内科诊断精华（Medical diagnostic essence）.docVIP

内科诊断精华（Medical diagnostic essence） 1, low fever, cough for more than 7 days, should be excluded from tuberculosis, Mycoplasma pneumonia. 2, sudden cold, high fever, accompanied by respiratory tract certificate, we should consider bacterial pneumonia. 3, chest pain without pleural friction sound, should pay attention to check whether there is rib cartilage inflammation, intercostal neuralgia, herpes zoster and so on. 4, a large number of purulent foul sputum, think of lung abscess or bronchiectasis. 5, persistent rales left shoulder, should be suspected of bronchiectasis. 6, repeated hemoptysis, but chest X-ray examination showed no definite lesion, should consider bronchiectasis or endobronchial tuberculosis. 7. Irregular patchy shadow of lung with eosinophilia of more than 1 x 109/L, which is usually suggestive of hypersensitivity pneumonitis. 8, sudden chest pain and dyspnea, be vigilant against spontaneous pneumothorax. 9, the diagnosis of right pleurisy, liver abscess and diaphragmatic empyema should be excluded. 10, long-term smoking in middle-aged and elderly people with irritating cough, persistent blood sputum or localized wheezing, should be vigilant against lung cancer. 11 patients with congenital heart disease or congenital heart disease who have fever of unknown origin for more than one week should be aware of subacute infective endocarditis. 12, cold after heart rate or arrhythmia, should think of viral myocarditis. 13, rest or temperature drop, heart rate is still fast, we should consider myocardial inflammatory lesions. 14, the diagnosis of hypertension, to exclude secondary hypertension. 15, hypertension with abdominal vascular murmur, often suggestive of renal hypertension. 16, the middle and old people suddenly abdominal, left neck, left upper limb pain, should guard against angina pectoris or acute myocardial infarction. 17, the diagnosis of angina pectoris, to rule out bile, pancreas, stomach and cervical spondylosis. 18, angina, sweating, irrita