Archive | February 2012

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17 EDEMA

17 EDEMA Harrison’s Manual of Medicine 17 EDEMA Definition Bibliography Definition Soft tissue swelling due to abnormal expansion of interstitial fluid volume. Edema fluid is a plasma transudate that accumulates when movement of fluid from vascular to interstitial space is favored. Since detectable generalized edema in the adult reflects a gain of ³3 L, renal […]

16 CYANOSIS

16 CYANOSIS Harrison’s Manual of Medicine 16 CYANOSIS Central Cyanosis Peripheral Cyanosis Bibliography The circulating quantity of reduced hemoglobin is elevated [>50 g/L (>5 g/ dL)] resulting in bluish discoloration of the skin and/or mucous membranes. CENTRAL CYANOSIS Results from arterial desaturation. Usually evident when arterial saturation is £85%. Particularly in dark-skinned individuals, cyanosis may […]

15 COUGH AND HEMOPTYSIS

15 COUGH AND HEMOPTYSIS Harrison’s Manual of Medicine 15 COUGH AND HEMOPTYSIS Cough Hemoptysis Bibliography COUGH Produced by inflammatory, mechanical, chemical, and thermal stimulation of cough receptors. ETIOLOGY Inflammatory—edema and hyperemia of airways and alveoli due to laryngitis, tracheitis, bronchitis, bronchiolitis, pneumonitis, lung abscess. Mechanical—inhalation of particulates (dust) or compression of airways (pulmonary neoplasms, foreign […]

14 DYSPNEA

14 DYSPNEA Harrison’s Manual of Medicine 14 DYSPNEA Definition Causes Bibliography Definition An abnormally uncomfortable awareness of breathing; intensity can be quantified by establishing the amount of physical exertion necessary to produce the sensation, but the pt’s general physical condition should be considered. Causes HEART DISEASE   Dyspnea is due to pulmonary capillary pressure, left atrial hypertension, […]

13 SLEEP DISORDERS

13 SLEEP DISORDERS Harrison’s Manual of Medicine 13 SLEEP DISORDERS Insomnia Hypersomnias (Disorders of Excessive Daytime Sleepiness) Disorders of Circadian Rhythmicity Bibliography Disorders of sleep are among the most common problems seen by clinicians. More than one-half of adults experience at least occasional insomnia, and 15– 20% have a chronic sleep disturbance. Approach to the […]

12 APHASIAS AND RELATED DISORDERS

12 APHASIAS AND RELATED DISORDERS Harrison’s Manual of Medicine 12 APHASIAS AND RELATED DISORDERS Global Aphasia Broca’s Aphasia (Motor or Nonfluent Aphasia) Wernicke’s Aphasia (Sensory or Fluent Aphasia) Conduction Aphasia Pure Word Deafness Pure Word Blindness Isolation of Speech Area Laboratory Studies in Aphasia Bibliography Aphasias are disturbances in the comprehension or production of spoken […]

11 PARALYSIS AND MOVEMENT DISORDERS

11 PARALYSIS AND MOVEMENT DISORDERS Harrison’s Manual of Medicine 11 PARALYSIS AND MOVEMENT DISORDERS Paralysis or Weakness Movement Disorders Bibliography PARALYSIS OR WEAKNESS GENERAL CONSIDERATIONS   The loss of power or control of voluntary muscle is usually described by pts as “weakness” or as some difficulty that can be interpreted as “loss of dexterity.” The diagnostic approach […]

10 ACUTE VISUAL LOSS AND DOUBLE VISION

10 ACUTE VISUAL LOSS AND DOUBLE VISION Harrison’s Manual of Medicine 10 ACUTE VISUAL LOSS AND DOUBLE VISION Clinical Assessment Transient or Sudden Visual Loss Diplopia Bibliography Clinical Assessment Accurate measurement of visual acuity in each eye (with glasses) is of primary importance. Additional assessments include testing of pupils, eye movements, ocular alignment, and visual […]

10 ACUTE VISUAL LOSS AND DOUBLE VISION

10 ACUTE VISUAL LOSS AND DOUBLE VISION Harrison’s Manual of Medicine 10 ACUTE VISUAL LOSS AND DOUBLE VISION Clinical Assessment Transient or Sudden Visual Loss Diplopia Bibliography Clinical Assessment Accurate measurement of visual acuity in each eye (with glasses) is of primary importance. Additional assessments include testing of pupils, eye movements, ocular alignment, and visual […]

9 DIZZINESS AND VERTIGO

9 DIZZINESS AND VERTIGO Harrison’s Manual of Medicine 9 DIZZINESS AND VERTIGO Pathologic Vertigo Bibliography Patients use the term dizziness to describe a variety of head sensations or gait unsteadiness. With a careful history, symptoms can be placed into more specific neurologic categories, of which faintness and vertigo are the most important. FAINTNESS   Faintness is usually […]