Transcript Differential Diagnosis Definitions

Differential Diagnosis
Definitions
Presented by M.A. Kaeser, DC
Winter 2010
Acute Abdomen
• General name for the presence of signs,
symptoms of inflammation of peritoneum
(abdominal lining)
www.templejc.edu
Bronchogenic Carcinoma
• More than 99% of malignant lung tumors arise
from the respiratory epithelium and are termed
bronchogenic carcinoma. This type of
carcinoma can be diveded in two main
subgroups: small cell lung cancer (SCLC) and
non-small cell lung cancer (NSCLC).
www.medstudents.com.br/pneumo/pneumo7/pneumo7.htm
Cauda Equina
The spinal cord ends in the lumbar area and continues through the vertebral
canal as spinal nerves. Because of its resemblance to a horse's tail, the
collection of these nerves at the end of the spinal cord is called the cauda
equina. These nerves send and receive messages to and from the lower limbs
and pelvic organs.
Clinical Reasoning
• Clinical reasoning is a major component of
clinical competence and is a dynamic process
that occurs before, during, and after the
collection of data through history, physical
examination, imaging, and endoscopic and
laboratory tests.
www.annals.org
Complication
• A secondary disease or condition developing in
the course of a primary disease or condition
www.merriam-webster.com
Contraindication
• Something (as a symptom or condition) that
makes a particular treatment or procedure
inadvisable
www.merriam-webster.com
Depression
• Most common psychological disorder that primary care
practitioners will encounter
• More common than any other disorder (with the
exception of hypertension) and is the 7th most common
outpatient diagnosis in family medicine
• Often undiagnosed and under-treatment
• 5% of population has major depression at any given
time
– Men 7-12% risk
– Women 20-25% risk
• 83 billion dollars in US and 11.5 in UK
Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B.,
McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Diabetic Neuropathy
• Diabetic neuropathy is a common complication
of diabetes, in which nerves are damaged as a
result of high blood sugar levels (hyperglycemia)
• On average, symptoms begin 10 to 20 years after
the diabetes diagnosis
• Approximately 50% of people with diabetes will
eventually develop nerve damage.
www.nlm.nih.gov
Embolism
• The obstruction of a blood vessel by a foreign
substance or a blood clot blocking the vessel
• Something travels through the bloodstream,
lodges in a vessel and plugs it
• Foreign substances that can cause embolism
include an air bubble, amniotic fluid, a globule
of fat, a clump of bacteria, chemicals (such as
talc), and drugs (mainly illicit ones).
www.medterms.com
Hypothyroidism
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Results from insufficient production of thyroid hormones
Overt hypothyroidism found in 0.3-2% of population
2:1 F:M
Increased prevalence with age
Primary
– Chronic autoimmune (Hashimoto’s) thyroiditis
– Radioactive iodine therapy
– Surgery
• Secondary
– Decreased pituitary secretion of TSH
• Usually accompanied by other manifestations of pituitary hyposecretion
• Causes: postpartum pituitary necrosis (Sheehan’s syndrome) and pituitary
tumors
Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B.,
McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Hyperthyroidism
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Results from elevated levels of thyroid hormones
Less common than hypothyroidism
2% in women, 0.2% in men
15% of cases are >60 y.o.
Grave’s disease - 60-80% of hyperthyroidism
Disorders associated with hyperthyroidism
– Grave’s disease
– Toxic multinodular goiter (Plummer’s disease)
• Most common cause in >40 y.o.
– Toxic adenoma
• Least common cause
– Thyroiditis
Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B.,
McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Incontinence
• Inability to control excretions
• Urinary incontinence is inability to keep urine in
the bladder
• Fecal incontinence is inability to retain feces in
the rectum
www.medterms.com
Indications
• In medicine, a condition which makes a
particular treatment or procedure advisable
www.medterms.com
Infarction
• The formation of an infarct, an area of tissue
death due to a local lack of oxygen
www.medterms.com
Lymphadenopathy
• Lymph nodes that are abnormal in size, consistency or number
• In children
– M/C cause is infectious or benign
• >40 y.o.
