Unit 1. Making a diagnosis.

Investigate and write all about the diagnosis. What's a diagnosis?

Medical diagnosis is the process of determining which disease or condition explains

a person's symptoms and signs. It is most often referred to as diagnosis with the
medical context being implicit. The information required for diagnosis is typically
collected from a history and physical examination of the person seeking medical
care. Often, one or more diagnostic procedures, such as medical tests, are also
done during the process. Sometimes posthumous diagnosis is considered a kind of
medical diagnosis.

Diagnosis is often challenging, because many signs and symptoms are nonspecific,
and can only be undertaken by registered and licensed health professionals. For
example, redness of the skin (erythema), by itself, is a sign of many disorders and
thus does not tell the healthcare professional what is wrong. Thus differential
diagnosis, in which several possible explanations are compared and contrasted,
must be performed. This involves the correlation of various pieces of information
followed by the recognition and differentiation of patterns. Occasionally the
process is made easy by a sign or symptom (or a group of several) that is
pathognomonic. Diagnosis is a major component of the procedure of a doctor's
visit. From the point of view of statistics, the diagnostic procedure involves
classification tests.

Investigate and write the different types of diagnosis. Give details.

Clinical diagnosis

A diagnosis made on the basis of medical signs and reported symptoms, rather
than diagnostic tests

Laboratory diagnosis

A diagnosis based significantly on laboratory reports or test results, rather than

the physical examination of the patient. For instance, a proper diagnosis of
infectious diseases usually requires both an examination of signs and symptoms, as
well as laboratory test results and characteristics of the pathogen involved.

Radiology diagnosis

A diagnosis based primarily on the results from medical imaging studies.

Greenstick fractures are common radiological diagnoses.

Tissue diagnosis
 A diagnosis based on the macroscopic, microscopic, and molecular examination
of tissues such as biopsies or whole organs. For example, a definitive diagnosis of
cancer is made via tissue examination by a pathologist.

Principal diagnosis

The single medical diagnosis that is most relevant to the patient's chief complaint
or need for treatment. Many patients have additional diagnoses.

Admitting diagnosis

The diagnosis given as the reason why the patient was admitted to the hospital;
it may differ from the actual problem or from the discharge diagnoses, which are
the diagnoses recorded when the patient is discharged from the hospital.[24]

Differential diagnosis

A process of identifying all of the possible diagnoses that could be connected to

the signs, symptoms, and lab findings, and then ruling out diagnoses until a final
determination can be made.

Diagnostic criteria

Designates the combination of signs, symptoms, and test results that the clinician
uses to attempt to determine the correct diagnosis. They are standards, normally
published by international committees, and they are designed to offer the best
sensitivity and specificity possible, respect the presence of a condition, with the
state-of-the-art technology.

Prenatal diagnosis

Diagnosis work done before birth

Diagnosis of exclusion

A medical condition whose presence cannot be established with complete

confidence from history, examination or testing. Diagnosis is therefore by
elimination of all other reasonable possibilities.

Dual diagnosis

The diagnosis of two related, but separate, medical conditions or co-morbidities.

The term almost always referred to a diagnosis of a serious mental illness and a
substance addiction, however, the increasing prevalence of genetic testing has
revealed many cases of patients with multiple concomitant genetic disorders.
Self-diagnosis

The diagnosis or identification of a medical condition in oneself. Self-diagnosis is

very common.

Remote diagnosis

A type of telemedicine that diagnoses a patient without being physically in the

same room as the patient.

Nursing diagnosis

Rather than focusing on biological processes, a nursing diagnosis identifies

people's responses to situations in their lives, such as a readiness to change or a
willingness to accept assistance.

Computer-aided diagnosis

Providing symptoms allows the computer to identify the problem and diagnose
the user to the best of its ability.[25][4] Health screening begins by identifying the
part of the body where the symptoms are located; the computer cross-references a
database for the corresponding disease and presents a diagnosis.[26]

Over diagnosis

The diagnosis of "disease" that will never cause symptoms, distress, or death
during a patient's lifetime

Wastebasket diagnosis

A vague, or even completely fake, medical or psychiatric label given to the

patient or to the medical records department for essentially non-medical reasons,
such as to reassure the patient by providing an official-sounding label, to make the
provider look effective, or to obtain approval for treatment. This term is also used
as a derogatory label for disputed, poorly described, overused, or questionably
classified diagnoses, such as pouchitis and senility,[citation needed] or to dismiss
diagnoses that amount to overmedicalization, such as the labeling of normal
responses to physical hunger as reactive hypoglycemia.

Retrospective diagnosis

The labeling of an illness in a historical figure or specific historical event using

modern knowledge, methods and disease classifications.
What's a medical history and when taking?

