CBC? ? ?
EF, stool test? ? ?
БИОХИМИЯ • • • Saturated Fat Unsaturated Fat Polar Compound Capillary Action BUN Potassium Sodium A/G ratio ALP CPK or CK GGT • • HDLs LDH or LD LDLs Uricacid
ЛАБОРАТОРИЯ • • P. O. L. T. (CLIA, OSHA, FDA) ACR Analyte m. Eq/L TPIV GEW GMW NA
Frequently used medical abbreviations ØA&E – Accident&Emergency ØAF – Arterial fibrillation ØAP – antero-posterior (x-ray) ØBd – bis die (lat. ) – twice daily ØBMI – body mass index ØBP – blood pressure ØC/O – complaining of ØCOAD – chronic obstructive airways desease ØCOPD – chronic obstructive pulmonary disease ØCSF – cerebrospinal fluid ØCVP – central venous pressure ØDVT – deep-vein trombosis ØPRN – pro re nata (lat. ) – as required ØSVT – supraventricular tachycardia ØVF – ventricular fibrillation ØFBC – full blood count ØGA – general anaesthetic ØMI – myocardial infarction ØNAD – no abnormality detected ØO/E – on examination ØO/A – on admission
NEUROLOGY
Complaints • Sensory loss (there are no common words for loss of taste and smell) Functions Loss Other symptoms Hearing Deafness Buzzing or ringing in the ear Sight Blindness Double vision (Diplopia) Blurring (loss of visual acuity – clarity of vision) Sensation Numbness (anaesthesia) Tingling or pins and needles (paraesthesia) balance Unsteadiness (ataxia) Dizziness ((vertigo)
Motor loss • Weakness – loss of power • Paralysis – complete loss of power • Tremor – involuntary rhythmic movements, especially of the hands • Abnormal gait - unusual manner of walking Speech may also be affected: hoarseness – a rough, deep voice; slurred speech – poor articulation.
Loss of consciousness I passed out I had a seizure I had a blackout I fainted I had a fit I had a convulsion
The motor system. Examination • Muscle bulk (amount of muscle tissue). Look for signs of wasting (muscle atrophy) • Muscle tone (amount of tension in a muscle when it’s relaxed). Can be increased (spasticity) or decreased (flaccidity) • Muscle power (strength) • Coordination • Gait • Reflexes • Involuntary movements (a tic or a tremor)
? ? ? • On examination, her face showed little or no expression. There was a tremor affecting mainly her right hand. She had generally increased muscle tone. Power, reflexes, coordination and sensation were within normal limits. Examination of her gait showed that she was slow to start walking and had difficulty stopping and turning.
Tendon reflexes (knee jerk) • Tendon hammer (reflex hammer) • The reflexes may be absent (0), diminished (-), normal (+) or brisk (+++)
Oncology
Oncology • A neoplasm is an abnormal new growth of tissiue (tumour) Malignant • Are likely to spread and cause serious illness or death Benign • Do not spread (invade)
• A lump or swelling is an collection of tissue or fluid which is visible or palpable You have a small growth/tumour in the bowl • I have a lump in my left breast There was a firm, palpable mass in the liver
Malignant tumours • Rapid growth • Invasiveness • The tumour may invade local tissues or may spread to distant parts of the body (metastasis). Neoplasms which are the result of metastasis are called secondaries, as opposed to the original tumour which is the primary
Symptoms • Related to the location of the tumour! • F. e. , space occupying lesion in the brain causes raised intracranial pressure (headache, vomiting, visual disturbance) • Tumours of the colon may obstruct (block) the lumen and cause change in bowel habit. • Bleeding, pain, weight loss
Ophthalmology
• • • 1 – squint 2 – irregular pupil 3 – dilated pupils 4 – constricted pupils 5 – cataract 6 – drooping of lids
How to examine the eye • Look for squint (strabismus), drooping of the upper lid (ptosis) or oscillation of the eyes (nystagmus). In lid lag the upper eyelid moves irregularly instead of smoothly when the patient is asked to look down.
