Principles of Diagnosis
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disease |
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lesions | well-defined, characteristic structural changes present in various organs/tissues
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disease is often associated with | lesions
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gross examination | examining with naked eye
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histological examination | exam with aid of microscope
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lesions can be recognized by what type of exam? | gross or histological
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specialized studies | supplement to histological exam, which evaluates properties of cell membranes & proteins within cell
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organic disease | associate with structural changes
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functional disease | no morphological abnormalities even though body functions may be profoundly disturbed
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pathology | study of disease
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pathologist | physician specializing in diagnosing & classifying diseases
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pathologists diagnose & classify diseases by examining the ___ of cells & tissues. | morphology
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symptoms of a disease | subjective manifestations in an affected individual
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signs of a disease | objective manifestations, detectable by clinician; physical findings
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abnormal lab test results | changes in quantity of circulating blood, or to biochemical constituents in blood fluids
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asymptomatic disease/illness | disease causing no discomfort/disability to affected individual
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in its early stages a disease is often | asymptomatic
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distinction between asymptomatic/symptomatic disease is one of degree depending | primarily on extent of disease
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etiology | cause, especially the cause of a disease
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disease of unknown etiology is one | for which the cause is not yet known
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etiological agent | agent responsible for cause of disease
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pathogenesis | manner by which disease develops
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pathogen | any microorganism that causes development of a disease
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lesions produced by various disease in a category are | morphologically similar or have similar pathogenesis
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congenital & hereditary diseases | result of a range of developmental disturbances
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inflammatory diseases | body reacts to injurious agent by means of inflammation
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sore throat or pneumonia, as an inflammatory disease, are caused by | bacteria or other microbiological agents
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as an inflammatory disease "hay fever" is | a manifestation of an allergic reaction or hypersensitivity state in the patient
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caused by antibodies formed against the patient's own tissues | inflammatory autoimmune diseases
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primary abnormality is degeneration of various parts of the body | degenerative diseases
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these are more advance/occur sooner that normal if age related & distinctly abnormal | degenerative lesions
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certain types of arthritis & arteriosclerosis are common examples of | degenerative diseases
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chief disturbance in some important metabolic process in the body | metabolic diseases
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common examples of metabolic diseases are | diabetes, disturbances of endocrine glands & electrolyte balances
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characterized by abnormal cell growth leading to formation of various benign/malignant tumors | neoplastic diseases
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goal of traditional medicine | cure or ameliorate disease
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health | condition in which mind/body function efficiently & harmoniously as integrated unit
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diagnosis | determination of nature & cause of patient's illness
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the diagnosis is based on | practitioner's evaluation, patient's subjective symptoms, physical findings & results of various lab tests
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prognosis | opinion concerning eventual outcome of disease/disorder; outlook for recovery
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history of present illness elicits details concerning | severity, time of onset & character of patient's symptoms
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past medical history provides details of | patient's general health & previous illnesses
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family history provides information about | health of parents & other family members
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social history deals with | patient's occupation, habits, alcohol & tobacco consumption & similar data
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review of symptoms inquires as to presence of symptoms other than | those disclosed in history of present illness
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possible dysfunctions of other organ systems are evaluated by | systematic inquiry
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physical examination | systemic evaluation of patient
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differential diagnosis the practitioner considers | number of diseases characterized by patient's symptoms
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practitioner can narrow list of diagnostic possibilities to arrive at correct diagnosis by | using selected lab test or other specialized diagnostic procedures
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medical consultant | physician with specialized training & experience in type of medical problems presented by patient
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disease-management team | composed of group of persons with special skills useful to care/treatment of patients with the diseases
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specific treatment | exerts highly specific & favorable effect on basic cause of disease
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symptomatic treatment | alleviates symptoms but doesn't influence course of underlying disease
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screening tests for disease are important because many diseases respond to treatment | are asymptomatic initially
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when left untreated the disease often progresses slowly causing | gradual but progressive organ damage until person is seriously ill with far advanced organ damage from the disease
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treatment of late-stage disease is often much less effective and may not be able to | restore function of organs that have been damaged
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disease-related organ damage can be prevented or minimized if | identified & treated in its asymptomatic stage
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a successful screening program should include | significant # of persons in group being screened are at risk for the disease
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a successful screening program should be | relatively inexpensive test not yielding excessive # false-positive/false-negative results in screening for the disease
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a successful screening program should provide for | early identification & treatment of disease with favorable influence on health/welfare of persons with the disease
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screening tests should target | group of persons with relatively high frequency of disease & age group disease likely to be present
