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ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ูˆุฑุญู…ุฉ ุงู„ู„ู‡ ูˆุจุฑูƒุงุชู‡ ุงู„ูŠูˆู… ุฅู† ุดุงุก ุงู„ู„ู‡
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ุณุฃุชุญุฏุซ ุนู† ูƒูŠู ุฃุฎุฐ ุชุงุฑูŠุฎ ู…ู† ู…ุฑุถู‰
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ู…ุดุงุฑูƒุฉ
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ุฑุฆูŠุณูŠุฉุŒ ุชุงุฑูŠุฎ ู…ุฏูŠู†ุฉ ุฅู†ุณุงู†ุŒ ุชุงุฑูŠุฎ ู…ุฏูŠู†ุฉ ุงู„ุณูŠุงุณุฉุŒ
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ุชุงุฑูŠุฎ ุนุงุฆู„ูŠุฉุŒ
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Explain the need to take the history and gain a
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consent. Ensure that the patient is comfortable.
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Presenting complaint. It's important to use an open
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questioning to elicit the patient to present
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complaint. ุดูƒูˆู‰ ุงู„ู…ุฑูŠุถุฉ ูˆู‡ุฐู‡ ูŠุนู†ูŠ ู„ุงุฒู… ุฃู† ุชุฃุฎุฐ
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ูˆุชูƒุชุจ
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ุจู†ูุณ ุงู„ู€ terminology ุฃูˆ ุงู„ู€ .. ุงู„ู€ .. ุงู„ู€ .. ูŠุนู†ูŠ the
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patient what he mentioned exactly. No medical
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terminology. ู…ู…ูƒู† patient complaint of dyspnea. We
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should not write that chief complaint is dyspnea
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because dyspnea is a medical terminology. So we
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have to ask a patient and ุชุญู‚ู‚ ุฅุฐุง ูƒุงู†ุช ุงู„ู…ุฑูŠุถุฉ
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ุชุดูƒูˆ ุนู† ุฃู‚ุตู‰ ู†ูุณู‡ุง. ูู…ุงุฐุง ุฌู„ุจุชูƒ ุงู„ูŠูˆู…ุŸ ุฃุฎุจุฑู†ูŠ ุฃูƒุซุฑ
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ุนู† ุฅุดุนุงุฑุงุชูƒ. ุฃุนุทูŠ ุงู„ู…ุฑูŠุถ ูˆู‚ุช ู„ุฅุฌุงุจุฉ ู…ุง. ูŠุญุงูˆู„ ุฃู† ู„ุง
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ูŠุชูˆู‚ู ุฃูˆ ูŠู‚ูˆู… ุจุชุญุฏูŠุซ ุงู„ุงุชุตุงู„ ูˆุงู„ู…ุดูƒู„ุฉ
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ุงู„ุฑุฆูŠุณูŠุฉ ูƒู…ุง ุฐูƒุฑู†ุง ููŠ ูƒู„ู…ุฉ ุงู„ู…ุฑูŠุถ ูŠุฌุจ ุฃู† ู†ุฐูƒุฑู‡ุง
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History of a present illness or
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history of a presenting complaint should be
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multiple.
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Risk factors, onset, duration, severity, course,
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Is it intermittent or continuous, precipitating
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factor, relieving factor, associated feature and
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previous episode.
