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Types of examination of the patient.




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 such as breathlessness, edema, cough, vomiting, fever, haemorrhage, headache and others. Some of these symptoms are objective, for example, haemorrhage or vomiting, because they are determined by objective study, while others, such as headache or dizziness (головокружение) are subjective, since they are evident only to the patient.

 

Symptoms lobular pne.

Fever had been persisting for two weeks and had been decreasing gradually.

The patient's breathing was rapid with 30-40 respirations per minute. There was breathlessness and cyanosis of the face associated with the accompanying bronchitis, decrease in the respiratory surface and occlusion of numerous bronchioles and alveoli.

The patient complained of the pain in the chest particularly on deep breathing in and cough ulent sputum. The pulse rate was accelerated and the arterial pressure.

The main signs rheumatic endoca.

The patient complained of a general malaise, early fatigue on exertion, cardiac discomfort and palpitation.

The physician found him to have been having an increase of body temperature to a subfebrile level for a prolonged period of time. The patient stated that the onset of the disease had been preceded by tonsillitis. The patient's pulse rate had become irregular and accelerated on physical exertion.

The blood analysis revealed moderate leucocytosis and an elevated ESR. The electrocardiogram showed the changes in the most important readings. On percussion the doctor determined the heart to be slightly enlarged. These symptoms were accompanied by diastole murmur heard at the apex and base of the heart.

Sources of botkin

/Е. in 1880 the prominent Russian scientist S. Botkin having advanced the idea of an infectious origin of this disease, proved his suggestions by such facts as the involvement in this pathologic process not only of the liver but also of the nervous system, the kidneys, the enlargement of the spleen, etc. Botkin's disease is known to be due to a filterable virus present in the blood, liver and found in stool and urine. The virus is infective only for man. As this virus cannot be seen under a usual microscope, it is revealed only by an electronic one. Being highly virulent virus survives in water, food, and on hands for days and weeks.

 

Clinic picture of gastric carcinoma

The clinical manifestations of gastric carcinoma vary with the stage of its development, location and spread through the lymphatic nodes and other inner organs. The main symptoms of gastric carcinoma are known to be disturbance in gastric digestion, epigastric pains, loss of weight and sometimes vomiting of blood. A prolonged, usually external, profuse bleeding results in severe anaemia. The appetite is usually reduced.

 

Symptoms f pulmonary

In the early stage of tuberculosis the patient usually complains of a general malaise, fatigue, loss of appetite and body weight. Cough may be dry or productive, i. e. with sputum discharge. Coughing becomes worse at night and in the morning. In patients with cavities in the lungs coughing is accompanied by a considerable discharge of sputum.

Sputum is mucopurulent. Its microscopic examination reveals a large number of pus corpuscles, erythocytes, and tuberculous organisms. Blood in the sputum is sometimes the first sign of tuberculosis. If large blood vessels are involved the discharge of blood may become profuse.

Fever is one of the permanent symptoms of pulmonary tuberculosis. In benign processes the body temperature is often subfebrile. In active forms it may range from 38∞ to 39∞C. A considerable elevation of temperature is observed in pneumonic forms, when fever persists at a level of 38∞C and higher for several months.





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