How to examine the eye Next examine the pupils and note whether: • they are equal in size • they are regular in outline (evenly circular) • they are abnormally dilated (large) Of constricted (small) • they react normally to light and accommodation (focus on near objects).
How to examine the eye To test the reaction to accommodation, ask the patient to look into the distance. Hold your finger in front of their nose, and ask the patient to look at it. The eyes should come together, or converge, and the pupils should constrict as the patient looks at the finger. Check also for cataract (opacity of the lens).
Radiology • • • MR f. MRI PET CAD CT scanning Radiopaque Dye (contrast) Radiodensity Radiolucent CCTA Ultrasound imaging
Gastroenterology • • Laxative Occult blood Jaundice Incontinence (bowel) Heartburn GERD Gallbladder
EСG Decide if the heart is performing normally or suffering from abnormalities, for example cardiac arrhythmia – extra or skipped heartbeats Indicate damage to heart muscle, such as heart attacks, or ischaemia of heart muscle (angina) Detect conduction abnormalities: heart blocks and bundle branch blocks (BBB) Screening for ischaemic heart disease during an exercise tolerance test, often carried out on an exercise bike or treadmill Provide information on the physical condition of the heart, for example in patients with left ventricular hypertrophy (LVH) Detect electrolyte disturbances, for example low plasma potassium levels
QRS complex can be widened or too tall T wave can be the right way up or inverted – the wrong way up
Vaccination • • • • Hepatitis B (Hep B) vaccine Rotavirus (RV) vaccines Diphtheria and tetanus toxoids and acellular pertussis (DTa. P) vaccine Haemophilus influenzae type b (Hib) conjugate vaccine Pneumococcal vaccines Inactivated poliovirus vaccine (IPV) Influenza vaccines Measles, mumps, and rubella (MMR) vaccine Varicella (VAR) vaccine(chickenpox) Hepatitis A (Hep. A) vaccine. Human papillomavirus (HPV) vaccines Meningococcal conjugate vaccines BCG vaccine (Bacillus Calmette–Guérin) Yellow fever vaccine Tick-borne encephalitis vaccine
Pediatrics Apgar score • The Apgar Score looks at five categories, at 1 st and 5 th minute after birth (0 -1 -2 points), maximum 10 points • Appearance (skin color) • Pulse (heart rate) • Grimace (reflex irritability) • Activity (muscle tone) • Respiration (breathing)
Classic Pediatric Symptoms • Often, when child is sick, he will have vague symptoms, like a fever, cough, or diarrhea, and he will get diagnosed with a simple viral infection. There are many symptoms, and patterns of symptoms, that are very distinctive for specific childhood illnesses and should make it easy for you to recognize when your child is sick with one of them, including: seal bark cough = croup (лающий кашель-круп) • fever followed by a rash = roseola (Лихорадка с сыпью- краснуха) • projectile vomiting = pyloric stenosis(рвота-стеноз привратника) • bilious (dark green) vomiting = intestinal obstruction or blockage (желчнаязеленая рвота- кишечная непроходимость • slapped cheeks (red rash) = Fifth disease (ярко-красные щеки-инфекционная эритема) •
• honey colored crusted rash = impetigo(сыпь с корочками желтого цвета- импетиго) • currant jelly stools (red mucousy stools) = intussusception (стул в виде смородинового желе- инвагинация) • a young child not moving his arm and holding it close to his abdomen after it has been pulled = nursemaid's elbow (малыш не двигает ручкой и держит близко к животу- вывих локтевого сустава) • sandpaper rash = scarlet fever (мелкая песковидная сыпь, малиновый язык-скарлатина) • polyuria (urinating a lot), polydipsia (drinking a lot), and weight loss = diabetes mellitus (полиурия, полидипсия, потеря веса- сахарный диабет)
