감별진단의 정석 : Differential Diagnosis in Primary Care

PART 1. 생체징후 관련 문제(Changes and Abnormalities in Vital Signs)
1. 혈압 이상(Blood pressure abnormalities) -------- 2
o 저혈압/쇼크(Hypotension/Shock) -------- 2
o 고혈압(Hypertension)(심혈관/혈액 문제 참조) -------- 24
2. 두근거림/심박 이상(Palpitation/Heart rate abnormalities) -------- 25
o 두근거림(Palpitation) -------- 25
o 서맥(Bradycardia) -------- 31
o 빈맥(Tachycardia) -------- 41
3. 호흡곤란/호흡 이상(Dyspnea/Respiratory abnormalities) -------- 72
o 호흡곤란(Dyspnea) -------- 72
o 환기장애:과호흡(Hyperpnea/Hyperventilation), 저환기(Hypoventilation) -------- 102
4. 체온 이상(Temperature abnormalities) -------- 108
o 발열/불명열(Fever/Fever of unknown origin) -------- 108
o 저체온(Hypothermia) -------- 118

PART 2. 전신/내분비 문제(General problems/Endocrine problems)
1. 체중감소/식욕부진(Weight loss/Anorexia) -------- 128
o 비자발적 체중감소(Involuntary weight loss) -------- 128
o 식욕부진(Anorexia) -------- 140
2. 체중증가/비만(Weight gain/Obesity) -------- 147
3. 피로(Fatigue) -------- 170
4. 의학적으로 설명되지 않는 증상(Medically Unexplained Physical Symptoms) -------- 185
5. 림프절 비대(Lymphadenopathy) -------- 202

PART 3. 통증/근골격 문제(Pain/Musculoskeletal problems)
Chapter 1. 전신/관절
1. 전신통증(Widespread pain) -------- 215
2. 관절통/관절부기(Arthralgia/Joint swelling) -------- 223

Chapter 2. 두경부
3. 두통(Headache) -------- 231
4. 얼굴 통증(Facial pain) -------- 258

Chapter 3. 목/등/허리/가슴
5. 목 통증(Neck pain) -------- 268
6. 허리 통증(Back pain) -------- 289
7. 가슴 통증(Chest pain):Musculoskeletal origin -------- 304

Chapter 4. 상지
8. 어깨 통증(Shoulder pain) -------- 310
9. 팔꿈치 통증(Elbow pain) -------- 335
10. 손목/손 통증(Wrist/Hand pain) -------- 350

Chapter 5. 고관절/하지
11. 고관절 통증(Hip pain) -------- 369
12. 무릎 통증(Knee pain) -------- 386
13. 발목/발 통증(Ankle/Foot pain) -------- 406

PART 4. 호흡기/알레르기 문제(Respiratory/Allergic problems)
1. 기침(Cough) -------- 420
2. 객혈(Hemoptysis) -------- 436
3. 호흡음의 이상(Abnormal breath sound) -------- 444
o 쌕쌕거림(Wheezing) -------- 444
o 협착음(Stridor) -------- 451

PART 5. 심혈관/혈액 문제(Cardiovascular/Hematologic problems)
1. 고혈압(Hypertension) -------- 464
2. 가슴통증/가슴불쾌감(Cardiac chest pain) -------- 481
3. 실신(Syncope) -------- 511
4. 부종(Edema) -------- 524
5. 심잡음(Heart murmur) -------- 533
6. 출혈경향(Bleeding tendency) -------- 544

PART 6. 소화기 문제(Gastrointestinal problems)
1. 삼킴곤란(Dysphagia) -------- 566
2. 구역/구토(Nausea/Vomiting) -------- 575
3. 복통/복부불편감(Abdominal pain/Abdominal discomfort) -------- 579
o 급성복통(Acute abdominal pain) -------- 579
o 만성복통/소화불량(Chronic abdominal pain/Dyspepsia) -------- 590
4. 설사(Diarrhea) -------- 598
o 급성설사(Acute diarrhea) -------- 598
o 만성설사(Chronic diarrhea) -------- 609
5. 변비(Constipation) -------- 617
6. 위장관 출혈(Gastrointestinal bleeding):토혈(Hematemesis), 혈변/흑색변(Hematochezia/Melena) -------- 630
o 상부위장관 출혈(Upper gastrointestinal bleeding) -------- 630
o 하부위장관 출혈(Lower gastrointestinal bleeding) -------- 638
o 원인미상의 위장관출혈(Obscure GI bleeding) = 소장출혈(Small bowel bleeding) -------- 644
7. 항문 증상(Anorectal complaints) -------- 650
8. 황달(Jaundice) -------- 661
9. 복부팽만/복수(Abdominal distension/Ascites) -------- 676