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ุทุจุนุง ุงู„ู€ Cough ุฑุณู…ูŠุงุช ุฏูŠุณู†ูŠุงุŒ ูƒูุŒ ูˆูŠุฒุŒ ู‡ู…ุจุชุณุณุŒ ุนุถู„ุฉ
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ุงู„ุญุฑุงุฑุฉุŒ ุฃุดุฎุงุต ุฃุฎุฑู‰ ุจุดูƒู„ ุนุงู… ุฃูˆ
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ุงู„ุดูŠุก ุงู„ุฃูˆู„ ู‡ูˆ ุงู„ู€ Cough. ุงู„ู€ Reflex ุชุนู…ู„ ูƒุฅุฌุงุจุฉ
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ู„ุฅุทู„ุงู‚ ู…ุญุทุฉ ู…ูุชูˆุญุฉ ุถุฏ
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ู†ุณุชุทูŠุน ุฃู† ู†ู‚ูˆู… ุจุชู†ุตูŠู ุงู„ู€ Cuff ุฅู„ู‰ ุซู„ุงุซุฉ ู…ู‚ุงู„ุงุช
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ุงู„ู€ Acute Cuff ุฃู‚ู„ ู…ู† ุซู„ุงุซุฉ ุฃุณุงุจูŠุน. ุฃุนู„ู‰ ุฑุณููŠุฑูŠุฉ
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ุงู„ุชุฑุงูƒูŠูŠู†ููƒุณูŠุง ู…ุซู„ ู†ู…ูˆู†ูŠุงุŒ ุจู„ู…ูˆู†ูŠุงุŒ ุงู…ุจูˆู„ูŠุฒู…ุŒ ู…ุฎุทุท
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ูƒูˆู†ุฌุณุชูŠููŠูƒุงุฑุฏูŠุง. ุฏุงุฆู…ุง ู…ูˆุงุฌู‡ุฉ ุจู€ Acute Cuff Sub
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-acute Cuff ู…ู† 3 ุฅู„ู‰ 8 ุฃุณุงุจูŠุน. Viral Infection Post
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-nasal drip. Gastroesophageal reflux. ุงู„ูƒูุฉ ุงู„ูƒุฑูˆู†ูŠุฉ
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NE ุชุณุชู…ุฑ ููŠ ุฃูƒุชุฑ ู…ู† 8 ุฃุณุงุจูŠุน ู…ุซู„ ุจู„ู…ูˆู†ูŠูˆ
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ุชูŠุจุฑูƒูˆู„ูˆุฒุณุŒ ุจุฑูˆู†ูƒุงู„ ุฃุฒู…ุฉุŒ COPDุŒ ุจุฑูˆู†ูƒูˆุฌูŠู† ุงู„ูƒุงุฑุณูŠู†ูˆู…ุฉ
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ุงูŠุฌูŠู†ูˆูู„ูŠูƒูŠุŒ ุจุฑูˆู†ูƒุงูŠุชุณุŒ post nasal drip
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gastroesophageal reflux disease. ุฏุฑุงุฌุงุช ู…ุซู„ ุงู„ุงุณ
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ุงู†ู‡ูŠุจุชุฑ ุฃูˆ ู…ุญุทุฉ ู‚ู„ูˆุจ.
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ู…ุงู„ู€ Nocturnal Cough ุนุงุฏุฉู‹ ุชุณุจุจ ููŠ ุงู„ู€
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Postnasal Drip, Gas Oesophageal Reflux Disease,
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Chronic Bronchitis, Bronchial Asthma, Obstructive
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Sleep Apnea, Left Ventricular Failure ุฃูˆ Heart
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Failure And Aspiration SputumุŒ ููŠ ุงู„ู€ Sputum ูŠุฌุจ
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ุฃู† ู†ุณุฃู„ ุนู† ุงู„ู…ู‚ุงูˆู…ุฉุŒ ูˆุงู„ู„ูˆู†ุŒ ูˆุงู„ุฑุงุฆุญุฉุŒ ูˆู…ุฎุชู„ูุฉ
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ุงู„ุจุฑุชู‚ุงู„ ูˆุงู„ุฑุงุฆุญุฉ.
