Y khoa - Dược - Chapter 42: Assisting in other medical specialties

42Assisting in Other Medical SpecialtiesLearning Outcomes (cont.)42.1 Describe the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics.42.2 Identify common diseases and disorders related to cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics.Learning Outcomes (cont.)42.3 Relate the role of the medical assistant in examinations and procedures performed in the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics.Introduction The medical assistant working for a specialist willAssist with the examinations Assist with diagnostic testing and processing specimensAddress common concerns and questions Perform basic administrative and clinical skillsWorking in Other Medical SpecialtiesAllergyAllergist Allergies ~ inappropriate immune responses Allergic reaction ~ inflammation and tissue damageLocal SystemicAnaphylaxisCardiologyCardiologist – heart disease and disordersBe familiar withThe structure of the cardiovascular system Typical exams and measurements Common heart diseases and treatmentsDiagnostic testsDermatologyDermatologists – skin diseases and disordersMedical assistant mustUnderstand elements of dermatologic exams and proceduresBe familiar with skin disorders and treatmentsUnderstand terminologyEndocrinologyEndocrinologists – diseases and disorders related to glands and hormonesMedical assistant Assists with examinations Collects specimens for analysisGastroenterologyGastroenterologists – disorders of the GI tract, liver and pancreasMedical assistant Understands the basic elements of GI exam and proceduresBecome familiar with GI disorders, treatments, and terminologyPatient education ~ prepares for the exams NeurologyNeurologists – diseases and disorders of the central nervous systemMedical assistantAssists with examination Perform diagnostic testingEducates patientsOncologyOncologist – tumors and cancerous growthsTumor Lump of abnormal cellsBenign or malignantMetastasis Carcinogenesis Medical assistantBe aware of common types of cancersPatient educationFamily education and supportOrthopedicsOrthopedist – disorders, injuries, and diseases of the muscular and skeletal systemsMedical assistant General examinationsX-raysCastingHot/cold treatmentPatient educationApply Your KnowledgeMatch the followingAllergist CardiologistDermatologist EndocrinologistGastroenterologistNeurologistOncologistOrthopedistSkin cancersNervous system disordersJoint and bone disordersVascular system disorders Hormonal imbalancesMalignant tumors Liver & pancreas disorders Immune system responsesANSWER:Diseases and Disorders Of Medical Specialties CardiologyCardiovascular diseaseCoronary artery diseaseHypertensionMyocardial infarctionRisk factorsInactivityObesityHigh blood pressureSmokingHigh cholesterolDiabetes Diseases and Disorders Of Medical Specialties (cont.)Cardiology Patient education ~ prevention of heart disease, stroke, or heart attackDiseases includeArterial and vascular disordersCoronary artery diseaseDysrhythmias Heart failureInflammation of heart tissueValvular diseases Dermatologic Conditions and DisordersSkin disorders includeAcne vulgarisContact dermatitisPsoriasis RingwormMoles Skin cancers WartsEczemaEndocrine Diseases and DisordersDiabetesCauses Pancreas ~ secretes less insulinBody ~ resistant to insulinHyperglycemiaGoal of treatment ~ normalize blood sugar levels Endocrine Diseases and Disorders (cont.)Thyroid disorders Hypothyroidism Decreased activity of the thyroid glandUnderproduction of thyroxineHyperthyroidism ~ increased gland activityGastrointestinal Disease and DisordersDocument GI symptoms accuratelyCommon diseases and disordersHerniaCholecystitis and cholelithiasis Colitis Constipation and diarrheaDiverticulitisGERDHemorrhoids Neurologic Diseases and DisordersCommon diseasesAlzheimer’s diseaseBells palsyEncephalitisEpilepsy MigrainesParkinson’s diseaseNeurologic Diseases and DisordersTraumaLoss of sensation and voluntary motionHemiplegiaParaplegia Quadriplegia Encephalopathy – alters brain function and structureOrthopedic Diseases and DisordersCommon diseases and disordersArthritisCarpal tunnel syndromeDislocations, sprains, and fracturesOsteoporosisLow back painCommon disorderTreatment ~ heat, analgesics, muscle relaxants, exercise, braces, traction, surgeryApply Your KnowledgeMatch disorder with specialty diabetes GERD paraplegia Grave’s disease cholelithiasis hypertension myocarditis acne bursitis Paget's disease psoriasis Alzheimer's diseaseCardiologyDermatologyEndocrineGINeurologyOrthopedic AABBCCDDEEFFBravo!ANSWER:Exam and Procedures in Medical SpecialtiesAllergy exams and testing – medical history and diagnostic testingMedical assistant Assist with or perform testsPatient educationAllergy Exams and Testing (cont.)Scratch testUsed to test for specific allergiesMay cause discomfort and itchingIntradermal test - more sensitive than the scratch testAllergy Exams and Testing (cont.)Patch test – discover the cause of contact dermatitisRAST – measures blood levels of antibodies to specific allergensCardiology ExamsAuscultation Blood