HypertensiveStatesofPregnancy:IntroductionHypertensivestatesinpregnancyincludepreeclampsia-eclampsia,chronichypertension(eitheressentialorsecondarytorenaldisease,endocrinedisease,orothercauses),chronichypertensionwithsuperimposedpreeclampsia,andgestationalhypertension(Table19–1).Preeclampsiaishypertensionassociatedwithproteinuriaandedema,occurringprimarilyinnulliparasafterthe20thgestationalweekan...[
阅读全文]
EssentialsofDiagnosisCliniciansshouldbeawareofindividualriskfactorsfordevelopmentofpulmonaryembolism.Pulmonaryembolismshouldbeconsideredincasesofunexplainedhypoxemia.Limitationsexistforallcurrentdiagnosticstudies.Allcliniciansshouldhaveadiagnosticalgorithmincasesofsuspectedpulmonaryembolism.GeneralConsiderationsVenousthromboembolism(VTE),acommonmedicalproblem,isthethirdmostcommonvasculardiseaseand...[
阅读全文]
ClinicalFindingsSymptomsandSignsPresentingsignsandsymptomsforpulmonaryembolismarenonspecific,whichmakesclinicaldiagnosisdifficult.ThemostcommonpresentingsymptomsnotedinthepatientsfromtheProspectiveInvestigationofPulmonaryEmbolismDiagnosis(PIOPED)studywhohadangiographicallyconfirmedPEweredyspnea,pleuriticchestpain,andtachypnea.Thefindingsonphysicalexaminationincludedincreasedrespiratoryrate,rales,t...[
阅读全文]
Renal&UrinaryTractDisordersForadiscussionofrenalandurinarytractfunctioninnormalpregnancy,seeChapter7:MaternalPhysiologyduringPregnancy.UrinaryTractInfectionAsymptomaticbacteriuria,acutecystitis,andacutepyelonephritisarecommonrenaldisordersinpregnancy.AsymptomaticBacteriuriaAsymptomaticbacteriuriaisdefinedasthepresenceofactivelymultiplyingbacteriaintheurinarytractexcludingthedistalurethrainapat...[
阅读全文]
CardiovascularDisorders**SeealsoChapter19:HypertensiveStatesofPregnancy.CardiovascularChangesinNormalPregnancyThemajorcardiocirculatorychangesthatoccurduringnormalpregnancyincludeanincreaseincardiacoutputandbloodvolumeandadecreaseinperipheralresistance(Table22–1).Duringnormalpregnancy,6–8.5Loffluidand500–900mmolofsodiumareretainedbecauseoftheactionofprogesterone,renin,aldosterone,andprolactin.A...[
阅读全文]
HematologicDisordersAnemiaAnemiaisasignificantmaternalproblemduringpregnancy.Ahemoglobinoflessthan11g/dLorahematocritoflessthan33%shouldbeinvestigatedandtreatedtoavoidbloodtransfusionanditsrelatedcomplications.Apregnantwomanwilllosebloodduringdeliveryandthepuerperium,andananemicwomanisthereforeatincreasedjeopardy.Duringpregnancy,thebloodvolumeincreasesbyabout50%andtheredbloodcellmassbyabout25%.Thi...[
阅读全文]
1.Sonography
TanaghoSmith'sUrology>Chapter6.RadiologyoftheUrinaryTract
2.Ultrasound
Harrison'sOnline>Chapter235.DiagnosticProceduresinRespiratoryDisease>ImagingStudies3.Ultrasound
WayCurrentSurgery>Chapter38.Neurosurgery&SurgeryofthePituitary>NeurodiagnosticProcedures...[阅读全文]
TheEchocardiogram:IntroductionThetermechocardiographyreferstotheevaluationofcardiacstructureandfunctionwithimagesandrecordingsproducedbyultrasound.Inthepastthreedecadesithasrapidlybecomeafundamentalcomponentofthecardiacevaluation.Currently,echocardiography("echo")providesessential(andsometimesunexpected)clinicalinformationandhasbecomethesecondmostfrequentlyperformeddiagnosticprocedureafterelectroc...[
阅读全文]
ImagingoftheCoronaryArteriesTheabilitytovisualizetheproximalsegmentsoftheleftandrightcoronaryarterieswasinitiallydemonstratedbyWeymanetal.SubsequentstudiesestablishedtheabilityofcolorandspectralDopplerexaminationtoimageandrecordthevelocityofflowfromTTEandTEEapproaches,particularlywithregardtotheleftanteriordescendingcoronaryartery.210However,visualizationofthecoronaryarteriesbyechocardiographyhasn...[
阅读全文]
PericardialDiseaseInnormalsubjects,thepericardiumisdifficulttovisualizesincethepericardialcavityisonlyapotentialspaceandvisceralandparietalpericardiallayersappearasasingleecho.Inthesettingofpericardialeffusion,thefluidappearsasasonolucentarea(orclearspace)separatingepicardiumfrompericardium.324Pericarditismaybeunaccompaniedbypericardialeffusionandinsuchcasesmaybeundetectablebyechocardiography.Inad...[
阅读全文]