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Pathognomonic (often misspelled as pathognomic and sometimes as pathomnemonic) is a term, often used in medicine, that means characteristic for a particular disease. A pathognomonic sign is a particular sign whose presence means that a particular disease is present beyond any doubt. Labelling a sign or symptom "pathognomonic" represents a marked intensification of a "diagnostic" sign or symptom.
The word is an adjective of Greek origin (παθογνωμονικόν [σύμπτωμα]), derived from páthos ("πάθος" meaning "disease") and gnōmon ("γνώμον" meaning "judge").
While some findings may be classic, typical or highly suggestive in a certain condition, they may not occur uniquely in this condition and therefore may not directly imply a specific diagnosis. A pathognomonic sign or symptom has very high specificity but does not need to have high sensitivity: for example it can sometimes be absent in a certain disease, since the term only implies that, when it is present, the doctor instantly knows the patient's illness. The presence of a pathognomonic finding allows immediate diagnosis, since there are no other conditions in the differential diagnosis.
Singular pathognomonic signs are relatively uncommon. Examples of pathognomonic findings include Koplik's spots inside the mouth in measles, the palmar xanthomata seen on the hands of people suffering from hyperlipoproteinemia, Negri bodies within brain tissue infected with rabies, or a tetrad of rash, arthralgia, abdominal pain and kidney disease in a child with Henoch-Schönlein purpura.
As opposed to symptoms (reported subjectively by the patient and not measured) and signs (observed by the physician at the bedside on physical exam, without need for a report) a larger number of medical test results are pathognomonic. An example is the hypersegmented neutrophil, which is seen only in megaloblastic anemias (not a single disease, but a set of closely related disease states). More often a test result is "pathognomonic" only because there has been a consensus to define the disease state in terms of the test result (such as diabetes mellitus being defined in terms of chronic fasting blood glucose levels).
In contrast, a test with very high sensitivity rarely misses a condition, so a negative result should be reassuring (the disease tested for is absent). A sign or symptom with very high sensitivity is often termed sine qua non. An example of such test is a genetic test to find an underlying mutation in certain types of hereditary colon cancer.[1][2]
Disease | Sign |
---|---|
Cytomegalovirus infection | Owl's eye appearance of inclusion bodies[3][4] |
Hodgkin's lymphoma | Pain within minutes[5] after drinking alcohol.[6] Reed-Sternberg cells (giant mono- and multinucleated cells) upon microscopy |
Lyme disease | Erythema chronicum migrans[7] |
Inclusion body myositis | Filamentous material seen in inclusion bodies under electron microscopy |
Hypocalcemia | Trousseau sign and Chvostek sign |
Tetanus | Risus sardonicus |
Measles | Koplik's spots |
Diphtheria | Pseudomembrane on tonsils, pharynx and nasal cavity |
Chronic hemorrhagic pancreatitis | Grey-Turner's sign (ecchymosis in flank area) |
Cholera | Rice-watery stool |
Enteric fever | Rose spots in abdomen |
Meningitis | Kernig's sign and Brudzinski's sign |
Cholecystitis | Murphy's sign (cessation of deep inspiration when inflamed gallbladder is palpated) |
Angina pectoris | Levine's sign (hand clutching of chest)[8] |
Patent ductus arteriosus | Machine-like murmur |
Pleural effusion | Stony-dull percussion |
Parkinson's disease[citation needed] | Pill-rolling tremors[citation needed] |
Whipple's disease | Oculo-masticatory myorhythmia |
Acute myeloid leukemia | Auer rod |
Multiple sclerosis | Bilateral internuclear ophthalmoplegia |
Congestive heart failure | Third heart sound |
Pericarditis | Pericardial friction rub |
Neurofibromatosis type I | Plexiform neurofibroma |
Pyelonephritis | White blood cell casts |
Rheumatic fever | Aschoff bodies |
Rabies | Hydrophobia and negri bodies |
Look up pathognomonic in Wiktionary, the free dictionary. |
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リンク元 | 「オピオイド」「distinct」「characteristic」「特徴的」「diagnostic」 |
Drugs | RECEPTOR TYPES | ||
μ受容体 | δ受容体 | κ受容体 | |
morphine | +++ | + | |
methadone | +++ | ||
etorphine | +++ | +++ | +++ |
levorphanol | +++ | ||
fentanyl | +++ | ||
sufentanil | +++ | + | + |
DAMGO | +++ | ||
butorphanol | P | +++ | |
buprenorphine | P | ーー | |
naloxone | ーーー | ー | ーー |
naltrexone | ーーー | ー | ーーー |
CTOP | ーーー | ||
diprenorphine | ーーー | ーー | ーーー |
β-funaltrexamine | ーーー | ー | ++ |
naloxonazine | ーーー | ー | ー |
nalorphine | ーーー | + | |
pentazocine | P | ++ | |
nalbuphine | ーー | ++ | |
naloxone benzoylhydrazone | ーーー | ー | ー |
bremazocine | +++ | ++ | +++ |
ethylketocyclazocine | P | + | +++ |
U50,488 | +++ | ||
U69,593 | +++ | ||
spiradoline | + | +++ | |
nor-Binaltorphimine | ー | ー | ーーー |
naltrindole | ー | ーーー | ー |
DPDPE | ++ | ||
[[[[D-Ala2,Glu4]deltorphin]] | ++ | ||
DSLET | + | ++ | |
endogenous Peptides | |||
met-enkephalin | ++ | +++ | |
leu-enkephalin | ++ | +++ | |
β-endorphin | +++ | +++ | |
dynorphin A | ++ | +++ | |
dynorphin B | + | + | +++ |
α-neoendorphin | + | + | +++ |
+アゴニスト ーアンタゴニスト P partial agonist
.