Name : Siti mariyam

Npm : 18310154
Class : ME 2

Understanding Language Focus Investigation

1. How does the doctor explain when the doctor is going to do and why on the investigation
at the first time?

“ Now I’m going to take some fluid off your back to find out what’s giving you these
headaches”

For the first time the investigation is carried out to establish a differential diagnosis first,
then provide informed consent to carry out the supporting examination stage according to
the symptoms experienced by the patient and then the results are obtained as a diagnosis
of the disease the patient is experiencing.

2. How does the doctor instruct the patient to take up the correct position?
“Now i want you to move right to the edge of the bed”
3. How does the doctor reassure the patient about the investigation?
“It won’t take very long”
“Now i’m going to give you a local anaesthetic so it won’t be sore”
4. How does the doctor combine reassurance with a warning in a sternal marrow
investigation?
“It shouldn’t be painful, but you will be aware a feelling of pressure”
“This may feel a little bit uncomfortable, but it won’t take long”
5. How do you know about a Lumbar Puncture on Meningitis?
Spinal tap (lumbar puncture). For a definitive diagnosis of meningitis, you'll need a
spinal tap to collect cerebrospinal fluid (CSF). In people with meningitis, the CSF often
shows a low sugar (glucose) level along with an increased white blood cell count and
increased protein.
In most cases lumbar puncture confirms or excludes bacterial meningitis. These children
have clinical signs of meningitis or septicaemia (rash) and should receive antibiotics in
spite of a “normal” cerebrospinal fluid.
6. What do you think of ECG on Myocardial infarction?
ECG Manifestations of Acute Myocardial Ischaemia (in Absence of LVH and LBBB)
are :
 ST elevation
New ST elevation at the J-point in two contiguous leads with the cut-off
points: ≥0.2 mV in men or ≥ 0.15 mV in women in leads V2–V3 and/or ≥ 0.1
mV in other leads.
 ST depression and T-wave changes.
New horizontal or down-sloping ST depression >0.05 mV in two contiguous
leads; and/or T inversion ≥0.1 mV in two contiguous leads with prominent R-
wave or R/S ratio ≥ 1.
 A study using MRI to diagnose myocardial infarction has shown that more
emphasis on ST segment depression could greatly improve the yield of the
ECG in the diagnosis of myocardial infarction (sensitivity increase from 50%
to 84%).
7. Could you explain about Barium Meal on Duodenal Ulcer?
For diagnosis of gastric ulcer barium meal can be performed. this is not at all
uncomfortable and involves no risk. the patient is made to swallow a white chalky
substance called barium that is visible on x-ray and then patient is made to lie down on a
tilted examining table. the tilting distributies the barium evenly around upper digestive
tract and x-ray can capture images at different angles. this allows the doctor to locate the
ulcer and to determine its type and severity. in almost 20% cases these x-rays do not
detect ulcers.
Sensitivity of barium contrast studies is higher for detection of duodenal than for gastric
ulcer. radiological findings of duodenal ulcer include filling defects of duodenal bulb.
8. How do you know about Crosby Capsule on Coeliac Disease?
The Crosby–Kugler capsule, also called the Crosby capsule, is a device used for
obtaining biopsies of small bowel mucosa, necessary for the diagnosis of various small
bowel diseases. This capsule was originally invented by Dr. William H Crosby to assist
in diagnosing Coeliac disease.
9. Can you explain the function of Ultrasound Scan on a Baby Small for dates 32 weeks?
Growth scan 32 weeks
If you measure 30cm (12in) or less at 32 weeks, or your customised results are below
your range, your midwife may offer you an ultrasound scan to be on the safe side. This
type of scan is called a growth scan. It's a more accurate way of measuring your baby's
growth than running a tape measure over your bump.
10. How do you think of Myelogram on Prolapsed Invertebral Disc?
All myelograms were done in the prone position. The free flow of a contrast medium was
seen up to the lower dorsolumbar region under the fluoroscope. Anteroposterior, lateral,
right and left oblique views at 45° and 60° were taken at the required levels. No x-ray
film was taken in the sitting position. The criteria for diagnosing disc prolapse are
angular indentation of the anterior or anterolateral aspect of the thecal sac opposite the
disc space, nerve root sheath amputation, and deviation suggestive of root compression.
Narrow dural sac and hourglass deformity at multiple levels are reliable signs of lumbar
stenosis. These strictures like defects are produced due to the narrowing of the spinal
canal by hypertrophied articular processes, thick ligamentum flavum, and capsular
ligaments.Blocks are produced either by extradural prolapsed disc, intradural tumours or
ruptured intradural disc. Striation of contrast has been attributed due to oedematous
nerves roots in the dural sac. Lateral indentation is a common myelographic defect but
all dents are not symptomatic.