clinical exam. & history taking

Upload: maniish-trivedi

Post on 03-Jun-2018

229 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/11/2019 Clinical Exam. & History Taking

    1/23

    H & C E A P

    1

    HH

    &&

    CC EE

    A A P

    C I C

    C D2009/10

  • 8/11/2019 Clinical Exam. & History Taking

    2/23

    H & C E A P

    2

    G AP

    . ,

    . H ,

    ,

    . I .

    . I ;

    . A

    C I C , CD

    .

  • 8/11/2019 Clinical Exam. & History Taking

    3/23

    H & C E A P

    3

    I 2

    1. G P H 4

    1.1 P 5

    1.2 P H 6

    1.3 M & A 7

    1.4 H 7

    1.5 8

    12

    2. C E

    2.1 G P 13

    2.2 I I 14

    2.3 H 16

    2.4 H & N 17

    2.5 C 18

    2.6 A & P 22

    2.7 L 23

    2.8 B 232.9 N 23

  • 8/11/2019 Clinical Exam. & History Taking

    4/23

    H & C E A P

    4

    1:

    C .

    / ,

    O , .

    O , . E

    . .

    A . A

    ( ). E

    , .

    ,

    ( ? )

    ( ? ).

    ( ? ? ).

    . C H I

    ? I ? . A

    , (

    ) .

    M P H

    P (P )

    H (HP )

    P M H (PMH )

    P H (P )

    P P O H

    F H (FH )

    M

    A

    H ( H )

    P H

    A

    M

    P M H

    L M

    E ( )

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    5/23

  • 8/11/2019 Clinical Exam. & History Taking

    6/23

    H & C E A P

    6

    1.2

    I : , ( , , , ),

    , , , (

    ) ( B, HI , ).

    D ? ?

    ?

    . H ,

    , , ,

    . A ?

    H ?

    H ( , , , ,

    A ?

    A ? E ( ,

    ) ( , ,

    A 10 50 .

    A .

    O , , ,

    .

    I : , , ,

    . A .

    I , ,

    , P .

    , ,

    .

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    7/23

    H & C E A P

    7

    1.3

    P ,

    . , .

    P

    , . L

    .

    I , ,

    ,

    . E ; , ,

    , ,

    , .

    G N .

    A

    E .

    .

    . A ,

    , ,

    . .

    1.4

    , ,

    . I , /

    . N

    .

    P

    . I

    .

    .

    A ( B, , ,

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    8/23

    H & C E A P

    8

    1.5

    G

    . K , , . N ,

    . A / . E

    .

    C

    .

    E .

    ( ) ( ).

    .

    .

    ( )

    , , .

    ( ) (

    A . L

    ( )

    ( ).

    .

    ( ) ( ) . P

    .

    E ( )

    , . . O

    , .

    , /

    .

    . I

    . I .

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    9/23

    H & C E A P

    9

    C

    A ,

    . I

    ( ) , ,

    , ( ) . A

    ( , ),

    ( IA) ( ). D A

    .

    B :

    ) I

    ) A ( ) (COPD)

    ) A / ,

    ( ) ( )

    )

    )

    . (

    I :

    1. ( ) ( , )

    ( , , )?

    2. C ( ) . ?

    3. P ( )

    . P ,

    , .

    4. ( ). E . A

    , , ?

    5. A , , ?

    6. A ?

    7. D ?

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    10/23

    H & C E A P

    10

    G

    I :

    1. ( ); A ? A ? H ?

    2. D ( ); C , ?

    3. N

    4. A ; E ? H ? B ?

    5. : ? ? I ? H ? A

    , ( ) ? D ?

    6. A ; ? I ? D ?

    ?

    7. A ? . A ? ;

    ( ) (

    A ? A ( )? A ?

    8. A ?

    9. A ( ), ? (L )

    / H

    . P . D , ,

    ( ). , , ()

    ( ).

    . I

    (), , . I

    , ,

    / . B ( ).

    .

    P

    ()

    ( ), ( ).

    .

    , , , (),

    .

    A , (

    , .

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    11/23

    H & C E A P

    11

    &

    F .

    , , , .

    A ( , )

    ( ), , , .

    , , ( ) .

    .

    , ,

    ( ). A

    , , ( )

    .

    N

    . P

    1. H ; ,

    , ,

    2. N

    3. , ( ) 4. M : , ,

    5. L ( )

    6. F

    7. N / ( )

    8. A ( )

    9. A

    10. ; , ,

    . A

    , . D

    ( )

    ( ).

    H

    I

    O

  • 8/11/2019 Clinical Exam. & History Taking

    12/23

    H & C E A P

    12

    I

    G : , , ,

    C : C , , , , , , .

    C : ; , , & ; IA ;

    : C , , , , , ,

    G : A , , , , , , ?

