Infectious disease Steps in dx

→ Importance → history
 Prevalence  establish 3 factors
♣ Morbidity and mortality → PE
♣ All worlds
♣ Between worlds Physical examination
→ vital signs
→ Importance → fever
→ localizing signs
 Prevalence
 Preventable/curable
Fever
 Alarming → normal body temp 36.5 – 37.7 oral
→ + 0.4 rectal
→ Objectives → + 0.8 tympanic
 Appreciate its importance → Circadian rhythm
 Describe the factors involved → Highest in the pm, lowest in the am
 State the steps in diagnosis → Incr with meals, ovulation, str exercise
♣ (the approach to an ambulatory → Regulation of body temp
febrile patient) → Hypothalamus
 Describe its management  Need heat: shiver
 Need to lose heat: inc blood to skin and
→ Outline soft tissue, sweat
 Importance
 Definitions Elevated temp
 Factors → physiologic conditions
 Steps in diagnosis → pathologic conditions
 Approach to the ambulatory febrile  hyperthermia
 Normal body temp ♣ reduce by physical means
 Fever  fever
 Management principles ♣ exogenous pyrogens –WBC
♣ endogenous pyrogens (cytokines-
→ Definition hypothalamus)
 Contamination
 Invasion Fever
 Infection → infections
→ immune and ct dx
→ Factors in Infection → neoplastic
 Host → Inflammation, infarction and trauma
→ Granulomatous disorders
♣ Susceptibility vs defenses
→ Metabolic disorders
 Innate → Others
 Adaptive
 Cellular Steps in Diagnosis
 Humoral → Hx
 Pathogen → PE
♣ Virulence and resistance → Lab exam
♣ Emerging organisms  CBC
 encounter  Clin path and radiology
 Bacteriology and Parasitology
Steps in the Diagnosis (Approach to the Febrile
Patient) Identify cause
→ History → direct means : smear, culture
→ General Data → indirect means: antibody titer, histopath, PCR
 Name, age, gender, occupation,
addresses, contact number (px as a Management
person) → specific (curative)
→ Chief complaint – direction  diagnosis first, unless life threatening
→ Present Illness → symptomatic
 Symptoms  adjuvant tx, relief of symptoms, diet,
 Course fluids, rest
 Remedies → preventive
→ Illness Syndrome
→ Past Reminders
 Illness and tx, contacts, dietary → a patient is a person who asks for and/or
preferences, habits – predisposition and needs help
exposure → a doctor provides competent holistic humane
→ Family care with respect for the dignity of the person
 Genetics, environmental,
predisposition, healthcare support