Week 05 - Pathology Internal 3
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Pathology
Internal and Pediatric Disease
Surgical and Dermatologic Disease
Headache
Wind , Heat,
Excessive Liver Yang
Phlegm , Dampness
KI qi deficiency
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1. Tension Headache
:,,
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Tension Headache
Tight feeling in head or neck muscles
A tightening band-like sensation around the neckand/or head
A constant dull, achy feeling on both sides of the head
Pain that primarily occurs in the forehead, temples orthe back of the head and/or neck
Chronic tension-type headacheschanges in sleeppatterns or insomnia
early morning or late day headache
fatigue, nausea.
Tension Headache
()
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Migraine Headache
Migraine w/o aura
Attacks lasting 4-72
hours
At least 2 of
- unilateral
- pulsating
- moderate to severe
- aggravated by
movement
At least one of
- Nausea
- Photophobia
- Phonophobia
(
)
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A temporary blind spot
Blurred vision
Eye pain
Seeing stars or zigzag
lines
Tunnel vision
.
.
Aura
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Cluster Headache
> ()
Hypothalamus
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Sinus Headache
,,
Yang Ming
Shao yang
Tai Yang
Jue Yin
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Headache
GB 20
Vertex headache : + Du 20 , LV3
Temporal headache : + Tai Yang, GB8, SJ3
Frontal headache : + GB14, UB2, LI4
Occipital headache : + UB10, SI3
Erysipelas
Blisters
Fever, shaking, and chills
Painful, very red, swollen,and warm skinunderneath the sore(lesion)
Skin lesion with a raisedborder
Sores (erysipelas lesions)on the cheeks and bridgeof the nose
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Erysipelas
Group A (or rarely group C or G) -hemolytic
streptococci
shiny, raised, indurated, and tender plaque-
like lesions with distinct margins.
Herpes Zoster
Angioedema
Contact Dermatitis
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Cupping and Letting blood
.
Furuncle (Boil),
TCM
1.
Heat toxin
2.
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Furuncles
Carbuncles
Furuncle
Merck
staphylococcal infection
Both furuncles and carbuncles may affect
healthy young people but are more common
in the obese, the immunocompromised
(including those with neutrophil defects), the
elderly, and possibly those with diabetes.
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(2010 Feb.)
Impetigo- Infectious eruptions offlaccid pustules, which rupture to form a thick
honey-colored to brow crust. staphylococcus
Acute Mastitis
Baby blowing wind against the breast
Or heat collecting
LV qi stagnation Blood stagnation
Damp Heat collect
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Acute Mastitis
Staphylococcal species are the most common 1
s/s
high fever
Erythema
Tenderness
Pain swelling, and warmth to the touch
Acute Mastitis
Staphylococcal infections
usually produce a
localized area of acute
inflammation that may
progress to the formationof single or multiple
abscesses.
Streptococcal infections
tend to cause a diffuse
spreading infection that
eventually involves the
entire breast. The involved breast tissue
is infiltrated by
neutrophils and may be
necrotic.
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Tetanus Lockjaw
Tetanus
S/S
Jaw stiffness (mostfrequent)
Difficulty swallowing
Restlessness
Irritability Stiff neck, arms, or legs
Headache
Sore throat
Tonic spasms
Opisthotonos opistho "behind
tonos "tension
Hyperextension
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Tetanus
Clostridium tetani.
exotoxin(tetanospasmin)
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PNSCNS
DTaP vaccine is a "3-in-
1" vaccine that protects
against
Diphtheria
Pertussis
Tetanus
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Acute Appendicitis
S/S Chills
Constipation
Diarrhea
Fever
Loss of appetite
Nausea
Shaking Vomiting
Acute appendicitis
CT scan : B- appendicitis
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McBurney Point
ASIS (anterior superior
iliac spine) to the
umbilicus (the belly
button).
ASIS 1/3
reffered pain
Obstruction - appendiceal lumen
mucus production intraluminal pressure
Bacteria trapped within the lumen
multiply and the appendix becomes distended
Venous congestion and edema
12 hours after onset, the inflammatory process
may spread through the wall of the VA.
