Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2920_Библиотеки_им_академика_М_И_Перельмана

Chronic sinusitis causes a continuous mu­copurulent discharge that leads to a musty breath odor, postnasal drip, nasal congestion, and a chronic nonproductive cough.

order causes halitosis and a bad taste in the mouth associated with regurgitation. The pa­tient may also report a chronic cough that’s most pronounced at night, hoarseness, odynophagia, neck pain, and “gurgling” sounds in the throat when he swallows liquids.

Halo vision refers to seeing rainbowlike colored rings around lights or bright objects. The rain­bowlike effect can be explained by this physical principle: As light passes through water (in the eye, through tears or the cells of various antereti­nal media), it breaks up into spectral colors.

types of glaucoma. Acute angle-closure glauco- ma—an ophthalmic emergency—also causes blurred vision, followed by a severe headache or excruciating pain in and around the affected eye. Examination reveals a moderately dilated fixed pupil that doesn’t respond to light, con­junctival injection, a cloudy cornea, impaired vi­sual acuity and, possibly, nausea and vomiting.

duces no symptoms until pain and blindness oc­cur in advanced disease. Sometimes, halos and blurred vision develop slowly.

ISTORY AND PHYSICAL EXAMINATION

Begin the physical examination by evaluat­ing the patient’s level of consciousness (LOC). Then check his vital signs. Be alert for signs of increased ICP—widened pulse pressure, brady­cardia, altered respiratory pattern, and in­creased blood pressure. Check pupil size and response to light, and note any neck stiffness. (See Differential diagnosis: Headache, pages 344 and 345.)

calized headache near the tumor site; as the tu­mor grows, the headache eventually becomes

of glaucoma is an ophthalmic emergency that may cause an excruciating headache as well as acute eye pain, blurred vision, halo vision, nau­sea, and vomiting. Assessment reveals conjunc­tival injection, a cloudy cornea, and a moder­ately dilated, fixed pupil.

Influenza type A H1N1, or swine flu, is a respira­tory disease of pigs caused by type A influenza virus. Swine flu viruses cause high levels of ill­ness and low death rates in pigs. Swine flu viruses normally don’t infect humans; however, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs. The virus has changed slightly and is known as H1N1 flu. Recent outbreaks of H1N1 flu have shown that the virus can be transmitted from person to per­son, causing transmission across the globe. The H1N1 flu is similar to influenza, and causes ill­ness and in some cases death. The symptoms of swine flu include headache, nonproductive cough, fatigue, myalgia, chills, fever, and vomit­ing. The use of antiviral drugs is recommended to treat H1N1 flu.

headache, myalgia, arthralgia, and malaise are followed by an abrupt onset of chills, fever, nau­sea, and vomiting. A maculopapular rash may also occur.

is caused by West Nile virus, a mosquito-borne flavivirus commonly found in Africa, West Asia, the Middle East and, rarely, in North America. Most patients have mild signs and symptoms, including fever, headache, body aches, rash, and swollen lymph glands. More severe infec­tion is marked by high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, and paralysis.