CHAPTER 42 Assisting in Other Medical Specialties 2014

CHAPTER 42 Assisting in Other Medical Specialties © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -2 Learning Outcomes (cont. ) 42. 1 Describe the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics. 42. 2 Identify common diseases and disorders related to cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics. © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -3 Learning Outcomes (cont. ) 42. 3 Relate the role of the medical assistant in examinations and procedures performed in the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics. © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -4 Introduction • The medical assistant working for a specialist will – Assist with the examinations – Assist with diagnostic testing and processing specimens – Address common concerns and questions – Perform basic administrative and clinical skills © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -5 Working in Other Medical Specialties • Allergy – Allergist – Allergies ~ inappropriate immune responses – Allergic reaction ~ inflammation and tissue damage • Local • Systemic • Anaphylaxis © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -6 Cardiology • Cardiologist – heart disease and disorders • Be familiar with – The structure of the cardiovascular system – Typical exams and measurements – Common heart diseases and treatments – Diagnostic tests © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -7 Dermatology • Dermatologists – skin diseases and disorders • Medical assistant must – Understand elements of dermatologic exams and procedures – Be familiar with skin disorders and treatments – Understand terminology © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -8 Endocrinology • Endocrinologists – diseases and disorders related to glands and hormones • Medical assistant – Assists with examinations – Collects specimens for analysis © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -9 Gastroenterology • Gastroenterologists – disorders of the GI tract, liver and pancreas • Medical assistant – Understands the basic elements of GI exam and procedures – Become familiar with GI disorders, treatments, and terminology – Patient education ~ prepares for the exams © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -10 Neurology • Neurologists – diseases and disorders of the central nervous system • Medical assistant – Assists with examination – Perform diagnostic testing – Educates patients © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -11 Oncology • Oncologist – tumors and cancerous growths • Medical assistant • Tumor – Lump of abnormal cells – Benign or malignant – Be aware of common types of cancers – Metastasis – Patient education – Carcinogenesis – Family education and support © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -12 Orthopedics • Orthopedist – disorders, injuries, and diseases of the muscular and skeletal systems • Medical assistant – General examinations – X-rays – Casting – Hot/cold treatment – Patient education © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -13 Apply Your Knowledge Match the following ANSWER: Allergist Skin cancers Cardiologist Nervous system disorders Dermatologist Joint and bone disorders Endocrinologist Vascular system disorders Gastroenterologist Hormonal imbalances Neurologist Malignant tumors Oncologist Liver & pancreas disorders Orthopedist Immune system responses P e r f e c t M a t c h ! © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Diseases and Disorders Of Medical Specialties 42 -14 • Cardiology – Cardiovascular disease • Coronary artery disease • Hypertension • Myocardial infarction – Risk factors • Inactivity • Obesity • High blood pressure • Smoking • High cholesterol • Diabetes © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Diseases and Disorders Of Medical Specialties (cont. ) 42 -15 • Cardiology – Patient education ~ prevention of heart disease, stroke, or heart attack – Diseases include • • • Arterial and vascular disorders Coronary artery disease Dysrhythmias Heart failure Inflammation of heart tissue Valvular diseases © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -16 Dermatologic Conditions and Disorders • Skin disorders include – Acne vulgaris – Contact dermatitis – Psoriasis – Ringworm – Moles – Skin cancers – Warts – Eczema © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -17 Endocrine Diseases and Disorders • Diabetes – Causes • Pancreas ~ secretes less insulin • Body ~ resistant to insulin – Hyperglycemia – Goal of treatment ~ normalize blood sugar levels © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -18 Endocrine Diseases and Disorders (cont. ) • Thyroid disorders – Hypothyroidism • Decreased activity of the thyroid gland • Underproduction of thyroxine – Hyperthyroidism ~ increased gland activity © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -19 Gastrointestinal Disease and Disorders • Document GI symptoms accurately • Common diseases and disorders – Hernia – Cholecystitis and cholelithiasis – Colitis – Constipation and diarrhea – Diverticulitis – GERD – Hemorrhoids © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -20 Neurologic Diseases and Disorders • Common diseases – Alzheimer’s disease – Bells palsy – Encephalitis – Epilepsy – Migraines – Parkinson’s disease © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -21 Neurologic Diseases and Disorders • Trauma – Loss of sensation and voluntary motion – Hemiplegia – Paraplegia – Quadriplegia • Encephalopathy – alters brain function and structure © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -22 Orthopedic Diseases and Disorders • Common diseases and disorders – Arthritis – Carpal tunnel syndrome – Dislocations, sprains, and fractures – Osteoporosis • Low back pain – Common disorder – Treatment ~ heat, analgesics, muscle relaxants, exercise, braces, traction, surgery © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -23 Apply Your Knowledge Match disorder with specialty ANSWER: A. B. C. D. E. F. C diabetes A myocarditis D GERD B acne E paraplegia F bursitis C Grave’s disease F Paget's disease D cholelithiasis B psoriasis A hypertension E Alzheimer's disease Cardiology Dermatology Endocrine GI Neurology Orthopedic Bravo! © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Exam and Procedures in Medical Specialties 42 -24 • Allergy exams and testing – medical history and diagnostic testing • Medical assistant – Assist with or perform tests – Patient education © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -25 Allergy Exams and Testing (cont. ) • Scratch test – Used to test for specific allergies – May cause discomfort and itching • Intradermal test - more sensitive than the scratch test © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -26 Allergy Exams and Testing (cont. ) • Patch test – discover the cause of contact dermatitis • RAST – measures blood levels of antibodies to specific allergens © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -27 Cardiology Exams • Auscultation – Blood pressure – Heart sounds • Electrocardiogram– measures the electrical activity of the heart • Palpation – Chest wall – Vessels in extremities © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -28 Cardiology Exams (cont. ) • Stress test – Measures response to a constant or increasing workload – Stress thallium ECG – Chemical stress test • Holter monitor – records ECG over a period of time © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -29 Radiography and Imaging Techniques • Chest x-ray • Radionuclide studies – Fluoroscopy – Venogram – Angiography © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -30 Radiography and Imaging Techniques (cont. ) • Ultrasound – reflected sound waves • Echocardiography – High-frequency sound waves – Tests structures and function of heart • Heart MRI – strong magnets and radio waves © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -31 Radiography and Imaging Techniques (cont. ) • Cardiac catheterization – Obtain blood samples – Measure pressure in the heart’s chambers – View the heart’s motion – Perform a balloon angioplasty – Insert a stent • Coronary artery bypass graft © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -32 Dermatology Exams • Whole-body skin examination – top layer of the entire surface of the skin • Wood’s light examination – skin is inspected under ultraviolet lamp in a darkened room © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -33 Endocrine Exams and Tests • Assessment – Skin condition – Weight and cardiac functioning – Physical exam ~ palpation of glands • Diagnostic urine and blood tests • Ultrasound, X-ray, and iodine scan © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -34 Gastroenterology Exams • Invasive exam procedure based on patient symptoms • Medical assistant – Provide reassurance and ensure comfort – Assist as permitted – Patient instructions © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -35 Gastroenterology Exams (cont. ) • Endoscopy – direct • Peroral endoscopy visualization of a – Esophagus body cavity – Stomach – Duodenum © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -36 Gastroenterology Exams (cont. ) • Colonoscopy – examination of the large intestine • Proctoscopy – examination of the lower rectum and anal canal • Sigmoidoscopy – examination of the sigmoid area of the large intestine © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -37 Diagnostic and Laboratory Testing (cont. ) • Lab tests – Analysis of stomach contents – Occult blood • Imaging techniques – Cholecystography • Gallbladder function test • Differentiate between bile duct obstruction and gallstones © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -38 Diagnostic and Laboratory Testing – Ultrasound – Barium swallow – esophagus, stomach, and small intestine – Barium enema – large intestine – Radionuclide imaging © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -39 Neurologic Exams and Diagnostic Testing • The neurologist evaluates – Cognitive function – Motor system – Cranial nerves – Reflexes – Sensory system © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Neurologic Exams and Diagnostic Testing (cont. ) 42 -40 • Electroencephalography (EEG) • Imaging procedures – Cerebral angiography – Brain scan – Computed tomography (CT scan) © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Neurologic Exams and Diagnostic Testing (cont. ) 42 -41 • Imaging procedures (cont. ) – Magnetic resonance imaging (MRI) – Positron emission tomography (PET scan) – Myelography – Skull X-rays © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Neurologic Exams and Diagnostic Testing (cont. ) 42 -42 • Lumbar puncture – Diagnose infection – Measure CSF pressure – Check for blood or proteins • Electromyography – neuromuscular disorders or nerve damage © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -43 Oncology Exams and Diagnostic Testing • Biopsy – Incisional or open – Needle • Medical Assistant – Standard Precautions, sterile technique – Specimen preparation and labeling – Clean and bandage site © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

