GP Testing

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Visual Examinations

  • GP assess the appearance of patient on arrival.
  • Looking for obvious signs of potential illness.
  • Looking for colour/pale/flushed skin.
  • Signs of pain on moving/mobility problems/breating difficulties. 
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Asking Questions

  • Order to clarify problems - e.g. current medication/treatment.
  • Discover patient's medical history.
  • Make a diagnosis.
  • GP will ask patient to describe the reason for attending surgery.
  • GP refers to notes for info on previous medical complications or family history.
  • GP be aware of any medications the patients on.
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Examine The Patient

  • Palpation
  • Percussion
  • Measuring Blood Pressure
  • Mesuring Temperature
  • Reflex Testing
  • Stethoscope
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Palpation

  • Act of feeling an area - abdominal.
  • Using the fingers & the brace of the second hand.
  • Application of the finger with light pressure to feel soft tissue.
  • Looking for areas of tendernedd, pain reaction, lumps & bumps, heat, abnormailities - unusual for that area.
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Percussion

  • Using 2 fingers - tap on the back of the chest - listen using a stethoscope for sound.
  • Sounds define if there's a problem.
  • Normal - hollow sound.
  • Abnormal - thus or crackling sound - indicating fluid build up - caused by an infection.
  • Using middle finger of one hand - tapping on the middle finger of the other - using a wrist action. 
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Percussion

  • Using 2 fingers - tap on the back of the chest - listen using a stethoscope for sound.
  • Sounds define if there's a problem.
  • Normal - hollow sound.
  • Abnormal - thus or crackling sound - indicating fluid build up - caused by an infection.
  • Using middle finger of one hand - tapping on the middle finger of the other - using a wrist action. 
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Measuring Blood Pressure

  • Using a sphygmomanometer - digital blood pressure machine. 

1) Place cuff above elbow on upper arm.

2) Pressure exerted as cuff inflates.

3) Place a stethoscope on brachial pulse point - inside elbow to listen to the pulse.

4) Inflate cuff - until no pulse sound can be heard - blood flow to the hand is temporarily stopped - restricts arterial blood flow.

5) Gradually reduce pressure in the cuff - until 1st pulse is heard - pressure of cuff is equal to pressure in blood vessel.

6) Systolic pressure - whilst the heart is contracting.

7) Keep deflating the cuff until last pulse sound is heard - diastolic pressure - heart in between beats.

8) Reading - systolic/diastolic.

9) Measured in mmHg.

10) Normal 120/80.

11) Abnormal - diastolic pressure over 95 - hypertension.

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Measuring Temperature

  • Using a digital thermometer.
  • Placed in loaction - forehead or mouth.
  • Place in ear - closest to core temperature - for a set time until it beeps.
  • Remove & record temperature.
  • Normal - 37C
  • Abnormal - 38C+ - indicated fever due to infection - below 35C - indicates hyperthermia.
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Reflex Testing

  • Determines problem with nerve pathways.
  • Knee jerk test.
  • Leg is relaxed - weight of leg supported by thigh.
  • Rubber relfex hammer - knock just under knee cap - leg hanging down.
  • Causing tendons to stretch - in a direction which isn't normal.
  • Sensory neurones pick up stimulus - transmit impulse to reflec arch in spine.
  • Impulse sent back to motor neurone - induce knee jerk movement.
  • If it doesn't knee jerk - indicate problem in nerve pathway.
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Using A Stethoscope

  • Medical instrument - used for listening to areas of the body - lungs, chest, heart.
  • Medical disks at the end of tubes - have ear pieces on the end.
  • Channesl sounds towards ear pieces.
  • Sounds aren't amplifies.
  • Help to diagnose problems - lung infection - cracking sounds - mucus membrance are pulling apart during breathing.
  • Used to diagnose problems in intestinal tract. 
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Diagnosis Tests

  • When a GP taken medical history & examined them - maybe in a position to make diagnosis.
  • Complexity of body - number of possible diagnosis - undertake further tests.
  • Blood/Urine samples.
  • Further diagnosis is needed.
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Computers

  • Contain patient's medical history.
  • Medical database - CDSS - clinical decision support system.
  • Use database - put described symptoms into database - give number of possible conditions.
  • Help encourage other possible conditions.
  • + - reduces medical errors in diagnosis.
  • - - too much reliabel on system instead using own knowledge.
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Referral

  • Once diagnosis made - maybe necessary to make referral to hopsital - for treatment or medical consultant.
  • Cariologist - heart & circulation system.
  • Oncology - cancer.
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