DIAGNOSTIC EVALUATION
Names:
Sara Álvarez.
Karen Benavides.
Leslie Cushqui.
Lady Medina.
Alexandra Verdesoto.
Nataly Vinueza.
Course: 10th “A”.
Date: 28/03/2025.
QUESTIONS:
1) Describe the key components of an effective medical interview. What specific skills are essential for establishing rapport with the patient and ensuring accurate information gathering.
An effective medical interview requires clear communication, empathy, and an organized structure. It is essential to start with a cordial introduction to build trust. Active listening and open-ended questions help gather detailed information, while directed questions clarify data without influencing responses. Validating the patient’s emotions and rephrasing information improves understanding. Finally, summarizing key findings ensures the accuracy of medical history and facilitates decision-making.
2) Consider a scenario where a patient is reluctant to share personal health information. What strategies would you employ during the interview to encourage openness and facilitate effective communication?
If a patient is reluctant to share information about his or her health, it is essential to implement strategies that facilitate open and effective communication. First, strengthening the doctor-patient relationship through confidentiality and empathy creates an atmosphere of trust. Body language, eye contact and active listening are key tools to promote good dialogue, and using clear language and avoiding technicalities reduces anxiety and improves understanding. If resistance persists, indirect approaches, such as addressing general health issues before dealing with sensitive topics, can be helpful. Finally, highlighting the positive impact of honest communication on diagnosis and treatment motivates the patient to be collaborative.
PHYSICAL EXAMINATION
QUESTIONS:
3) Describe the significance of auscultation during a physical examination. What specific techniques should be used when auscultating the heart and lungs, and what key findings would you listen for?
Auscultation is essential for evaluating the circulatory, respiratory, and gastrointestinal systems. By using a stethoscope, clinicians can assess organ function, identify pathological conditions, and make informed decisions. In cardiac auscultation, the diaphragm detects high-pitched sounds (S1, S2, murmurs), while the bell captures low-pitched ones (S3, S4). All four valve areas should be examined. For pulmonary auscultation, a systematic comparison of both sides helps detect breath sounds, wheezes, or crackles. Normal lung sounds include vesicular, bronchovesicular, bronchial, and tracheal, while abnormal ones include crackles, wheezes, rhonchi, and pleural rub. Cardiac abnormalities such as murmurs, extra heart sounds, rubs, and clicks may indicate valve disease, heart failure, or pericarditis.
4) Explain the importance of inspecting the skin during a physical examination. What specific signs or abnormalities should you look for, and how might these findings guide your differential diagnosis?
Skin inspection is key to the physical examination, as it provides signs of systemic diseases. Color, texture, temperature, and lesions should be assessed. Relevant findings include pallor or cyanosis (anemia, hypoxia), jaundice (liver disease), rashes (infections, allergies), ulcerated lesions (cancer, infections), petechiae or ecchymoses (hematologic disorders), and edema (venous insufficiency, autoimmunity). These signs help guide the differential diagnosis and determine further testing.