Health and disease. Levels of health care. General aspects of the patient examination. Common complaints, symptoms and syndromes

Primary level

Sub-Health care centers
Primary healthcare centers

Secondary level

Sub district hospitals
Community Health centers

Tertiary level

Medical college hospitals
District hospitals

Outpatient specialist care

• Care that is more specific than basic care, requires more equipment, and is more expensive to maintain.
• Specific order time.
• Referral required.
• Occasional health care
• Specialist care. (In the case of a chronic patient)
• Close to residence.
•Specialization specific. (Internal medicine, rheumatology, neurology, etc.)

Inpatient specialist care

• It is organized at the city/county level.
• High demand for equipment and personnel, 24-hour care.
• One-day supply. The patient stays there only as long as his condition requires it.
• Referral required. Except: Traumatology, obstetrics and gynecology

Primordial prevention

Prevention of emergence of development of risk factors.

Health education and promotion

Primary prevention

Prevention of disease when risk factor is present

Lifestyle modification, immunization

Secondary intervention

Prevention of complication from occurring.

Early diagnosis and optimized care

Tertiary prevention

Prevention of disability or death

Rehabilitation

Quaternary prevention

Prevention of over diagnosis and treatment

Rehab

Physical examination

-inspection
-olphaction
-palpation
-percussion
-auscultation

Skin color

• Ash gray, sweaty: heart attack, shock Skin color:
• Grey-pale, no sweat: kidney disease
• White-pale: anemia
• Yellow-pale: liver disease,
• Red, hot, sweaty: hypoglycemia
• Red, dry: CO poisoning, cyanide poisoning
• Cyanotic (bluish-purple discoloration): lack of oxygen

Skin turgor

• Decreased: Exsiccosis (dehydration), old age
• Edema (water): heart failure, kidney disease, etc

Skin temperature

Warm: fever, hyperthyroidism
Cool: cooling down, stress, hypothyroidism

SMELLING

• Patients with kidney failure often smells like urine.
• Liver patients emit a sweet, aromatic odor.
• In poorly adjusted diabetics: the breath smells of acetone

Dull tapping sound: high, soft, short

muscle, dense organs (liver, spleen), fluid accumulation, airless lungs

Resonant tapping sound: deeper, louder, long sounding

Healthy lungs

Tympanic tapping sound: higher than sharp and musical in character

Air containing organs, (stomach, intestine) pneumothorax

Fevers

• Fever (subfebrile) up to 38 ℃
• Moderate fever up to 39 ℃
• High fever between 39-40 ℃
• Hyperpyrexia above 40℃
• Hypothermia below 35℃