PowerPoint® to accompany
Medical Assisting
Chapter 40
Second Edition
Ramutkowski Booth Pugh Thompson Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Assisting with Examinations in the
Basic Specialties
Objectives:
401 Briefly describe the medical specialties of internal
medicine, pediatrics and obstetrics and gynecology.
402 Describe the types of examinations and diagnostic
tests performed in each of these specialties and the
medical assistant’s role in them.
403 List and describe some common diseases and
disorders seen in these medical specialties and typical
treatment for them.
2
Assisting with Examinations in the
Basic Specialties
Objectives (cont.)
404 Explain the medical assistant’s duties in assessing for
chronic fatigue syndrome.
405 Identify common signs of domestic violence and child
abuse.
406 Describe the medical assistant’s responsibilities in
performing a scoliosis examination.
407 Describe the medical assistant’s role in assisting with a
cervical biopsy.
3
Introduction
Medical practice
act is a law that
defines the exact
duties physicians
and other health
care personnel
may perform.
Medical assistants
are allowed to
perform clinical
procedures only
under the
supervision of the
physician.
Because state laws vary, you will need to know
the scope of practice for medical assistants in the
state where you work.
4
Specialty Examinations
Specialties are
physicians who have
taken additional
training beyond
medical school and
their residencies.
They must pass
rigorous examinations
in their chosen
specialty.
5
Internal Medicine
Diagnosis and treats
disorders and
diseases of the
body’s internal
organs.
They treat medical
problems with
medicine, and/or
modalities
(therapeutic agents.)
An internist can refer patients to a doctor in one of the
internal medicine subspecialties.
6
Assisting with the Physical
Examination
Usually the same as a general physical
examination.
You may be expected to assess for chronic
fatigue syndrome.
Patients must have four or more of the following:
• Impairment in shortterm memory, sore throat, muscle
pain, tender lymph nodes, multijoint pain without
swelling, unrefreshing sleep and postexertional
malaise lasting more than 24 hours.
7
Detecting Substance Abuse
Signs of abuse
Alcohol Depressed pulse
rate, respiration and blood
pressure.
Cocaine – Excitation,
increase pulse rate and
blood pressure.
Inhalants – Muscle
weakness, hearing loss,
changes in heart rate,
nausea and dizziness.
8
Detecting Domestic Violence
Report
Injuries that the patient tries to hide or excuse
Unusual bruising
Signs in a patient’s tone of voice or choice of
words
Reporting suspected domestic violence is
mandatory in some states.
Keep list of services available for patient
handy.
9
Detecting Elder Abuse
Occurs in all racial, socioeconomic and
religious groups
Risk factors:
History of alcoholism, drug abuse or violence
in the family.
History of mental illness in the abuser.
Isolation of the victim from family members.
Recent stressful events affecting the abuser or
victim.
10
Detecting Elder Abuse (cont.)
Signs of neglect:
Foul odor from the patient’s body
Poor skin color
Inappropriate clothing for the season
Soiled clothing
Extreme concern about money
11
Diagnostic Testing
Measurement of arterial blood gases
Radiologic tests
Chest xray
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Venography and venous ultrasonography
Radionuclide imaging
12
Diseases and Disorders
Diseases of Aging
Constipationdiarrhea cycle
Hyperlipidemia
Osteoporosis
Alzheimer’s diseases
Infectious diseases
Infectious mononucleosis
Lyme disease
Pneumonia
13
Sexually Transmitted Diseases
Diseases acquired through
sexual contact with an
infected person.
Candidiasis
Chlamydia
Genital herpes
Genital warts
Gonorrhea
Trichimoniasis
14
Apply Your Knowledge
What are symptoms seen in patients
who are abusing inhalants?
15
Apply Your Knowledge –Answer
What are symptoms seen in patients
who are abusing inhalants?
Inhalants users can have muscle
weakness, hearing loss, changes in
heart rate, nausea and dizziness.
16
Pediatrics
Specializes in the
health care of
children, monitoring
their development
and diagnosing and
treating their illness.
To be a good
pediatric medical
assistant, you must
first like children of
all ages.
You role as liaison
between caregiver
and physician will be
an important one.
17
Assisting with the Pediatric
Physical Examination
Ask questions about eating
habits, sleep patterns, daily
activities, immunization
schedules and toilet training.
Adolescents may be sensitive
toward rapid growth and
physical, sexual and social
development.
Calmly explain procedures and
be cheerful and mindful of a
child’s feeling.
18
Assisting with the Pediatric Physical
Examination (cont.)
Examining the Well Child
Infants need seven wellbaby
examinations during their first year
at these intervals
•
•
•
•
2 weeks,
1 month
2 month
4 month
•6 month
•9 month
•1 year
19
Assisting with the Pediatric Physical
Examination (cont.)
Examining the Well Child
Children in the second year of life should have
checkups at 15 and 18 months.
From the age of 2, children should have
checkups every year.
Follow Universal Precautions and prepare
for the physical examination the same way
you would for an adult except draping and
positioning.
20
Examining for Scoliosis
An abnormal lateral curving
of the spine into an S curve.
Appears most often in
adolescent girls.
Treatment may include
exercises, a Milwaukee brace,
surgical rod implantation.
Untreated scoliosis can cause
debilitating symptoms as the
patient matures.
21
Detecting Child Abuse or Neglect
Notice signs of physical injury
Bruises or burns
Lesions on child’s genitalia
Dirty or neglected appearance
Hunger
Extreme sadness or fear
Inability to communicate
22
Detecting Child Abuse or Neglect
(cont.)
Physician will exam for:
Internal injuries, tenderness when palpated or
auscultated
Malnutrition, tooth discoloration, unhealthy
gums
Lack of cognitive ability, dulled neurological
responses
You are legally responsible for reporting
suspected child abuse or neglect.
23
Pediatric Diseases and Disorders
AIDS
Attention Deficit Hyperactivity Disorder and
Learning Disabilities (ADH)
Cerebral Palsy
Congenital Heart Disease
Down Syndrome
Hepatitis B
Respiratory Syncytial Virus
24
Pediatric Diseases and Disorders
(cont).
Sudden Infant
Death
Syndrome
Spina Bifida
Viral
Gastroenteritis
25