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E G Heinze 《Primary care》1979,6(4):699-715
Size, shape, location and etiology must all be considered in the differential diagnosis of stroke. A logical sequence of steps will be helpful in the evaluation of individual patients. 相似文献
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The term "papilledema" describes optic disc swelling resulting from increased intracranial pressure. A complete history and direct funduscopic examination of the optic nerve head and adjacent vessels are necessary to differentiate papilledema from optic disc swelling due to other conditions. Signs of optic disc swelling include elevation and blurring of the disc and its margins, venous congestion, and retinal hard exudates, splinter hemorrhages and infarcts. Patients with papilledema usually present with signs or symptoms of elevated intracranial pressure, such as headache, nausea, vomiting, diplopia, ataxia or altered consciousness. Causes of papilledema include intracranial tumors, idiopathic intracranial hypertension (pseudotumor cerebri), subarachnoid hemorrhage, subdural hematoma and intracranial inflammation. Optic disc edema may also occur from many conditions other than papilledema, including central retinal artery or vein occlusion, congenital structural anomalies and optic neuritis. 相似文献
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The initial approach to the patient with memory complaints should consist of a focused history, mental status examination, and functional assessment. Patients with MCI should be monitored every 6 to 12 months for conversion to dementia. Delirium, depression, amnestic disorders, and aphasias should be considered in the differential diagnosis of memory impairment. Once a diagnosis of dementia is made, patients should have a brain CT or MRI scan and laboratory tests to assist with determining the cause. It is crucial that dementia be recognized and evaluated at the earliest stage so as to begin appropriate therapy and allow the patient to have a role in management decisions. In the future, therapies for MCI may prevent conversion to dementia. The need for early recognition makes the development of diagnostic tools, such as quantitative or functional neuroimaging, and genetic or clinical biologic markers essential. 相似文献
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Umbilical inflammatory conditions may result from a variety of congenital and acquired abnormalities, some of which may be life threatening. An understanding of the developmental anatomy of the umbilicus provides a basis for formulating an approach to both evaluation and treatment of these conditions. A case report is presented. 相似文献
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目的探讨肺炎型肺癌的诊断及鉴别诊断。方法回顾性分析32例肺炎型肺癌的临床、影像学及病理表现,探讨其诊断要点。结果32例肺炎型肺癌中咳嗽、咳痰30例,发热20例,热型不一,胸闷气短14例,2例无明显症状体检发现。肿瘤大小2.1~11.7cm,肺周边部24例,肺门部8例,病理示细支气管肺泡癌16例,腺癌12例,腺鳞癌2例,小细胞癌2例。结论肺炎型肺癌多位于肺周边部,易误诊为肺炎,以细支气管肺泡癌、腺癌多见,抗炎治疗无效,需病理确诊,主要以手术治疗。 相似文献
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The prominent T wave is an abnormal T-wave morphology encountered in the earliest phase of ST-segment elevation acute myocardial infarction (AMI). Prominent T waves, however, are associated with other diagnoses, including hyperkalemia, early repolarization, and left ventricular hypertrophy (LVH). This article focuses on the electrocardiographic differential diagnosis of the prominent T wave with the presentation of 4 illustrative cases. We also recommend that the designation hyperacute should refer exclusively to the prominent T waves of ST-segment elevation AMI. 相似文献
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咳嗽变异型哮喘(Cough variant asthma,CAV)又称咳嗽性哮喘、过敏性咳嗽或非典型哮喘,是一种慢性的且不伴有喘鸣和呼吸困难的干性咳嗽.慢性咳嗽是临床上经常遇到的问题,其中相当一部分就是CAV.CAV可发生于任何年龄,由于无明显的肺部阳性体征,易被误诊.CAV的概念是在1981年被正式提出的,由于近年来该病的诊断方法和标准不断地完善,加上临床医生的广泛重视,因此CAV的误诊率大大下降.目前认为CAV的发病机制与气道炎症反应和气道高反应性有关,主要症状咳嗽是由于支气管平滑肌收缩,刺激了咳嗽感受器而引起的. 相似文献
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Thyroiditis is a group of inflammatory thyroid disorders. Patients with chronic lymphocytic thyroiditis (also referred to as Hashimoto's thyroiditis) present with hypothyroidism, goiter, or both. Measurement of serum thyroid autoantibodies and thyroglobulin confirms the diagnosis. Subacute granulomatous thyroiditis (sometimes referred to as de Quervain's disease) is a self-limited but painful disorder of the thyroid. Physical examination, elevated erythrocyte sedimentation rate, elevated thyroglobulin level and depressed radioactive iodine uptake (RAIU) confirm the diagnosis. Subacute lymphocytic thyroiditis (silent thyroiditis) is considered autoimmune in origin and commonly occurs in the postpartum period. Symptoms of hyperthyroidism and depressed RAIU predominate. Acute (suppurative) thyroiditis is a rare, infectious thyroid disorder caused by bacteria and other microbes. The rare, invasive fibrous thyroiditis (Riedel's thyroiditis) presents with a slowly enlarging anterior neck mass that is sometimes confused with a malignancy. 相似文献
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