    G : P , , , , , ,

    & J : P , , , ,

    N : H , , , , , , .

  • 8/11/2019 Clinical Exam. & History Taking

    13/23

    H & C E A P

    13

    2.1

    L

    . I

    . N ,

    .

    P , , . I

    . C ( ,

    )

    ( ).

    . , ,

    .

    P

    . A

    .

    .

    , ,

    . O , .

    I , . 45

    . .

    .

    ,

    . .

    E

    AM

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    14/23

    H & C E A P

    14

    2.2

    I :

    1. M

    2. C /

    3. C

    4.

    5. /

    6. C

    , ,

    , .

    M

    P .

    ,

    . C

    .

    C /

    . A ? A

    ? A ? I

    ? A ? ?

    C

    . O , ,

    , .

    ( ) , . C ,

    . J ,

    , . P , ,

    A . M

    ( ),

    , ( , ), ( , ) .

    E

    AM

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    15/23

    H & C E A P

    15

    /

    A 5 F : F , F , F , F

    F . A . F

    , .

    . C (

    , ),

    .

    . .

    C

    A P ; A , ,

    . I

    , .

    E

    AM

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    16/23

    H & C E A P

    16

    2.3

    .

    H , , .

    N ,

    .

    P ,

    .

    L , ( ) . A

    4 (D ) ,

    .

    P .

    ; ,

    P D , , . A

    .

    C .

    .

    P

    , / .

    . .

    ,

    . A

    . ,

    . ( , , ) ( , ,

    ) .

    E

    AM

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    17/23

    H & C E A P

    17

    2.4

    A , .

    H ; , (

    ) ( )

    J P J P (

    ). J P .

    P ;

    (

    ( ) ;

    .

    A ( ),

    ( ), .

    C .

    (

    ). A ,

    ( ).

    M

    L , ( ),

    N

    L ( ),

    ( ), . L .

    A .

    ( )

    45 . I

    2 . J P

    3 .

    E

    AM

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    18/23

    H & C E A P

    18

    2.5

    . , , . 45 .

    B ,

    .

    3.2. (

    ), . CO2

    ( ) , ,

    .

    .

    L , , . A

    ? C

    ( ), (

    ) ( ).

    B, . A

    , / .

    P

    . A ( )

    ( ) . I

    .

    C .

    . I

    . I , ( )

    .

    E

    A

    M

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    19/23

    H & C E A P

    19

    P ! P . A

    ( ), ( )

    ( ).

    ( ).

    ; . G (

    . ,

    . A , , ,

    . . ;

    ,

    .

    O ,

    ( , ). N

    , . B

    ( ) .

    ,

    ( ), .A , . I

    ).

    .

    . F (

    ), . I

    .

    A

    .

    C

    B . L

    , . F . L

    , . A J P.

    E

    A

    M

    I

    N

    A

    IO

    N

  • 8/11/2019 Clinical Exam. & History Taking

    20/23

    H & C E A P

    20

    I , ,

    . (

    ),

    . P

    , .

    . I

    . I .

    A ( 5 ),

    2 .

    A , .

    B . A

    , ( ),

    ( 3 4 ) .

    .

    ( 1, 2) . ( 1)

    .

    ( 2) .

    .

    , .

    ,

    ( ) ,

    ( ).

    G 4

    ; ( 2)

    ( 2). C

    .

    E

    A

    M

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    21/23

    H & C E A P

    21

    L

    M A P

    B 5 IC , L

    2 IC , 4 IC , L 2 IC , L

    D M M D M M

    I M D M M D M

    A , 3 4 , . A 4 4

    3 3 .

    F ( )

    , , .

    I

    .

    E

    A

    M

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    22/23

    H & C E A P

    22

    2.6

    A P ( )

    . A , , ,

    . I

    , , .

    L , ,

    , , , , ,

    ( PEG ).

    4 (2 2) 9 (3 3) . 4

    ( Q), (L Q),

    ( LL) (LLL). 9 ,

    , , ( ), (LIF),

    ( ), ( IF), ( )

    . .

    :

    1. ; , ( ),

    .

    2. D ; .

    , .

    . .

    ; , . A .

    P 1) 2) .

    .

    A . L 20 30 . A . I

    .

    E

    A

    M

    I

    N

    A

    I

    O

    N

  • 8/11/2019 Clinical Exam. & History Taking

    23/23

    H & C E A P

    2.7

    E , , ,

    L ; , , E , (

    C 5

    .

    2.8

    .

    L , . A ? P

    , . P

    2.9

    1) I . A

    . A

    .

    2) I , FA ,

    .

    3) A , ,

    .

    4) C

    .

    E

    A

    M

    I

    N

    A

    I

    O