic lung disease, respiratory failure, cyanosis history + + blood gas analysis
I type: PaO2 <60mmHg PaCO2 normal - severe pneumonia induced
II-type : PaO2 <60mmHg PaCO2> 50mmHg-COPD induced
11. chest blunt trauma
(1) tension pneumothorax chest trauma history + = extensive subcutaneous emphysema (grip snow flu) + tracheal deviation + Shift + percussion drum sound breath sounds disappeared
(2) history of chest trauma hemothorax + = offset + percussion dullness tracheal breath sounds decreased + X + ray costophrenic angle disappeared, curved high density
(3) History of chest trauma rib fractures = + bone fricative
Check the items respiratory diseases
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 count, electrolyte
treatment of respiratory diseases principles
1. General treatment: rest, nutrition, prevention of infection / oxygen
2. symptomatic treatment / drug treatment
(1) anti-infective therapy: use of broad-spectrum antibiotic or combination
(2 ) anti-tuberculosis treatment: early, regular, joint, rules, full
(3) anti-shock: expansion, the use of vasoactive drugs
(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, + rest or mouth with nitroglycerin can mitigation + 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 arched Up elevation
V1-6 extensive anterior wall myocardial infarction
V1-3 anteroseptal myocardial infarction
V3-5 limited 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 pulmonary tone and 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)
1 级 140-159 or 90-99 below 160/100
2 160-179 or 100-109 lower than the 180/110
3 级 ≥ 180 or ≥ 110
risk stratification
low risk: 1. Lifestyle.
in crisis: 1 + 2 factors; two are not associated with, or less than 2 factors. 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 slightly restricted
III Activity was limited
IV class symptoms at rest
right heart failure left ventricular failure + = Full HF
4. arrhythmia:
(1) AF = absolute rhythm shortage ranging from + pulse wave + f + ECG 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 / min)
(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 / ventricular fusion wave
(4) Other: See some of the third leg of electrocardiographic
5. valvular heart disease
(1) mitral stenosis = dyspnea (exertional, paroxysmal, night, orthopnea , acute 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 All hair samples rough systolic murmur, left subscapular angle to the armpit or conduction
(3) aortic stenosis = breathing difficulties + angina + syncope + ejection murmur to the neck conduction
(4 ) = aortic insufficiency of paroxysmal nocturnal palpitations + angina + noise + breathing + AustinFliht peripheral vascular symptoms (flush pulse, Mussctz sign, significant fluctuations in carotid artery, capillary pulsation Zheng, arterial tone and Durozicz shooting levy)
major flap valve murmurs occur during the switching nature of
mitral stenosis murmur ; diastolic rumble open like
Systolic mitral regurgitation off hair-like
open systolic aortic stenosis jet-like
diastolic aortic insufficiency related sigh like
6. shock signs = P ↑ + Bp ↓ + speed + pulse fine cold limbs, hair
(1) signs of hemorrhagic shock + Hemorrhage off
(2) signs of cardiogenic shock = shock + left heart failure
cardiovascular system to further examine
1. electrocardiogram, Holter
2. echocardiography
3. chest X ray
4. fundus examination (hypertension), radionuclide
5. myocardial enzymes
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 protein, troponin, creatine kinase 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 receptor blockers, calcium channel blockers, ACEI (angiotensin converting enzyme inhibitors), angiotensin II receptor blockers
(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, etc.
Diagnosis of urinary system diseases
formula
1. glomerular nephritis: the eyelid / facial edema and history of streptococcal infection + young + + C3 + hematuria and proteinuria decreased blood pressure
2. urinary tract infection
(1) = pyelonephritis women + back pain + fever + pyuria, WBC casts
(2) acute exacerbation of chronic pyelonephritis = urinary bladder irritation, injury history + + recurrent low back pain + fever + pain + WBC knocked on kidney area increased
(3) married women with lower urinary tract infection = + hot + bladder irritation
3. hematuria after kidney stones = activities + colic + B over the waist or the X-
4. ureteral stones = activities of hematuria after + + X-ray lumbar colic
5. RCC = old + (painless) gross hematuria
6. nephritis, renal failure = years of history of hypertension hematuria and proteinuria + + serum creatinine (decompensated 133, 442 decompensated, failure of 707, uremia) increased
7. prostatic hyperplasia = elderly + urinary + for voiding difficulty
further examination of urinary system diseases
1. abdominal B ultrasound, plain film
2. urine routine, ESR, renal function, blood gas analysis
3. pyelography
4. biopsies
5. gynecological examination
6. creatinine, glomerular filtration rate
7. renal function
8. radionuclide renography
9. cystoscopy
principles of treatment of urinary system
1. General treatment: attention to rest, low sodium / low protein diet
2. symptomatic treatment
(1) anti-infective
(2) diuretic antihypertensive
(3) dialysis
1. hyperthyroidism = sudden palpitations + eye (eyes bulging) + emotional + sweating + goiter
check: T3/T4/TSH 131I radionuclide thyroid
2. thyroid cancer = thyroid nodules + B Super
3. Diabetes = more than three a little blood glucose: fasting 7.0, meal 11.1, OGTT
(1) 1 = more than three a diabetes incidence of acute + low + Green Junior + rotten apple
(2) 2 = middle-aged diabetic + hard + slow onset of ketoacidosis diabetic ketoacidosis and hyperosmolar
differences: 33.3 for the glycemic index to check the limits of
: fructosamine, insulin release test, C peptide release assay, glycosylated hemoglobin
