诊断学课件症状学部分发热

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1、SectionIIICommonSymptoms(fever)Dr.ZhuorenLuFirstHospitalXianJiaotongUniversityConceptssymptoms:subjectivedisturbances,forinstanceheadache,chestpain,abdominalpain,dyspnea,cough,palpitation,nausea,vomiting,andsoon.physicalsigns:objectivemarks,forexamplefever,edema,cyanosis,jaundice,d

2、iarrhea,confusion,coma,skineruption,scar,murmurandsoon.Inaboardsense,bothsubjectiveandobjectiveabnormalcouldbecalledassymptoms.A.Fever(pyrexia)1.Definition:Feverrepresentsadisturbanceinwhichthereisupwardshiftofthebody’stemperature.lThenormalbodytemperaturetakeninthemouth,isclosedto37

3、℃(36.337.2℃).lOraltemperaturerecordingsisapproximatelyequaltosimultaneousrectaltemperaturereading.Thetemperatureoftheskinoftheaxillaisslightlower(0.20.4℃)thanthatinthemouth.2.Physiology:Anindividual’sbaselinetemperaturevaries(lessthan1℃)(lowestinthemorning),activity(exercise),phys

4、iologicalevents(ovulation),andhabit(smoking).Eldlyhaslowerbaselinetemperatureandoftenproducelessfeverresponse.3.Clinicalclassificationlowfever:37.438℃middlefever:38.139℃highfever:39.141℃excessivelyhightemperature(hyperpyrexia):above41℃4.Typeoffever(1)Continus(persistent)fevers:Fev

5、ercurveshowsthehightemperaturefrom3940℃maycontinuefordaysorweekswithfluctuationlessthan1℃betweenmorningandevening(typhoid)(2)Remittentfevers:Itissimilartocontinuousfever,buttheswingoftemperatureisgreaterthan2℃andthetemperaturedoesnotfalltonormal(rheumaticfever).(3)Intermittent(perio

6、dic)fevers:Thetemperatureriseseverysecondorthirddayatapproximatelythesametime.Thetemperaturerisesabruptlytoabout40℃forafewhoursonlyandthenfallsabruptlytonormalorbelow(malaria).(4)Undulantfevers:Thetemperaturechartshowsrisesupto3940℃,lastingfor714days,fallingtonormalforaboutthesamep

7、eriodbutrecurringovermanyweeksormonths.(5)Relapsing(recurrent)fevers:Thetemperaturerisesabruptlyto39℃oraboveforafewdaysandthenfallsabruptlytonormal(Hodgkin’sdisease).(6)Irregularfevers:Thefevercurveisirregular(bronchopneumonia).5.Etiology(1)Infectionsbyvariousinfectiousagents(bacteri

8、a,viruses,fu