pressureHeart soundsPalpationChest wallVessels in extremitiesElectrocardiogram– measures the electrical activity of the heartCardiology Exams (cont.)Stress test Measures response to a constant or increasing workloadStress thallium ECGChemical stress testHolter monitor – records ECG over a period of timeRadiography and Imaging TechniquesChest x-rayRadionuclide studies FluoroscopyVenogramAngiography Radiography and Imaging Techniques (cont.)Ultrasound – reflected sound wavesEchocardiographyHigh-frequency sound wavesTests structures and function of heartHeart MRI – strong magnets and radio wavesRadiography and Imaging Techniques (cont.)Cardiac catheterizationObtain blood samplesMeasure pressure in the heart’s chambersView the heart’s motionPerform a balloon angioplastyInsert a stent Coronary artery bypass graftWhole-body skin examination – top layer of the entire surface of the skinWood’s light examination – skin is inspected under ultraviolet lamp in a darkened roomDermatology ExamsEndocrine Exams and TestsAssessment Skin conditionWeight and cardiac functioningPhysical exam ~ palpation of glands Diagnostic urine and blood tests Ultrasound, X-ray, and iodine scanGastroenterology ExamsInvasive exam procedure based on patient symptomsMedical assistant Provide reassurance and ensure comfortAssist as permittedPatient instructionsGastroenterology Exams (cont.)Endoscopy – direct visualization of a body cavityPeroral endoscopy EsophagusStomachDuodenum Gastroenterology Exams (cont.)Colonoscopy – examination of the large intestineProctoscopy – examination of the lower rectum and anal canalSigmoidoscopy – examination of the sigmoid area of the large intestineDiagnostic and Laboratory Testing (cont.)Lab testsAnalysis of stomach contentsOccult bloodImaging techniquesCholecystography Gallbladder function test Differentiate between bile duct obstruction and gallstonesDiagnostic and Laboratory TestingUltrasoundBarium swallow – esophagus, stomach, and small intestineBarium enema – large intestineRadionuclide imagingNeurologic Exams and Diagnostic TestingThe neurologist evaluates Cognitive function Cranial nervesMotor systemReflexes Sensory systemNeurologic Exams and Diagnostic Testing (cont.)Electroencephalography (EEG)Imaging proceduresCerebral angiographyBrain scanComputed tomography (CT scan)Neurologic Exams and Diagnostic Testing (cont.)Imaging procedures (cont.)Magnetic resonance imaging (MRI) Positron emission tomography (PET scan) Myelography Skull X-raysNeurologic Exams and Diagnostic Testing (cont.)Lumbar puncture Diagnose infectionMeasure CSF pressureCheck for blood or proteins Electromyography – neuromuscular disorders or nerve damageOncology Exams and Diagnostic TestingBiopsyIncisional or open Needle Medical AssistantStandard Precautions, sterile techniqueSpecimen preparation and labelingClean and bandage siteOncology Exams and Diagnostic Testing (cont.)X-raysCT scans and MRI Blood tests to detect tumor markersUltrasonographyCancer TreatmentA combination of treatments is usedSurgery Removal of all or part of the tumorMost effective if tumor contained or localizedRadiation therapy Kills or stop the growth of tumor cellsDamages cells the undergo rapid divisionCancer TreatmentChemotherapy Anticancer drugs administered to kill malignant cellsUsed alone or in combinationHighly toxic ~ use PPE Orthopedic Exam and ProceduresAssessment byInspection Palpation Diagnostic testsMedical assistantDrapePosition and support patientPatient instructionsOrthopedic Exam and Procedures (cont.) Bone and muscle biopsiesElectromyographyUrine and blood testsRadiographic examsX-raysCT scan and MRI AngiographyDiskographyArthrographyBone scansOrthopedic Exam and Procedures (cont.) Arthroscopy View of the inside of a jointArthroscopeJoint replacement surgeryApply Your KnowledgeTrue or False: ___ An ECG tests the function of the heart through reflected sound  waves.___ A scratch test uses extracts of suspected allergens to test for  specific allergies An ultraviolet lamp is used in a Wood’s light examination. A colonoscopy examines only the sigmoid portion of the colon. A PET scan studies the blood flow and metabolic activity of the brain. A needle aspiration is performed using an open biopsy. Arthroscopy is used to visualize the inside of a joint. TechocardiogramFANSWER:Very Good!TFsigmoidoscopyTFTneedle In Summary 42.1 The medical specialties discussed in this chapter include: allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics. 42.2 Many common diseases and disorders are identified in the specialty practices. You should have an understanding of the implications of these diseases on the patient and the necessary treatments.In Summary (cont.)42.3 Exams and diagnostic tests performed in allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics specialties are numerous. During most of these exams and tests, your role may include patient safety and comfort, educating the patient about the necessary preparation and the procedure, and assisting the physicianEnd of Chapter 42Diagnosis is not the end, but the beginning of practice.  ~Martin H. Fischer