History, examination and differential diagnosis
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History, examination and differential diagnosis

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History, examination and differential diagnosis Presentation Transcript

  • 1. Elements
    • Theoretical knowledge
      • anatomy
      • physiology
      • pathology
      • pharmacology
      • medicine
      • surgery etc.
    Normal & disease
  • 2. Clinical skills
    • History
    • Physical examination
    • Diagnosis
    • Investigation
    • Treatment
    Patients present with symptoms and signs rather than disease
  • 3. History
    • Presenting problem
    • Context
      • personal
        • age
        • sex
        • occupation
      • social
        • domestic arrangements
        • lifestyle
      • medical
        • chronic illness
        • medications
        • previous surgery
    Process of communication
  • 4. History - II
    • Obtain information from the patient
      • listen
      • identify precise symptoms
      • avoid leading questions initially
      • ask questions to fill in the gaps
    • Collateral history
      • trauma, confused, paediatric etc
    All the information that cannot be obtained by examining the patient
  • 5. Art of History Taking Translate
  • 6. Common language
    • Standard formula
    • Common among clinicians
    • Precise terminology vs
      • “ haemorrhoids”
      • “ can’t breathe”
      • “ trouble passing water”
  • 7. Physical examination
  • 8. Differential diagnosis
    • Consider all the possibilities
    • Weight them
    • Diagnosis
    • Test the hypothesis
    • Re prioritise
    • Diagnosis
    • Treat
    • Evaluate response
  • 9.