Please do not sign for your friend(s) its a criminal Punishment: 6 months schorsing automatically non eligible to promote

ote to 2nd year in this academic year.

APPROACH TO DIAGNOSIS & PATIENT`S TREATMENT

R.MUCHTAN SUJATNO NADJWA ZAMALEK D

Human body
Consist of many systems System is : a set or series of interconnected or interdependent parts or entities (organs), that function together in a common purpose or produce results impossible of achievement by one of them acting 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

Normal Individual
Disease agents Pathophysiology Sick/ill Individual

Diagnosis
Pharmacology

How? Treatment
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Non Pharmacology

Diagnosis
Definition: The act or process of deciding the nature of a disease conditioned by examination of symptoms. Diagnose: to make a diagnosis Diagnostic: of or constituting 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

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 the patients is followed for clinical response. Rational understanding of disease and plans for treatment are best acquired by learning about the normal human processes on a basic science level.
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Likewise, being aware of how disease alters the normal physiological processes is also best understood on a basic science level.

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History taking Symptom

Definition : any subjective evidence of disease or 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 of something Any objective evidence of disease such evidence as is perceptible to the examining physician

Examples :
Anemic or icteric sclera
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Etiology
The study or theory of the factors that cause disease and the method of their introduction to the host the cause 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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Any questions ???

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Pathology
Branch of medicine which treats of the essential nature of disease, especially of the structural and functional changes in tissues and organs of the body which cause or are 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 and that every cell descends from some preexisting cell.
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Clinical Pathology
Pathology applied to the solution of clinical problems, especially the use of 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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Etiology
Healthy Human Pathophysiology
-

Sick

Symptoms

- Signs
- Lab.evaluations
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S.typhi

Etiology

Healthy Human
Pathophysiology
Endotoxin

Sick/ill

- Symptoms : fever, headache

- Signs : fever
- Lab.evaluations : leukopenia,
culture (+), Widal (+)

Diagnosis : Typhoid fever

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Any questions ???

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The purpose and function of Clinical Pathology

1. 2. 3. 4.
5.

Confirming or rejecting diagnosis Providing guidelines in patient management Establishing a prognosis Detecting disease through case finding or screening 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 Diabetic dose

Maintain Oral Anti Diabetic dose

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*2HPP : 2 hours post prandial (after meal)

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
*ALT : Alanine aminotransferase

Prognosis : bad
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Detecting disease through case finding or screening

Screening of the donors for Hepatitis B Virus : HBsAg : HBsAg : (+) Donors rejected (case findings)

HBsAg : (-)

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)

Brings laboratory testing to the site of the patient rather than obtaining a specimen and sending it to the laboratory.

Used in variety of settings :

Emergency departments Operating suites

Examples :
Hemoglobin level Blood gas analysis

Clinics
Home Monitoring etc

Hormones
Blood glucose etc
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THANK YOU FOR YOUR ATTENTION

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