How to Answer Physician Preoperative Diagnosis Questions (Complete Guide)
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Key Explanation
This topic involves physician preoperative diagnosis. A strong answer should include explanation, application, and examples.
Original Question
Sex: F Age: 81 DOS: 1/1/20XX PHYSICIAN: PREOPERATIVE DIAGNOSIS: Anemia. POSTOPERATIVE DIAGNOSIS: Prepyloric gastric ulcer, Hiatus hernia, Chronic antral gastritis. OPERATIVE PROCEDURE: Esophagogastroduodenoscopy, CLO test biopsy of gastric ulcer, conscious sedation. SURGEON: Conscious Sedation: 25 min. FINDINGS: The patient is a female, who denies any symptoms at all. She says that she eats well, has no abdominal pain, no difficulty with her bowels, but she was found to be anemic by Dr. Thompson. Her examination shows a 4-cm hiatus hernia with no evidence of distal esophagitis. Her antrum shows mild chronic gastritis. In the prepyloric region, there is an ulcerated lesion that is approximately 5 mm in diameter, with heaped-up margins. Biopsy of this was taken, as well as testing for CLO or H pylori. This is likely the cause of her anemia, in spite of her lack of symptoms, and depending on the results of the CLOtest, we will start her on Prevacid at this time, awaiting the biopsies. In the event there is a neoplastic process, obviously additional treatment would be indicated. TECHNIQUE: After explaining the operative procedure, the risks, and potential complications of bleeding and perforation, the patient was given 170 mg of propofol intravenously for conscious sedation. Her pulse was 80, saturations 98, blood pressure 173/107. The end-viewing gastroscope was inserted through the oropharynx, esophagus, stomach, and duodenum. Photographs were taken. A sample was taken for H pylori. Then, biopsies of the ulcer were taken. The air and instruments were gradually withdrawn and removed. The patient tolerated the procedure well.
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