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screening groups of persons for a disease in early asymptomatic stage requires | type of test that can identify characteristic manifestation of the disease
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false-positive | test is positive when no disease is present
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less sensitive screening tests can yield an excess | of false-negative results
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false-negative | test is negative when disease is present
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screening test results should | provide some benefit to the person being screened
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there is no point in screening for a disease if | there is no treatment available to arrest progression of disease
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cost-effective screening test for diabetes | urine test to detect glucose in urine
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cost-effective screening test for colon tumors | tests to detect blood in stools
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cost-effective screening test for abnormalities in epithelium of uterine cervix that is predisposed to cancer | Papanicolaou smear (Pap tests)
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cost-effective screening test for very early breast cancer at stage when can be treated most effectively | mammograms - breast x-ray examinations
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can also be used to screen for carriers of some genetic diseases | screening tests
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screening tests to identify genetic disease trait carriers allows for | persons to make decisions about future childbearing or management of future pregnancy
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invasive procedures | patient's body is actually "invaded" in some way in order to obtain diagnostic information
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noninvasive procedures | entail minimal/no risk/discomfort to patient in order to obtain diagnostic information
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with any diagnostic procedure the practitioner must | possible disadvantages to patient vs. benefits derived from info obtained during procedure
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it would be unwise to perform a potentially risky diagnostic procedure if | info gained would not significantly contribute to diagnosis or influence course of treatment
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can be used to determine the concentration of various constituents in the blood/urine frequently altered by disease | clinical lab tests
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using clinical lab tests could determine concentration of urea in blood to diagnose | kidney function issues
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clinical lab tests can detect concentrations of hemoglobin & quantity of reduced red cells in | patients with anemia
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clinical lab tests can determine concentration (activity) of | enzymes in blood
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enzyme levels in blood can be elevated, and detected with clinical lab tests, due to | enzymes leaking from diseased/injured organs
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when enzyme synthesis is increased as a result of disease | enzyme levels in blood can be elevated & detected with clinical lab tests of blood
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when there is elevated enzyme levels in clinical lab tests of blood, it can indicate | excretion of enzymes impaired due to blockage of normal excretory pathways by disease
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clinical lab tests may also be used to | evaluate function of organs
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clearance tests | measure rate at which a substance is removed from blood & excrete in urine
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provides a measure of renal function | clearance tests
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pulmonary function tests | measure rate at which air moves in/out of lungs
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determination of concentration of O2 & CO2 in blood can also indicate | pulmonary function
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simple device applies to finger can rapidly calculate the amount of O2 carries by hemoglobin as another | measure of pulmonary function
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measure of liver function | tests that measure uptake & excretion of various substances by the liver
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serial analysis of liver uptake substances can be used to monitor | response of certain tumors to treatment
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microbiological tests | detect presence of disease-producing organisms in urine, blood & feces
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determine responsiveness of organisms to antibiotics | microbiological tests
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serologic tests | detect & measure presence of antibodies as indication of response to infectious agents
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ECG, EEG, & EMG are | tests measuring electrical impulses associated with various bodily functions/activities
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the most widely used test of electrical activity is | the ECG (electrocardiogram)
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ECG (electrocardiogram) | electrodes measure serial changes in electrical activity of heart during various phases of cardiac cycle
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identifies disturbances in heart rate/rhythm & abnormal conduction of impulses through heart | ECG (electrocardiogram)
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heart muscles injury (i.e. heart attack) can be recognized by means of | characteristic abnormalities in cardiogram
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EEG (electroencephalogram) | measures electrical activity of brain via electrodes attached to various areas on scalp
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EEG can detect | brain tumors, strokes, & many abnormalities of cerebral structure/function
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EMG (electromyogram) | measures electrical activity of skeletal muscles at rest & at contraction
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EMG detects abnormal electrical activity often encountered in | various inflammatory/degenerative diseases involving skeletal muscles
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radioisotope (radionuclide) studies | evaluates function of various organs by administering radioisotope
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radioisotope | substance labeled with radioactive material
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specially processed albumin labeled with radioisotope is administered intravenously as | measure of pulmonary blood flow; used frequently to detect blood clots in lung
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phosphorus containing isotopes are concentrated in | skeletal system; can detect deposits of tumor in bones
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using radioactive material injected intravenously can be used to evaluate | blood flow to heart muscle & identify areas of damaged heart muscle
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endoscopy | exam of interior of body by means of various flexible/rigid tubular instruments
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endoscopic tubular instruments are named according to | part of body designed to examine
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esophagoscope | used to examine interior of esophagus
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gastroscope | used to examine interior of stomach
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bronchoscope | used to examine interior of trachea & major bronchi
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cystoscope | used to examine interior of bladder
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sigmoidoscope | rigid tube used to examine rectum & sigmoid colon
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colonoscope | flexible tube used to examine entire length of colon
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laparoscope | used to visualize abdominal & pelvic organs
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laparoscopy | procedure used to visualize abdominal & pelvic organs
