HSC10

What is Diagnosis?

Diagnosis is the identification of a disease process by a healthcare professional causing a person's ill health or other complaints.

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Why do GPs ask Questions?

  • To clarify symptoms
  • Help make a diagnosis
  • Find out medical history
  • Find out about current lifestyle
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Name Three Physical Examinations.

  • Visual examination
  • Using a stethoscope
  • Taking blood pressure
  • Reflex testing
  • Measuring temperature
  • Percussion
  • Palpation
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What is a Visual Examination?

Looking at the affected part of the body where possible.

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How is a Stethoscope Used?

  • Channelling sounds via a metal dish to two tubes in the ears
  • From the lungs/heart/chest
  • To identify abnormal sounds
  • Eliminates background noise
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What is Palpation?

  • Feeling part of the body with the fingers
  • Helps to detect pain by applying pressure
  • Can detect tumours and swellings
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How are Reflexes Tested?

  • Patient's legs dangling over edge of the bed
  • A point just below the kneecap is tapped
  • Using a rubber hammer
  • This stretches the tendon
  • Sending a nerve impulse to spinal cord
  • Triggers the thigh muscle to contract
  • Lower leg jerks upward
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What is Percussion?

  • Placing one or two fingers
  • On chest/body/back
  • Tapping the fingers with the other hand
  • Listening to the sound made
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How is Temperature Taken?

  • A digital thermometer
  • Disposable
  • Placed under tongue
  • Left until the thermometer beeps
  • Record reading taken
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How is Blood Pressure Measured?

  • Using a sphygmomanometer
  • Cuff placed around upper arm
  • Pressure exerted as cuff inflates and tightens
  • Stops pulse, restricting arterial blood flow
  • Systolic reading - pressure of heart beat recorded
  • Cuff is deflated and loosened
  • Diastolic reading - pressure between beats
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Name Two Diagnostic Techniques.

  • Tissue biopsy
  • ECGs
  • Urine tests
  • Blood tests
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What is a tissue biopsy?

  • Small sample of tissue is removed through a hollow needle or by punch biopsy
  • Sample is examined under a microscope or through biochemical tests by a cytologist
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What is Electrocardiography?

  • Electrodes 
  • Attached to chest/wrist/ankles
  • Recording electrical activity of the heart
  • Healthy heart produces a normal wave pattern
  • On a monitor screen
  • Abnormal wave patterns indicate dysfunction
  • Needs a cardiologist to interpret wave patterns
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Why are Blood Samples Taken?

  • To test glucose levels
  • To test cholesterol
  • To count blood cells
  • To measure gas content
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Why are Computers Used during Diagnosis?

  • To look up medical records
  • To use a clinical support system to aid diagnosis
  • To print prescriptions
  • To help prescribe treatment
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What is Diagnostic Imaging?

Diagnostic imaging is a range of techniques that produce 2D/3D images used to look at the appearance of internal organs.

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How are X-Rays Taken?

  • X-rays are electromagnetic radiation
  • X-ray machine produces an invisible beam of x-rays
  • Directed at a specific part of the body
  • Sheet of photographic paper
  • Placed behind body part being x-rayed
  • Enables them to penetrate soft tissue
  • Can't pass through thick bone
  • Dense tissue/bone absorb the radiation
  • Picture shows bones as light/white
  • Soft tissue absorb less
  • Picture shows soft tissue as dark/black
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How are Contrast X-Rays Taken?

  • A contrast medium
  • Put into patient's digestive tract
  • Medium contains metal salts that are opaque to x-rays
  • Patient swallows the liquid
  • Called a barium swallow
  • Flavoured to make it more palatable
  • Time is allowed for liquid to coat area
  • X-ray images are taken
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How are CT Scans Taken?

  • Uses x-rays to build up an image of a slice of the body
  • Patient placed on a table and slid into a tube-like scanner
  • Scanner rotates around patient
  • Emitting and receiving x-rays
  • Data received is processed by computer into an image
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How are PET Scans Taken?

  • Patient placed on a table and slid into a tube-like scanner
  • Gamma camera detects emitted gamma radiation
  • Data received is processed by computer into an image
  • The areas with the brightest colours indicates the areas with the most radiation
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How are Radionuclide Scans Taken?

