Why should you see an internist
At the beginning of an internal examination, the doctor first asks the patient about his medical history: His complaints and assumptions about the cause, but also previous illnesses, current medication intake, past stays abroad are of interest to the internist and are included in his diagnosis. This questioning is called the anamnesis. The family history is particularly important, as a number of diseases are genetic and can occur in families.
Then the internist gets an impression of the general condition of his patient. In addition to weight and height, it measures body temperature, pulse and blood pressure. He also looks for typical signs of illness such as
- Skin folds when dehydrated
- Yellow skin (jaundice)
- Pale skin with anemia (anemia)
- Water retention
- Redness or swelling of the skin
He checks whether the lymph nodes in the neck, in the groin or in the armpits are enlarged, which would indicate an increased activity of the immune system. The doctor uses the stethoscope to listen to the heart and lungs for unusual noises. He can detect both heart valve defects and narrowing of the airways. When tapping the back, the internist hears whether there is liquid in the lungs: a healthy lung sounds hollow, a liquid-filled lung sounds muffled.
By simply palpating the abdomen of a patient lying relaxed, the doctor can determine whether the liver, spleen or gall bladder are enlarged or whether an organ reacts to pressure with pain. He can also feel the intestinal winds and free water in the abdomen and evaluate the bowel activity based on the intestinal noises. He examines the fundus and throat and checks various reflexes of his patient on the knees, elbows and soles of the feet. He also assesses the condition of the patient's blood vessels, skeleton and psyche and regularly checks how the patient's state of health is developing.
The internist decides which further procedures are necessary based on the findings from the preliminary examination. Basically, he will order a blood test, as many complaints are reflected in changed blood values.
If there is a suspicion of a heart disease, he will first subject his patient to an EKG, if necessary an echocardiography or, moreover, a cardiac catheter examination in order to clarify the exact cause.
High blood pressure is so harmful to the organism that the doctor monitors the blood pressure of the affected patient with regular measurements and, if necessary, regulates it with medication. The same goes for high blood sugar levels. Diabetics are also constantly checked for neurological deficits, such as diabetic foot syndrome (e.g. using microfilament or tuning fork). You should also be examined by an ophthalmologist once a year.
Nowadays, imaging procedures such as B. ultrasound or endoscopy is used. These methods enable the internist to look inside the patient without surgery. With the help of endoscopy, the doctor can also view hollow organs from the inside. The cytoscope allows a view into the bladder, the colposcope into the vagina, the laparoscope into the abdominal cavity, and the gastroscope and colonoscope into the stomach and intestines. Each device is specially designed for its application, but always contains an optical unit with lighting and a working channel through which instruments can be inserted.
Biopsies and punctures play a big role in detecting cancer. Many patients are spared total operations thanks to tissue examinations if the findings are normal. In addition, doctors have a number of examination methods available for early cancer detection (smear examination, stool examination, etc.), which can save many lives if they are regularly observed by the patient.
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