Differential Diagnosis Definitions

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  1. 1. Differential DiagnosisDifferential Diagnosis DefinitionsDefinitions Presented by M.A. Kaeser, DCPresented by M.A. Kaeser, DC Winter 2010Winter 2010
  2. 2. Acute AbdomenAcute Abdomen General name for the presence of signs,General name for the presence of signs, symptoms of inflammation of peritoneumsymptoms of inflammation of peritoneum (abdominal lining)(abdominal lining) www.templejc.edu
  3. 3. Bronchogenic CarcinomaBronchogenic Carcinoma More than 99% of malignant lung tumors ariseMore than 99% of malignant lung tumors arise from the respiratory epithelium and are termedfrom the respiratory epithelium and are termed bronchogenic carcinoma. This type ofbronchogenic carcinoma. This type of carcinoma can be diveded in two maincarcinoma can be diveded in two main subgroups: small cell lung cancer (SCLC) andsubgroups: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).non-small cell lung cancer (NSCLC). www.medstudents.com.br/pneumo/pneumo7/pneumo7.htm
  4. 4. Cauda EquinaCauda 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.
  5. 5. Clinical ReasoningClinical Reasoning Clinical reasoning is a major component ofClinical reasoning is a major component of clinical competence and is a dynamic processclinical competence and is a dynamic process that occurs before, during, and after thethat occurs before, during, and after the collection of data through history, physicalcollection of data through history, physical examination, imaging, and endoscopic andexamination, imaging, and endoscopic and laboratory tests.laboratory tests. www.annals.org
  6. 6. ComplicationComplication A secondary disease or condition developing inA secondary disease or condition developing in the course of a primary disease or conditionthe course of a primary disease or condition www.merriam-webster.com
  7. 7. ContraindicationContraindication Something (as a symptom or condition) thatSomething (as a symptom or condition) that makes a particular treatment or proceduremakes a particular treatment or procedure inadvisableinadvisable www.merriam-webster.com
  8. 8. DepressionDepression Most common psychological disorder that primary careMost common psychological disorder that primary care practitioners will encounterpractitioners will encounter More common than any other disorder (with theMore common than any other disorder (with the exception of hypertension) and is the 7exception of hypertension) and is the 7thth most commonmost common outpatient diagnosis in family medicineoutpatient diagnosis in family medicine Often undiagnosed and under-treatmentOften undiagnosed and under-treatment 5% of population has major depression at any given5% of population has major depression at any given timetime Men 7-12% riskMen 7-12% risk Women 20-25% riskWomen 20-25% risk 83 billion dollars in US and 11.5 in UK83 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.
  9. 9. Diabetic NeuropathyDiabetic Neuropathy Diabetic neuropathy is a common complicationDiabetic neuropathy is a common complication of diabetes, in which nerves are damaged as aof diabetes, in which nerves are damaged as a result of high blood sugar levels (hyperglycemia)result of high blood sugar levels (hyperglycemia) On average, symptoms begin 10 to 20 years afterOn average, symptoms begin 10 to 20 years after the diabetes diagnosisthe diabetes diagnosis Approximately 50% of people with diabetes willApproximately 50% of people with diabetes will eventually develop nerve damage.eventually develop nerve damage. www.nlm.nih.govwww.nlm.nih.gov
  10. 10. EmbolismEmbolism The obstruction of a blood vessel by a foreignThe obstruction of a blood vessel by a foreign substance or a blood clot blocking the vesselsubstance or a blood clot blocking the vessel Something travels through the bloodstream,Something travels through the bloodstream, lodges in a vessel and plugs itlodges in a vessel and plugs it Foreign substances that can cause embolismForeign substances that can cause embolism include an air bubble, amniotic fluid, a globuleinclude an air bubble, amniotic fluid, a globule of fat, a clump of bacteria, chemicals (such asof fat, a clump of bacteria, chemicals (such as talc), and drugs (mainly illicit ones).talc), and drugs (mainly illicit ones). www.medterms.com
