Symptomatology

Symptomatology in clinical practice Dr. B. K. Iyer Cardicare

Symptomatology terms Symptomatology is the clinical picture of all the patient's symptoms and signs Any deviation from health that can only be perceived or felt by the patient When a symptom has a physical manifestation that can be detected by others Set of symptoms & signs associated with & characteristic of any one particular disease. Symptom Sign Syndrome Symptomatology

Symptomatology types Acute Subacute Chronic Symptomatology

Symptomatology outcomes ,[object Object],Abnormal condition or complication due to the original disease and remains after original disease has resolved Temporary improvement in the symptoms and signs of a disease without the underlying disease being cured Return of the original symptoms and signs of the disease Exacerbation Sequela Remission Relapse Outcome

Symptomatology association ,[object Object],Current Past medical / surgical Family Social Drug allergy History A diagnosis is a determination as to the cause of the patient's symptoms and signs

Symptomatology - significance ,[object Object],[object Object],[object Object],[object Object]

Symptomatology - significance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Misleading symptomatology in PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Misleading symptomatology in PUO ,[object Object],[object Object],[object Object],Categories of Illness Causing PUO Infections 30 - 40 % Malignancies 20 – 25 % Collagen Vascular Disease 10 – 20 % Miscellaneous 15 – 20 % Undiagnosed 10 – 15 %

Changes in terminology in PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification in PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Aetiologies of PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Remember not to forget travel, animal exposure. 15% of PUO

Symptomatology changes in PUO ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clues to aetiologies of PUO ,[object Object],[object Object],[object Object],[object Object]

Clues to aetiologies of PUO Arnow PM. Fever of Unknown Origin. Lancet, 1997; 350:575-580 Localizing Symptoms may indicate the source of fever Back Pain TB Spondylitis / Bone Metastasis Headache Chronic Meningitis/GCA RUQ Pain Liver Abscess LUQ Pain Splenic Abscess Oral & Genital Ulcer Behcet’s Disease Jaw Claudication Temporal Arteritis Subtle changes in behavior Granulomatous Meningitis Diagnostic delay has adverse effect in: Intra Abdominal Infection Miliary Tuberculosis Recurrent Pulmonary Emboli Disseminated Fungal Infection Temporal Arteritis

Minimal Diagnostic tests for PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Other Basic Tests for PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Invasive Procedures in PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Imaging in PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clues to diagnostic tests of PUO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Arnow PM. Fever of Unknown Origin. Lancet, 1997; 350:575-580

Symptomatology

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Symptomatology