General treatment: life guidance, diet, physical exercise, disease monitoring, drug treatment to prevent complications
:
secretagogues agents, sulfur Urea -2 Non obesity, diet and exercise control is not ideal
biguanide -
obese and type 2 insulin -1 complications
a glucosidase inhibitor - postprandial hyperglycemia
diagnosis of blood diseases formula
1. leukemic = heat + Bleeding + sternum tenderness + pancytopenia
2. aplastic anemia = appearance + + three-line to reduce bleeding tendency
3. = autoimmune hemolytic anemia anemia Maung + 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 + thrombocytopenia (less than 100-109), red white blood cell count normal
6.DIC = extended multi-site bleeding + PT +3 P test positive
further examination of blood system diseases
1. Bone marrow biopsy
2. cell morphology
3. liver and kidney function, abdominal B-
4. blood
blood system diseases treatment
general treatment: rest, infection control, use of broad spectrum antibiotics
leukemia: chemotherapy and bone marrow transplantation
chemotherapy:
acute leukemia, acute lymphoblastic-DVLP program
(daunorubicin, Changchun new base, L-asparaginase, prednisone)
acute Fei Lin-DA program
(daunorubicin, cytarabine)
promyelocytic - chronic RA
Leukemia
autoimmune hemolytic anemia: glucocorticoids, splenectomy
TTP: corticosteroids, splenectomy
AA: male hormones, immune agents, bone marrow transplantation
anemia: iron supplementation + VC, preoperative anemia, a serious infusion of red blood cells
women with systemic lupus erythematosus = erythema + butterfly + photosensitivity + ulcer positive
+ arthritis + ANA + RA = Single = rheumatoid arthritis in large joints
older 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 = history + + garlic pupil pinpoint changes in taste + wet lung auscultation Sound + cholinesterase activity decreased
diagnosis of cerebral vascular disease formula
1. intracerebral hemorrhage = + hypertension in elderly patients with acute onset of + consciousness + + Location signs
2. thrombosis = quiet state disease (coronary heart disease, hyperlipidemia)
3. Brain = incidence of acute cardiac embolism + thrombosis (subacute endocarditis)
pulmonary dyspnea + chest pain + = hemoptysis, lower extremity embolus (varicose veins / lower limb gangrene)
4. subarachnoid hemorrhage = incidence of acute + meningeal irritation + CT
5. infarction = hypertension + paralysis + CT no lesions
meningitis diagnosis formula
tuberculous meningitis = + with meningeal irritation symptoms (fever night sweats)
disease brain = meningeal irritation + virus infection (fever)
of the brain = + purulent meningeal irritation (heat)
ECM = meningeal irritation + + skin in winter and spring ecchymosis
mucosal petechia meningeal irritation + JE = respiratory failure + summer and autumn
diagnosis of traumatic brain injury disease 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 spindle hematoma < br> 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 + + + cervical lifting pain vaginal bleeding
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 pain held) + heat + vaginal discharge
4. cervical cancer = contact bleeding or irregular vaginal bleeding + food vegetation patterns (Ib of limited cervical, Ib1 of longitude <= 4cm)
5. Ovarian cancer = older women + + bloating + abdominal mass, weight loss
6. Uterine fibroids = + The amount of women of childbearing age uterus increases too much + + anemia appearance
Diagnosis of pediatric diseases 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: Cool
tear limbs less oliguria ; (3) severe: no blood in urine reduced
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 < br> 4. Drug treatment: infection control, protection of intestinal mucosa
2. eruptive diseases in children with
(1) measles = fever + flu + body on the mucosal papules + measles spots
(2) RV = fever + flu + on + red papules tender lymph nodes behind the ear
(3) Emergency = protruding heat + hot back rash
(4) RV = fever + herpes + itchy concentric water 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) + low serum calcium + phosphate
limb fracture and dislocation of large joints proprietary fracture diagnostic formula
signs: unusual activity / feeling of bone rubbing / 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. humeral fractures = + children + with hands palm down posterior 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 + hip + limb + shorter side of the lower extremity internal rotation and adduction deformity
7. = palm of your hand with anterior shoulder dislocation to injury + elbow + ipsilateral contralateral hand care CJR sign positive
8. femoral neck fracture = hip external rotation of limb deformities trauma + + trochanter Move
+ Pauwels angle
acute purulent infection of soft tissue swelling = pain
1. carbuncle = middle-aged + fever chills swollen knot + + skin ulceration after hard honeycomb sores
2. subcutaneous acute cellulitis = trauma + pain + swelling + swollen skin temperature fluctuations in the high sense of ill-defined + the pus
3. erysipelas = flaky skin, limb or facial erythema + + bulge + recur clear boundary
4. Acute lymphangitis / lymphadenitis red line + = skin contact local lymph nodes pain
diagnosis of breast disease formula
1. Acute mastitis = breast tenderness pregnant women + + hot + WBC increased
floating sense of acute mastitis + = abscess formation
2. breast cystic hyperplasia = cyclic breast swelling + + tired after the palpable mass increased
3. breast cancer risk factors + = quality hard not smooth painless lump + axillary lymph nodes
treatment principles:
1. General treatment: rest, nutrition, health care
2. symptomatic treatment / drug treatment / causes of treatment
3. surgical treatment
4. cancer treatment
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