Clinical diagnostics of internal diseases

Subject and Tasks of Propaedeutics

The discipline serves as the basis for studying cardiology, gastroenterology, pulmonology, and other clinical fields. A physician must not only identify pathology but also understand all the nuances of its development.

Key learning objectives include:

• Mastering history taking (anamnesis collection) as the primary source of baseline data.
• Mastering physical examination methods (inspection, palpation, percussion, auscultation).
• The skill of interpreting laboratory and instrumental tests.
• The ability to formulate a diagnosis from an initial hypothesis to a final conclusion.
• Developing deontological skills to build a trusting relationship with the patient.

Information gathering: goals and features

Patient interview is a subjective method that depends on the physician's experience. To make its results objective, medical documentation must contain only facts, avoiding premature conclusions and emotions. This enables other physicians to independently assess the patient's condition. The research structure in a broad sense includes questioning, observation (of intonation, facial expressions), and recording the anamnesis.

Five tasks are solved during information gathering:

1. Diagnostic — searching for facts to establish a diagnosis.
2. Prognostic — assessing the potential severity of the disease.
3. Source search — identifying those who can provide additional information (relatives, colleagues, other physicians).
4. Deontological — achieving compliance and trusting contact.
5. Psychological — understanding the "internal picture of the disease" (the person's attitude toward their condition).

Stages and structure of diagnosis

The diagnostic process in Russian medicine traditionally consists of sequential steps: data collection $\rightarrow$ analysis and integration into syndromes $\rightarrow$ generation of a hypothesis $\rightarrow$ differential diagnosis $\rightarrow$ formulation of a detailed diagnosis.

Two types of diagnosis are distinguished:

• Preliminary. Based on initial examination and interview. Necessary to outline a plan for further instrumental and laboratory studies.
• Clinical (final). Based on the totality of all clinical and supplementary (special) data. Serves as the basis for prescribing treatment.

Both types of diagnosis share a single structure:

1. Primary disease.
2. Complications of the primary disease.
3. Comorbidities.

Class and exam questions

What else to study on this topic

• Methodology of anamnesis collection and its types
• Basic principles of physical examination (inspection, palpation, percussion, auscultation)
• The role of laboratory and instrumental research methods
• Differential diagnosis algorithm

Other topics in the "Additional Topics" section

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.