Peritoneal irritation then develops.
http://en.wikipedia.org/wiki/File:Surface_projections_of_the_organs_of_the_trunk.png -
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Acute intestinal obstruction
Stag Qi, blood, cold, heat, or parasitic
organisms collecting in the intestinal tract and
blocking passage
Acute Intestinal Obstruction
: ,,(),,
or,,,,,()
Anticholinergic:The action of certain medications that inhibit thetransmission of parasympathetic nerve impulses and therebyreduce spasms of smooth muscle
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Intestinal strangulation
TCM: Small Intestine Patterns
1. Qi Pain
Acute twisting pain of thelower abdomen
Abdominal distension
Borborygmus
Flatulence
Bearing down pain in thetestes
Referring to the lumbar region
Hernia
2. Qi Tied
Sudden violent abdominalpain
Dislike of pressure
Abdominal distension
Constipation
Borborygmi Flatulence
Vomiting
Appendicitis
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Worms(Small intestine pattern)
Abdominal pain and distension, bad taste in
mouth, shallow complexion
1. roundworm : abdominal pain, vomiting
roundworm, cold limbs
2. hookworm : eat strange objects
3. pinworm : itchy anus, worse in the evening
4. tapeworm : constant hunger
. ^^
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Acute perforation of gastric and duodenal ulcer
,
Phlegm lodging in ST Irregular eating habit
Emotional frustration
Excessive fatigue
Cold excess invading
and the coagulated
blood obstruction MJ
Closure of the interior
and exhaustion of theExterior
,
sudden severe painradiate to the shoulder
Looks very ill
rapid heart rate
Sweating
an abdomen that istender and firm to thetouch
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Acute disease of the biliary tract
Acute cholecystitis
Gall stone
Roundworm
Emotional problem
Irregular eating habits
External excesses
Damp heat
Liver and Gall bladder
Acute cholecystitis
Be sharp, cramping, or
dull
Come and go
Spread to the back or
below the right
shoulder blade
Occur within minutes of
a meal
Abdominal fullness
Clay-colored stools
Fever
Nausea and vomiting
Yellowing of skin andwhites of the eyes
(jaundice)
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Murphy's sign
Pain is felt during
inhalation or coughing
when the physician
palpates your RUQ due
to the inflammation of
the gallbladder. ,
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Clinical Findings Biliary Colic Acute Cholecystitis
Right upper quadrant
pain
Present Present
Abdominal
tenderness
Absent to mild Moderate to severe,
especially over the
liver or gallbladder
(Murphy's sign)
Fever Absent Usually present
Leukocytosis Absent Usually > 11,000/l
Duration of
symptoms
< 4 hr > 6 hr
Ultrasound Gallstones Gallstones,
thickening of the
gallbladder wall
Hemorrhoids
.
UB30 (Bai Huan Shu)
DU1 (Chang qiang)
UB57 (Cheng Shan)
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Buergers disease
TCM
Invasion by cold and dampness
Lodge in the channel and obstruct the passageof Qi and Blood
Tobacco and alcohol
Activating the blood so as to clear the channels
Buergers disease
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Thromboangiitis Obliterans
20~ 40,
claudication of the foot :,
ulcerations
http://www.mayoclinicproceedings.com/content/82/4/448/F1.large.jpg -
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1.?
2.
Raynaud's Phenomenon
Emotional Stress
Cold
Vasoconstriction
http://upload.wikimedia.org/wikipedia/commons/f/fc/Raynaud's_Syndrome.jpg -
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Scleroderma
Scleroderma
CREST
2010/FEB.
