1. Learning Aim B Physiological disorders and their care
Diagnosis of disease
Learning Aim B
Physiological disorders and their care

2. Diagnosis of disease: LA B
P2: Compare investigative and diagnostic procedures for different types of physiological disorders. M2: Assess the importance of specific procedures in confirming the diagnosis of physiological disorders. D2: Justify the potential benefits of different investigations of treatment options for service users with physiological disorders.

3. Definition of Diagnosis
Diagnosis: the process by which the nature of the disease or disorder is determined, based on the signs and symptoms/

4. How do GPs diagnose a disease or disorder?
What do they do?
Question the patient
Examine the patient
Do some investigations
Refer for further tests
Explain any tests
Explain any treatments
Do the paperwork

5. Questioning
Patient’s own words Uncover signs and symptoms Medical history Looking for a pattern

6. Examine the patient
Palpate Listen using stethoscope Observe Investigate

7. GP role play Read the script and information.
In pairs, play the GP or the patient.
Highlight where the GP:
Used questioning
Physical examination
Took medical history
Referred on for further tests

8. Two types Investigations
General measurements:
Taken for most patients who are unwell
Diagnostic procedures:
Specific to that body system and those signs and symptoms

9. Starter
What are the 6 general measurements you will need to discuss in your coursework for P2?
What are the differences between general investigative measurements and diagnostic procedures?

10. General measurements vs. Diagnostic procedures
Done first
Often referred to hospital or specialist clinic
Carried out by GP in the room
Specific to certain signs and symptoms
Carried out on most patients
Specific to one body system
Only needs general equipment
Needs specialised equipment

11. General measurements Looking for any abnormal readings
A baseline if the disorder progresses
Standard investigations:
Pulse rate
Blood pressure
Temperature
Respiratory rate

12. General measurements
General measurements taken to investigate physiological disorders must be reliable, valid and accurate.
It is important to:
understand the test to make sure the correct information is collected
use accurate equipment and understand how to use it safely
use the correct technique (following clinical guidelines)
explain the procedure to the service user, answer questions and provide reassurance.
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13. Pulse rate
The pulse is a wave of pressure caused by blood being pumped through the arteries by the heart. It measures how fast the heart is beating and it can be felt in any artery.
It is usual to take the pulse at the radial artery in the wrist.
In unconscious people, the carotid artery in the neck can be used.
The average adult resting pulse rate is usually between 70 and 80 beats per minute.
Babies and young children normally have a faster pulse rate than adults.
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14. Respiration rate
The respiration rate is the number of times a person takes a breath in one minute. Respiration rates can be measured by:
observing and counting the number of times a person’s chest rises and falls in one minute
putting your cheek close to the person’s nose and mouth and counting the number of breaths you feel on your cheek in one minute.
A healthy adult’s breathing rate is usually around breaths per minute.
Babies and young children have a faster breathing rate.
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15. Assignment time! BOTH disorders P2 1. Define the term diagnosis.
2. What are the differences between Investigative procedures and Diagnostic procedures?
3. Which general investigative procedures will be used by the GP at the surgery for your disorder?
4. What information will this give the GP?
*You must reference where this information has been taken from – keep a list in your Bibliography*
BOTH disorders

16. Appropriate for individual
Investigations cost money…
Staff time
Equipment
Building

17. Blood tests
General investigation Venepuncture – several ml Send away to lab at the hospital

18. Blood tests Finger prick test: Diabetes Blood coagulation
PKU heel prick test:

19. Blood tests 1 Haemoglobin Electrolytes (blood salts) Hormone levels
Anaemia
Electrolytes (blood salts)
Renal disorders, diabetes, metabolic bone disorders***
Hormone levels
Pregnancy, endocrine disorders
Blood gases, O2 and CO2
Respiratory disease

20. Blood tests 2 Specific enzyme tests Plasma proteins pH
Heart attack
Plasma proteins
Bleeding disorders pH
Renal disorders, diabetes
Blood culture: septicaemia

21. Blood tests
Blood tests are used in the diagnosis of a wide variety of physiological disorders. For example:
Blood glucose levels to diagnose diabetes.
Thyroid function tests (to measure thyroid-stimulating hormone (TSH) and thyroxine (T4) in the blood).
Erythrocyte sedimentation rate (ESR) to test for inflammatory conditions such as rheumatoid arthritis.
Prostate-Specific Antigen (PSA) test for prostate cancer.

