INFORMATION ACQUIRED FROM INVESTIGATIONS

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INFORMATION ACQUIRED FROM INVESTIGATIONS

• Confirmatory information- e.g. in case of a
  suspected renal
• stone, visualization of a stone on
  ultrasonography.
• Additional information- e.g in a patient of
  cirrhosis, knowing
• the diameter of CBD and splenic artery on
  ultrasonography would indicate the severity and
  stage of the disease.
• Corroborative information- e.g. in a suspected
  case of acute cholecystitis visualization of free
  fluid in Morrisons pouch with a thickened GB
  wall would suggest a high possibility of an acute
  cholecystitis.
• Negative information- e.g. absence of free fluid
  in cases of abdominal trauma would suggest
  absence of an organ laceration haemoperitoneum.
• Progress information- e.g. comparing of s.
  Bilirubin levels along with SGOT and SGPT in
  cases of Hepatitis at regular intervals for the
  follow up.

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PROCEDURE OF ORDERING INVESTIGATIONS

• History taking- the history is to be taken in
  detail so as to
• understand the nature of complaints.
• 2. Examination- detailed general and systemic
  examination is
• necessary to check in corroboration with the
  history to locate the organ involved and to
  understand the type of disturbance.
• 3. Provisional diagnosis and differential
  diagnosis- it is the most important step before
  ordering for investigations. The provisional and
  its closest differential diagnosis have to be
  worked out before ordering any investigations.
• 4. Finally its most important to order for the
  relevant investigations in order to clinch the
  diagnosis. At this level, a step wise approach is
  most often in the interest of the patient.

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INTERPRETATION OF THE INVESTIGATIONS
Interpretation of the investigations is usually
in the light of

• Prognostication
• Hb in anaemia
• S. Bil, AST, ALT in
• hepatitis
• -ESR in chronic
• infections esp
• Tuberculosis
• -S. Creatinine in renal
• failure

• Diagnostic and Therapeutic
• approach
• Blood sugars in cases of Diabetes
• ECG in cases of MI
• X ray chest in pleural effusion
• CT scan in stroke patients

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USES OF INVESTIGATIONS

• Help in establishing and confirming the
  diagnosis.
• Help in staging the disease.
• Help in assessing various organ dysfunctions.
• They are the important most parameters in
  prognosticating cases.
• They help in keeping the progress record.
• Some investigations are also prove to be of a
  therapeutic value
• e.g. HSG- in cases of infertility.
• CT guided biopsy, USG guided aspiration or tap.

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GENERAL INSTRUCTIONS TO PATIENTS

• Information regarding the indications or the need
  for the investigation.
• What will the investigation yield ( positive or
  negative)
• Explain to the patient the procedure in detail (
  invasive or non invasive).
• Who will perform the test has to be explained to
  the patient
• Duration of the procedure and the cost of the
  procedure is to be explained.
• What are the side effects of the procedure
  (especially about the contrast agent that is
  being used).
• In special situations e.g. in claustrophobic
  patients going for a CT or an MRI an open machine
  can be used or the patient is to be explained
  fully and reassurance is to be given to avoid any
  difficulties during the procedure.
• For invasive procedures the consent of the
  patient is important.

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Problem oriented teaching
Balance of KNOWLEDGE CONCEPTS SKILL AT
TITUDE CORELATIONS
Homeopathic Education
Wide clinical exposure Bed side training and
skills Multi prong Evaluvation.
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