  • Radionuclide is placed in patient's body, either by swallowing or injection
  • Several hours are taken to allow it to travel to the body part being examined
  • Patient lies still while gamma camera detects emitted gamma radiation
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How are MRI Scans Taken?

  • Patient placed on a table and slid into a tube-like scanner
  • Scanner equipped with electromagnets
  • Passes through current to produce magnetic field
  • This causes hydrogen atoms to align parallelly
  • A strong pulse of radiowaves are emitted, knocking them out of place
  • Radiowaves are stopped and atoms realign
  • Produces a radio signal
  • Detected by a receiver
  • Data recieved is processed by computer into an image
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How are Ultrasound Scans Taken?

  • Uses a probe which produces high frequency sound waves
  • These waves penetrate through soft tissue
  • Gel is put on patient's skin
  • Gel is used to make better contact between probe and skin
  • Probe is placed on skin
  • Receiver detects sound waves
  • Connected to a computer that processes the data
  • Computer creates an image
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How is Amniocentesis Performed?

  • At 15/20 weeks into the pregnancy
  • An antiseptic solution is used to clean the abdomen
  • Injection site is numbed with anaesthetic
  • Needle inserted through abdomen into uterus
  • Positioned with the aid of an ultrasound scan
  • Amniotic fluid extracted
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How is Chronic Villus Sampling Performed?

  • During first 12 weeks of pregnancy
  • Using hollow cannula
  • Inserted through uterus wall to placenta
  • Positioned with the aid of an ultrasound scan
  • Sample is collected
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How is the Blood Test for PKU Performed?

  • Testing for amino acid
  • Heel ***** test
  • Blood sample taken from baby's heel
  • Blood is collected on piece of filter paper and sent to lab for analysis
  • Levels of amino acid will be tested
  • Test carried out during first week of baby's life
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How is the Dental Examination for Caries Performed

  • Child lies back on dental chair
  • Dentist examines teeth using a mirror and dental explorer
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How are Eye Tests for Visual Defects Performed?

  • Child asked to remove glasses / contact lenses
  • Child sits 20ft from snellen chart
  • Child covers one eye while reading out each letter on the chart
  • This will be done with both eyes one at a time
  • Performed by an optician
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How are Physical Examinations for Hip Dislocation

  • Baby is laid on its back
  • Its hips are moved gently outwards
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How is Tonometry for Glaucoma Performed?

  • Performed by a optometrist
  • Using a non-contact tonometer
  • Blows a few puffs of air onto each eye
  • Air bounces back at instrument
  • Giving a measurement of pressure inside each eye
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How is the Smear Test for Cervical Cancer Performe

  • The woman lies down on a couch
  • Undressed from waist down
  • A speculum
  • Inserted into vagina
  • Holds the walls of the vagina open
  • Cervix is visible
  • A small soft brush
  • Used to collect sample of cells taken from surface of cervix
  • Sample sent to the lab for analysis
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How is a Mammogram Performed?

  • Uses x-rays
  • Taken of each breast separately
  • Breast placed on x-ray machine and gently compressed with a clear plate
  • Two x-rays are taken at different angles
  • X-ray results examined by radiographer
  • Results sent to patient
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How is a Physical Examination for Testicular Cance

  • GP holds a small torch against the lump in the testicles to see whether light passes through it
  • Cancer lumps tend to be solid
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Describe the Difference between Active and Passive

Active Immunity:

  • Acquired from vaccinations
  • Production of antibodies against disease

Passive Immunity:

  • Antibodies passed from mother to baby
  • Shorter lasting than active
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How does Immunisation Work?

  • Vaccines are dead or weakened pathogens
  • Of a specific disease
  • Injected into the body
  • Stimulating an immune response
  • Body produces antibodies
  • Memory cells produced
  • On second exposure memory cells recognise pathogens
  • Antibodies destroy pathogen
  • Protected against disease in the future
  • Fewer people pass on disease
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Name Two Infant/Child Vaccines.

  • Diphtheria
  • Pertussis (Whooping Cough)
  • Tetanus
  • MMR (Measles, Mumps and Rubella)
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Describe Diphtheria.

