Common Stuffs in Medicine Posting

 Forward

"STUFF" is a common word in our various wards, clinics, grand rounds and seminars. In this piece it denotes basic clinical skills and ability to interpret clinical symptoms, signs and laboratory results to be able to make a meaningful diagnosis.

Common stuffs is designed as a synopsis for medical students, house officers and junior residents alike to compliment other major textbooks. It covers history taking and clinical examination in general and in respect to the most commonly encountered medical conditions in our clinical settings. It also contains important information on presentations and treatments with respect to these clinical conditions. It is my sincere hope that this book will help improve our knowledge in terms of recognition, diagnosis and management of common ailments. -  Dr. Abdul Habu (Consultant physician).

Preface

Clinical postings can be very challenging. This is because of colossal nature of information medical students are bombarded with within relatively short period of time. Students sometimes find it difficult to sieve and extrapolate relevant and crucial information from most standard textbooks because of their voluminous nature. The aim of this book is to provide a portable source of highly germane and

vital information for medical students. house officers and younger medical officers.

Optimal benefit could however be derived from the book when combined with standard textbooks for better understandings.

To achicve the aim of this book, only common medical cases in Nigeria and other west Arican Countries are discussed.

Reporting history taking and examination findings could also constitute some

puzzles for medical students. This book also contains sample clerkings of most

commonly encountered mcdical cases both in the wards and during clinical examinations.

The book can also serve as a quick revision material for those preparing for clinical examinations.

I hope the book will stimulate the interest of the readers in further readings.

Dr. 0GUNYELE Tirimidhi Titilope (Author)

Federal Medical center, Nguru

Chapter 1

Symptoms, Signs and Diagnosis

SYMPTOMS

Symptoms are abnormal feelings of body

functions noticed by patient

•  That may indicate presence of a disease
• It is subjective
• And it is reported by patient

It is complain made by the patient to

physician or other health practitioner

Sometimes it may be physiologic e.g. symptoms of pregnancy and perimenopausal symptoms

The terms "chief complains" or "presenting complains" or presenting symptoms are used to describe major concerns (symptoms) that make patient to seek the help of a dočtor

Cardinal symptoms are those that lead to

ultimate diagnosis

Specific symptoms are those that are

specific to a particular disease or region

of the body

• E.g. dysuria is a symptoms of urinary system
• While palpitation is a symptom of cardiovascular system

Nonspecific symptoms are those that are not specific to a particular disease nor body region

• E.g. fever
• And fatigue

SIGNS

Signs are indication of health conditions or diagnosis that are detected by a physician or other health practitioners during physical examination.

It may not have meaning to the patient

It may not be part of pauent s complain

Some complains of patient can be picked

up during examination as signs, for

example:

• Patient complaining of leg swelling (symptom) may be noticed to have pedal edema (sign)

Mostly different terms are used to described symptoms and signs however some single terms refers to both symptoms and signs. E.g;

• Dyspnea
• Fever
• Convulsion

Pathognomonie signs

These are signs whose presence proved beyond doubt the presence of a particular

discase.

Singular pathognomonic signs are relatively

uncommon

Examples

• Palmar xanthomata in hyperlipoproteinemia
• Koplik's sign in the mouth is most pathognomonic sign in measles 
• Negri bodies in brain tissue in Rabies

DIAGNOSIS

It is process of attempting to identifying a

possible disease or disorder and opinion

reached by the process.

It is the determination of nature of disease condition by careful history, examinations and investigations.

It is also disease condition identified by

above process.

Differential diagnosis

A list of most common causes of set(s) of

symptom(s), sign(s) or a clinical condition

Or a list of other disorders similar to a

disorder.

A process of weighing the probability of a

disorder versus another accounting for a

patient's clinical condition.

The mnemonics "VINDICATE M" could

help considering all possible differential of

clinical conditions

• V: Vascular
• I: Intlammatory/Infectious/ Infestations
• N: Neoplasm/ Nutritional 
• D: Drugs/ Deficiency/ Degenerative
• I: ldiopathic/ Intoxications/ latrogenc
• C: Congenital/ Connective
• A: Autoimmune/ Allergic
• T: Traumatic
• E: Endocrine/ Environmental
• M: Metabolic

Print this post