物理治療鑑別診斷(一)
Differential Diagnosis for Physical Therapists (I)
| 節 | 週二 |
|---|---|
3 10:10–11:00 | 物理治療鑑別診斷(一) YB602 2 節連堂 |
4 11:10–12:00 |
* 根據陽明交大上課時間表所列
1. 醫學篩檢原則 2. 實驗診斷數據判讀 3. 各系統主訴症狀鑑別評估 4. 各系統篩檢評估技巧練習 5. 紅旗現象 6. 常見慢性疾病之辨識 1. Medical Screening Principles 2. Interpretation of medical and laboratory test results 3. Differential diagnosis for symptoms and signs involving multiple systems and/or body regions 4. Evaluation of multiple systems and/or body regions 5. Red flags 6. Recognition of common chronic diseases
本課程目的於讓學生具備知識和專業技能,以有效地篩檢全身性疾病,解釋臨床發現,並從個案之症狀或醫學診斷中,鑑別評估其與動作損傷之相關問題,並做出合理的臨床判斷,以啟動物理治療介入;當患者問題超出物理治療專業處置範圍時,則必須能夠執行適當的轉診。 學生在修習完本課程後,應具有以下能力: 1. 能描述個案訪談的重要性,在病史蒐集過程中,並能使用關鍵問題與症狀報告做判斷 2. 能針對臨床症狀執行評估,鑑別出個案之紅旗現象或嚴重醫療問題 3. 能做出醫療轉診判斷,並確定轉診的緊急程度 4. 能辨識疼痛牽連模式,判斷它們起源於內臟器官或是肌肉骨骼疾病 5. 能熟練地執行身體各系統之醫學篩檢評估 6. 能解釋醫學檢查結果 This course will introduce the knowledge and professional skills the students need to competently screen for systemic diseases, interpret clinical findings and differentially diagnose movement related impairments from medical conditions. This course enables the student to make sound clinical judgment for initiating a physical therapy intervention or making the appropriate decision regarding the next step of referral when the client condition is beyond the scope of physical therapy practice. Upon completing this course, the student will be able to: 1. Describe the importance of the patient interview and highlight key questions/symptom reports that aid the information gathering process 2. Screen for signs and symptoms indicative of red flags or serious medical disorders 3. Identify situations that require a medical referral and determine the urgency of such referral 4. Identify pain referral patterns and determine if they are consistent with internal organ involvement versus musculoskeletal pathology 5. Demonstrate proficiency in physical examination components for multiple systems and/or body regions 6. Interpret medical examination findings
小考、課堂表現、分組報告
| 週次 | 主題 |
|---|---|
| 第 1 週 | 10:00-12:00 Medical Screening Principles 醫學篩檢原則 |
| 第 2 週 | 無課 |
| 第 3 週 | Interview skill and communication (including culture competence) 問診技巧與溝通 |
| 第 4 週 | 1.Chief complaints: headache, dizziness, syncope 主訴:頭痛、頭暈、昏厥 2.Evaluation of nervous system and vestibular system: lab 神經系統、前庭系統篩檢評估(含顱神經檢查):技巧練習 3.Team-based learning: differential diagnosis case study 團隊合作學習案例:神經系統案例鑑別診斷 |
| 第 5 週 | 無課 |
| 第 6 週 | 1.Chief complaints: edema, palpitation, angina 主訴:水腫、心悸、心絞痛 2.Evaluation of circulatory system: lab 循環系統篩檢評估:技巧練習 3.Team-based learning: differential diagnosis case study 團隊合作學習案例:循環系統案例鑑別診斷 |
| 第 7 週 | 1.Chief complaints: chest pain, cough, dyspnea 主訴:胸痛、咳嗽、喘息 2.Evaluation of organs in the thoracic cavity: lab 胸部器官篩檢評估:技巧練習 3.Team-based learning: differential diagnosis case study 團隊合作學習案例:呼吸系統案例鑑別診斷 |
| 第 8 週 | 清明節 放假一天 |
| 第 9 週 | 無課 |
| 第 10 週 | 1.Chief complaints: abdominal pain, diarrhea, constipation 主訴:腹痛、腹瀉、便秘 2.Evaluation of organs in the abdominal cavity: lab 腹部器官篩檢評估:技巧練習 3.Team-based learning: differential diagnosis case study 團隊合作學習案例:消化系統案例鑑別診斷 |
| 第 11 週 | 無課 |
| 第 12 週 | 1.Chief complaints: dysmenorrhea, vaginal bleeding, hematuria, proteinuria, pollakisuria 主訴:月經痛、陰道出血、血尿、蛋白尿、頻尿 2.Evaluation of genitourinary system: lab 泌尿生殖系統篩檢評估:技巧練習 3.Team-based learning: differential diagnosis case study 團隊合作學習案例:泌尿生殖系統案例鑑別診斷 |
| 第 13 週 | 無課 |
| 第 14 週 | Interpretation of medical and laboratory test results 實驗診斷數據判讀(含健康檢查數據判讀) |
| 第 15 週 | 1. Chief complaints: insomnia, red eye, pruritus, leg cramp 主訴:失眠、紅眼症、皮膚癢、腿抽筋 2. Red flags: fever, fatigue/malaise, unintentional weight loss, epistaxis 紅旗現象:發燒、倦怠、不明原因體重減輕、流鼻血 |
| 第 16 週 | 期末考:分組報告 Recognition of common chronic diseases: diabetes mellitus, dyslipidemia, hyperuricemia and gout, metabolic syndrome, chronic kidney disease, sarcopenia, menopausal syndrome, osteoporosis 常見慢性疾病之辨識:糖尿病、高血脂、高尿酸血症與痛風、代謝症候群、慢性腎病、肌少症、停經症候群、骨質疏鬆症 |
| 第 17 週 | |
| 第 18 週 |
1. Goodman and Snyder: Differential Diagnosis for Physical Therapists- Screening for Referral. 6th edition, WB Saunders, 2017. 2. 家庭醫師臨床手冊,第四版,臺灣家庭醫學醫學會,2017。