Diagnostic process Flashcards

1
Q

What are the sections of the diagnostic process?

A

Observation
History taking
Physical examination
Investigations

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2
Q

What can influence the disease process and the patient’s clinical presentation?

A
  • psychological state
  • personality
  • socioeconomic status
  • domestic/work environment
  • beliefs
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3
Q

What are the major factors we can observe at first sight about a patient?

A
  • age/milage
  • gender
  • nationality
  • occupation
  • skin / hair / eyes
  • demeanour
  • gait, BMI, deformities
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4
Q

Which is the most important part of patient assessment?

A

history

• gives 70-90% of information used in diagnosis

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5
Q

What are the sections of the patient History?

A
Chief complaint
Past health issues
Social / occupational history
Family history
Systems review
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6
Q

What questions do you ask in the chief complain section of patient Hx?

A
  • onset
  • location
  • duration
  • character, course
  • allieving/aggaraving
  • radiation
  • treatment
  • frequency, severity, activities affected, associated symptoms
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7
Q

What questions do you ask in the past health issues section of patient Hx?

A
  • surgery (hospitalisation, x-rays, scans)
  • allergies
  • medication, supplements, immunizations
  • pertinent medical history (obstetric, psychiatric, illnesses)
  • last GP appointment
  • events: accidents, fractures, dislocations
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8
Q

What questions do you ask in the social/occupational Hx section of patient Hx?

A
  • Smoking
  • Hobbies, home environment
  • Alcohol
  • Drugs (social)
  • Occupation
  • Nutrition
  • Exercise (sex), environment
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9
Q

What questions do you ask in the family Hx section of patient Hx?

A
  • parents health / age of death, from what
  • children health
  • family history of diseases
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10
Q

What is the definition of a red flag?

A
  • fact of patient Hx indicative of omnious condition that requires immediate care
  • bloody stools, unplanned weight loss
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11
Q

What is the definition of a yellow flag?

A
  • fact of patient Hx that might influence perception or management of disease process
  • stress, depression, poor support system
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12
Q

What is a systems review?

A

Answers may tell us:
• how the pathology may have affected other systems as well as the main complaint
• indication of another separate pathology going on simultaneously
• may encourage a new lead
• red and yellow flags

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13
Q

What questions do you ask in a systems review?

A
  • Vascular
  • Infectious
  • Neoplasm
  • Drugs
  • Inflammatory/Idiopathic
  • Congenital
  • Autoimmune
  • Trauma
  • Endocrine/Metabolic
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14
Q

What are the 3 different methods for conducting the physical examination?

A
  • in turn -examine each system seperately
  • top to toe
  • signs -search for physical signs which would confirm diagnosis (not for novice)
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15
Q

What do you look for with palpation?

A
  • superficial vs deep
  • texture
  • heat
  • firmness
  • tenderness
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16
Q

Why do you do investigations?

A
  • screening (breast cancer)
  • confirm diagnosis
  • monitoring (post fracture)
17
Q

What are the classifications of medical investigations?

A

Removal of fluid/tissue and examined in lab
Creating an image
Direct exam

18
Q

List examples of tests that use Removal of fluid/tissue and examined in lab

A
  • blood tests for …
  • urine examination
  • MCS
  • faecal exam
  • CSF exam
  • tissue biopsy (bone marrow)
  • semen
  • amniocentesis
19
Q

List examples of tests that create and image

A
  • radiography
  • ultrasonography
  • computerized tomography
  • magnetic resonance imaging
  • nuclear scanning
  • positron emission tomography
20
Q

List examples of tests that use direct examination of a body part

A
  • gastroscopy
  • colonoscopy
  • laparoscopy (key hole surgery)
  • esophagoscopy
  • cystoscopy (bladder)
  • colposcopy (cervix)
21
Q

List examples of extra investigations

A
  • electrical studies (ECG, EEG, EMG, nerve conduction studies)
  • pulmonary function tests
  • tests of absorption (lactose tolerance test, Schilling’s test)
22
Q

List different types of blood tests

A
  • full blood count
  • electrolytes
  • ESR, CRP
  • iron studies
  • blood glucose
  • lipoprotein studies
  • cardiac enzymes / markers
  • kidney function tests
  • hormone assays (pregnancy test)
  • tumour markers
  • serological testing
  • blood typing
  • clotting and coagulation tests
23
Q

MCS

A

microscopy, culture, sensitivity test