lab2 - 2 Diagnosing a Disease Objectives In this chapter we...

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8 2 Diagnosing a Disease Objectives In this chapter we will study the thought process and procedures involved in clinical diagnosis; methods used in the physical examination of a patient; common diagnostic tests performed in the laboratory; common diagnostic tests performed on the living body; some signs of disease; and some terms and abbreviations for diseases and diagnostic tests. Medical Diagnosis In chapter 1 of this manual, we examined some characteristics of disease. Now we turn our attention to some of the ways a clinician diagnoses a disease. The word diagnose literally means “to know through”—that is, how a clinician can know, through examination of the patient’s signs and symptoms, what the underlying cause is. This chapter describes some of the processes and medical terminology associated with diagnosis. The Chief Complaint Diseases are sometimes discovered when patients report for routine medical checkups. Some diseases are asymptomatic —they do not produce any discomfort. For example, hypertension (high blood pressure) is nicknamed “the silent killer” because it typically does not produce noticeable symptoms until the damage is already extensive. Since a blood pressure measurement is one of the routine procedures in a medical examination, it may reveal hypertension of which the patient is unaware. Often, however, a patient presents him- or herself at a clinic because he or she feels that something is wrong. The patient’s primary medical concern is called the chief complaint (CC). When a CC is identified, the search is on for the underlying etiology. The clinician then becomes a medical detective, bent on identifying the culprit so that it can be treated. Diagnosis as Hypothesis Testing The process of diagnosis is an application of the hypothetico-deductive scientific method. The clinician formulates hypotheses (“These signs could be caused by…”) and then embarks on a search for evidence that either supports or rules out each hypothesis. The first few symptoms the patient reports and the first few signs the clinician observes may lend themselves to multiple interpretations—that is, the cause could be any number of things. For example, the patient may complain of leg pain. This could have a musculoskeletal, neurological, or cardiovascular etiology. The clinician’s task is to ask the appropriate questions and observe the appropriate signs to support one of these hypotheses and rule out the others. Are the ankles swollen? This could indicate a cardiovascular problem. Do the patient’s joints hurt when he or she moves? This could indicate a musculoskeletal disorder. Does the patient feel pain shooting down the back of the leg? This could indicate a neurological disorder. The clinician can then ask further questions during the interview to progressively narrow down the possibilities: Where is the pain? What is it like? How bad is it? How often does it
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lab2 - 2 Diagnosing a Disease Objectives In this chapter we...

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