zatchot 1-6 L Flashcards
Sections of the medical history.
I. Introductory information (identifying data) – ID.
II. Chief complaint – CC.
III. History of the present illness – HPI.
IV. Life history: 1.Past medical history – PMH
Family history – FH.
Psychosocial history – PSH.
Medications and habits – MH.
VIII. Review of systems – ROS
The main complaints in diseases of the respiratory system, cardiovascular system, gastrointestinal tract, kidney, osteoarticular system.
1- Respiratory
* Cough (dry, wet, paroxysmal)
* Sputum (mucous, purulent ,rusty)
* Hemoptysis
* Chest pain
* Breathlessness (dyspnea)
2-–. Cardiovascular
* Pain in the region of the heart
* Heart rhythm disturbances
* Headache
3-Alimentary
* Appetite disorders
* Swallowing disorders
* Heartburn
* Eructation
* Nausea, vomiting
* Abdominal pains
* Diarrhea
* Constipation
4-–Urinary
* Fever
* Painful urination
* Pain in loin region
* Red urine
* Altered urine volume
Types of impairment of consciousness.
– Three grades of consciousness disturbance are distinguished :
1. Torpor : is a state of stunning out of which the patient may be taken out for a short time by speaking to him. The patient is poorly oriented in the surrounding situation, answers the questions slowly and late
Sopor (sleep) : is more pronounced consciousness disturbance. The patient does not react to surrounding people, although sensitivity, including pain sensitivity, is preserved, reacts to examination.
Coma :
is more pronounced consciousness disturbance.
The patient does not react to surrounding people, although sensitivity,
including pain sensitivity, is preserved, reacts to examination.
Coma and the reasons for their occurrence.
–consciousness and response to external stimuli (pain, etc.) are completely absent.
1-Complete muscle relaxation and loss of reflexes are observed.
2-Regulation of vital functions (breathing, circulation) are damaged, but saved.
3-Thus, in coma there is a complete unconsciousness, loss of sensitivity and movements.
—occurance :
1-alcoholic coma
2-hypoglycaemic coma
3-diabetic (hyperglycaemic) coma
4-hepatic coma
The position of the patient. Forced situation.
1-Forced position during a bronchia asthma attack:
-(asthma accompanied by sharp difficulty of expiration) the patient takes forced sitting position leaning with his hands on the back of a chair, edge of a bed, his knees, etc. This position gives a possibility to fix the shoulder girdle and to switch additional respiratory musculature, specifically, muscles of the neck, back and breast enabling expiration
2-Forced position during cardiac asthma attack:
During cardiac asthma attack and pulmonary edema caused by blood congestion in lesser circulation circle vessels the patient is eager to take vertical (sitting) position with legs dropped down which decreases blood inflow to the right cardiac chambers and gives a possibility to unload lesser circulation circle to some extent (orthopnea position)
Facial expression in various diseases.
-they are several types :
1-Facies mitralis : (face of a patient with mitral valve stenosis)
2-Acromegaly :The increased growth hormone of acromegaly produces enlargement of both bone and soft tissues. of the head
3-Facies nephritica : (face of a patient with renal diseases) pain, puffy, with upper and lower eyelids edema,
4-Facies leonine : (face of patient with leprosy)
5-Facies Corvisari : is characteristic for patients with pronounced cardiac insufficiency..
6-Facies micsedemica : face of a patient with thyroid gland hypofunction (myxedema).
7-Facies Basedovica : (face of a patient with thyrotoxicosis): anxious, exasperated or frightened face expression is marked,
8-hirsutism facies : Face of a female patient with hirsutism developed due to excessive testosterone in the organism
Physique, types of constitution, anthropometry.
–Anthropometry
1- height, weight,
2-BMI = the mass (weight) of the body (kg)/[height (m) ×height (m)] (kg/m²)
3-waist circumference.
4-hip circumference
5-body type: correct, incorrect, strong, moderate, or weak
–body types :
1-Normosthenic type :is characterized by correct habitus with proportional parts of body, well-developed somatic musculature, correct chest shape
2-Asthenic type :
-predominant body development in length,
-muscles are weakly developed,
-shoulders are sloping,
-long neck
3-Hypersthenic type :
-predominant body development in width;
-medium height or lower,
-enhanced nutrition,
-muscles are well-developed.
-shoulders are wide, neck is short
Types of temperature curves.
— In a healthy human being body temperature
fluctuates in a narrow range: from 36,0°C to 37,0°C.
1-Continued fever (febris continua): long-term body
temperature increase with diurnal fluctuations not
exceeding 1°C.
2-Remittent fever (febris remittens): long term body temperature increase with diurnal fluctuations exceeding 1°C.
3-Intermittent fever (febris intermittens): high fever changed by normal body temperature (below 37°С) for 1-2 days and then rising again up to 38-40°С.
