Chapter 9 - Assisting with highly specialized examinations. After you have mastered the material in this chapter, you will be able to: Discuss the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, ophthalmology, orthopedics, otology, surgery, and urology; describe the types of examinations and diagnostic tests performed in each of these specialties and the medical assistant’s role in these examinations and tests;...
CHAPTER Assisting with Highly Specialized Examinations © 2011 The McGraw-Hill Companies, Inc All rights reserved 92 Learning Outcomes 9.1 Discuss the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, ophthalmology, orthopedics, otology, surgery, and urology 9.2 Describe the types of examinations and diagnostic tests performed in each of these specialties and the medical assistant’s role in these examinations and tests 9.3 Identify the most common diseases and disorders seen in these medical specialties and typical treatments for them © 2011 The McGraw-Hill Companies, Inc All rights reserved 93 Learning Outcomes (cont.) 9.4 Carry out the procedure for assisting the physician in performing a scratch test 9.5 Carry out the procedure for assisting with a sigmoidoscopy 9.6 Prepare the ophthalmoscope for use 9.7 Carry out the procedure for assisting with a needle biopsy © 2011 The McGraw-Hill Companies, Inc All rights reserved 94 Introduction • Many physicians choose to specialize • The medical assistant working for a specialist will – Assist with the examinations – Assist with diagnostic testing and processing specimens © 2011 The McGraw-Hill Companies, Inc All rights reserved The Medical Assistant’s Role in Specialized Examinations 95 • Physicians that specialize focus on one body system, a single type of disease, or medical intervention • Medical assistant role – General administrative and clinical tasks – Assist with examinations and procedures – Communicate with and educate patients © 2011 The McGraw-Hill Companies, Inc All rights reserved 96 Allergy • Allergist – diagnoses and treats allergies • Allergies – inappropriate immune system responses to normally harmless substances • Allergen – substance that causes an allergic reaction • Allergic reactions may be localized or systemic Anaphylaxis life-threatening allergic reaction â 2011 The McGraw-Hill Companies, Inc All rights reserved 97 Allergy Examinations • Involves a medical history and diagnostic testing • You must understand the function of the immune system and how allergies are treated – Allergen avoidance – Medications – Desensitization to a substance © 2011 The McGraw-Hill Companies, Inc All rights reserved 98 Allergy Testing • Scratch test – Used to test for specific allergies – May cause discomfort and itching • Intradermal test – A dilute solution of allergen into the skin – More sensitive than the scratch test • Patch test – A linen or paper patch is soaked with an allergen – Contact dermatitis • RAST – Measures blood levels of antibodies to specific allergens © 2011 The McGraw-Hill Companies, Inc All rights reserved 99 Apply Your Knowledge How does the medical assistant participate in specialty examinations? ANSWER: The medical assistant performs general administrative and clinical tasks, assists with examinations and procedures, and communicates with and educates patients Match the following: ANSWER: C May be localized or systemic response A _ Allergen A Substances causing an allergic reaction B _ Anaphylaxis _ D Inappropriate immune responses C Allergic reaction E Diagnoses and treats allergies _ D Allergies _ B Life-threatening reaction E Allergist © 2011 The McGraw-Hill Companies, Inc All rights reserved 910 Cardiology • Cardiologist – specializes in heart disease and disorders • Medical assistant must be familiar with – The structure of the cardiovascular system – Typical examination and measurements – Tests performed • Electrocardiography • Stress testing • Echocardiography © 2011 The McGraw-Hill Companies, Inc All rights reserved 957 Otology • Otologist – treats diseases and disorders of the ears • Otorhinolaryngologist – specializes in nose and throat disorders • Medical assistant – Auditory screening – Assists with diagnostic tests © 2011 The McGraw-Hill Companies, Inc All rights reserved 958 Diseases and Disorders • Outer ear – Cerumen impaction – Otitis externa – Pruritus • Middle ear – – – – • Inner ear – – – – Labyrinthitis Ménière’s disease Presbycusis Tinnitus Otitis media Mastoiditis Otosclerosis Ruptured eardrum © 2011 The McGraw-Hill Companies, Inc All rights reserved 959 