医学生物ppt般内科病例讨论（2）课件

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1、ㄧ般內科病例討論PGY侯欣妤VS陳志雄1业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友PatientProfileChartNo.:27356231,王清祥Age:61y/oGender:maleDateofadmission:2009/04/232业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友ChiefcomplaintGeneralizedpolymorphouseruptionofmaculeswithmilditchingoverwholebodyfor20days&m

2、outhulcerssince7daysago3业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友PresentillnessAcaseofHTN,type2DMfor10yearswithpoorcontrolat台南署立醫院andgoutyarthritisGeneralizedpolymorphouseruptionskinlesionoverface,trunkandlimbsfor20daysInitial:leftshoulderitchingspreadtoantchestwallwho

3、lebody,SharplydemarcatedredmaculesNotenderness,nobullae,nonecrosisMouth&lipsulcersince7daysagoWeeksago:Lowgradefever,mildcoldrecoverynowNodysuria,abdominalpainNotravelhistory4业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友PresentillnessRecentdruguse:Anti-goutagent5业精于勤荒于嬉行成于思毁

4、于随→【医学生物PPT，欢迎收藏分享】豆丁网友PastMedicalHistory1.Medicalhistory:Hypertension--------(+)Diabetesmellitus---(+)ChronichepatitisB--deniedChronichepatitisC--deniedGout--(+)2.Surgicalhistory:nil3.Drugallergy:unknown6业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友7业精于勤荒于嬉行成于思毁于随→【医学生物PPT，

5、欢迎收藏分享】豆丁网友PersonalHistorySmoking:(-)Drinking:(-)Betelnutsuse:deniedHistoryofoverseatravel:deniedHistoryofcontactwithanimalsorsickpeople:denied8业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友PhysicalexamVitalsign:T:36.9P:76R:18BP:131/71mmHgConsciouslevel:clearPeripheralperfusi

6、on:distalextremities:warm,pinkSkin:pruritis(+),rash(+),normalturgor,normalskincolor,nobullae,nodesqumateHEENT:Eyes:conjunctivanotpale,Mouth:ulcer(+)esp.lowerlipsNeck:Supple,nolymphadenopathyNothyroidenlargement9业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友PhysicalexamChest&L

7、ungs:Symmetricalexpansion,clearbreathingsoundHeart:HS:Regularheatbeat,nomurmurAbdomen:soft,flattenderness(-),reboundingpain(-)Normalactivebowelsounds,Noabdominalbruit10业精于勤荒于嬉行成于思毁于随→【医学生物PPT，欢迎收藏分享】豆丁网友ThereisnopreviousCXRonthePACS.>Bilateralapicalpleuralthickenin

8、gnoted.ThereisanodularshadowatLLLoflung,couldbenippleshadowortruepulmonarylesion.>Normalheartsizeisnoted.>Degenerativechangewithmarginalspurforma