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DISEASE: SIGNS AND SYMPTOMS
Disease may be acute, chronic, malignant, or benign. Of these terms, chronic
and acute have to do with the duration of a disease, malignant, and benign with its
potentiality for causing death.
An acute disease process usually begins abruptly and is over soon. Acute
appendicitis, for example, is characterized by vomiting, and pain usually localized
in the lower right side. It usually requires immediate surgical treatment. The term
chronic refers to a process that often begins very gradually and then persists over a
long period. For example, ulcerative colitis is a chronic disease. Its peak incidence
is early in the second decade of life. The disease is characterized by relapsing attacks
of bloody diarrhea that persist for weeks to months. These attacks alternate with
asymptomatic periods that can last from weeks to years.
The terms benign and malignant, most often used to describe tumours, can be
used in a more general sense. Benign diseases are generally without
complications, and a
good prognosis is usual. A wart on the skin is a benign tumour
caused by a virus; it produces no illness and usually disappears spontaneously if
given enough time (often many years). Malignancy implies a process that, if left
alone, will result in fatal illness. Cancer is the general term for all malignant
tumours.
Diseases usually are indicated by signs and symptoms. A sign is defined as an
objective manifestation of disease that can be determined by a physician; a symptom
is subjective evidence of disease reported by the patient. Each disease entity has a
constellation of signs and symptoms; individual signs such as fever, however, may
be found in a great number of diseases.
Fever is an abnormal rise in body temperature. It is most often a sign of
infection but can be present whenever there is tissue destruction, as, for
example, from a severe burn or when large amounts of tissue have died because of
lack of blood supply. Fever is a highly significant indicator of disease.
The pulse rate is another easily obtainable and important piece of information.
The heart rate varies with the level of physical activity: the heart beats faster dur-
ing exercise and more slowly during rest. An inappropriate heart rate (or pulse)
may be indicative of disease. The heart rate increases in the feverish patient. A
weak, rapid pulse rate may be a sign of severe blood loss or of disease within
the heart itself. Irregularity of the pulse is an important indicator of heart
malfunction.
The respiratory rate (rate of breathing) is modified by disease. Persons with
fever have an increased respiratory rate, which serves to lower body temperature
(this rapid breathing is analogous to the panting of a dog).