/
Dry Cough
Shortness of breath Wheezing
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Blanching, blueness, or redness
of fingers and toes in response toheat and cold (Raynaud'sphenomenon)
Hair loss
Skin hardness
Skin is abnormally dark or light
Skin thickening and shiny handsand forearm
Small white lumps beneath theskin
Tight and mask-like facial skin Ulcerations on fingertips or toes
Joint pain
Numbness and pain in the feet
Pain, stiffness, and swelling offingers and joints
Wrist pain
Bloating after meals
Constipation
Diarrhea
Difficulty swallowing
Esophageal reflux or heartburn Weight loss
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3
A, Generalized morphea. B, Diffuse edema of hands. C, Firm, thickened skin. D, Flexion
contractures of fingers. E, Raynaud's phenomenon (pallor phase). F, Ischemic digital ulcer. G,
Telangectasias on the face (a), dorsum of the hand (b), mucosa (c). H, Calcinosis cutis.
Urinary Tract Infection
1. KI def
2. damp heat collect inL.J
- Spreading the UB qiand clearing L.J. of heatand dampness
95% ascending
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3
UTI
Acute Cystitis Pressure in the lower pelvis
Painful urination
Frequent need to urinate
Urgent need to urinate
Decreased ability to holdurine
Need to urinate at night
Abnormal urine color --cloudy
Blood in the urine
Foul or strong urine odor
Pyelonephritis Back pain or flank pain
Chills with shaking
Severe abdominal pain(occurs occasionally)
Fatigue
Fever
General ill feeling
Chills with shaking
Mental changes orconfusion*
Skin changes
Kidneys (acute pyelonephritis)
Upper back and side (flank)
pain
High fever
Shaking and chills
Nausea
Vomiting
Bladder (cystitis)
Pelvic pressure
Lower abdomen discomfort
Frequent, painful urination
Blood in urine
Urethra (urethritis) Burning with urination
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Escherichia coli (E. coli) 75%
,,
Cystitis-
Pyelonephritis
TCM : Renal Colic
Stone Urinary dysfunction
- Damp heat collecting forming stone
Spreading and draining the contents of the
water passageways by eliminating Dampness
and Heat
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Renal Colic
CT
Renal Stone(renal lithiasis)
1.,.
2. 80%+(calcium oxalate or calciumoxalate mixed with calcium phosphate)
3. ()
4. 50% ()
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1. Calcium stones
High oxalate levels in some fruits and vegetables,
in nuts and chocolate.
Your liver also produces oxalate.
Dietary factors, high doses of vitamin D
intestinal bypass surgery
several different metabolic disorders can increase
the concentration of calcium or oxalate in urine. Calcium stones calcium phosphate.
Foods that contain oxalates
Fruits blackberries, blueberries, raspberries, strawberries, currants(),
kiwifruit, concord (purple) grapes, figs, tangerines, plums
Vegetables spinach, Swiss chard(), beet greens(), collards(),
okra, parsley, leeks and quinoa
celery, green beans, rutabagas, and summer squash
Nuts and seeds
almonds, cashews, peanuts Legumes
soybeans, tofu, soy products
Grains wheat bran, wheat germ, quinoa
Other cocoa, chocolate, and black tea
Quinoa
Rutabagas
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3
2. Struvite stones
UTI
.
3. Uric acid stones
Uric acid stones can form in people who are
dehydrated, those who eat a high-protein
diet and those with gout.
Certain genetic factors and disorders of the
blood-producing tissues also may predisposeyou to uric acid stones.
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Gout.
Puricil
:
http://4.bp.blogspot.com/_pMxMXFn7L-4/Sdclrps0BjI/AAAAAAAAFec/wKbzeOTdLrQ/s1600-h/gotamao.gifhttp://2.bp.blogspot.com/_pMxMXFn7L-4/Sdc3hDnILpI/AAAAAAAAFe0/252sFtDjwJM/s1600-h/Podagra.jpghttp://4.bp.blogspot.com/_pMxMXFn7L-4/Sdclr0MvB1I/AAAAAAAAFek/hZ917an1Lrw/s1600-h/gout_labeled.jpg -
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/
Severe pain in the side and back, below the ribs
Pain that spreads to the lower abdomen and
groin
Pain on urination
Pink, red or brown urine
Nausea and vomiting
Persistent urge to urinate Fever and chills if an infection is present
TCM
UB 23, SP6
,,
Jumping Exercise