内科学课件:-内科学绪论.ppt
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- 内科学 课件 绪论
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1、INTRODUCTION TO INTERNAL MEDICINE Wu qingmingInternal MedicineSurgeryPediatricsgynecologyPathologyMicrobiologyGeneticsBiochemistryPharmacologyPathologic-physiologyDiagnosticsImmunologyHow to Teach Internal Medicine Lecture (Bilingual teaching) Bedside teaching: including Respiratory system, Cardiova
2、scular system, Gastrointestinal system, Kidney and urinary system, Endocrinology, Hematology, etc.Bedside Teaching Cardiovascular system: Heart failure(心衰); CHD(冠心病)/ Hypertension(高血压); Cardiomyopathy(心肌病)/ pericarditis(心包炎); Arrhythmia(心律失常); Respiratory system : ARDS(呼衰)/COPD; Pneumonia(肺炎); TB(肺结
3、核)/ Hydrothorax(胸腔积液); Lung Cancer(肺癌); Gastrointestinal system : Cirrhosis(肝硬化); Peptic ulcer(消化性溃疡)/ upper GI bleeding(上消化道出血); IBD(炎症性肠病); Acute pancreatitis(急性胰腺炎)/ abdominal pain(腹痛待查);Bedside Teaching Kidney and urinary system : Glomerulonephritis (primary and secondary)(原发性肾小球疾病;继发性肾小球疾病); Ch
4、ronic Renal Failure(尿毒症); urinary tract infection(尿路感染) Hematology :Leukemia(白血病);Anemia(贫血);Lymphoma(淋巴瘤);Disorders of hemostasis (出血性疾病) Endocrinology :Diabetes Mellitus(糖尿病);Hyperthyroidism(甲亢);hypothyroidism(甲减) 。 TimeMon.Tues.Wes.Thurs.Fri.Mor-ning7:30-9:45Take history and physical examination,
5、 and follow morning round10:0011:30Bedside teachingAfternoon1:30-4:30LectureCase StudyLectureLecture确保床旁教学质量确保床旁教学质量内分泌科和心内科师生在进行病例讨论Reference Books 希氏内科学精要 Cecil Essentials of Medicine Harrisons Principles of Internal Medicine 现代内科学英语精要 人民卫生出版社 2002 陈灏珠主编. 实用内科学. 人民卫生出版社 2005 王吉耀王吉耀主编 内科学试题与题解 上海科学
6、技术文献出版社,2002 王吉耀王吉耀主编 内科临床病例分析双语学习内科临床病例分析双语学习, 人民卫生出版社 2005How to learn1. To combine internal medicine with basic scientific knowledge2. To combine theory with practiceStartTold what we Need to knowLearn itGiven problem to illustrate how to use itSubject based learningLectures Approach to patients
7、Pathogenesis Pathologic-physiology & Clinical features Diagnosis TreatmentBasic theoryBasic knowledgeEssential skillStartProblem posedIdentify what We need to knowLearn itApply itProblem-based learningTo Learn How To Learn An educational method that allow you to learn about medicine as you attempt t
8、o deal with real-life medicine situations.To develop effective reasoning skills through Information gathering Problem synthesis Hypothesis generation Data analysis Decision makingLearning of skills Inquiry skills Thinking skills Problem solving skillsClinical decision making4 steps for dealing with
9、clinical problems:1. Making diagnosis2. Identify the severity of the disease3. According to the severity of disease, to make therapeutic protocol4. Follow up the results of the treatmentClinical thinking (临床思维 ) Diagnostic (诊断思维) Therapeutic (治疗思维)Diagnostic thinking skills History Taking Physical e
10、xamination Hypothesis of diagnosis developing a differential diagnosis Searching the evidence Select the related lab. tests and other techniques A 45 year-old man presented on Jan. 28, 2004 to the emergency department with melena for three times and vomiting of blood. Key information Problem Hypothe
11、sis Rx 45 yr. M GI ulcer GI bleeding cancer varices drug-inducedThe Principles of Diagnostic Thinking 一元论 多考虑常见病 先考虑器质性疾病,后考虑功能性诊断 用排除法作鉴别诊断The principles for selecting Diagnostic tests 先了解所选试验的有效性、安全性和价格 排除诊断时,选敏感度高的试验 肯定诊断时,选特异度高的试验 首选无创伤性的检查 当检查结果与临床不符时,应作详细分析而不能片面依赖实验检查结果The Principles of Therap
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