内科学 呼吸系统总论-瞿介明【荐】.ppt

Introduction to Respiratory System Major tasks: What disease? (disease’s diagnosis) How to deal with it ?(disease’s management) Clinical Presentation Common presenting symptoms: Dyspnea (shortness of breath) Cough Less common symptoms: Hemoptysis (the coughing up of blood) Chest pain (often with a pleuritic characteristics) Acute (over a period of hours to days): Acute attack of asthma Acute pulmonary edema Bacterial pneumonia Pneumothorax Pulmonary embolus Subacute (over days to weeks): Asthma Chronic bronchitis Pleural effusion Congestive heart failure Pneumocystis carinii pneumonia in patients with AIDS Wegeners granulomatosis, eosinophilic pneumonia, Bronchiolitis obliterans with organizing pneumonia Guillain-Barre syndrome, myasthenia gravis Chronic (over months to years): COPD Chronic interstitial lung disease Chronic cardiac disease Acute or chronic? Seasonal or associated with wheezing? Associated with symptoms suggestive of postnasal drip or gastroesophageal reflux? Associated with fever or sputum? Any associated diseases or risk factors for disease (e.g., cigarette smoking, risk factors for infection with HIV, environmental exposures)? Originating from the airways: Bronchitis, Bronchiectasis, Cystic fibrosis, Bronchogenic carcinoma, Bronchial carcinoid tumors Originating from the pulmonary parenchyma: Pneumonia, Lung abscess, Tuberculosis, Infection with Aspergillus, Goodpasture’s syndrome, Idiopathic pulmonary hemosiderosis (IPH) Originating from the vasculature: Thromboembolic diseases, Arteriovenous malformations Usually originating from involvement of the parietal pleura: Pleuritis Pneumothorax Neoplasm Pulmonary embolism Pneumonia The number of years of smoking The intensity (i.e., number of packs per day) The interval