Differential Diagnosis Definitions Presented by M.A. Kaeser, DC Winter 2010
Acute Abdomen • General name for the presence of signs, symptoms of inflammation of peritoneum (abdominal lining) www.templejc.edu
Bronchogenic Carcinoma • More than 99% of malignant lung tumors arise from the respiratory epithelium and are termed bronchogenic carcinoma. This type of carcinoma can be diveded in two main subgroups: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). www.medstudents.com.br/pneumo/pneumo7/pneumo7.htm
Cauda Equina The spinal cord ends in the lumbar area and continues through the vertebral canal as spinal nerves. Because of its resemblance to a horse's tail, the collection of these nerves at the end of the spinal cord is called the cauda equina. These nerves send and receive messages to and from the lower limbs and pelvic organs.
Clinical Reasoning • Clinical reasoning is a major component of clinical competence and is a dynamic process that occurs before, during, and after the collection of data through history, physical examination, imaging, and endoscopic and laboratory tests. www.annals.org
Complication • A secondary disease or condition developing in the course of a primary disease or condition www.merriam-webster.com
Contraindication • Something (as a symptom or condition) that makes a particular treatment or procedure inadvisable www.merriam-webster.com
Depression • Most common psychological disorder that primary care practitioners will encounter • More common than any other disorder (with the exception of hypertension) and is the 7th most common outpatient diagnosis in family medicine • Often undiagnosed and under-treatment • 5% of population has major depression at any given time • Men 7-12% risk • Women 20-25% risk • 83 billion dollars in US and 11.5 in UK Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Diabetic Neuropathy • Diabetic neuropathy is a common complication of diabetes, in which nerves are damaged as a result of high blood sugar levels (hyperglycemia) • On average, symptoms begin 10 to 20 years after the diabetes diagnosis • Approximately 50% of people with diabetes will eventually develop nerve damage. www.nlm.nih.gov
Embolism • The obstruction of a blood vessel by a foreign substance or a blood clot blocking the vessel • Something travels through the bloodstream, lodges in a vessel and plugs it • Foreign substances that can cause embolism include an air bubble, amniotic fluid, a globule of fat, a clump of bacteria, chemicals (such as talc), and drugs (mainly illicit ones). www.medterms.com
Hypothyroidism • Results from insufficient production of thyroid hormones • Overt hypothyroidism found in 0.3-2% of population • 2:1 F:M • Increased prevalence with age • Primary • Chronic autoimmune (Hashimoto’s) thyroiditis • Radioactive iodine therapy • Surgery • Secondary • Decreased pituitary secretion of TSH • Usually accompanied by other manifestations of pituitary hyposecretion • Causes: postpartum pituitary necrosis (Sheehan’s syndrome) and pituitary tumors Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Hyperthyroidism • Results from elevated levels of thyroid hormones • Less common than hypothyroidism • 2% in women, 0.2% in men • 15% of cases are >60 y.o. • Grave’s disease - 60-80% of hyperthyroidism • Disorders associated with hyperthyroidism • Grave’s disease • Toxic multinodular goiter (Plummer’s disease) • Most common cause in >40 y.o. • Toxic adenoma • Least common cause • Thyroiditis Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Incontinence • Inability to control excretions • Urinary incontinence is inability to keep urine in the bladder • Fecal incontinence is inability to retain feces in the rectum www.medterms.com
Indications • In medicine, a condition which makes a particular treatment or procedure advisable www.medterms.com
Infarction • The formation of an infarct, an area of tissue death due to a local lack of oxygen www.medterms.com
Lymphadenopathy • Lymph nodes that are abnormal in size, consistency or number • In children • M/C cause is infectious or benign • >40 y.o. • Malignant causes are more likely • Less than 1 month is usually infectious • More than 1 month is abnormal • In association with constitutional symptoms (fatigue, fever, weight loss, unusual rashes, or arthralgias) suggest malignancy, infection, autoimmune diseases, or serum sickness-like syndrome • >1 cm = abnormal • Softer or fluctuant lymph nodes suggest infectious or inflammatory causes • Harder nodes suggest malignancy • Pain suggests inflammatory, absence of pain suggests more serious condition or malignancy Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Meningitis • Meningitis is an inflammation of the membranes (called meninges) that surround the brain and spinal cord • Meningitis may be caused by many different viruses and bacteria • It can also be caused by diseases that can trigger inflammation of tissues of the body without infection (such as SLE and Behcet’s Disease) www.medicinenet.com
