COMA
(Algorithmic Diagnosis of Symptoms and Signs)
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Is there a history of drug or alcohol ingestion? This is a very important question to ask, as many cases of coma are due to acute alcohol intoxication, delirium tremens, opium poisoning, ... DIAGNOSTIC WORKUP
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Is there weight loss? If there is weight loss, one must consider a neoplasm, endocrine disorders such as hyperthyroidism or diabetes mellitus, malnutrition or malabsorption, and ... DIAGNOSTIC WORKUP
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Is there dyspnea? If there is a history of dyspnea, heart disease or lung disease should be suspected.
Is there a history of drug or alcohol ... DIAGNOSTIC WORKUP
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Are there convulsive movements or incontinence? The presence of convulsive movements should suggest convulsions, and the differential diagnosis of this is discussed on
page 88
. ... DIAGNOSTIC WORKUP
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Fatigue is a very common, although nonspecific, presenting symptom that refers to the sensation of exhaustion during or after usual activities, or a feeling of inadequate energy to begin these activities. Fatigue is a... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Insomnia may be a primary diagnosis or a complaint or symptom secondary to an underlying acute or chronic disorder. Many patients have insomnia but do not tell their doctors, so... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Syncope is often referred to by patients as “fainting” and is defined as a loss of postural tone and consciousness. Syncope usually lasts for brief periods of a few minutes. Longer periods are of more concern,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Coma is a state of total unawareness of the self and the environment. There is no eye opening or response to voice or painful stimuli. Coma can be due to dysfunction of either bilateral cerebral cortex or the reticular activating... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Complaints of fatigue indicate a general state of decreased endurance for, or interest in, activities. It is typically associated with tiredness and sleepiness. Depression as a cause of fatigue in adolescents frequently... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Syncope is temporary loss of consciousness and muscle tone due to decreased cerebral blood flow. It is otherwise known as fainting or blackout. Syncope is a common pediatric problem that, in contrast... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Distal weakness is most likely secondary to neuropathy, and is often associated with loss of deep tendon reflexes (DTRs) either with or without sensory abnormalities. In contrast, increased... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Proximal weakness is usually due to dysfunction of the lower motor unit; that is, anterior horn cells in the spinal cord, neuromuscular junction (NMJ), or the muscle itself. The neurologic... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... It is customary to assume that the cause of the disorder is psychogenic and simply to prescribe a sleeping pill to anyone suffering from insomnia, hoping that it will go away by itself. Although this may be true in many cases, the conscientious
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... The differential of syncope or a brief loss of consciousness is best developed with the use of physiology and, to a lesser extent, anatomy. Like convulsions (see page 128), syncope is due to a
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... Somnolence is a deep sleep from which the patient can be aroused. Coma is an unconscious state from which the patient cannot be aroused. Because somnolence may be simply an early stage of coma,
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... The analysis of the causes of weakness depends on a knowledge of both anatomy and biochemistry. Strength depends on an intact healthy muscle, peripheral nerve, and lower and upper motor neuron pathways and a functioning
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... Fatigue is a feeling of excessive tiredness, a lack of energy, or exhaustion accompanied by a strong desire to rest or sleep. This common symptom is distinct from weakness, which involves... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Insomnia is the inability to fall asleep, remain asleep, or feel refreshed by sleep. Acute and transient during periods of stress, insomnia may become chronic, causing constant fatigue, extreme... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... A decrease in the level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... A common neurologic sign, syncope (or fainting) refers to a transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes.... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Acute or Subacute*
Electrolyte abnormality
Hyperkalemia
Hypokalemia
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... Neurologic or Mechanical Causes, or Both
Mediated by vagal stimulation or autonomic insufficiency, or both
Vasovagal reaction (often associated with strong emotion or pain)
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... Usually No Lateralizing Signs, Normal Brainstem Reflexes
Drug withdrawal after chronic intoxication, especially
Alcohol
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... Congenital
Antithrombin III deficiency
Protein C deficiency
Protein S deficiency
Homocystinuria
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... Sometimes called chronic Epstein-Barr virus, or myalgic encephalomyelitis, chronic fatigue and immune dysfunction syndrome is typically marked by debilitating... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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Fatigue
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Fatigue is a feeling of excessive tiredness, lack of energy, or exhaustion accompanied by a strong desire to rest or sleep. This common symptom is distinct from weakness, which involves... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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Insomnia
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Insomnia is the inability to fall asleep, remain asleep, or feel refreshed by sleep. Acute and transient during periods of stress, insomnia may become chronic, causing constant fatigue, extreme anxiety as... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A decrease in level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage,... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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Syncope
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... A common neurologic sign, syncope (or fainting) refers to transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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Coma
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Anne Cather Cutlip
Coma represents a state of unarousable unresponsiveness in which the patient has no evidence of self or environmental awareness (1).
