Unit 2 Seminar Overview I human Review 2021/2022

I Human review o Harvey Hoya  Essential HTN o You will initially get an overview of the patient but you need to start asking questions o HPI  How can I help you today? Is a good opening question  Do you have any other symptoms or concerns?  Current or past medical problems that you have?  Tell me about the health of your grandparents?  Tell me about your diet and what you normally eat?  Do you have any problems with fatigue, difficulty sleeping?  Any nausea, vomiting, constipation, diarrhea?  Ask about urination  Ask about allergies  Ask about prescription medication  Ask how severe their symptoms or problem is  Ask about heat/cold intolerance  Ask about dizziness, weakness, numbness  Ask about alcohol intake  Ask about tobacco use  Ask about drug use  Ask about thyroid problems  Any chest pain  Any breathing issues  Ask about musculoskeletal issues  Ask when symptoms started o Exam  Look at skin  Look in eyes  With ophthalmoscope o Look for retinopathy  Look at mouth  Palpate the neck  Measure the JVP  Look at chest wall anterior and posterior  Palpate PMI and listen to heart  Palpate the chest and lungs then auscultate  Auscultate the abd and femoral arteries  Measure abd girth  Palpate and percuss the abd  Check mental status This study source was downloaded by from CourseH on :11:21 GMT -06:00  Auscultate the carotid arteries o Key findings and problem statement  Key findings are blood pressure measured times 2  Note other important findings during the exam  The most key thing would be the blood pressure  Choose differentials  Hypertension, primary and secondary  White coat HTN  Obstructive sleep apnea o Tests  Sleep study  CMP  CXR- PA and lateral  Thyroid function test-TFT  Echocardiogram-transthoracic  EKG  CBC  UA o Management plan  Have diagnosis  Write a goal  Talk about medications  Follow-up management o Write up a H&P  The Art of Diagnosis and Treatment o Make sure you are doing the right thing because the diagnosis you make will stay on the patient’s medical record o Always take the patient serious, no matter what they say o If a patient misses appointments, it could be due to other issues such as vehicle issues, not something negative. Make your own opinions on patients rather than taking other peoples advice on a patient o OLD CARTS  Onset, Location/radiation, duration, character, aggravating factors, reliving factors, timing and severity o Save UCSD’s Practial Guide to Clinical Medicine  Good site to look at o History of Present Illness  Chief complaint  Ask questions  Get the patients story o Past medical history  Ask patients to bring in all medications  Important to ask about allergies every visit