Examination of the Patient

Before treating the patient it is necessary to make a correct diagnosis of the disease and to determine its aetiology, i.e. the causes of the disease. The examining doctor must know well the pathogenesis of any disease, i.e. the way and mechanism of its development, as well as the symptoms revealing it.

A number of different procedures is used to establish a diagnosis: history-taking; physical examination, which includes visual examination, palpation, percussion, auscultation; laboratory studies, consisting of urinalysis, blood, sputum and other analyses; instrumental studies, for example, taking electrocardiograms or cystoscopy, X-ray examination and others.

For determining a disease, it is very important to know its symptoms, i.e. the signs of a disease. They are breathlessness, edema, cough, chill, vomiting, fever, haemorrhage, headache, rash, swelling and others. Some of these symptoms are objective, e.g., haemorrhage or vomiting, because they are determined by objective study, while others, such as headache or dizziness are subjective, since they are evident only to the patient.

The physical examination includes three stages: general examination; local examination; examination of body systems.

On general examination, the patient is examined from head to toes: this helps to estimate the physical and mental state of the patient. The doctor also determines the patient’s weight and height, observes his facial expression, movements, speech, state of lymphatic nodes, muscles, bones, joints.

On local examination, the doctor examines the patient’s head, eyes, nose, ears, oral cavity, neck, thyroid gland, etc. to estimate the functional state of particular parts of the body.

Examination of body systems includes the study of the respiratory, endocrine, nervous and other systems. On this stage, the doctor applies the technique of palpation and percussion to determine whether the borders of internal organs are normal or abnormal. By means of auscultation he can reveal rales in the lungs in case of pneumonia or bronchitis, or heart murmurs if a patient suffers from cardio-vascular diseases.

Laboratory analyses are important as well. Blood analysis revealing leukocytosis immediately indicates the presence of inflammation in the body. Urinalyses help to reveal the presence of urinary tract infections such as cystitis, nephritis or pyelonephritis. Analysis of sputum is performed to confirm the diagnosis of tuberculosis.

Instrumental procedures also help to determine health problems. Electrocardiograms are necessary to monitor the heart work. X-ray usually shows the borders and structure of the internal organs, fractures and fissures, accumulation of liquid in the lungs, etc.

So, examination of the patient is a complex procedure helping to timely reveal diseases or dysfunctions of any organs and start their treatment.

Exercise 8. Answer the questions:

1. What is it necessary to know to make a correct diagnosis?

2. What kind of procedures are used to establish a diagnosis?

3. What groups can symptoms be divided into?

4. What is the difference between the objective and subjective symptoms?

5. What does the scheme of the physical examination include?

6. What is examined during each stage of physical examination?

7. Why are laboratory analyses important?

8. What does X-ray help to reveal?

Exercise 9. Match the English word-combinations with their Ukrainian equivalents:

1. history-taking and auscultation	а) прощупування та простукування
2. to make a diagnosis	b) кровотеча та висип
3. palpation and percussion	c) запаморочення та кашель
4. X-ray and urinalysis	d) переломи та тріщини
5. haemorrhage and rash	e) ознаки та симптоми
6. fractures and fissures	f) поставити діагноз
7. signs and symptoms	g) збирання анамнезу та прослуховування
8. dizziness and cough	h) Рентген та аналіз сечі

Exercise 10. Match the symptoms with their explanations:

1. haemorrhage 2. cough 3. headache 4. rash 5. fever 6. vomiting 7. chill 8. edema

a) small red spots on the skin b) removal of the contents of the stomach c) feeling of coldness during high fever d) pain in the head e) profuse bleeding from injured blood vessels f) accumulation of fluid under the skin or in the body cavities g) high body temperature h) reflex which helps to remove foreign substances and microbes from the airways

1.	2.	3.	4.	5.	6.	7.	8.

Exercise 11. Guess what disease is described:

Model: inflammation of the lungs is pneumonia.

1. inflammation of the kidneys

2. inflammation of the lungs

3. inflammation of the urinary bladder

4. inflammation of bronchi

5. inflammation of the eye conjunctiva

6. pus accumulation around the kidneys

7. lesion in the stomach

8. infection caused by Mycobacteria

Exercise 12. Translate the words in italics:

1. Хрипи в легенях usually appear in case of пневмонії чи бронхіту.

2. Increased leukocytosis indicates наявність запалення в організмі.

3. If a patient suffers from серцево-судинних захворювань, he may have шуми у серці.

4. Аналіз сечі helps виявити the presence of urinary tract infections such as цистит та нефрит.

5. On general examination the doctor observes the patient’s вираз обличчя, рухи, мовлення, стан лімфатичних вузлів, м’язів, суглобів.

6. The local examination includes the examination of the patient’s голови, очей, вух, носу, ротової порожнини, шиї, щитовидної залози.

7. Огляд систем організму is carried out by means of прощупування, простукування, прослуховування.

8. Examination of the patient is a комплексна процедура that helps вчасно виявити diseases.

Exercise 13. Fill in with the necessary information from the text:

1. The cause of the disease is known a _________________________________________________.

2. The physical examination includes the following procedures _____________________________.

3. The pathogenesis is known as _____________________________________________________.

4. The instrumental studies may include _______________________________________________.

5. The laboratory studies consist of ___________________________________________________.

6. To make a diagnosis the doctor should make the following procedures _____________________.

7. Three stages of physical examination are: ____________________________________________.

8. The signs of a disease is known as __________________________________________________.

Exercise 14. Complete the table:

Physical examination	Laboratory examination	Instrumental examination

Exercise 15. Fill in the sentences with the words from the box:

urinalyses, history-taking, subjective, X-ray, palpation, laboratory, symptom, objective

1. Typical sings that can characterize particular disease are called ______________________.

2. Blood tests and sputum analyses are performed during _________________ examination.

3. Haemorrhage, rash, cough are ________________ symptom.

4. Breathlessness, dizziness are _________________ symptom.

5. The fracture of bones can be revealed by ___________________.

6. _____________________ is the first step in patient’s examination.

7. ________________ is performed to determine to boarders of internal organs.

8. The doctors usually administer _________________ to reveal urinary tract infections.

Exercise 16. Put the verbs in brackets into the correct tense form. Translate the sentences into Ukrainian:

1. The cause of the disease (to call) aetiology.

2. Yesterday the students (to learn) the pathogenesis of pneumonia.

3. Tomorrow I (to take) the ECG to monitor my heart work.

4. If blood analysis (to reveal) leukocytosis, the patient (to administer) antibiotics.

5. The medical examination (to carry) out twice a year, as a rule.

6. The stomach troubles of the patient (to determine) by vomiting.

7. In a week, students (to observe) the professor examine his patients.

8. Good day light (to allow) to estimate the colour of the patient’s skin, conjunctiva, oral cavity.

Exercise 17. Put questions to the underlined words:

1. To make a diagnosis the doctor needs the findings of blood analysis.

2. Any disease is usually revealed by its symptoms.

3. The patient was administered uninalysis to confirm cystitis.

4. Objective symptoms include haemorhage, vomiting, cough, etc.

5. She felt dizziness and nausea after taking these pills.

6. Physical examination is the first objective stage in examination of a patient.

7. By means of auscultation the examiner can reveal rales in the lungs heart murmurs.

8. The diagnosis of TB will be confirmed after analysis of sputum.