Medical discipline. Including respiratory medicine, gastroenterology, cardiovascular medicine, neurology, oncology, endocrinology, hematology, infectious diseases, pediatrics, etc. Internal medicine consultation Respiratory medicine: diseases included include colds, pneumonia, emphysema, tuberculosis, bronchiectasis, asthma, lung cancer, cor pulmonale, respiratory failure, chronic bronchitis, pneumothorax, lung abscess, pleural effusion, and interstitial lung disease.

On December 1, 2017, the "English Translation and Writing Standards in the Public Service Field" was officially implemented, stipulating that the English name of the internal medicine standard is Internal Medicine Department. [1]

Chinese name

Internal Medicine

Foreign name

Internal Medicine Department

Division

Clinical Medicine

Status

The Mother of Medicine

Including

Disease definitions, causes, symptoms, signs, etc.< /p>

Introduction

Internal medicine is a specialty of clinical medicine. It is the basis of almost all other clinical medicine and is also known as the mother of medicine. The content of internal medicine includes the definition of disease, etiology, pathogenesis, epidemiology, natural history, symptoms, signs, experimental diagnosis, imaging examination, differential diagnosis, diagnosis, treatment, and prognosis. The method of internal medicine is to conduct physical examination after medical history inquiry or interview, and conduct experimental diagnosis and imaging examination based on the medical history and examination findings, in order to eliminate the less likely ones among the many differential diagnoses and obtain the most likely diagnosis; After diagnosis, internal medicine treatment methods include follow-up observation, lifestyle, drugs, interventional treatments (such as cardiac catheterization, endoscopy), etc. The use of drugs is adjusted according to the patient's condition to prevent and deal with side effects and complications.

Red Cross

Internal medicine occupies an extremely important position in clinical medicine. It is not only the basis of various clinical medicine disciplines, but also closely related to them. The knowledge of internal medicine comes from medical practice. In the process of treating diseases and saving lives, medical scientists in the past have continuously accumulated experience, discarded the false and retained the true, discarded the rough and extracted the essence. They have continuously improved their level of understanding through practice. Through years of long-term accumulation, they have gradually formed a systematic system. methods of diagnosing and treating diseases. Generations of medical scientists have sorted out and summarized the knowledge gained through practice. And after systematic research (including evidence-based medicine research), it developed into internal medicine. An excellent clinician must not only have the desire to serve the people, but also have the ability to serve the people. To acquire the ability to treat diseases, one must be good at reading and diligent in practice, and constantly sum up experience and lessons in practice. Only after so many years of in-depth study and hard work can one become successful.

The significance of internal medicine examination: used to understand the chest, cardiopulmonary auscultation, bowel sounds, heart rate, murmurs, heart rhythm, liver, spleen, abdominal wall varicose veins, etc.

Internal medicine is generally divided into: cardiology, neurology (headache, facial paralysis, coma, convulsions, dizziness, muscle atrophy and involuntary movements), respiratory medicine (fever, cough, hemoptysis, difficulty breathing, hiccups), gastroenterology, nephrology, and endocrinology. (edema, abnormal growth and development, abnormal urine output, glucose, thyroid enlargement), rheumatology, hematology, hepatology, infectious diseases, otolaryngology, and pediatric internal medicine.

Disciplinary branches

Internal medicine includes subspecialties classified according to different organ systems: cardiology, respiratory medicine, hepatobiliary gastroenterology, nephrology (urology), hematology, Oncology, Endocrinology, Infectious Diseases, Immunology, Rheumatology, Neurology, Pediatrics, Neurology, Geriatrics, etc., but the classification of subspecialties may vary from place to place and even from hospital to hospital. Most of the subspecialties have established their own medical societies, which review the qualifications of subspecialty doctors and hold academic activities. Internal medicine in a broad sense also includes non-surgical treatment specialties such as dermatology, ophthalmology, psychiatry, rehabilitation (rehabilitation), radiology, palliative care, environmental and occupational diseases.

Gastroenterology

Examination features

The main contents of internal physical examination are as follows:

·Heart examination: apical pulse, heart boundary Size, heart rate, whether the rhythm is regular, whether there are heart and blood vessel murmurs, and pericardial friction.

·Respiratory system: chest sound, lung and liver boundary, respiratory rate, presence or absence of wet and dry rales and pleural friction sounds. ·Digestive system: Whether there is tenderness in the abdomen, whether the liver and spleen are enlarged, whether there are masses, whether there are shifting dullness, and whether bowel sounds are normal.