Oncology Exams and Diagnostic Testing (cont. ) 42 -44 • X-rays • CT scans and MRI • Blood tests to detect tumor markers • Ultrasonography © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -45 Cancer Treatment • A combination of treatments is used • Surgery – Removal of all or part of the tumor – Most effective if tumor contained or localized • Radiation therapy – Kills or stop the growth of tumor cells – Damages cells the undergo rapid division © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -46 Cancer Treatment • Chemotherapy – Anticancer drugs administered to kill malignant cells – Used alone or in combination – Highly toxic ~ use PPE © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -47 Orthopedic Exam and Procedures • Assessment by – Inspection – Palpation – Diagnostic tests • Medical assistant – Drape – Position and support patient – Patient instructions © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -48 Orthopedic Exam and Procedures (cont. ) • Bone and muscle biopsies • Electromyography • Urine and blood tests • Radiographic exams – X-rays – CT scan and MRI – Angiography – Diskography – Arthrography – Bone scans © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -49 Orthopedic Exam and Procedures (cont. ) • Arthroscopy – View of the inside of a joint – Arthroscope • Joint replacement surgery © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -50 Apply Your Knowledge True or False: ANSWER: ___ F An ECG tests the function of the heart through reflected sound waves. echocardiogram T A scratch test uses extracts of suspected allergens to test for ___ specific allergies T An ultraviolet lamp is used in a Wood’s light examination. F A colonoscopy examines only the sigmoid portion of the colon. sigmoidoscopy T A PET scan studies the blood flow and metabolic activity of the brain. F A needle aspiration is performed using an open biopsy. needle T Arthroscopy is used to visualize the inside of a joint. © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -51 In Summary 42. 1 The medical specialties discussed in this chapter include: allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics. 42. 2 Many common diseases and disorders are identified in the specialty practices. You should have an understanding of the implications of these diseases on the patient and the necessary treatments. © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -52 In Summary (cont. ) 42. 3 Exams and diagnostic tests performed in allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, and orthopedics specialties are numerous. During most of these exams and tests, your role may include patient safety and comfort, educating the patient about the necessary preparation and the procedure, and assisting the physician © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

42 -53 End of Chapter 42 Diagnosis is not the end, but the beginning of practice. ~Martin H. Fischer © 2014 by Mc. Graw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.