lect approach to diagnosis & patient`s_110709.ppt
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Please do not sign foryour friend(s) its acriminal Punishment: 6months schorsingautomatically non eligibleto promote to 2nd year in
this academic year.
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this academic year.
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APPROACH TO DIAGNOSIS
& PATIENT`S TREATMENT
R.MUCHTAN SUJATNO
NADJWA ZAMALEK D
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Human body
Consist of many systems System is : a set or series of
interconnected or interdependent parts orentities (organs), that function together in
a common purpose or produce resultsimpossible of achievement by one of themacting or operating alone.
System consist of many organs Organ consist of tissues Tissue consist of cells
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Respiratory system
Organs:
nose, throat, trachea, bronchus,
bronchioles, lung, etc.
Tissue:
muscle, connective
Cells: epithel
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Systems work properly healthy human
System(s) work improperly sick/ill :
Signs & symptoms (e.g fever/febris)
Asymptomatic (e.g increase of blood
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Diagnostic: of or constituting a diagnosis
Diagnosis
Definition: The act or process ofdeciding the nature of a disease
conditioned by examination of
symptoms.
Diagnose: to make a diagnosis
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Diagnosis approach to disease Physicians usually tackle clinical situations
by taking a history of disease (History taking
anamnesis)
Performing a physical examination Additional examination (supporting
diagnostic tools):
- General: Laboratory, Radiology
- Specific: Audiology, Ophthalmology
Formulating a diagnosis
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The synthesis of the history taking, physical
examination, radio-imaging or laboratory test
Clinical Data Base After reaching a diagnosis, a treatment
plasn is usually initiated, and thepatients is followed for clinical response.
Rational understanding of disease andplans for treatment are best acquired bylearning about the normal humanprocesses on a basic science level.
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Likewise, being aware of howdisease alters the normalphysiological processes is alsobest understood on a basicscience level.
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History taking Symptom
Definition :
any subjective evidence of diseaseor of patients condition.
Examples :
Fatigue, nausea
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Healthy people could become ill by
one or another reasons called
etiology.
Mechanism of diseases is called
pathophysiology/pathogenesis
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Physical examination
Sign
Definition :
An indication of the existence ofsomething
Any objective evidence of disease
such evidence as is perceptible to theexamining physician
Examples :
Anemic or icteric sclera
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Etiology
The study or theory of the factors
that cause disease and the method oftheir introduction to the host thecause of disease.
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Pathophysiology/pathogenesis
Pathophysiology : the physiology of
disordered function.
Pathogenesis :
the development of morbid conditions or
disease; more specifically, the cellular
events and reactions and other pathologic
mechanisms occurring in the development of
disease.
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Anyquestions
???
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Pathology
Branch of medicine which treats ofthe essential nature of disease,
especially of the structural andfunctional changes in tissues andorgans of the body which cause orare caused by disease.
Cellular and Clinical Pathology
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Cellular (anatomical)
Pathology
Regards the cells as a starting points
of the phenomena of disease andthat every cell descends from some
preexisting cell.
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Clinical Pathology
Pathology applied to the solution of
clinical problems, especially the useof laboratory methods in clinical
diagnosis.
Body fluid (incl.secretion,excretion)examination
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Disease : disruption of normal body
function
Anything which disrupts homeostasis may
be viewed as a disease agent (etiology).
Disease agents :
Infectious agents Physical and chemical agents
Inherited genetic alterations
Acquired mutation and cancer
Malnutrition
Inflammation and autoimmunity
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Healthy
HumanSick
Pathophysiology
Etio logy
- Symptoms
- Signs
- Lab.evaluations
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Healthy Human Sick/illPathophysiology
Etiology
- Symptoms : fever, headache
- Signs : fever
- Lab.evaluations : leukopenia,
culture (+), Widal (+)
S.typhi
Endotoxin
Diagnosis : Typhoid fever
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Any
questions???
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The purpose and function of Clinical Pathology
1. Confirming or rejecting diagnosis
2. Providing guidelines in patient management
3. Establishing a prognosis
4. Detecting disease through case finding orscreening
5. Monitoring follow up therapy
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Confirming or rejecting diagnosis
Patient with fever
Differential diagnosis:
Dengue
Typhoid
Laboratory results:
Dengue (-)
Typhoid (+)
Final diagnosis:
Dengue reject
Typhoid confirm
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Providing guidelines in patient
management
Patients with Diabetes Mellitus
2HPP* Blood glucose levels :
Mr.A : still high (300 mg/dL) Mrs.B : normal (110 mg/dL)
Increase Oral Anti Diabeticdose
Maintain Oral Anti Diabeticdose
*2HPP : 2 hours post prandial (after meal)
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Establishing prognosis
Patients with acute viral hepatitis
Cellular liver enzymes : ALT* level
Mr.X : high (400 IU) Mrs.Y: very high (1400 IU)
Prognosis : good Prognosis : bad
*ALT : Alanine aminotransferase
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Detecting disease through
case finding or screening
Screening of the donors for
Hepatitis B Virus :
HBsAg :
HBsAg : (+)
HBsAg : (-)
Donors rejected (case findings)
Donors accepted (screening
healthy subjects)
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Monitoring follow up therapy
Patient with urinary tract infection
After finished 1 cured dosage of
certain antibiotic
Urine culture still (+)
Change antibiotic with
the sensitive one
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Types of Clinical laboratory
Examination
Screening Test:
Hb, leukocyte count, ALT, AST
Confirmatory Test: Culture, HCV, Blood glucose
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Point of Care Testing(POCT)
Bringslaboratory testing to the site of the patient ratherthan obtaining a specimen and sending it to thelaboratory.
Used in variety of settings :
Emergency departments
Operating suites Clinics
Home Monitoring
etc
Examples :
Hemoglobin level
Blood gas analysis Hormones
Blood glucose
etc
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THANK YOU FOR
YOUR ATTENTION
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