【诊断学课件】症状学部分：发热.pptVIP

Section III Common Symptoms(fever) Dr. Zhuoren Lu First Hospital Xian Jiaotong University Concepts symptoms: subjective disturbances, for instance headache, chest pain, abdominal pain, dyspnea, cough, palpitation, nausea, vomiting, and so on. physical signs: objective marks, for example fever, edema, cyanosis, jaundice, diarrhea, confusion, coma, skin eruption, scar, murmur and so on. In a board sense, both subjective and objective abnormal could be called as symptoms. A. Fever (pyrexia) 1. Definition: Fever represents a disturbance in which there is upward shift of the body’s temperature. lThe normal body temperature taken in the mouth, is closed to 37℃(36.3?37.2℃). lOral temperature recordings is approximately equal to simultaneous rectal temperature reading. ?The temperature of the skin of the axilla is slight lower(0.2?0.4℃) than that in the mouth. 2. Physiology: An individual’s baseline temperature varies (less than 1℃) (lowest in the morning), activity (exercise), physiological events (ovulation), and habit (smoking). Eldly has lower baseline temperature and often produce less fever response. 3. Clinical classification low fever: 37.4?38℃ middle fever: 38.1?39℃ high fever: 39.1?41℃ excessively high temperature (hyperpyrexia): above 41℃ 4. Type of fever (1) Continus (persistent) fevers: Fever curve shows the high temperature from 39?40℃ may continue for days or weeks with fluctuation less than 1℃ between morning and evening (typhoid) (2) Remittent fevers: It is similar to continuous fever, but the swing of temperature is greater than 2℃ and the temperature does not fall to normal (rheumatic fever). (3) Intermittent (periodic) fevers: The temperature rises every second or third day at approximately the same time. The temperature rises abruptly to about 40℃ for a few hours only and then falls abruptly to normal or below(malaria). (4) Undulant fevers: The temperature chart shows rises up to 39?40℃, lasting for 7?14 days, falling to normal for a