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1、INTRODUCTIONTOINTERNALMEDICINEJiyaoWang,MD.MSC.Professor&ChairDept.ofInternalMedicineShanghaiMedicalCollege,FuDanUniversityInternalMedicineSurgeryPediatricsgynecologyPathologyMicrobiologyGeneticsBiochemistryPharmacologyPathologic-physiologyDiagnosticsImmunologyHowtolea
2、rn1.Tocombineinternalmedicinewithbasicscientificknowledge2.TocombinetheorywithpracticeLecturesIntroductionPathogenesisPathologyPathophysiologyClinicalfeaturesDiagnosisTreatment,PreventionBasictheoryBasicknowledgeEssentialskillBedsideTeachingWhatisexpectedofthephysician
3、Nogreateropportunity,responsibility,orobligationcanfalltothelotofahumanbeingthantobecomeaphysician.Tact,sympathyandunderstandingareexpectedofphysician.TebeagoodDoctorInthecareofthesuffering,physicianneedstechnicalskill,scientificknowledge,andhumanunderstanding.Thecombi
4、nationofmedicalknowledge,intuition,experience,andjudgmentdefinestheartofmedicine,whichisessentialtothepracticeofmedicine.Thepatient-physicianrelationshipPhysiciansneedtoapproachpatientsnotas“cases”or“diseases”,butasindividualswhoishuman,fearful,andhopeful,seekingrelief
5、,helpandreassurance.Idealpatient-physicianrelationshipBasedon:ThoroughknowledgeofthepatientMutualtrustAbilitytocommunicateClinicalSkillsTakinginformativehistory;Performingthoroughphysicalexamination;Usingdiagnostictoolsjudiciously,alwaysaskingwhethertheresultswillalter
6、themanagementandbenefitthepatient.HistorytakenInlisteningtothehistory,thephysiciandiscoversnotonlysomethingaboutthediseasebutalsosomethingaboutthepatient.Theprocessofhistory-takingprovidesanopportunitytoobservethepatient'sbehaviorandtowatchforfeaturestobepursuedmore.th
7、oroughlyduringthephysicalexamination.TodevelopeffectivereasoningskillsInformationgathering(informativehistory,thoroughphysicalexamination)ProblemsynthesisHypothesisgenerationDecisionmakingEssentialskillLearningofEssentialSkillsInquiryskillsThinkingskillsProblemsolvings
8、killsEssentialskillDealingwithclinicalproblemsMakingdiagnosisIdentifytheseverityofthediseaseAccordingtotheseverityofd
