Definition Peptic Ulcer Disease is defined as an ulcer occurring in a region that touches gastric aci d(胃酸) and pepsin(胃蛋白酶) and usually refers to gastric ulcer(胃溃疡) or duodenal ulcer (十二指肠溃疡)
Importance of Inquiry Gaining clinical information and collecting case history based on systemic inquiry Base of clinical practice *60~80% diagnosis could be induced from interview between patient and physician New form: consultation by phone, in internet
Referred pain Because of this convergence and the fact that the spinal neurons are most often activated by inputs from the skin, activity evoked in spinal neurons by input from deep structures is mislocalized by the patient to a place that is roughly coextensive with the region of skin innervated by
Definition Frequent micturition: voiding at frequent intervals, due to a sense of bladder fullness Normal: 3-5 times in the day time 0-1 time in the night 200-400ml each time
Significance General condition comprehension Confirm history information Specific sign collection for the diagnosis of certain disease infers certain accessory examines Grossly preclude some certain disorders Contribute a relation between the physician and the patient
Five Ways of GI Bleeding Hematemesis: vomitting of blood of altered blood coffee grounds) indicates bleeding proximal to ligament of Treitz Melena: Tarry stool. Altered (black) blood per rectum(>60ml) Hematochezia: Bright red or maroon rectal bleeding implies bleeding beyond
It is well known that advances in scientific medicine have occasionally threatened to displace the history and physical examination in the evaluation of the patient. However, we usually discover that technologic advances serve to make the physical examination more rational and provide new understanding or objective documentation of long- appreciated physical finding
