All Things Medical

Оглавление

Sheldon Cohen M.D. FACP. All Things Medical

PART 1. THE PREVENTION OF MEDICAL ERRORS

PART 2. THE COMPLETE MEDICAL EXAMINATION

The Medical History

CLINICAL EXAMPLES

Patient’s own words or medical clarification

Tabulate complaints separately

Duration

CLINICAL EXAMPLES

Introduction

Duration

Nature of the symptoms:

CLINICAL EXAMPLES

Introduction

Allergies

Acute infectious diseases

Immunizations

Past Medical History

Past Surgical History

Past Traumatic History

Medications

Other Drug Use

Obstetric History

Sexual History

CLINICAL EXAMPLES

Definition

Heritable illnesses

How used

What it can’t do

The future

CLINICAL EXAMPLES

Sleeping

Insomnia

Narcolepsy

Restless Leg Syndrome

Nutrition

Exercise

Hobbies

Tobacco

Alcohol

Caffeine

CLINICAL EXAMPLES

CLINICAL EXAMPLES

Introduction

Skin including nails and hair. Skin

Nails

Hair

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

Cranial nerves:

Motor system:

Sensory system:

Autonomic nervous system:

CLINICAL EXAMPLES

CLINICAL EXAMPLE

The Physical Examination

CLINICAL EXAMPLES

Skin

Hair

Nails

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

CLINICAL EXAMPLES

Laboratory Data

Neutrophils

Eosinophils

Basophils

Lymphocytes

Monocytes

Hematocrit

Hemoglobin

Red blood cell indices

3. Platelets

Blood smear:

A complete urinalysis includes:

Blood Urea Nitrogen (BUN)

Creatinine

Uric acid

Electrolytes

Chloride

Potassium

Bicarbonate (CO2)

Calcium

Phosphorus

Bilirubin

SGOT (AST)

SGPT (ALT)

LDH

Alkaline phosphatase (ALP)

Total protein

Total Cholesterol

Triglyceride

PART 3. CASE REPORTS

PART 4. RISK FACTOR ANALYSIS AND HEALTH SCREENING

PART 5. SUMMARY & PATIENT RESPONSIBILITY

PART 6. SYMPTOMS NEVER TO IGNORE

PART 7. THE PERFECT PRESCRIPTION

PART 8. HORMONES, NERVES, AND STRESS

PART 9. MAN THE BARRICADES: THE STORY OF THE IMMUNE SYSTEM

PART 10. CANCER: PAST, PRESENT, AND FUTURE

Key Points

What are targeted cancer therapies?

How do targeted cancer therapies work?

How are targeted therapies developed?

What was the first target for targeted cancer therapy?

What are some other targeted therapies?

What impact will targeted therapies have on cancer treatment?

Where can I find information about clinical trials of targeted therapies?

What are some resources for more information?

Back to the author:

PART 11. MEDICAL RESOURCES

Отрывок из книги

“Es Irrt Der Mensch, So Lang Er Strebt”

(As long as human beings strive, they will make errors)

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A woman was walking her dog down a residential side street and noticed a neighbor lying unconscious on her garage floor. She rushed in, was unable to revive her, and called the paramedics who transported her to the closest hospital emergency department. Examination revealed a seventy-five year old unconscious woman with a bruised head. An emergency CT scan of the brain revealed a collection of blood under the lining of the brain known as a subdural hematoma. This hematoma was very small, so her physicians elected watchful waiting rather than surgery. The patient regained consciousness, but was very restless and agitated, a state that persisted over the next few days. She also had some difficulty in walking, lost strength in one of her extremities and required the use of a walker. She was rational, but stated she “Was jumping out of my skin.” This persisted until her physician prescribed a tranquilizer in an attempt to calm her. The anxiety improved, but the patient then became confused and disoriented. This worried her physicians who ordered further tests thinking that perhaps the hematoma had enlarged or other cerebral pathology had developed, or there were undiagnosed medical problems. There were no new findings identified. Thinking that perhaps the confusion and disorientation was due to the tranquilizer prescribed to calm his patient, the physician discontinued it. Indeed, within two days the patient’s problem had resolved. All this time the rehabilitation transfer was not possible because this requires a clear mind and a cooperative patient, neither of which was possible while she was having her symptoms. Different physicians and a new healthcare team attended to her in the rehabilitation unit. They started her on rehabilitation, but after a day or two they found her to be confused and disoriented making progress impossible. They called her hospital physician to tell him what had happened. In the meantime, she was in the rehab unit for a full week and could not make any progress due to her altered mental state. When her physician arrived, he discovered why the patient had relapsed. Somehow—and no one could tell him how—the medication that he had discontinued because it caused her confusion and disorientation had been restarted. He never found out why. This medical error caused considerable delay, set back the patient’s progress and could have resulted in serious consequences.

Patient identification

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