  • Bacterial infection
  • Corynebacterium diphtheriae
  • Spread through respiratory droplets (by coughs/sneezes of an infected person)
  • Or spread by contaminated food
  • Symptoms: sore throat, high temperature, breathing difficulties
  • Causes foul smelling blood stained mucus
  • Once infected toxins produced by bacteria spread through bloodstream to organs
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Describe Pertussis (Whooping Cough).

  • Bacterial infection
  • Bordetella pertussis
  • Spread through respiratory droplets (by a cough/sneeze of an infected person)
  • In the lungs and airways
  • Symptoms: runny nose, high temperature, vomiting after coughing
  • Causes a dry, intense cough which makes a 'whooping' noise
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Describe Tetanus.

  • Bacterial infection
  • C. tetani
  • Lives in soil
  • Caused by flesh wounds being contaminated
  • Symptoms: spasms, stiffness, lockjaw
  • Untreated can cause death
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Describe Measles.

  • Viral infection
  • Paramyxovirus
  • Spread through respiratory droplets (from coughs/sneezes of an infected person)
  • Symptoms: cold-like symptoms e.g. fatigue, red and sensitive-to-light eyes, high temperature
  • After four days a reddish-brown skin rash develops behind the ears and spreads to the rest of the body
  • Can cause blindness/death
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Describe Mumps.

  • Viral infection
  • Spread through respiratory droplets (by coughs/sneezes of an infected person)
  • Symptoms: headaches, joint pain, high temperature
  • Causes painful swellings at the side of the face
  • 'Hamster face' appearance
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Describe Rubella.

  • Caused by a virus
  • Airborne
  • Symptoms: red-pink skin rash covering the body, swollen glands, cold-like symptoms
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Describe Cholera.

  • Bacterial infection
  • Cholerae bacterium
  • Spread by drinking contaminated water
  • Symptoms: severe diarrhoea, vomiting, dehydration
  • Can cause severe dehydration
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Describe Hepatitis A/B.

  • Viral infection
  • Hepatitis A virus/Hepatitis B virus
  • Spread by eating contaminated food (hepatitis A)
  • Or by infected bodily fluids (hepatitis B)
  • Symptoms: vomiting, fatigue, loss of appetite
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Describe Typhoid.

  • Caused by bacteria
  • Salmonella typhi
  • Caused by contaminated food / water
  • Symptoms: vomiting, loss of appetite, diarrhoea
  • Can cause: blood poisoning and internal bleeding in the digestive system
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Describe Rabies.

  • Viral infection
  • Spread by being bitten/scratched by an infected animal
  • Symptoms: vomiting, high temperature, headaches
  • Can cause death
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Name Three Side Effects of Vaccines.

  • High temperature
  • Cold-like symptoms
  • Fatigue
  • Loss of appetite
  • Aching muscles
  • Redness at the injection site
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What is Immunisation?

Stimulating an immune response via a pathogen.

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What is Vaccination?

An injection of a dead or weakened pathogen.

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Name One Vaccination a Person should get before Tr

  • Cholera
  • Hepatitis A
  • Hepatitis B
  • Typhoid
  • Rabies
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Give Two Examples of Self-Treatment.

  • Bed rest
  • Drinking plenty of fluids
  • Keep warm
  • Take over-the-counter medication
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What are the Principles of Home Nursing?

  • Individuals can be nursed in the comfort of their own home
  • Family/friends provide basic nursing care
  • Supervise treatment/'administering of medication
  • Informal carers can manage hygiene e.g. bathing/washing
  • Informal carers can provide nutrition
  • Help prevent pressure sores
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Give One Example of when Home Nursing would be Use

  • Patient has a minor illness
  • Patient has home dialysis
  • Person is diabled but doesn't require hospital care
  • Person is elderly and bed ridden
  • Patient isn't able to care for themselves
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Give Two Examples of Administering Drugs.

  • By mouth
  • Sprays
  • Inhalers
  • Suppositories
  • Injection
  • Cream
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Why are Drugs Tested before they are Licensed?