Approach. ... History ... Physical examination ... Testing ... Diagnostic assessment.
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Fatigue
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Meg Hayes
Fatigue is both a normal human response as well as a symptom of physical or psychological disease. It is a subjective sensation that is multicausal and nonspecific for which no one definition is... Approach ... History ... Physical examination ... Testing. ... Diagnostic assessment
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Insomnia
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Charles E. Henley
Insomnia is more than just being unable to fall asleep. It is a subjective condition of insufficient or nonrestorative sleep despite an adequate... Approach. ... History ... Physical examination. ... Testing ... Diagnostic assessment
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Syncope
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... James C. Chesnutt
Syncope is a common and concerning medical problem, which accounts for 3% of emergency room visits and up to 6% of hospital admissions. Although... Approach. ... History ... Physical examination ... Testing. ... Diagnostic assessment. ... Pictures
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... Differential Overview
❑ Alcohol intoxication
❑ Drug overdose
❑ Hypoglycemia
... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Infectious mononucleosis
❑ Depression
❑ Diabetes ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Orthostatic/Autonomic
❑ Neurally mediated hypotension
❑ Volume depletion ... Diagnostic Approach ... Clinical Findings
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... Chronic fatigue and immune dysfunction syndrome (CFIDS) — also known as chronic fatigue syndrome, chronic Epstein-Barr virus [EBV], benign myalgic encephalomyelitis, and “Yuppie flu” ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... A decrease in level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Syncope
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A common neurologic sign, syncope (or fainting) refers to transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes. An episode... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Fatigue
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... Fatigue is a feeling of excessive tiredness, lack of energy, or exhaustion accompanied by a strong desire to rest or sleep. This common symptom is distinct from weakness, which involves the muscles, but may... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Insomnia is the inability to fall asleep, remain asleep, or feel refreshed by sleep. Acute and transient during periods of stress, insomnia may become chronic, causing constant fatigue, extreme anxiety as bedtime approaches,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A decrease in level of consciousness (LOC), which can range from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Syncope
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... A common neurologic sign, syncope (or fainting) refers to transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Fatigue
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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...Defined as lack of energy for activitiesand decreased endurance for them. Principal Causes of Fatigue Physiologiccauses Pathologic causes ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Syncope is a transient loss of consciousnessand postural tone usually produced by impaired cerebral blood flow.Generally, a syncopal episode in childhood is a benign isolatedevent; however, some causes can be life... Principal Causes of Syncope and Dizziness ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Consciousness—awarenessof one's self and environment—depends on integrityof reticular activating system and cerebral hemispheres. Disease processes that depress reticularactivating system and/or both... Principal Causes of Alteration in Consciousness ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Fatigue is a feeling of excessive tiredness, a lack of energy, or exhaustion accompanied by a strong desire to rest or sleep. This common symptom is distinct from weakness, which involves the muscles, but may occur... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Insomnia is the inability to fall asleep, remain asleep, or feel refreshed by sleep. Acute and transient during periods of stress, insomnia may become chronic, causing constant... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... A decrease in the level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... A common neurologic sign, syncope (or fainting) refers to a transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
...
It is customary to assume that the cause of the disorder is psychogenic
and simply to prescribe a sleeping pill to anyone suffering from insomnia,
hoping that it will go away by itself. Although... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
...
The differential of syncope or a brief loss of consciousness is best
developed with the use of physiology and, to a lesser extent,
anatomy. Like... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
...
The analysis of the causes of weakness depends on a knowledge of both
anatomy and biochemistry. Strength depends on an intact
healthy muscle, peripheral nerve, and lower and upper motor neuron pathways ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
...
Somnolence is a deep sleep from which the patient can be aroused. Coma
is an unconscious state from which the patient cannot be aroused. Because
somnolence may be simply an early stage of coma, its etiologies... Pictures
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... Amy R. Brooks-Kayal, MDEric Marsh, MD, PhD Coma - BASICS Coma - description Coma is defined as a state in which the patient is unresponsive with eyes closed, usually lasting <24>... Coma - DIAGNOSIS ... Coma - TREATMENT ... Coma - FOLLOW UP ... Coma - bibliography ... Coma - CODES ... Coma - FAQ
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