1 internal medicine
TRANSCRIPT
Internal MedicinePropedeutics
Goals• Dentists don’t treat only healthy people• Dental treatments can affect the patient
health• Dentists can discover some signs of
special diseases• Emergency treatments in internal medicine• Increase the communication skills• Give a wider horizon to medicine• Help to be more competitive
Dentistry - Internal Medicine Propedeutics1. Introduction. History taking. The principles of physical examination. 2. Techniques of physical examination. Physical examination of the head and neck region.3. History taking in chest and lung diseases.4. Physical examination of the chest and lung.5. Disorders of the respiratory system (pneumonia, bronchial asthma, pleural diseases, tumors).6. History taking in cardiovascular diseases. Physical examination of the cardiovascular system.7. Symptoms and signs of common cardiovascular diseases (ischaemic heart diseases, valvular diseases, heart failure).8. Symptoms and signs of vascular diseases. Examination of the peripherial vessels. (Hypertension, diseases of the venous system and peripherial arteries).9. Symptoms of the abdominal diseases.10. Physical examination of the abdomen.11. Symptoms and signs of common gastrointestinal disorders (oesophageal diseases, ulcers, gastrointestinal tumors, liver and biliary diseases, pancreatitis).12. Symptoms and signs of endocrine diseases, diabetes mellitus and metabolic disorders.13. Physical examination of the kidney and genitourinary system. Symptoms and signs of common renal diseases (glomerulonephritis, nephrotic syndrome, urinary tract infections, nephrolithiasis, renal failure).14. Symptoms and signs of common haematological diseases.
• Barbara Bates Guide to physical examination and history
taking
• Lynn S. Bickley Bates’ guide to physical examination and
history taking
Diagnosis – an injured mosaic
The main parts of the diagnosis– Pathological– Etiological– Anatomical– Prognostic
Medical examination
• Patient history
• Physical examination
• Laboratory and instrumental examination
Patient history0. Introduction
Date of the historyIdentifying dataSource of referralReliability of the history
Patient history0. Introduction1. Chief complaint(s)
Patient history0. Introduction1. Chief complaint(s)2. Present illness
Present illness
• Location• Quality• Quantity or severity• Timing (onset, duration, frequency)• Setting in which it developed• Factors that aggravated or relieved• Associated manifestations• Treatments
Patient history0. Introduction1. Chief complaint(s)2. Present illness3. Past history
Past history
• Most important diseases in chronological order (hospitalisations)
• Operations, injuries, accidents• Allergies (drug, food, pollens etc.)• Transfusion(s)• Screening tests
Patient history0. Introduction1. Chief complaint(s)2. Present illness3. Past history4. Current health status
Current health status• Social circumstances• Occupation (recent and past)• Enviromental hazards (home, school, workplace)• Diet (incl. beverages)• Alcohol and illicit drugs (type, amount, frequency, duration
of use)• Tobacco (type, amount, duration)• Current medication• Exercise and leisure activities• Sleep patterns• Sexual history
Patient history0. Introduction1. Chief complaint(s)2. Present illness3. Past history4. Current health status5. Family history
Family history• Parents, siblings, spouse, children, other
relatives– age; age and cause of death; health status; important diseases
• Occurence of– Diabetes– Hypertension, heart diseases, stroke– Infective diseases– Malignant diseases– Coagulation disorders– Psychiatric diseases, alcoholism, drug addiction– Symptoms like those the patient
Patient history0. Introduction1. Chief complaint(s)2. Present illness3. Past history4. Current health status5. Family history6. Review of organ systems
Review of organ systems• General
– General status– Usual weight, weight change– Fatigue– Fever
• According to organs• Skin, Head, Eyes, Ears, Nose, Mouth, Neck,
Breasts, Respiratory, Cardiac, Gastrointestinal, Urinary, Genital etc.
Patient history0. Introduction1. Chief complaint(s)2. Present illness3. Past history4. Current health status5. Family history6. Review of organ systems