4-Hectic fever (febris hectica): sufficient temperature increase up to 39-41°С (more often by the evening) changed by normal temperature within 24 hours. Increase of temperature is accompanied by pronounced chill, and its increase - by emaciating sweating
Examination of the skin and visible mucous membranes.
—-1-color:
-there are 5 types we can distinguished while we examine the patient :
1- Paleness = -anemias - peripheral circulation pathology:
2-Redness = 2-1peripheral vessels dilation: fever 2-2erythrocytosis, polycythemia
3-Cyanosis (bluish) = :
3-1Central cyanosis – diffuse, warm: develops in result of insufficient blood oxygenation in the lungs in various respiratory organs diseases
3-2. Peripheral cyanosis (acrocyanosis), cold : appears in case of slowing down of peripheral
circulation, in venous congestion in patients with cardiac insufficiency.
3-3. Limited, local cyanosis :develops in result of peripheral veins congestion due to their compression with tumor,
4-Jaundice ; three kinds of jaundice are distinguished = :
1. parenchymal (in hepatic parenchyma lesion);
2. mechanical (in obturation of common bile duct with a concernment or its compression with a tumor);
3. hemolytic (in enhanced hemolysis of erythrocytes)
5-Bronze (brown) = Bronze (brown) skin color is usually seen in adrenal insufficiency.
—-2- humidity (moisture) :
–they are several types :
1-Moderate (normal)
2-Excessive (sweating) – diabetes mellitus (especially when blood sugar is low)
3- Dry (dryness) -renal failure, skin diseases
4-Peeling - , «uremic powder»
—-3-elasticity (turgor):
1-Decrease in elasticity of skin - patients of old age, dehydration (vomiting, diarrhea).
2-Increase in turgor and tension of skin - liquid delay.
Classification of skin rashes.
-1–Hemorrhagic
1-petechiae,
2-ecchymosis,
3- purpura
-2–Non-hemorrhagic:
1-erythema (including erythema nodosum),
Condition of subcutaneous fat.
1-development (moderate, weak, excessive),
2-largest deposition sites,
3-presence of edema,
4-thickness of the fat fold at the lower angle of the scapula and on the abdomen at the level of the navel
——(obesity) ; Primary (exogenous constitutional, or alimentary-metabolic) obesity based on energetic imbalance (absolute or relative increase of energy income with food or decrease of its waste due to hypodinamia)
–the opposite of the obesity is the chexcia
Localization of edema in diseases of the cardiovascular system and kidneys.
1-Prevalence(local, general)
2-Sites (extremities, abdomen, face)
3-Degree of severity (pastiness, severe)
4-Consistency(soft, dense)
5- Skin color in edema sites
-Local edema :
the main causes :
1. regional lesion of venous outflow
2-. acute inflammatory reaction of skin and subcutaneous fat
3-. local cutaneous allergic reaction, Quincke’s edema.
-Diffuse or general edema : in cardiac, renal and other visceral organs diseases
are, caused by combination of lesions of numerous
mechanisms taking part in water-electrolytic balance
in the organism.
ex : Ascites = is the accumulation of fluid in the peritoneal cavity ( renal )
ex: Hydropericardium is the accumulation of fluid in the pericardial cavity
Hydrothorax = is the accumulation of fluid in the pleural cavity
—The following methods are used for disclosure of peripheral edemas:
1. palpation method
2. follow-up of bodymass dynamics;
Palpation of lymph nodes, their characteristics
–Normally peripheral lymph nodes :
present round or oval formations from 5 to 20 mm in size. They are not elevated above the skin level and that is why not disclosed during examination.
–location of lymph nodes :
1. Pre-auricular 2. Posterior auricular 3. Tonsillar 4. Submaxillary
5. Submental 6. Cervical 7. Supra- and subclavian 8. Anconeal (elbow) and
9. Inguinal
– we should exam the lymph nodes for distinguish :
a) size b) shape c) consistency d) painless
e) movability f) adhered
—-diseases : there are two types
1- Diffuse, systemic lymph nodes lesion
-inflammatory changes (for example, in certain infections)
2. local enlargement of regional lymph nodes
-inflammatory (local suppurative processes)
Examination of hair, nails and thyroid gland.
–Hair :
1- Dull, brittle, hair loss, premature hair graying
2-Type of growth (malepattern, femalepattern)
–nails :
1-Form
2-Color
3-Brittleness
4-Deformation
5- Striation
—-Watch-glasses symptom and drumsticks the main causes:
1-long purulent lung diseases (abscesses, bronchiectasis),
2-congenital heart defects (with severe tissue hypoxia),
3-bacterial endocarditis
–thyroid gland :
the methods of examinations
Complaints of patients with respiratory diseases and their pathogenesis.
there is 2 type
– Main :
1.Cough
2.Sputum
3.Breathlessness
4.Chest pain
5.Haemoptysis
6.Wheeze
–Nonspecific-
Fever, Chills, Sweating, Weakness,
decreeing working ability.
