1 / 29

Principles of Clinical Pathology & Decision Making

Principles of Clinical Pathology & Decision Making. Chapter 1 Pathology. Terminology. Pathology – the study of the biological causes , effects, and processes of disease Pathogenesis – the underlying cause of a disease or the development of a disease Etiology – the mechanisms of disease.

nibaw
Download Presentation

Principles of Clinical Pathology & Decision Making

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Principles of Clinical Pathology & Decision Making Chapter 1 Pathology

  2. Terminology • Pathology – the study of the biological causes, effects, and processes of disease • Pathogenesis – the underlying cause of a disease or the development of a disease • Etiology – the mechanisms of disease

  3. Terminology • Sign – an objective, observable indication of pathology, usually discovered during physical examination; can be seen or measured by the clinician • Symptom – subjective complaint reported by the patient; an abnormal function, appearance, or sensation experienced by the patient • Medical conditions often produce characteristic patterns of signs and symptoms

  4. Terminology • Clinical presentation – the overall "picture" of signs, symptoms, medical history, and physical examination

  5. Terminology • Diagnosis – refers to the specific injury, illness, disease, or condition a patient has, as determined by medical examination • Differential diagnosis – the identification of several conditions that might have similar clinical presentations; requires referral to a physician for further laboratory or imaging studies for clarification of the diagnosis

  6. Terminology • Coexisting or comorbid conditions – a medical condition in addition to the primary problem; can complicate recovery from an injury or illness, or require treatment modifications

  7. Theories of Disease & Pathogenesis • Biomedical model of health and illness • Attributes the cause of disease to abnormal cell, tissue, or organ function • Abnormal function can be caused by anatomical or physiological defects, or by factors such as bacteria and viruses

  8. Theories of Disease & Pathogenesis • Psychosocial theories • Consider the psychological and social effects on illness and disease • Patients who cannot adapt cognitively or socially to a major injury may be more prone to chronic illness and may not respond to treatment as expected • Emotional stress (e.g., academic, financial, social, etc.) can confuse the clinical presentation of an illness

  9. Theories of Disease & Pathogenesis • Genetic factors • Errors in DNA and RNA replication can contribute to pathogenesis, the effectiveness of the immune system, and rate of tissue healing • Genetic and congenital disorders are commonly identified in pediatric patients

  10. Clinical Decision Making • A process used by athletic trainers to formulate a diagnosis • Information from medical history and physical examination used to determine a differential diagnosis & best course of action

  11. Clinical Decision Making • The athletic trainer’s diagnosis may lead to actions such as: • First aid • Emergency transport • Treatment and rehabilitation • Reassessment • Modification of activity • Referral to other health care specialists

  12. Clinical Decision Making • Recognizing characteristic patterns of signs and symptoms can suggest potential pathogenesis and help to determine a course of action

  13. Medical History • “an account of the events” related to a patient’s state of health • the scope of the medical history should be appropriate for the specific injury/illness

  14. Medical History • Purposes • determine potential pathogenesis • identify co-existing conditions • determine the stage of the injury or illness • identify contraindications to treatment

  15. Medical History • Procedures • must be thorough and complete • established rapport with patient • guides the physical examination

  16. Medical History • Components • chief complaint • description and course of present illness • personal medical history • family medical history • review of systems

  17. History of Current Injury/Illness • When did your condition start? • What makes your condition better? • What makes it worse? • Is your condition better or worse in • The morning or at night? • Is your condition better or worse with breathing, urination, eating, excitement or stress, rest, or certain body positions?

  18. History of Current Injury/Illness • Have you had X-rays, MRIs, or CT scans for this • condition? • What treatment have you received for this condition? • Is your condition getting better, getting worse, or not changing either way? • Have you ever had any condition like this before? • Is there anything else I need to know about you or your condition?

  19. Medical Tests • Imaging studies and laboratory tests, and when those tests were performed, should be documented • Medications (both prescription and nonprescription) for all current and coexisting conditions should be recorded • Many medications have side effects or require treatment precautions

  20. Causes of Pain • Mechanical • caused by musculoskeletal injuries • appears only in the injured structure • Intermittent • related to movement or position • relieved by removing the offending stress

  21. Causes of Pain • Chemical • biochemical substances released with tissue injury can produce pain and inflammation • this type of pain is constant, although intensity may change, and cannot be relieved by movement or position, although it may worsen with such changes • medication addresses chemical causes and thus nearly always decreases this type of pain • poorly localized and may refer to other locations if nerves or adjacent anatomical structures are affected

  22. Causes of Pain • Perceptual • a person’s response to pain is affected by cultural, social, and personal experiences • it is possible for the physical (mechanical and chemical) origin of pain to be "healed" while the perception of pain remains

  23. Pain Generating Tissues • Different tissues produce different types of pain • Cutaneous pain • generated by skin and subcutaneous tissues pain • localized to the area of tissue damage

  24. Pain Generating Tissues • Different tissues produce different types of pain • Deep somatic pain • originates in bones, nerves, muscles, tendons, ligaments, arteries, or joints • may refer or cause autonomic reactions such as sweating, pallor, nausea, and syncope

  25. Pain Generating Tissues • Different tissues produce different types of pain visceral pain • produced by the internal organs of the cardiovascular, hematological, pulmonary, digestive, urogenital, endocrine, and reproductive systems can • nociceptorsrelay a diffuse signal that refers to associated dermatomes or produce a deep, gnawing ache in the thorax or abdomen

  26. Red Flags • Constant pain • Heart palpitations • Fainting • Night pain or night sweats • Visual problems • Unexplained weight loss

  27. Red Flags • Severe shortness of breath • Recurrent nausea or vomiting • Difficult or painful urination • Blood in urine or stool • Excessive malaise or fatigue

  28. Assessment of General MedicalIllnesses • History • Present complaints • Medical history • Family history • Palpation • Inspection • Special Tests • Vital signs • Percussion • Auscultation • Neurological screening • Special Tools • Otoscope • Stethoscope • Sphygmomanometer • Peak flow meter • Urinalysis test strip • Glucometer

  29. Differential Diagnosis • Your assessment may identify more than one condition that might be causing the problem

More Related