英文诊断学总论_PPT课件

History Taking
• Obtain as much information as needed to diagnose and treat the illness.
• Requirements for the physicians: • A genuine, profound, and absorbing interest in
patient. • 5 components of physical examination:
inspection, palpation, percussion ,auscultation and smelling.
Laboratory findings
• To detect pathogenic or functioning information. • Chemical, biological and physiological tests. • X-film, CT, MR. • gastroscopy, angiography and bronchoscopy etc.
Physical Diagnosis
• Today’s medical students • Tomorrow’s clinicians
Physical Diagnosis
• What is the meaning of “Clinician”?
Physical Diagnosis
• What is the main responsibility of the clinician?
the patient's well being • A deep-seated, well-grounded self confidence in
abilities • A through knowledge of the diseases • Ability to see the problem from the
patient来自百度文库s viewpoint
History Taking
• Obtaining a medical history is an "art" • Talk with, rather talk to the patient. • Listen attentively and guide a patient
effectively. • Ask searching questions. • Interrogation of family and friends if
necessary.
History Taking
• Know all about the disease • Symptoms and signs
• Knowledge
– Unedited factual information provided by the patient.
– May not necessarily be accurate or precise.
• Comprehension
– Understanding the facts related by the patient. – Affirm what the patient said.
• 6 levels of intellectual functioning： knowledge, comprehension, application, analysis, synthesis, and evaluation
6 levels of intellectual functioning
diseased subjects.
The Intellectual process of diagnosis
• Information requires clarification and amplification.
• Information must be carefully weighed as to its clinical significance and its possible relationship to the patient's complaints
– Symptoms: patient's complaints, or his recognition of something abnormal.
– Signs: findings elicited by physical examination
• Past history • Family history • Systems review
Physical Examination
• Begins when greeting the patient. • Sedulously practicing the art of
observation make a student to a clinician.
How to conduct physical examination
Interpretation of laboratory data
• Lots variables alter laboratory tests results. • Specificity and sensitivity of the tests. • Overlapping between the healthy and the
• Making diagnosis • Treat a disease • Treat a patient
The contents of diagnosis
• Verbal observation or history taking • Physical observation or examination • Laboratory observation
• Application of the sensory end organ to the patient.
• In a rational, thorough, and accurate fashion. • With efficiency and minimal discomfort to the