Curs de medicina interna - PIM Copy
Curs de medicina interna - PIM Copy
Curs de medicina interna - PIM Copy
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COSTIN ANCA<br />
CORUGĂ ANA-MARIA<br />
CURS DE MEDICINĂ INTERNĂ<br />
PENTRU ASISTENŢII MEDICALI<br />
EDITURA <strong>PIM</strong>
COSTIN ANCA<br />
CORUGĂ ANA-MARIA<br />
CURS DE MEDICINĂ INTERNĂ<br />
PENTRU ASISTENłII MEDICALI<br />
EDITURA <strong>PIM</strong><br />
Iaşi, 2008
EDITURA <strong>PIM</strong><br />
Soseaua Stefan cel Mare nr. 11 Iasi -700498<br />
Tel. / fax: 0232-212740<br />
e-mail:editurapim@pimcopy.ro<br />
www.pimcopy.ro<br />
EDITURĂ ACREDITATĂ CNCSIS BUCUREŞTI<br />
66/01.05.2006<br />
AUTORI:<br />
Dr. Costin Anca<br />
– Medic specialist medicină <strong>de</strong> familie, cadru didactic<br />
al şcolii postliceale sanitare „Grigore Ghica Vodă”, Iaşi.<br />
Dr. Corugă Ana-Maria – Medic specialist ORL, cadru didactic al şcolii<br />
postliceale sanitare „Grigore Ghica Vodă”, Iaşi.<br />
ISBN: 978-606-520-027-2
CUPRINS<br />
PNEUMOLOGIA ( Dr. Corugă Ana-Maria )...........................................................................7<br />
Anatomia şi fiziologia aparatului respirator..................................................................... ..... 7<br />
NoŃiuni <strong>de</strong> semiologie respiratorie.........................................................................................10<br />
InvestigaŃii utile în afecŃiunile respiratorii.............................................................................13<br />
Traheobronşita acută..............................................................................................................15<br />
Bronhopneumopatia obstructivă cronică............................................................................... 17<br />
Pneumoniile........................................................................................................................... 19<br />
Pneumonia lobară.......................................................................................................... ...20<br />
Bronhopneumonia.......................................................................................................... ..22<br />
Pneumoniile atipice........................................................................................................ ..24<br />
SupuraŃiile pulmonare......................................................................................................... ..25<br />
Tuberculoza............................................................................................................................30<br />
Astmul bronşic........................................................................................................................42<br />
Pneumotoraxul........................................................................................................................45<br />
Cancerul bronşic.....................................................................................................................46<br />
CARDIOLOGIA ( Dr. Costin Anca ).....................................................................................49<br />
Anatomia şi fiziologia aparatului cardio-vascular..................................................................49<br />
Semiologia aparatului cardio-vascular...................................................................................52<br />
Explorarea aparatului cardio-vascular....................................................................................57<br />
Cardita reumatismală..............................................................................................................59<br />
Stenoza mitrală.......................................................................................................................60<br />
InsuficienŃa mitrală.................................................................................................................64<br />
Stenoza aortică........................................................................................................................65<br />
InsuficienŃa aortică..................................................................................................................67<br />
Endocardita bacteriană............................................................................................................68<br />
Hipertensiunea arterială..........................................................................................................72<br />
Hipotensiunea arterială...........................................................................................................76<br />
Tulburări <strong>de</strong> ritm.....................................................................................................................77<br />
Angina pectorală.....................................................................................................................85<br />
Infarctul miocardic..................................................................................................................89<br />
Bolile venelor ..................................................................................................................... ...93<br />
Bolile arterelor........................................................................................................................97<br />
InsuficienŃa cardiacă...............................................................................................................99<br />
Moartea subită...................................................................................................................... ..110<br />
Şocul cardiogen.................................................................................................................... ..112<br />
Pericarditele..................................................................................................................... ....116<br />
GASTROENTEROLOGIA (Dr. Costin Anca).................................................................. ....118<br />
Anatomia şi fiziologia aparatului digestiv.......................................................................... ....118<br />
NoŃiuni <strong>de</strong> semiologie a aparatului digestiv....................................................................... ....119<br />
InvestigaŃii paraclinice........................................................................................................ ....125<br />
Esofagita acută.................................................................................................................... ....137<br />
Diverticulii esofagieni....................................................................................................... .....138<br />
Cancerul esofagian............................................................................................................ .....139<br />
Boala <strong>de</strong> reflux gastroesofagian........................................................................................... ..140<br />
Hernia gastrică transhiatală.................................................................................................. ..141<br />
Gastritele acute şi cronice......................................................................................................143<br />
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Ulcerul gastric şi duo<strong>de</strong>nal....................................................................................................143<br />
Cancerul gastric.....................................................................................................................157<br />
Hemoragiile digestive superioare..........................................................................................159<br />
Hepatitele cronice..................................................................................................................161<br />
Cirozele hepatice...................................................................................................................166<br />
Sindromul icteric...................................................................................................................170<br />
Litiaza biliară........................................................................................................................172<br />
Colecistita acută....................................................................................................................173<br />
Colecistita cronică.................................................................................................................174<br />
Pancreatita acută............................................................................................................. ......175<br />
Pancreatita cronică........................................................................................................... .....177<br />
Boala inflamatorie cronică a intestinului...............................................................................178<br />
Enteropatia glutenică.............................................................................................................179<br />
Sindromul colonului iritabil..................................................................................................180<br />
Parazitozele intestinale..........................................................................................................181<br />
BOLI DE NUTRIłIE ŞI METABOLISM ( Dr. Costin Anca )............................................182<br />
Diabetul zaharat.....................................................................................................................182<br />
Obezitatea..............................................................................................................................196<br />
Guta.................................................................................................................................... ...200<br />
Sindromul X metabolic..........................................................................................................202<br />