A medical history is a report that includes information gained from a patient's

medically relevant recollections (e.g., symptoms, concerns, past diseases) and
questioning regarding their concerns. While a physician should generally take their
time to take a thorough history, situations such as. medical emergencies

Write and define the steps for taking a patient's history into the correct order.

Procedure Steps

Step 01

Introduce yourself, identify your patient and gain consent to speak with them.
Should you wish to take notes as you proceed, ask the patients permission to do so.

Step 02 - Presenting Complaint (PC)

This is what the patient tells you is wrong, for example: chest pain.

Step 03 - History of Presenting Complaint (HPC)

Gain as much information you can about the specific complaint.

Step 04 - Past Medical History (PMH)

Gather information about a patients other medical problems (if any).

Step 05 - Drug History (DH)

Find out what medications the patient is taking, including dosage and how often
they are taking them, for example: once-a-day, twice-a-day, etc.

At this point it is a good idea to find out if the patient has any allergies.

Step 06 - Family History (FH)

Gather some information about the patients family history, e.g diabetes or cardiac
history. Find out if there are any genetic conditions within the family, for example:
polycystic kidney disease.

Step 07 - Social History (SH)

This is the opportunity to find out a bit more about the patient’s background.
Remember to ask about smoking and alcohol. Depending on the PC it may also be
pertinent to find out whether the patient drives, e.g. following an MI patient cannot
drive for one month. You should also ask the patient if they use any illegal
substances, for example: cannabis, cocaine, etc.

Also find out who lives with the patient. You may find that they are the carer for an
elderly parent or a child and your duty would be to ensure that they are not
neglected should your patient be admitted/remain in hospital.

Step 08 - Review of Systems (ROS)

Gather a short amount of information regarding the other systems in the body that
are not covered in your HPC.

Step 09 - Summary of History

Complete your history by reviewing what the patient has told you. Repeat back the
important points so that the patient can correct you if there are any
misunderstandings or errors.

You should also address what the patient thinks is wrong with them and what they
are expecting/hoping for from the consultation. A useful acronym for this is ICE
[I]deas, [C]oncerns and [E]xpectations.

Step 10 - Patient Questions / Feedback

During or after taking their history, the patient may have questions that they want
to ask you. It is very important that you don’t give them any false information. As
such, unless you are absolutely sure of the answer it is best to say that you will ask
your seniors about this or that you will go away and get them more information
(e.g. leaflets) about what they are asking. These questions aren’t necessarily there to
test your knowledge, just that you won’t try and 'blag it'.

Step 11

When you are happy that you have all of the information you require, and the
patient has asked any questions that they may have, you must thank them for their
time and say that one of the doctors looking after them will be coming to see them
soon.

This guide is designed for students and doctors. If you are applying for medical
school and would like more information on the UCAT please check out our
complete guide and our guide on how to practice for your exam. We've also
prepared a UCAT Practice Test to help you prepare for the exam.
Write the Socrates mnemonic medicine.

SOCRATES is a mnemonic acronym used by emergency medical services,

physicians, nurses, and other health professionals to evaluate the nature of pain
that a patient is experiencing.

Investigate all about the Diabetes and the types of Diabetes.

Diabetes is a group of diseases in which the body doesn't produce enough or any
insulin, doesn't properly use the insulin that is produced, or exhibits a combination
of both. When any of these things happens, the body is unable to get sugar from
the blood into the cells. That leads to high blood sugar levels.

Investigate and write all about the Hyperthyroidism, Hemoglobin HA1C test,
and the insulin.

uglycemic individuals with overt hypo- or hyper-thyroidism were selected. Age- and
sex-matched controls were recruited. Baseline HbA1c and reticulocyte counts (for
estimation of RBC turnover) were estimated in all the patients and compared.
Thereafter, stable euthyroidism was achieved in a randomly selected subgroup and
HbA1c and reticulocyte count was reassessed. HbA1c values and reticulocyte counts
were compared with baseline in both the groups.

Do the exercise B on page 2.

1-introductory small talk

2-history of present condition

3-past medical history

4- family history

5-social history

6-chief complain

7-medication

Do the exercise A on page 4.

a. 3c
b. 3a
c. 3b
d. 6
e. 3
f. 1
g. 5
h. 4
i. 4
j. 7
k. 5
Do the exercise A on page 10.

1. By strictly controlling carbohydrates in the diet

2. They pointed out that sugar is a form of carbohydrate and all
carbohydrates contain approximately the same amount of energy
3. The amount of glucose entering the blood will be the same.
4. No ,are important in a balanced diet

Do the exercise D on page 11.

2. 450/300*300=450cals

3. 400/300-420=560cals

4. 500/300*210=350cals

5. 400/350*175=200cals
Do the exercises A and B on page 12.

2. Too low thyroid function

3. Abnormal dyslipidemia

4. to high glucose

5. to high production