Internal Medicine

1. Internal Medicine Propedeutics

2. Goals • Dentists don’t treat only healthy people • Dental treatments can affect the patient health • Dentists can discover some signs of special diseases • Emergency treatments in internal medicine • Increase the communication skills • Give a wider horizon to medicine • Help to be more competitive

3. Dentistry - Internal Medicine Propedeutics • Introduction. History taking. The principles of physical examination. 2. Techniques of physical examination. Physical examination of the head and neck region. 3. History taking in chest and lung diseases. • Physical examination of the chest and lung. • Disorders of the respiratory system (pneumonia, bronchial asthma, pleural diseases, tumors). 6. History taking in cardiovascular diseases. Physical examination of the cardiovascular system. 7. Symptoms and signs of common cardiovascular diseases (ischaemic heart diseases, valvular diseases, heart failure). 8. Symptoms and signs of vascular diseases. Examination of the peripherial vessels. (Hypertension, diseases of the venous system and peripherial arteries). 9. Symptoms of the abdominal diseases. 10. Physical examination of the abdomen. 11. Symptoms and signs of common gastrointestinal disorders (oesophageal diseases, ulcers, gastrointestinal tumors, liver and biliary diseases, pancreatitis). 12. Symptoms and signs of endocrine diseases, diabetes mellitus and metabolic disorders. 13. Physical examination of the kidney and genitourinary system. Symptoms and signs of common renal diseases (glomerulonephritis, nephrotic syndrome, urinary tract infections, nephrolithiasis, renal failure). 14. Symptoms and signs of common haematological diseases.

4. Barbara Bates Guide to physical examination and history taking • Lynn S. Bickley Bates’ guide to physical examination and history taking

5. Diagnosis – an injured mosaic

6. The main parts of the diagnosis • Pathological • Etiological • Anatomical • Prognostic

7. Medical examination • Patient history • Physical examination • Laboratory and instrumental examination

8. Patient history 0. Introduction Date of the history Identifying data Source of referral Reliability of the history

9. Patient history 0. Introduction 1. Chief complaint(s)

10. Patient history 0. Introduction • Chief complaint(s) • Present illness

11. Present illness • Location • Quality • Quantity or severity • Timing (onset, duration, frequency) • Setting in which it developed • Factors that aggravated or relieved • Associated manifestations • Treatments

12. Patient history 0. Introduction • Chief complaint(s) • Present illness • Past history

13. Past history • Most important diseases in chronological order (hospitalisations) • Operations, injuries, accidents • Allergies (drug, food, pollens etc.) • Transfusion(s) • Screening tests

14. Patient history 0. Introduction • Chief complaint(s) • Present illness • Past history • Current health status

15. Current health status • Social circumstances • Occupation (recent and past) • Enviromental hazards (home, school, workplace) • Diet (incl. beverages) • Alcohol and illicit drugs (type, amount, frequency, duration of use) • Tobacco (type, amount, duration) • Current medication • Exercise and leisure activities • Sleep patterns • Sexual history

16. Patient history 0. Introduction • Chief complaint(s) • Present illness • Past history • Current health status • Family history

17. Family history • Parents, siblings, spouse, children, other relatives • age; age and cause of death; health status; important diseases • Occurence of • Diabetes • Hypertension, heart diseases, stroke • Infective diseases • Malignant diseases • Coagulation disorders • Psychiatric diseases, alcoholism, drug addiction • Symptoms like those the patient

18. Patient history 0. Introduction • Chief complaint(s) • Present illness • Past history • Current health status • Family history • Review of organ systems

19. Review of organ systems • General • General status • Usual weight, weight change • Fatigue • Fever • According to organs • Skin, Head, Eyes, Ears, Nose, Mouth, Neck, Breasts, Respiratory, Cardiac, Gastrointestinal, Urinary, Genital etc.

20. Patient history 0. Introduction • Chief complaint(s) • Present illness • Past history • Current health status • Family history • Review of organ systems