Hipoglicemiile.......................................................................................................................203<br />
Hiperlipoproteinemiile...........................................................................................................203<br />
NEFROLOGIA ( Dr. Costin Anca ).....................................................................................205<br />
Anatomia şi fiziologia aparatului renal.................................................................................205<br />
Semiologia aparatului renal...................................................................................................205<br />
Explorarea aparatului renal....................................................................................................208<br />
Bolile glomerulare ( Glomerulonefritele)..............................................................................209<br />
Sindromul nefrotic.................................................................................................................213<br />
InfecŃiile tractului urinar........................................................................................................214<br />
Cistita...................................................................................................................................216<br />
Pielonefritele........................................................................................................................218<br />
Cancerul renal........................................................................................................................222<br />
Boala polichistică renală..................................................................................................... ...224<br />
InsuficienŃa renală acută.........................................................................................................227<br />
InsuficienŃa renală cronică......................................................................................................231<br />
HEMATOLOGIA ( Dr. Corugă Ana-Maria )................................................................. ......239<br />
NoŃiuni <strong>de</strong> anatomie şi fiziologie................................................................................... ......239<br />
NoŃiuni <strong>de</strong> semiologie.................................................................................................... ......242<br />
InvestigaŃii utile în afecŃiunile hematologice................................................................ ........244<br />
Anemiile....................................................................................................................... ........246<br />
Anemia feriprivă....................................................................................................... ........246<br />
Anemia posthemoragică............................................................................................ . .......248<br />
Anemiile megaloblastice.............................................................................................. .....249<br />
Anemiile hemolitice................................................................................................... .......251<br />
Hemopatiile maligne.................................................................................................... .........254<br />
Leucemiile................................................................................................................. .......254<br />
Limfomul Hodgkin.................................................................................................. .........257<br />
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Mielomul multiplu............................................................................................................ 259<br />
Sindroame hemoragice.........................................................................................................260<br />
Purpura trombocitopenică.................................................................................................260<br />
Hemofilia...........................................................................................................................261<br />
REUMATOLOGIA ( Dr. Corugă Ana-Maria )................................................................... 263<br />
NoŃiuni <strong>de</strong> anatomie şi fiziologie........................................................................................ .263<br />
NoŃiuni <strong>de</strong> semiologie......................................................................................................... .265<br />
InvestigaŃii utile în reumatologie......................................................................................... 266<br />
Reumatismul articular acut.................................................................................................. 267<br />
Poliartrita reumatoidă...........................................................................................................269<br />
Spondilita anchilozantă....................................................................................................... .272<br />
Boala artrozică.................................................................................................................... .273<br />
ENDOCRINOLOGIA ( Dr. Corugă Ana-Maria )...............................................................276<br />
NoŃiuni <strong>de</strong> anatomie şi fiziologie........................................................................................ 276<br />
NoŃiuni <strong>de</strong> semiologie......................................................................................................... 280<br />
InvestigaŃii utile în endocrinologie..................................................................................... 285<br />
AfecŃiunile hipofizei şi hipotalamusului............................................................................. 287<br />
A<strong>de</strong>nomul cromofob........................................................................................................... 287<br />
Gigantismul şi acromegalia............................................................................................. 288<br />
Nanismul hipofizar.......................................................................................................... 289<br />
InsuficienŃa hipofizară..................................................................................................... 290<br />
Diabetul insipid............................................................................................................... 291<br />
Sindromul adipozo-genital.............................................................................................. 293<br />
AfecŃiunile tiroi<strong>de</strong>i............................................................................................................. 293<br />
Tireotoxicoza................................................................................................................... 293<br />
Hipotiroidia...................................................................................................................... 295<br />
Guşa nodulară.................................................................................................................. 297<br />
Cancerul tiroidian............................................................................................................ 298<br />
AfecŃiunile paratiroi<strong>de</strong>i...................................................................................................... 299<br />
Hipertiroidia.................................................................................................................... 299<br />
Hipotiroidia..................................................................................................................... 300<br />
AfecŃiunile suprarenalei..................................................................................................... 301<br />
Boala Addison................................................................................................................. 301<br />
Sindromul Cushing......................................................................................................... .302<br />
Hiperaldosteronismul...................................................................................................... .303<br />
Feocromocitomul............................................................................................................ .304<br />
Sindroamele adreno-genitale.......................................................................................... .305<br />
AfecŃiunile gona<strong>de</strong>lor........................................................................................................ .306<br />
Hipogonadismul.............................................................................................................. 306<br />
Criptorhidia...................................................................................................................... 308<br />
Hirsutismul..................................................................................................................... 308<br />
Boala polichistică ovariană............................................................................................. 308<br />
Pubertatea precoce.......................................................................................................... 309<br />
Pubertatea întârziată........................................................................................................ 309<br />
TESTE................................................................................................................................ 311<br />
BIBLIOGRAFIE................................................................................................................ 323<br />
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