– Malignant causes are more likely
• Less than 1 month is usually infectious
• More than 1 month is abnormal
• In association with constitutional symptoms (fatigue, fever, weight loss,
unusual rashes, or arthralgias) suggest malignancy, infection, autoimmune
diseases, or serum sickness-like syndrome
• >1 cm = abnormal
• Softer or fluctuant lymph nodes suggest infectious or inflammatory causes
• Harder nodes suggest malignancy
• Pain suggests inflammatory, absence of pain suggests more serious condition
or malignancy
Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B.,
McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Meningitis
• Meningitis is an inflammation of the
membranes (called meninges) that surround the
brain and spinal cord
• Meningitis may be caused by many different
viruses and bacteria
• It can also be caused by diseases that can trigger
inflammation of tissues of the body without
infection (such as SLE and Behcet’s Disease)
www.medicinenet.com
Metastasis
• The process by which cancer spreads from the place at
which it first arose as a primary tumor to distant
locations in the body
• Metastasis depends on the cancer cells acquiring two
separate abilities -- increased motility and invasiveness
• Cells that metastasize are basically of the same kind as
those in the original tumor
• If a cancer arises in the lung and metastasizes to the
liver, the cancer cells in the liver are lung cancer cells.
However, the cells have acquired increased motility and
the ability to invade another organ.
www.medterms.com
Myelopathy
• Disturbance or disease of the spinal cord
• A disorder in which the tissue of the spinal
cord is diseased or damaged
medical-dictionary.thefreedictionary.com/
Pneumonia
• A disease of the lungs characterized especially
by inflammation and consolidation of lung
tissue followed by resolution and by fever, chills,
cough and difficulty in breathing
• Caused especially by infection
www.merriam-webster.com
Primary Care
• Health care provided by a medical professional
(as a general practioner or a pediatrician) with
whom a patient has initial contact and by whom
the patient may be referred to a specialist for
further treatment
medical-dictionary.thefreedictionary.com
Secondary Care
• The provision of a specialized medical service
by a physician specialist or a hospital on referral
by a primary care physician
medical-dictionary.thefreedictionary.com
Teritiary Care
• Treatment given in a health care center that
includes highly trained specialists and often
advanced technology
medical-dictionary.thefreedictionary.com
Primary Prevention
• A program of activities directed at improving
general well-being while also involving specific
protection for selected diseases, such as
immunization against measles
medical-dictionary.thefreedictionary.com
Secondary Prevention
• A level of preventive medicine that focuses on
early diagnosis, use of referral services, and
rapid initiation of treatment to stop the progress
of disease processes or a handicapping disability
Tertiary Prevention
• A level of preventive medicine that deals with
the rehabilitation and return of a patient to a
status of maximum usefulness with a minimum
risk of recurrence of a physical or mental
disorder
medical-dictionary.thefreedictionary.com
Radiculopathy
• Disease of the spinal nerve roots
• Compression of the nerve root-the part of a
nerve between vertebrae
• This compression causes pain to be perceived in
areas to which the nerve leads.
medical-dictionary.thefreedictionary.com
Sensitivity
• Probability that the test is positive when
given to a group of patients with the disease
• A large sensitivity means that a negative test
can rule out the disease.
www.childrens-mercy.org/stats/definitions/sensitivity.htm
Specificity
• The probability that the test will be negative
among patients who do not have the disease
• A large specificity means that a positive test
can rule in the disease
www.childrens-mercy.org/stats/definitions/specificity.htm
Stroke
• Clinical syndrome consisting of the sudden or rapid onset of a
constellation of neurologic deficits that persist for more than 24
hours secondary to a vascular event
• 3rd leading cause of death in the US
• Most common cause of disability
• Most frequently cited reason for patients needing long-term care
• 1/3 of stroke survivors will have permanent disability
• ½ of the 4.4 million survivors will have no or little disability
• Two types of stroke
– Ischemic
– Hemorrhagic
Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B.,
McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Vertebrobasilar Insufficiency
• Transient ischemia of the brain stem and
cerebellum due to stenosis of the vertebral or
basilar artery
• A disorder caused by decrease of blood flow in
the vertebral or basilar arteries due to
atherosclerosis or compression placed on the
external wall of the arteries
• Symptoms may include loss of vision, dizziness,
or nausea
medical-dictionary.thefreedictionary.com