Name medical specialties and define each.

There are such specialties in the hospitals as:

Taking a History

15. What are the components of the history-taking process? Describe each component.

Taking a patient's history is the initial part of clinical examination and its main aim is to find out the patient's present problem. The history-taking process is a well-established and commonly used sequence.

1. History of presenting complaint. The main symptoms should be clearly defined as soon as possible, to find out the cause of admission or seeking medical advice. The onset, severity, progression, associated features or symptoms are all important. A special focus is also made on pains associated or not with specific organs.

2. History of present illness. The patient is requested to give an account of recent events in their own words which in this way may be recorded in the history sheet.

3. Systemic enquiry also known as the review of systems. The history is taken of the main symptoms of the major bodily systems.

4. Past medical history. Patients are asked about their previous medical/surgical diseases.

5. Drug history and allergies. Information is obtained on any medication prescribed, self-administered drugs.

6. Family history provides information about any predisposition to disease, and relevant information on relatives.

7. Social history. Information is collected about the patient's occupational, social, personal factors, such as habits, employment, housing, interests, sports, hobbies, physical exercise, the use of alcohol, tobacco, recreational drugs.

16. What organs and systems are reviewed during the examination and why? What general symptoms do you know? What disorders are they associated with?

Systemic enquiry also known as the review of systems is one of the main parts of history-taking process. The history is taken of the main symptoms of the major bodily systems:

General: mood, fatigue, anorexia, fever, night sweats, rashes, heat/cold intolerance.

Cardiovascular system: chest pain, palpitations.

Respiratory system: shortness of breath, cough, sputum, wheeze, hemoptysis.

Gastrointestinal system: nausea, vomiting, indigestion, abdominal pain, heartburn, change in bowel habit.

Genitourinary system: nocturia, frequency, incontinence, change in color/smell of urine, menstrual difficulties.

Central nervous system: headaches, weakness, dizziness, fits, faints, vertigo.

17. What are the recommendations for the effective communication of the doctor with the patient?

There are some recommendations for the effective doctor-patient communication:

Show the patient your attention.

Start by eliciting the presenting complaint.

Let the patient tell story in their own words.

Try not to interrupt.

Use the language which the patient understands.

Summarize the story for the patient to check, correct and add more relevant details.

Obtain the patient's history also from other sources of information.

Surgery

18. What is surgery? What does it deal with and what methods does it use? What are the main controlling factors in surgery? Define them.

Surgery has been described as a branch of medicine which treats diseases, injuries, deformities, malformations and other pathological conditions by methods which involve opening, manipulating and repairing a part of the body.

The main controlling factors in surgery are anesthesia and asepsis. Anesthesia is used to avoid shock in a patient and to make him insensitive to pain. It is produced by anesthetic drugs which are administered cither locally to reduce feeling in the area of the operation or to put a patient to sleep. Asepsis is a complex of measures used to prevent introduction of microorganisms into the wound from without. It means that everything which comes into contact with the wound (instruments, dressings, suture materials, rubber gloves) must be absolutely germ-free, i.e. sterile.

19. What is the difference between the corrective and curative surgery?

Corrective surgery

At present, corrective surgery is employed for clubfoot, harelip, cleft palate, bowlegs, deformed spine, congenitally dislocated hip joints, and many heart and blood-vessel diseases. In correcting defects caused by accident or disease, plastic surgery is used.

Curative surgery

Surgery is employed in the treatment of sarcoma, tuberculosis, and osteomyelitis. The brain is subjected to inspection and many kinds of operations, including removal of tumors, evacuation of abscesses, and clearing of blood clots and other obstructions to blood vessels are performed.

20. What anesthesia methods do you know? Compare different types of anesthesia.

Anesthesia is the loss of feeling or sensation. There are two types of anesthesia: general anesthesia, which causes a loss of consciousness, and local anesthesia, where the anesthetic "freezes" the nerves in the area covered by the operation.

There are different types of general anesthesia:

General: anesthesia resulting in amnesia. General anesthesia can be achieved with intravenous agents, such as propofol. Amnesia is the main characteristic, while analgesia and muscle relaxation may be present.

Regional: loss of pain sensation, with varying degrees of muscle relaxation, in certain regions of the body. It is administered with local anesthesia to peripheral nerve bundles, such as the brachial plexus in the neck.

Spinal: also known as subarachnoid block. It refers to a regional block resulting from a small volume of local anesthetics being injected into the spinal canal. The subarachnoid block is usually injected between the 4^th and 5^th lumbar vertebrae, because the spinal cord usually stops at the 1^st lumbar vertebra, while the canal continues to the sacral vertebrae. It results in a loss of pain sensation and muscle strength, usually up to the level of the chest (nipple line or 4^th thoracic dermatome).

Local anesthesia is similar to regional anesthesia, but exerts its effect on a smaller area of the body. In local anesthesia, the patient may be conscious during the course of the operation or given a sedative, a drug that induces sleep.

21. What are the methods of sterilization? Characterize the methods you know.

Sterilization — the process of cleaning surgical instruments from microorganisms, which is performed by using specific machines — sterilizers and autoclaves. The methods of sterilization include boiling, low or high pressure steam sterilization and cold sterilization by strong antiseptics (applied to edged instruments that would be blunted by boiling).

22. What are the required procedures to prepare the patient for an operation? What are the post-operative procedures?

It is also necessary to prepare the patient for the operation. So patient shouldn't eat or drink anything for twelve hours before the operation to avoid complications with anesthesia. A patient is often given an enema before the operation to empty the colon from wastes. The area to be operated is thoroughly cleaned, shaved and painted with the solution of iodine. The patient is put on an operation table, covered with a sterilized cloth and administered narcosis. The surgeon prescribes the patient proper post-operative treatment. When the stitches are due for removal — this is usually done a week after the operation — the patient is discharged.

23. What instruments and equipment are used during operation and what are they used for?

Surgery requires a large variety of specialized equipment. In addition to the special operating table, there are high-intensity lights and the anesthesia machine. There are vacuum machines to suck, out the excessive blood and other fluids from the part of the body which is being operated on. The main instrument table is covered with a large collection of scalpels, forceps, suture needles, retractors, and other instruments.

Date: 2015-12-17; view: 1373