Kazi yangu inanilazimu ku-do medical check up kila mwaka. Juzi nimetoka kufanyiwa coz it has been a year now since i last did one. Docta bwana kanistua. Kaniambia nisasambue then kashika shika eggs zangu then mtalimbo wangu aka penis.
Why all these? Alijaribu kunieleza kwa kweli sikumuelewa maana I was in a shock! A big shock!
Wataalam nielezeeni alikua ananicheki nini? Medical ya last year sikufanyiwa hivi mbona!
Mkuu kama alivyojaribu kusema member mmoja hapa ni sahihi kabisa kwa daktari wako kukufanyia hivyo.Ili kufikia true positive or true negative diagnosis kwa mgonjwa yeyote Daktari yeyote mzuri especially primary care physician lazima apitie hatua zifuatazo:Naeleza kwa kifupi:
1)Kwanza atakufanyia medical interview,ndiyo hiyo medical history.Hapo atakuuliza jina lako,umri wako,kazi yako,unaishi wapi,umeoa nk Atakuuliza tatizo lililokufanya u seek medical attention inaitwa main complaint(s).Atakuuliza kila kitu hapa-present illness,magonjwa yako ya siku za nyuma,kama una magonjwa chronic like diabetes,hypertension,malignancies etc,ulishafanyiwa surgical operation(s).Atakuuliza any disease conditions in ur immediate family members ili kujua kama kuna any genetic correlation btn ur complaints and the diseases of ur family members.Atakuuliza your personal and social history.Unavuta sigara,unatumia madawa ya kulevya,unakunywa pombe;ulianza lini,pombe gani,mara ngapi kwa wiki,chupa ngapi nk nk.Atakuuliza your sexual life,number of sexual partners,homosexuality,hetero nk,Allergies to medications,foods,dawa unazotumia nk nk.
Kama mgonjwa wa kike:Basi pia lazima aulizwe kama anakumbuka mwaka wake alioanza bleeding(menarche),last time ya menstruation,is it regular/irregular..,number of pregnancies,live births,induced/spontaneous abortions,gynecological visits,menopause kwa wenye umri huo nk nk
2)physical/clinical examination..Ndiyo hiyo aliyokufanyia.Atachukua vital signs:BP,body temperature,pulse rate,respiratory rate.Sasa hii imegawanyika katika sehemu nne:a)inspection:Lazima aangalie mwili wako wote including 'ndundukali' yako au 'kipochi manyoya' kwa kinadada.Aaangalie kama una scars,herniations,masses,moles,any discharges,contours of the skin:whether flat/scaphoid/distention nk nk
b)palpation:Kwa kifupi sana:Ndiyo huko kushikwa shikwa na kukandamizwa!Ikiwezekana inabidi a check mifumo yote ya mwili.Kila mfumo kuna magonjwa atayaangalia kulingana na historia yako au just for the sake of checking any other significant even insignificant comorbid ambayo itamsaidia ku arrive at a valid diagnosis hence ensuring appropriate treatment.Ni muhimu sana.Wataalam wa acute abdomen wanaiheshimu sana hii!
c)auscultation:Atapitisha stethoscope kusikiliza sounds of the viscera.Ma cardiac murmers,pulmonary sounds,ma bowel sounds nk ndiyo yako hapa.
d)percussion
😛ia ataangaliza sounds kujua kama kuna internal masses,any organ enlargement nk nk
3)Ata order lab tests kulingana na atakayo suspect katika hatua mbili hapo juu.Au just for the sake of thorough medical check up.
4)Ata order imaging tests for further confirmation of diagnosis.Kwa mfano kama ana differential diagnosis ya appendicitis,acute cholecystitis,pancreatitis,perforated duodenal ulcer,small bowel obstruction nk aki order USG au CT scan basi itamsaidia kufikia accurate anatomical diagnosis.
Mkuu ninachotaka kukwambia ni kwamba hiyo ni hali ya kawaida unapokutana na daktari mzuri tena shukuru manake wengine huwa wana skip hizi hatua na mwisho wake wasilione tatizo hata kama unalo(false negative diagnosis) au watakupa tatizo ambalo huna(false positive diagnosis).
Kwahiyo hata kina dada mkiminywaminywa chuchu na Madaktari wala msishtuke kwani ni vitu vya kawaida kwa physicians in clinical practice.