22. P2 Question 3 6 General measurements – pulse rate etc.
Explain each one
Blood tests – for your disorder
Question 4 is coming next!

23. General measurements vs. Diagnostic procedures
Done first
Often referred to hospital or specialist clinic
Carried out by GP in the room
Specific to certain signs and symptoms
Carried out on most patients
Specific to one body system
Only needs general equipment
Needs specialised equipment

24. Diagnostic procedures
UK websites – on the NHS (NOT WebMD)
Mind map:
Scans?
Tests?
What they are and how they are done?
What results they will be expecting and the outcome?

25. Scans
Different kinds of scans are used in the diagnosis of physiological disorders. They can produce detailed images of body organs like the heart and brain or bones and joints.
For example:
Computerised Tomography (CT scans) and Computerised Axial Tomography (CAT scans) combine a series of X-rays and use computer processing to create cross-sectional images.
Magnetic Resonance Imaging (MRI scans) use strong magnetic fields and radio waves to produce detailed images.
Ultrasound scans use high frequency sound waves to create an image. An echocardiogram produces an image of the heart using sound waves.
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26. X-rays
X-rays use radiation to examine bones, joints and some body systems.
A barium X-ray is a radiographic examination that allows visualisation of the digestive tract. The barium solution can be used either orally (a Barium swallow) or rectally (a Barium enema) and is used to diagnose abnormalities such as tumours, ulcers and other inflammatory conditions.
X-rays are also used in coronary angiography. A catheter is passed into an artery in the groin or arm and guided into the coronary arteries using X-rays. A dye is injected into the catheter to highlight the arteries supplying the heart with blood.
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27. Respiratory tests
Respiratory tests are used in the diagnosis of a variety of respiratory disorders, such as asthma and Chronic Obstructive Pulmonary Disease (COPD). For example:
Spirometry measures the volume of exhaled breath (the forced expiratory volume)
Peak expiratory flow test measures how fast an individual can blow air out of their lungs (peak expiratory flow).
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28. Specialised tests (1)
A variety of other specialised tests are used in the diagnosis of physiological disorders. For example:
Electrocardiogram (ECG) records the rhythm and electrical activity of the heart. An exercise ECG test, or ‘stress test’ taken during exercise (usually on a treadmill) can help identify the symptoms of angina, which is usually a result of  coronary heart disease (CHD)
Endoscopies are tests that look inside the body. An endoscope is a long flexible tube with a tiny camera and light at one end. Endoscopies can examine the trachea (bronchoscopy); bladder (cystoscopy); bowel (colonoscopy); uterus (hysteroscopy).
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29. Specialised tests (2)
A biopsy is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease. Biopsies can be taken from various parts of the body including the liver, lung or bronchus. A bone marrow biopsy is one of the main diagnostic tests for acute myeloid leukaemia.
A lumbar puncture uses a needle to extract a sample of cerebrospinal fluid from around the spine. The fluid can then be checked for the presence of infection or cancerous cells.
A rectal exam is a manual examination of the rectum. This is an important diagnostic test for rectal or prostate cancer.
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30. Diagnostic tests
Activity sheet 14.8

31. Importance of recognising non-specific or confusing symptoms
Feel listened to
Sometimes signs and symptoms are vague
Test results can help clarify
Sometimes it can take months or even years to get a diagnosis
Lupus, ME

32. Coronary Heart Disease
Similar conditions…
Diabetes
Asthma
Bowel cancer
Parkinson's disease
Rheumatoid arthritis
Coronary Heart Disease
Type 1 / Type 2
Chronic obstructive pulmonary disease
Haemorrhoids
Essential tremor
Fibromyalgia
Gastric reflux
Chronic pancreatitis
Congestive heart failure
Irritable Bowel Syndrome (IBS)
Normal pressure hydrocephalus
Osteoarthritis
Severe indigestion

33. P2, 8. Explain how each test is carried out and in which situation it would be used.
Explain how each test works and when they would use it.
It is like a flowchart
Usually, this would be when another test hasn't conclusively shown a clear diagnosis.
So if they are still unsure they will do another test.

34. Assignment time! BOTH disorders P2
*You must reference where this information has been taken from – keep a list in your Bibliography* P2
5. Which specific diagnostic tests will they do for your disorder?
6. In which setting will the tests be carried out?
7. Why is it important to recognise non-specific or confusing symptoms?
8. Explain how each test is carried out and in which situation it would be used.
BOTH disorders