Apply Your Knowledge Arrange disorders properly: Inner Ear Ménière’s Disease Cerumen impaction Otosclerosis Middle Ear Otitis externa Mastoiditis Labyrinthitis Tinnitus 10 Pruritus Outer Ear Otitis media Ruptured eardrum 11 Presbycusis Nice Job! © 2011 The McGraw-Hill Companies, Inc All rights reserved 960 Surgery • Surgeons – Repair wounds and broken bones – Repair or remove diseased or injured organs, limbs, or tissues – Usually specialize in one field • Medical assistant – Presurgical • Patient education • OR preparation • Skin preparation – Surgical assisting – Postsurgical • Decontamination of OR and equipment Dressing wounds â 2011 The McGraw-Hill Companies, Inc All rights reserved 961 Surgery (cont.) • Biopsy – Simple surgical procedure – Types • Open • Needle – Sterile technique required © 2011 The McGraw-Hill Companies, Inc All rights reserved 962 Urology • Urologist – Diagnoses and treats urological disorders and diseases • Male and female urinary system • Male reproductive system • Medical assistant – Assists with general exams – Collects and processes urine and blood – Patient education © 2011 The McGraw-Hill Companies, Inc All rights reserved 963 Urology Examinations • Thorough history – Frequency or urgency of urination – Difficulty or pain – Incontinence • Palpation – kidneys and bladder • Inspection – external genitalia • Male reproductive system – Inspection – Palpation – Testicular self-exam © 2011 The McGraw-Hill Companies, Inc All rights reserved 964 Diagnostic Testing • Urine and blood tests • Semen analysis and smears • Cystometry • Cystoscopy • Testicular biopsy © 2011 The McGraw-Hill Companies, Inc All rights reserved 965 Diseases and Disorders • Cystitis • Prostate cancer • Epididymitis • STDs • Hydrocele • Urethritis • Impotence • Kidney stone • Prostatic hypertrophy • Prostatitis © 2011 The McGraw-Hill Companies, Inc All rights reserved 966 Apply Your Knowledge What are the types of biopsies you might assist with when working for a surgeon? ANSWER: You might assist with open biopsies and needle biopsies What examination should be done by a 27-year-old male patient to detect cancer? ANSWER: He should a monthly testicular selfexamination Fantastic! © 2011 The McGraw-Hill Companies, Inc All rights reserved 967 In Summary 9.1 The medical specialties discussed in this chapter include allergy, which is diagnosing and treating allergies, cardiology, dermatology ,endocrinology, gastroenterology, neurology, oncology, ophthalmology, orthopedics, otology, surgery, and urology 9.2 Exams and diagnostic tests performed in these 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 © 2011 The McGraw-Hill Companies, Inc All rights reserved 968 In Summary (cont.) 9.3 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 9.4 A scratch test is performed to determine if a patient has an allergic reaction to substances It involves scratching the skin with these substances and then observing the skin for any reaction © 2011 The McGraw-Hill Companies, Inc All rights reserved 969 In Summary (cont.) 9.5 A sigmoidoscopy is done to examine the rectum, anus, and sigmoid colon The patient is placed in knee-chest or Sims’ position and should be kept safe and comfortable during the procedure 9.6 The ophthalmoscope is used to examine the eye It is prepared by checking the charge and turning on the light, replacing the bulb if necessary and attaching the lens if needed © 2011 The McGraw-Hill Companies, Inc All rights reserved 970 In Summary (cont.) During a needle biopsy, a piece of tissue is removed and tested for abnormalities such as cancer The medical assistant may position and drape the patient, clean and dress the site, and assist the physician as required © 2011 The McGraw-Hill Companies, Inc All rights reserved 971 End of Chapter Diagnosis is not the end, but the beginning of practice. ~Martin H. Fischer © 2011 The McGraw-Hill Companies, Inc All rights reserved ... the physician in performing a scratch test 9. 5 Carry out the procedure for assisting with a sigmoidoscopy 9. 6 Prepare the ophthalmoscope for use 9. 7 Carry out the procedure for assisting with a... Techniques 9 15 (cont.) • Cardiac catheterization – catheter is threaded through a vein into the heart – Obtain blood samples – Measure pressure in the heart’s chambers – View the heart’s motion – Perform... administrative and clinical tasks – Assist with examinations and procedures – Communicate with and educate patients © 2011 The McGraw-Hill Companies, Inc All rights reserved 9 6 Allergy • Allergist – diagnoses