  11. 11. HypothyroidismHypothyroidism Results from insufficient production of thyroid hormonesResults from insufficient production of thyroid hormones Overt hypothyroidism found in 0.3-2% of populationOvert hypothyroidism found in 0.3-2% of population 2:1 F:M2:1 F:M Increased prevalence with ageIncreased prevalence with age PrimaryPrimary Chronic autoimmune (Hashimotos) thyroiditisChronic autoimmune (Hashimotos) thyroiditis Radioactive iodine therapyRadioactive iodine therapy SurgerySurgery SecondarySecondary Decreased pituitary secretion of TSHDecreased pituitary secretion of TSH Usually accompanied by other manifestations of pituitary hyposecretionUsually accompanied by other manifestations of pituitary hyposecretion Causes: postpartum pituitary necrosis (Sheehans syndrome) and pituitaryCauses: postpartum pituitary necrosis (Sheehans syndrome) and pituitary tumorstumors Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
  12. 12. HyperthyroidismHyperthyroidism Results from elevated levels of thyroid hormonesResults from elevated levels of thyroid hormones Less common than hypothyroidismLess common than hypothyroidism 2% in women, 0.2% in men2% in women, 0.2% in men 15% of cases are >60 y.o.15% of cases are >60 y.o. Graves disease - 60-80% of hyperthyroidismGraves disease - 60-80% of hyperthyroidism Disorders associated with hyperthyroidismDisorders associated with hyperthyroidism Graves diseaseGraves disease Toxic multinodular goiter (Plummers disease)Toxic multinodular goiter (Plummers disease) Most common cause in >40 y.o.Most common cause in >40 y.o. Toxic adenomaToxic adenoma Least common causeLeast common cause ThyroiditisThyroiditis Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
  13. 13. IncontinenceIncontinence Inability to control excretionsInability to control excretions Urinary incontinence is inability to keep urine inUrinary incontinence is inability to keep urine in the bladderthe bladder Fecal incontinence is inability to retain feces inFecal incontinence is inability to retain feces in the rectumthe rectum www.medterms.com
  14. 14. IndicationsIndications In medicine, a condition which makes aIn medicine, a condition which makes a particular treatment or procedure advisableparticular treatment or procedure advisable www.medterms.com
  15. 15. InfarctionInfarction The formation of an infarct, an area of tissueThe formation of an infarct, an area of tissue death due to a local lack of oxygendeath due to a local lack of oxygen www.medterms.com
  16. 16. LymphadenopathyLymphadenopathy Lymph nodes that are abnormal in size, consistency or numberLymph nodes that are abnormal in size, consistency or number In childrenIn children M/C cause is infectious or benignM/C cause is infectious or benign >40 y.o.>40 y.o. Malignant causes are more likelyMalignant causes are more likely Less than 1 month is usually infectiousLess than 1 month is usually infectious More than 1 month is abnormalMore than 1 month is abnormal In association with constitutional symptoms (fatigue, fever, weight loss,In association with constitutional symptoms (fatigue, fever, weight loss, unusual rashes, or arthralgias) suggest malignancy, infection, autoimmuneunusual rashes, or arthralgias) suggest malignancy, infection, autoimmune diseases, or serum sickness-like syndromediseases, or serum sickness-like syndrome >1 cm = abnormal>1 cm = abnormal Softer or fluctuant lymph nodes suggest infectious or inflammatory causesSofter or fluctuant lymph nodes suggest infectious or inflammatory causes Harder nodes suggest malignancyHarder nodes suggest malignancy Pain suggests inflammatory, absence of pain suggests more serious conditionPain suggests inflammatory, absence of pain suggests more serious condition or malignancyor malignancy Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
  17. 17. MeningitisMeningitis Meningitis is an inflammation of the membranesMeningitis is an inflammation of the membranes (called meninges) that surround the brain and(called meninges) that surround the brain and spinal cordspinal cord Meningitis may be caused by many differentMeningitis may be caused by many different viruses and bacteriaviruses and bacteria It can also be caused by diseases that can triggerIt can also be caused by diseases that can trigger inflammation of tissues of the body withoutinflammation of tissues of the body without infection (such as SLE and Behcets Disease)infection (such as SLE and Behcets Disease) www.medicinenet.com
  18. 18. MetastasisMetastasis The process by which cancer spreads from the place atThe process by which cancer spreads from the place at which it first arose as a primary tumor to distantwhich it first arose as a primary tumor to distant locations in the bodylocations in the body Metastasis depends on the cancer cells acquiring twoMetastasis depends