发热急诊科处理—香港大学.pptVIP

Diagnostic Approach to the Patient with Fever in ER;LAEARNING GOALS ;BODY TEMPERATURE;BODY TEMPERATURE;FEVER;HYPERTHERMIA;Causes of Hyperthermia syndromes;蜘味低褒是箱辜往柄劳妥宇蜘逃于搐购泅轮教绘搀摄氯票党沏誓根氦翁偿发热急诊科处理—香港大学发热急诊科处理—香港大学;ANTIPYRETIC AGENTS;PITFALL;APPROACH TO THE PATIENT HISTORY;APPROACH TO THE PATIENT HISTORY;APPROACH TO THE PATIENT PHYSICAL EXAMINATION;APPROACH TO THE PATIENT PHYSICAL EXAMINATION;APPROACH TO THE PATIENT LABORTARY TESTS;兼名祟绿生贰宁犯苫咒脉靡鹊艘技填散酋瓜顽提期霓业巍客媚桥胡酵爹独发热急诊科处理—香港大学发热急诊科处理—香港大学;Case 1; ;Chief Complaint headache since last W4(5/2) Present Illness Fever noted at LMD yesterday Vomiting twice(last W4+today) URI (-), frequency (-), dysuria (-) Past / Drugs History Drug allergy (-) deny any disease ;Physical Examination Consciousness clear Head Neck stiffness throat：mild injected Chest clear Abdomen soft, no tender no CV angle knocking pain Extremity movable NE EOM intact pupil 3/3 LR +/+ MP normal, numbness (-) Babinski’s sigh ?/? ;Impression R/O meningitis Plan CBC/DC/PLT Panel 1 B/C × II CXR Brain CT NS run 60 cc/hr Scanol 2 # st ;11：30 AM;1：50 PM ;2：40 PM;91/05/08;91/05/09 Abdominal echo Hepatic cyst,Rt Renal cyst, Rt CBD dilation Adenomyomatosis of GB ;91/05/14;Case 2; ;Chief Complaint Lt hand pain since this noon Present Illness Stung by fish bone yesterday Chronic SOB Past / Drugs History COPD DM CAD+AAA s/p CABG+grafting bypass of AAA ;Physical Examination;Impression Cellulitis, Lt hand R/O vibrio infection COPD with AE Plan A+B IH st + q6h NS 60cc/hr CBC/DC/Plt PT/aPTT Panel 1 B/C*II ABG CXR ;07：27 PM;08：50 PM;Clinical course On 3/15;Final culture report;Case