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laparoscopy can be used to visualize abdominal & pelvic organs and also | perform various surgical procedures to excise tissues/organs formerly removed through much larger incisions
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ultrasound | technique for mapping echoes produced by high-frequency sound waves transmitted into the body
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ultrasound is widely used during pregnancy to | study uterus, position of placenta & fetus within uterus, identify fetal abnormalities & detect twins
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using ultrasound to study structure/function of heart valves can detect | valve abnormalities & identify blood clots in association with infection of the valve
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X-ray examination | x-rays are passed through the part of the body to be examined & rays leaving body expose an x-ray film
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extent to which x-rays are absorbed by tissues as they pass through body depends on | density of tissues
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during x-ray exams, tissues of low density appear as | black
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during x-ray exams, tissues of high density appear as | white
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during x-ray exams, tissues of varying densities appear as | varying shades of gray
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roentgenogram (radiograph) | x-ray image produced on the film
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a contrast medium is needed when using x-ray to examine | intestinal & urinary tract, bronchi, fallopian tubes & biliary tract
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contrast medium | dense radiopaque substance that enhances visibility
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administered when x-ray examination of linings of internal organs that have little contrast | contrast medium
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this is necessary in order to x-ray exam interior of gastrointestinal tract | suspension of barium sulfate to swallow or administer as an enema
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bronchogram | visualizing lining of bronchi by instilling radiopaque oil into bronchi
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intravenous pyelogram (IVP) | radiopaque substance injected into vein & excreted in urine as blood flows through kidney outlining contour of urinary tract
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retrograde pyelogram | cystoscope introduced into bladder & dye introduced directly into ureters
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arteriogram or angiogram | dye injected to study blood flow of lrg arteries & identify areas of obstruction
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using arteriography is often used to detect | narrowing/obstruction of coronary &/or carotid arteries which carry blood to brain
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obstruction of pulmonary arteries by blood clots can also be identified by | arteriography
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cardiac catheterization | study flow of blood through heart & can detect abnormal communications between cardiac chambers
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CT (computed tomography) scan | highly sophisticated x-ray machine produces images of body in cross section by rotating x-ray tube around patient at various levels
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in CT scans the amount of radiation absorbed is not read on an x-ray film; instead | radiation detectors fed into computer that reconstructs data into images of patient's anatomy
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abnormalities of internal organs that cannot be identified by standard x-ray exams can | often be identified with CT scans
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increases in used of CT scans in recent years has been used in screening | asymptomatic persons for lung/colon tumors & screening studies in children
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due to increased exposure to radiation in CT scans this is a comparable alternative exam | ultrasound exam
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magnetic resonance imaging (MRI) | produces computer-constructed images of various organs/tissues
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MRI scans depend on response of | hydrogen protons contained in water molecules when placed in a strong magnetic field
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in MRI scans, when a pulse of radiofrequency waves is directed at the protons they are | temporarily dislodged from their orientation, then when return to original position emit signal (resonance) measured & used to produce image
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MRI is useful in demonstrating areas where myelin sheaths of nerve fibers have been damaged in a neurological disease called | multiple sclerosis
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positron emission tomography (PET scan) | related to radioisotope studies but more complex/sophisticated & one of newest diagnostic imaging tests
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positrons | unique subatomic particles that have same mass as electrons but carry positive charge
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positrons are formed when | atoms are bombarded in cyclotron which high-energy particles, which breaks down atomic nuclei & releases positrons along with other subatomic particles
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when escaping positrons collide with negatively charged electrons circling nuclei they | produce radiation that can be detected & measured by sensitive radiation detectors
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PET scan studies provide information on | metabolic activities of organ/tissue being studied, site within organ where compound is being metabolized & blood flow to organ being studied
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major clinical application for PET scans is | to assess biochemical functions within in the brain
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PET scans are able to measure changes in brain functions associated with | strokes, brain tumors, Alzheimer disease, Parkinson disease, & some degenerative hereditary diseases of nervous system
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A disease in which no morphologic abnormalities can be identified, despite a disruption of bodily function, is | Functional Disease
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physician who specializes in the diagnosis and classification of disease is | pathologist
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A disease caused by chromosomal damage at birth would be classified as | congenital
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A young woman has a benign growth of cells on her thymus. This patient's condition would be classified as | neoplastic disease
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The opinion of a physician concerning the origins of a disease in a patient is called | etiology
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A physician examines a patient and determines that the origin of the patient's condition was a Giardia infection caused by drinking contaminated water. The physician's evaluation is called | an etiology
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A diagnostic test that measures an organ or system's uptake and excretion through the use of a radioactive material is | radioisotope
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Examining diseased tissue with the naked eye is called a ________ examination | gross
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esophagoscopes, gastroscopes, cystoscopes, and sigmoidoscopes are all tools used for | endoscopy
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A computed tomographic scan is a type of | x-ray machine
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The major clinical use of PET scans today is to examine the | brain
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An MRI scan uses a magnetic field to align hydrogen protons | within the water that naturally composes the patient's tissues
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Common types of cytologic and histologic examinations include | pap smear & biopsy
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genetic abnormalities, abnormalities in #/distribution of chromosomes, intrauterine injury resulting of various agents, or interaction of environmental/genetic factors | congenital/hereditary diseases
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Created by:
lfrancois
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