Respiratory medicine examination

·Nervous system: whether the state of consciousness is clear, whether the language is fluent, whether the brain nervous system examination, muscle strength, muscle tone, physiological reflexes are normal, whether there are pathological signs .

· General conditions: Whether the sclera is yellowish, whether the conjunctiva is ruddy, whether there is edema in the eyelids and ankles.

Classification

Internal medicine can be divided into the following categories: respiratory medicine, gastroenterology, cardiovascular medicine, neurology, endocrinology, hematology, infectious diseases, pediatrics, etc. . Respiratory Medicine: Diseases included include colds, pneumonia, emphysema, tuberculosis, bronchiectasis, asthma, lung cancer, cor pulmonale, respiratory failure, chronic bronchitis, pneumothorax, lung abscess, pleural effusion, and interstitial lung disease.

Internal Medicine Consultation

Endocrinology: It is a place in the hospital that specializes in the treatment of endocrinology diseases. You should see the endocrinology department for the following symptoms: weight change: weight loss or gain, Such as weight loss, obesity; physical development disorders: growth and development disorders, such as excessive shortness or giantness; mental symptoms: mental excitement, irritability, depression, reticence; changes in the skeletal system: unexplained bone pain, waist and leg pain, Osteoporosis, easy fracture; gastrointestinal symptoms: loss of appetite, hyperactivity, abdominal distension, increased stool frequency; changes in urine output: thirst, polydipsia, polyuria, increased nocturia; edema: especially accompanied by dry skin and thick lips Those with enlarged tongue; symptomatic hypertension: especially accompanied by sanguinary appearance, acne, cyclic lower limb muscle weakness or paroxysmal hypertension

Hematology Department: a very professional department. It mainly treats anemia (some anemia with complex causes), leukemia, hemophilia, lymphoma, myeloproliferative diseases and some complications that fall within the scope of hematology. For example, sometimes DIC requires intrablood treatment. Department of Infectious Diseases: It is the department that treats infectious diseases. Common infectious diseases include bacillary dysentery, typhoid, cholera, toxic hepatitis A, meningococcal meningitis, scarlet fever, whooping cough, influenza, measles, filariasis, Japanese encephalitis, schistosomiasis, etc.

Examination

The significance of internal medical examination: used to understand chest, cardiopulmonary auscultation, bowel sounds, heart rate, murmurs, heart rhythm, liver, spleen and abdominal wall varicose veins.

The main contents of the internal medical examination are as follows:

·Heart examination: apical pulse, heart size, heart rate, whether the rhythm is regular, whether there are heart and blood vessel murmurs, and pericardial friction sound.

·Respiratory system: chest sound, lung and liver boundary, respiratory rate, presence or absence of wet and dry rales and pleural friction sounds.

· Digestive system: Whether there is tenderness in the abdomen, whether the liver and spleen are enlarged, whether there are masses, whether there are shifting dullness, and whether bowel sounds are normal.

· Nervous system: Whether the state of consciousness is clear, whether the language is fluent, whether the brain nervous system examination, muscle strength, muscle tone, physiological reflexes are normal, and whether there are any pathological signs.

·General conditions: Whether the sclera is yellowish, whether the conjunctiva is ruddy, whether there is edema in the eyelids and ankles.

Consultation

Internal medicine consultation includes the following contents:

1. Disease history: Do you have any diseases that have been diagnosed by a regular hospital? If so, what are the medication treatments and their effects?

2． Family history: Is there any family history of hereditary diseases, infectious diseases, hypertension, diabetes, coronary heart disease, stroke, tumors, etc.

3. Personal history: nature of work, eating habits, tobacco and alcohol habits, etc.

4. Key symptoms to ask: Do you have paroxysmal palpitations, chest tightness, chest pain, paroxysmal dizziness, syncope, obvious weight loss, abnormally shaped stools, black and bloody stools, diarrhea, dry cough, hemoptysis, irritability, frequent urination, urgent urination, painful urination, and low-grade fever? ,etc.