Metastasis • The process by which cancer spreads from the place at which it first arose as a primary tumor to distant locations in the body • Metastasis depends on the cancer cells acquiring two separate abilities -- increased motility and invasiveness • Cells that metastasize are basically of the same kind as those in the original tumor • If a cancer arises in the lung and metastasizes to the liver, the cancer cells in the liver are lung cancer cells. However, the cells have acquired increased motility and the ability to invade another organ. www.medterms.com
Myelopathy • Disturbance or disease of the spinal cord • A disorder in which the tissue of the spinal cord is diseased or damaged medical-dictionary.thefreedictionary.com/
Pneumonia • A disease of the lungs characterized especially by inflammation and consolidation of lung tissue followed by resolution and by fever, chills, cough and difficulty in breathing • Caused especially by infection www.merriam-webster.com
Primary Care • Health care provided by a medical professional (as a general practioner or a pediatrician) with whom a patient has initial contact and by whom the patient may be referred to a specialist for further treatment medical-dictionary.thefreedictionary.com
Secondary Care • The provision of a specialized medical service by a physician specialist or a hospital on referral by a primary care physician medical-dictionary.thefreedictionary.com
Teritiary Care • Treatment given in a health care center that includes highly trained specialists and often advanced technology medical-dictionary.thefreedictionary.com
Primary Prevention • A program of activities directed at improving general well-being while also involving specific protection for selected diseases, such as immunization against measles medical-dictionary.thefreedictionary.com
Secondary Prevention • A level of preventive medicine that focuses on early diagnosis, use of referral services, and rapid initiation of treatment to stop the progress of disease processes or a handicapping disability
Tertiary Prevention • A level of preventive medicine that deals with the rehabilitation and return of a patient to a status of maximum usefulness with a minimum risk of recurrence of a physical or mental disorder medical-dictionary.thefreedictionary.com
Radiculopathy • Disease of the spinal nerve roots • Compression of the nerve root-the part of a nerve between vertebrae • This compression causes pain to be perceived in areas to which the nerve leads. medical-dictionary.thefreedictionary.com
Sensitivity • Probability that the test is positive when given to a group of patients with the disease • A large sensitivity means that a negative test can rule out the disease. www.childrens-mercy.org/stats/definitions/sensitivity.htm
Specificity • The probability that the test will be negative among patients who do not have the disease • A large specificity means that a positive test can rule in the disease www.childrens-mercy.org/stats/definitions/specificity.htm
Stroke • Clinical syndrome consisting of the sudden or rapid onset of a constellation of neurologic deficits that persist for more than 24 hours secondary to a vascular event • 3rd leading cause of death in the US • Most common cause of disability • Most frequently cited reason for patients needing long-term care • 1/3 of stroke survivors will have permanent disability • ½ of the 4.4 million survivors will have no or little disability • Two types of stroke • Ischemic • Hemorrhagic Family Medicine: Ambulatory Care & Prevention, ed. By Mengel, M.B., McGraw Hill Compaines Incorporated. New York, 5th edition, 2009.
Vertebrobasilar Insufficiency • Transient ischemia of the brain stem and cerebellum due to stenosis of the vertebral or basilar artery • A disorder caused by decrease of blood flow in the vertebral or basilar arteries due to atherosclerosis or compression placed on the external wall of the arteries • Symptoms may include loss of vision, dizziness, or nausea medical-dictionary.thefreedictionary.com