MindMap Gallery Internal Medicine
Internal Medicine - Rheumatic Diseases, shares the etiology, pathogenesis, clinical manifestations, differential diagnosis, prevention, and treatment of gout. If you are interested, you can take a look.
Edited at 2023-07-28 16:30:27This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
Endocrine and metabolic diseases
Hyperthyroidism696
Cause
Increased thyroxine
clinical manifestations
Special clinical manifestations
GO
Pretibial myxedema
thyroid storm
thyrotoxicosis heart disease
Apathetic hyperthyroidism
Thyrotoxicosis type 3
One-time thyrotoxicosis during pregnancy
General clinical manifestations
Thyrotoxicosis
goiter
Eye signs
examine
Thyroid function is most sensitive
TSH
TT4
TT3
diagnosis
step
Thyrotoxicosis Diagnosis
Does thyrotoxicosis result from hyperthyroidism?
Diagnosis of hyperthyroidism
reason
GD diagnosis
treat
primary chronic adrenocortical insufficiency
definition
Cause
Infection (adrenal tuberculosis is common)
clinical manifestations
Darkening of skin pigmentation all over the body (exposed areas, friction areas, areola, scars)
Mucosal pigmentation (gingiva, tongue, buccal mucosa)
Adrenal crisis (exacerbation)
ACTH, melanocyte stimulating hormone↑
examine
blood biochemistry
hyponatremia, hyperkalemia
Blood routine
Normocytic normochromic anemia
Neutrophils ↓ Lymphocytes ↑ Eosinophils ↑
hormone
diagnosis
treat
diabetes
definition
Type 1=T1DM
clinical manifestations
IA
LADA
honeymoon period
IB
diabetic ketosis, acidosis
mechanism
Pancreatic beta destruction → absolute insulin deficiency
Type 2 = T2DM
clinical manifestations
Hypoglycemia (first onset)
mechanism
Mainly insulin resistance/insufficient secretion of insulin
summary
Abnormal alpha function Defective incretin secretion
beta deficiency insulin resistance
Mainly insulin resistance + insufficient insulin secretion
gestational diabetes
T2DM
Pathogenesis
IGR IFG IGT → Diabetes
complication
Microvascular disease
typical changes
Thickening of microvascular basement membrane Microcirculation disorder
lesions
diabetic nephropathy
Main causes of end-stage renal failure
Main causes of death in T1DM
diabetic retinopathy
Main causes of blindness
Atherosclerotic cardiovascular disease ASCVD
T2DM
neurological complications
peripheral nerves
distal symmetric polyneuropathy
Sensory motor nerves of hands and feet
Distribution of gloves and socks
focal single nerve
oculomotor nerve
median nerve
popliteal nerve
autonomic nerve
urinary retention
diabetic foot
amputation
acute severe metabolic disorder
DKA hyperosmolar hyperglycemic syndrome
examine
Urine glucose measurement
Positive urine sugar → blood sugar value exceeds renal glucose threshold (10mmol/L)
OGTT
mostly according
diagnosing diabetes
main indicators
Diabetes condition control
venous plasma
GHbA1
HbA1c
8-12w average blood sugar level
Glycated plasma albumin measurement
FA→2-3w average blood sugar level (recently)
Pancreatic beta cell function test
C-peptide release test
Not affected by insulin antibodies and exogenous insulin
diagnosis
treat
in principle
early and long term
Positive and rational
Comprehensive Treatment
Comprehensive compliance
Individualized treatment
5 key points
diabetes education
medical nutrition therapy
exercise therapy
blood sugar treatment
medical treatement
urinary tract disease
Nephrotic syndrome NS
Cause
Pathophysiology
Pathological type
Complications and prevention
diagnosis
Differential diagnosis
treat
prognosis
rheumatic diseases
gout
Etiology and pathogenesis
hyperuricemia
gout
clinical manifestations
>40 (male), (female) post-menopausal, family history
asymptomatic period
Hyperuricemia asymptomatic
Acute arthritis phase and intermittent phase
hot
fever
acid
Hyperuricemia (some acute and normal)
Urate crystals
pain
(Midnight/early morning) Severe joint pain, redness, swelling, heat and pain, functional impairment
ease
colchicine
self-limiting
Relieve within 2 weeks
Location
Unilateral 1st metatarsophalangeal joint
Tophi and chronic arthritis stage
tophi
ears 👂
kidney
gouty nephropathy
uric acid nephrolithiasis
acute renal failure
examine
Blood uric acid measurement
male
208-416μmol/L(3.5-7.0mg/dl)
female
149-358(2.5-6.0)
Urine uric acid measurement
Increased uric acid production
After 5 days of purine-restricted diet, uric acid excretion was >3.57mmol/d (600mg)
Synovial fluid/tophus contents
Urate crystals
Ultrasonography
Double track sign/heterogeneous low and high echo mass shadow
X-ray examination
CT and MRI
diagnosis
Differential diagnosis
prevention
Control hyperuricemia
Control acute arthritis attacks
Prevents uric acid crystal formation and kidney damage
treat
non-drug
Liquor limit
Reduce intake of high-purine foods
Reduce intake of fructose-rich beverages
Weight control
Prevent strenuous exercise/sudden cold
Drink plenty of water (2000ml/d)
Increase your intake of fresh vegetables
Regular diet and daily rest
regular exercise
No smoking
drug
acute
nonsteroidal anti-inflammatory drugs
Indomethacin
Diclofenac
etoricoxib
Adverse reactions, use with caution
Adverse reactions
Gastrointestinal ulcers and bleeding
Use with caution
active peptic ulcer
renal insufficiency
colchicine
1.5mg/d
Glucocorticoids
For NSAIDs, colchicine treatment is ineffective/contraindicated, and patients with renal insufficiency
interictal and chronic phases
Lower uric acid (serum uric acid <5mg/dl, >3mg/dl)
Acute attack >2 times/min
chronic gouty arthritis
tophi
Treatment of concomitant diseases
hypertension
Losartan
amlodipine
Hyperlipidemia
chronic kidney disease
Operation
Lower uric acid
Inhibit uric acid synthesis
Allopurinol
Adverse reactions
胃肠道症状
皮疹
药物热
肝酶升高
骨髓抑制
50-100mg/d (maximum 600mg/d)
febuxostat
Available
轻至中度肾功能不全
Adverse reactions
肝功能异常
腹泻
20-40mg/d (maximum 80mg/d)
Promote uric acid excretion
Benzbromarone
Adverse reactions
胃肠道症状
皮疹
肾绞痛
粒细胞减少
肝毒性
25mg/d, maximum 100mg/d
probenecid
0.5g/d, maximum 2g/d, disabled for sulfonamide allergy