  • Effectiveness
  • Safety
  • Outline any severe side effects
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What is a Non-Prescription Drug?

  • Over-the-counter
  • Not as strong as prescription drugs
  • Not prescribed by the GP
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Why are not all Drugs taken Orally?

  • Chemical may be damaged by digestion
  • May take too long to be absorbed into the bloodstream
  • Unable to swallow as unconscious
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What are the Three Names a Drug Has?

  • Chemical name
  • Generic name
  • Brand name
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Drugs for Medical Purposes Aim to:

  • make up chemical imbalance
  • help body fight infectious diseases
  • relieve or palliate symptoms
  • reduce pain
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How are Drugs Classified?

  • Chemical make up
  • Disorder treated
  • Specific effects on the body
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What is Operative Surgery?

Surgery involving incision, inspection and the removal of diseased tissues or organs or the replacement/redirection of body channels or implantation of electronic/medical devices.

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Why is Surgery Used?

  • Remove unhealthy tissue
  • Modify or rebuild damaged or dieased body structures
  • Bypass malfunctioning organs
  • Implant electronic or medical devices to improve body functions
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What is Transplant Surgery?

  • Taking organs from a donor person and using them to replace diseased organs in a patient
  • Organs and tissues that can be successfully transplanted include: the heart, lungs, liver, kidney, bone marrow and cornea
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What is meant by Aseptic Technique?

  • Microbe-free practices
  • To avoid wound contamination
  • During surgery
  • E.g. sterilisation of implements
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What is Local Anesthesia?

  • Using drugs/chemicals
  • To block nerve pathways
  • No loss of consciousness
  • Pain free
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Give One Example where Local Anaesthesia would be

  • Dental treatment
  • Epidurals for childbirth
  • Stitches
  • Eye surgery
  • Endoscopy
  • Brain surgery
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What is Microsurgery?

Using a range of specialised equipment to perform operations on very small structures in the body.

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What is Laser Surgery?

  • Using intense beams of light to cut through tissue
  • The laser is focused on a very small spot, enabling great precision to be used
  • Lasers can be used to remove skin blemishes
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What is Endoscopic Surgery?

  • An endoscope is a long, thin, flexibe tube
  • Inserted through a natural opening e.g. down the throat
  • By small incision
  • The tube has a light and camera at the end
  • Transmits an image to a monitor screen
  • Image is shown on screen
  • Used to collect tissue samples
  • Keyhole surgery
  • A tiny brush/instrument cuts away small sample of tissue
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What is Radiotherapy?

  • High intensity radiation is used
  • Will destroy cancer cells in the patient's body
  • By damaging cancerous cells
  • A beam of radiation is focused on the tumour in the body
  • Building up effect through repeated low level doses
  • To minimise damage to their healthy cells
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What is Peritoneal Dialysis?

  • A small incision made in the lower abdomen
  • A bag of liquid containing salts inserted (suspended)
  • Contents empty due to gravity
  • Through a catheter into cavity
  • So waste from blood diffuses into the liquid
  • Waste is then discarded
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What is Haemodialysis?

  • Incision made in arm/leg
  • A tube inserted in
  • Needle inserted to connect to a tube
  • Leading to a dialysis machine 
  • Blood pumped through machine and filtered
  • Waste from blood diffuses in machine
  • Saline solution fed back into blood
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Discuss the Ethical Issues related to Treating Obe

For:

  • They have a choice as a patient which is a basic human right
  • By continuing with his dietary pattern whilst on the waiting list for surgery his weight may be increasing
  • Patient already has diabetes type 2 as a result of his lifestyle – this lifestyle may affect other organs and the management of his diabetes
  • All humans are equally deserving – principle of NHS

Against:

  • Patient is responsible for his own health and predicament
  • Places a drain on NHS resources including staffing, equipment, drugs
  • Wastes NHS resources
  • The surgery is expensive
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Discuss the Ethical Issues related to Treating Lun

For:

  • Patient has a choice which is a basic human right
  • Condition may worsen
  • Unethical for doctors to deny treatment - Hippocratic oath

Against:

  • Responsible for his own ill health
  • Side effects may be worse than benefits
  • Using up limited NHS resources
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