天津医科大学临床医学概论重点总结.doc

Arthritis resulting in degeneration of the bones and joints, especially those bearing weight and results in bone rubbing against bone. Symptoms: pain after repetitive use; morning stiffness 15 mins Signs: tenderness, bone crepitus,swelling joint Hand: Heberden’s node and Bouchard’s node Foot: Hallux Valgus Diagnosis: arthrocentesis; arthroscopy; joint replacement NSAIDs: aspirin; ibuprofen; nabumetone; naproxen Rheumatoid arthritis: is an auto immune disorder, may also affect the skin, eyes,lungs, heart, blood or nerves, and it’s a chronic disorder. Risk factors: 40-50 years old; women men Morning stiffness 1 hour; Joint pain is often felt on both sides of the body; The fingers (but not the fingertips), wrists, elbows, shoulders, hips, knees, ankles, toes, jaw, and neck may be affected. 9. Symptoms: Chest pain when taking a breath (pleurisy) Eye burning, itching, and discharge Nodules under the skin (usually a sign of more severe disease) Numbness, tingling, or burning in the hands and feet Joint destruction may occur within 1 - 2 years after the disease appears Rheumatoid nodules: necrotizing granuloma 坏死性肉芽肿 11. Sjogrens syndrome; pleuritis; pericarditis; anemia; Felty’s syndrome: 1) rheumatoid arthritis; 2) an enlarged spleen (splenomegaly);3) an abnormally low white blood count. 12. ACR 1987 criteria: Diagnosis: 1) erythrocyte sedimentation rate;2) C-reactive protein; 3) rheumatoid factor Medicine: methotrexate Gout is a common painful form of arthritis. It causes swollen red hot and stiff joints. Gout occurs when uric acid builds up in your blood. Causes: hyperuricemia: high levels of uric acid Symptoms: podagra; tophus (tophi 复数): are chalky deposits of uric acid that commonly occur in the elbows and earlobes. Medicine: 见5, but can use corticosteroids and colchicine(特有药) Spinal disc herniation types: 1) disc degeneration: chemical changes associated with aging causes discs to weaken, but wit