The internal medical examination can provide clues to the following diseases:

The main organs of the human body, the heart, liver, spleen, lungs, and kidneys, are all within the scope of the internal medical examination. For many diseases and signs, Such as bronchitis, pneumonia, pleurisy, arrhythmia, pericarditis, cardiopulmonary insufficiency, hepatosplenomegaly, anemia, jaundice, etc. It has preliminary screening and diagnostic functions. Some people think: "Physical examinations require electrocardiogram and abdominal B-ultrasound anyway, and internal medical examinations can be dispensed with." This is not the case. Any instrument and equipment examination has limitations. For example, electrocardiogram examination has qualitative diagnostic value for myocardial ischemia and arrhythmia, but it is not specific for the diagnosis of congenital heart disease and rheumatic valvular heart disease; while general physical examination is not When performing a cardiac B-ultrasound, misdiagnosis may be missed without medical inspection, palpation, and percussion. The doctor can directly hear the murmur on the chest with a stethoscope, make a diagnosis, and propose further auxiliary examination items, which is beneficial to the early detection and timely treatment of the disease.

Dietary therapy

1. Salvia miltiorrhiza and chicken (pork ribs)

Reconciling Qi and blood, improving circulation. Medicinal materials: 12 grams of Salvia miltiorrhiza, 12 grams of red peony root, 12 grams of Angelica sinensis, 6 grams of Chuanxiong, 12 grams of raw rehmannia, 3 grams of licorice, 10 grams of Poria, 10 grams of Atractylodes, 3 grams of turmeric, 3 grams of orange, 3 grams of Citrus aurantium, 9 grams of cassia twigs, 5 red dates, 12 grams of wolfberry. Soak the medicinal materials first. , after boiling for five minutes, pour the soup into another pot, continue to heat and boil, add the chicken, simmer until the chicken is cooked, add an appropriate amount of rice wine and salt, and bring to a boil.

2. Lycium chrysanthemum tea

10 grams of wolfberry, 3 grams of chrysanthemum, 15 grams of raw hawthorn slices, and 15 grams of cassia. It is suitable for patients with high blood fat and can prevent arterial porridge. hardened.

3. Longan and jujube kernel tea

10 grams of Poria cocos, 15 grams of longan meat, and 30 grams of wild jujube kernels. Boil it into soup. After removing the residue, add 30 grams of white fungus. Appropriate amount of rock sugar is suitable for patients with restlessness, poor sleep, irregular heartbeat, and slightly swollen limbs.

Differences from surgery

In essence, although internal medicine and surgery both belong to the category of medicine, even though they have so many similarities, they are very common. However, the nature of their work and the way of thinking of surgeons and surgeons are quite different. As a systematic discipline, internal medicine has its practicality, but it has a complete set of theoretical systems. It studies the human body as an independent system. However, due to the intervention of human factors, surgery more often needs to think of the human body as an open system.

If physicians are called “home”, then surgeons are “craftsmen”.

But if a physician just closes up his studies and does not engage in clinical practice, he will never become a "physician" in the true sense; similarly, if a surgeon only studies how to perform surgery If he does something beautifully and perfectly but neglects theoretical study and summary, he will never become a "skilled craftsman". Perhaps due to the different nature of work, there are also certain differences in the external temperament of internal and external doctors. The requirements for doctors in surgical work are to be vigorous, bold and careful, decisive and straightforward, and calm and methodical in dealing with problems. Internal medicine work requires doctors to be thoughtful, knowledgeable and meticulous. Female students who graduate from medical school generally aspire to work in internal medicine, because internal medicine work requires more patience and meticulousness. Male students all aspire to do surgical work, because surgical work is more challenging, more fulfilling, and more attractive.

Discipline classification

Medical internal medicine is the core discipline in clinical medicine. The comprehensive diagnosis and treatment thinking of clinical medicine are concentrated in internal medicine; and in clinical practice Among them, internal medicine diseases are also the most common. Therefore, learning internal medicine well is not only beneficial to learning and mastering other subjects, but also is the need of most patients.

Studying internal medicine should be based on basic medicine and diagnostics. This new course should be learned while reviewing and consolidating courses such as anatomy, physiology, pathology and diagnostics. In learning, we should pay attention to the principles of integrating theory with practice and step by step, and continuously improve our problem-solving abilities through thinking, discovering problems, and analyzing problems.

Internal medicine is a secondary discipline, including respiratory disease, circulatory disease, gastroenterology, urology disease, hematology, endocrinology and metabolism, rheumatology and immunology, and the nervous system. In order to reflect comprehensive quality education, the curriculum is designed to comply with the transformation of the medical model. According to the teaching plan, the total teaching hours are 126 hours, 98 hours of classroom teaching, 28 hours of inter-class internship, and nearly one semester of graduation internship. The teaching content is rich and scientific in structure. Clinical practical content is combined with basic theory and organically integrated with surrounding sciences, which adapts to the role of this course in cultivating talents.