PART 7. 신장/비뇨생식기 문제(Renal/Genitourinary problems)
1. 혈뇨(Hematuria) -------- 686
2. 단백뇨(Proteinuria) -------- 696
3. 다뇨증(Polyuria) -------- 701
4. 무뇨증/핍뇨증(Oliguria/Anuria) -------- 711
5. 배뇨통(Dysuria) -------- 721
6. 하부요로증상(Lower urinary tract symptoms) -------- 728
7. 요실금(Urinary incontinence) -------- 741
8. 성매개감염과 연관된 증상(Sexually transmitted infection related symptoms) -------- 746
o 요도분비물(Urethral discharge) -------- 746
o 생식기 궤양(Genital ulcer) -------- 753
o 생식기 사마귀(Genital warts) -------- 759

PART 8. 산과/부인과/유방 문제(OB/GY/Breast problems)
1. 월경 관련 증상(Menstruation related symptoms) -------- 766
o 월경통(Dysmenorrhea) -------- 766
o 월경과다(Menorrhagia)(비정상생식기출혈에서 다룸) -------- 774
o 무월경(Amenorrhea) -------- 774
o 폐경(Menopause) -------- 792
2. 질 출혈/비정상 생식기출혈(Vaginal bleeding/Abnormal genital bleeding) -------- 800
3. 외음부 병변(Vulvar lesions) -------- 814
o 외음부 덩이(Vulvar masses) -------- 814
o 외음부 궤양(Vulvar ulcers) -------- 822
o 외음부 피부병변(Vulvar dermatoses) -------- 833
o 외음부 통증(Vulvar pain, Vulvodynia) -------- 837
4. 유방 증상(Breast problems) -------- 841
o 유방 통증(Breast pain, Mastalgia) -------- 841
o 유방 덩어리(Breast mass) -------- 848
o 유방 분비물(Nipple discharge) -------- 856
o 유방 비대/여성형 유방(Gynecomastia) -------- 862

PART 9. 신경-정신 문제(Neuro-Psychiatric problems)
1. 정신상태/의식변화(Altered mental status) -------- 868
2. 어지럼증/현훈/현기증(Dizziness/Vertigo/Lightheadedness) -------- 873
3. 발작/뇌전증(Seizure/Epilepsy) -------- 892
4. 떨림/파킨슨병(Tremor/Parkinson's disease) -------- 900
5. 보행이상/운동실조(Abnormal gait/Ataxia) -------- 914
6. 팔다리 근력약화/마비(Limb weakness/Paralysis) -------- 924
7. 손발저림(Numbness and Tingling on Hands and Feet) -------- 936
8. 인지-기억장애/기억상실(Cognitive-memory impairment/Amnesia) -------- 950
9. 언어장애(Disorders of speech and language) -------- 963
10. 기분변화(Mood change) -------- 967
11. 불안(Anxiety) -------- 982
12. 불면증/수면장애(Insomnia/Sleep disorder) -------- 989
13. 정신증(Psychosis) -------- 999

PART 10. 눈/귀/코/두경부 문제(Eye/Ear/Nose/Head & Neck problems)
Chapter 1. 눈 관련 문제
1. 시력장애(Visual impairment)/시력상실(Vision loss) -------- 1011
2. 충혈눈(Red eye) -------- 1021
3. 눈통증(Eye pain) -------- 1032
4. 눈건조감(Dry eye) -------- 1040

Chapter 2. 귀 관련 문제
5. 이통(Otalgia, Ear pain) -------- 1047
6. 난청(Hearing loss) -------- 1053
7. 이명(Tinnitus) -------- 1061

Chapter 3. 코/구강 관련 문제
8. 코피(비출혈)(Epistaxis, Nasal bleeding) -------- 1074
9. 코막힘(비폐색)(Nasal obstruction) -------- 1080
10. 후각장애(Smell disorder) -------- 1088
11. 미각장애(Taste disorder) -------- 1092
12. 입냄새(구취)(Halitosis) -------- 1099
13. 구강건조(Dry mouth, Xerostomia) -------- 1106
14. 구강 점막 병변(Oral mucosal lesions) -------- 1111
o 수포/궤양 병변(Vesiculobullous/Ulcerative lesions) -------- 1111
o 백색 병변(White lesions) -------- 1120

Chapter 4. 두경부 관련 문제
15. 경부 이상감각증(Globus pharyngeus) -------- 1128
16. 발성장애/쉰소리(Dysphonia/Hoarseness) -------- 1132
17. 목덩이(경부종물)(Neck mass) -------- 1141

PART 11. 피부 문제(Dermatologic problems)
[SPECIAL REVIEW] 피부질환의 일반적인 접근전략 -------- 1150
1. 피부 가려움증(Pruritus) -------- 1155
2. 건조한 피부(Dry skin) -------- 1167
3. 두드러기/혈관부종(Urticaria/Angioedema) -------- 1177
4. 물집병변(Vesicular-bullous lesions) -------- 1187
5. 구진인설병변(Papulosquamous eruptions) -------- 1196
6. 자반/점상출혈(Purpura/Petechiae) -------- 1205
7. 원형/과녁모양 병변(Annular/Targetoid lesions) -------- 1215
8. 전신 피부발진(Generalized rash) -------- 1222