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Consistency, cirrhosis, upper respiratory tract
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infection, a mucoid like in a chronic bronchitis
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or bronchial asthma, a mucopurulent and bacterial
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infection. Bronchectasis can cause copious amount
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of the sputum production, lung abscess and
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necrotizing pneumonia. The color Usually yellow,
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green in bacterial infection, rusty sputum ุฃูˆ it
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is caused by pneumococcal pneumonia or
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streptococcal pneumonia. Blood tinged sputum in
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case of TB. Prostate sputum with blood tinged in
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acute pulmonary edema. Second case symptoms in
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respiratory symptoms is dyspnea ุงู„ุชูŠ ู‡ูŠ ุดุนูˆุฑ ุบุฑูŠุจ
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ู„ู„ุงุญุฑุงุฑุฉ. ูŠุฌุจ ุฃู† ู†ุณุฃู„ ู…ุฑุฉ ุฃุฎุฑู‰ ุนู† ุงู„ุงู†ุชู‚ุงู„ุŒ ุงู„ุฏูˆุฑุฉุŒ
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ุงู„ุถุฑูˆุฑูŠุŒ
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ู…ุซู„ ุงูƒูŠูˆุช ุฏูŠุณู†ูŠุง ุงูƒูŠูˆุช ุฎู„ุงู„ ุฏู‚ูŠู‚ุฉ ู…ุซู„ ู†ูŠู…ูˆ ุซูˆุฑุงูƒุณ
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ุฃุฒู…ุฉ ุจู„ู…ูˆู†ุฑุŒ ุงุฏูŠู…ุฉ ุงู…ุจูˆู„ูŠุฒู…ุŒ ู„ุงุฑู†ุฌุงู„ ุงุฏูŠู…ุฉุŒ foreign
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body inhalation. ูƒู„ ู‡ุฐุง ูŠู…ูƒู† ูŠุณุจุจ ููŠ ุงูƒูŠูˆุช ุงูˆู„ุงุฏ
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ุฏูŠุณู†ูŠุง ุฑุงุจุท ุฎู„ุงู„ ุณุงุนุงุช ุฃูˆ ุฃูŠุงู… ู…ุซู„ ู‡ูŠู…ูˆ ุซูˆุฑุงูƒุณ
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ู†ูŠู…ูˆู†ูŠุงุŒ ุงูƒูŠูˆุช ุจุฑูˆู†ูƒุงูŠุชุณ ุฃูˆ ุฎู„ุงู„ ุดู‡ุฑ ุฃูˆ ุนุงู… ู…ุซู„
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ุงู†ูุณูŠู…ุฉุŒ COPDุŒ ู†ูŠู…ูˆูƒู†ูŠูˆุณูŠุง ุฃูˆ ููŠุจุฑูˆุณูŠุง ู„ู„ุฏู…
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ูˆ ุงู†ุชุฑุณุชูŠุดูŠุง ู„ู„ุฏู… ู„ุฐู„ูƒ
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ูŠุฌุจ ุฃู† ู†ู‚ูˆู… ุจุชุฌุงุฑุจ ุฏูŠุณู†ูŠุง ูƒู… ุดุฑุท ุงู„ู‡ูˆุงุชูุŸ
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ู‡ู„ ุงู„ุดุฎุต ู„ุฏูŠู‡ ุชุฌุงุฑุจ
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ู…ุณุชูŠู‚ุธูŠุฉ ุงู„ู„ูŠู„ุฉ ุฃูˆ ุงู„ู„ูŠู„ุฉุŸ ุฃูˆ ู‡ู„ ูŠุฌุจ ุนู„ู‰ ุงู„ุดุฎุต ุฃู†
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ูŠุฌู„ุณ ุฃูˆ ูŠุณุชุทูŠุน ุฃู† ูŠู†ุงู… ู…ุฌู†ูˆู†ุŸ
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ุชุนุทูŠู†ุง ููƒุฑุฉ ุนู† ุตุนูˆุจุฉ ุงู„ู€ Dyspnea ู…ุซู„ู‹ุงุŒ ุฅุฐุง ูƒุงู†
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ุงู„ู…ุฑูŠุถ ูŠุดุนุฑ ุจุงู„ุฏุณู†ูƒ ููŠ ุฑุงุญุชู‡ ุฃูˆ ุฅู†ู‡ ูƒุซูŠุฑ ุบุงุฒูŠ
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ู„ุชุฎุฑุฌ ู…ู† ุงู„ู…ู†ุฒู„ุŒ ูุงู„ุฏุณู†ูƒ ููŠ ุฑุงุญุชู‡ ุฃูˆ ุงู„ู…ุฑูŠุถ ูŠุดุนุฑ
115
00:08:20,230 --> 00:08:24,390
ุจุงู„ุฏุณู†ูƒ ููŠ ุฑุงุญุชู‡ุŒ ู‡ุฐุง ู‡ูˆ ุงู„ุฌุงู…ุนู‡ ุงู„ุฑุงุจุนู‡ ููŠ ู…ุฌู„ุณ
116
00:08:24,390 --> 00:08:30,810
ุงู„ุชุญู‚ูŠู‚ ุงู„ู„ุงุฌุฆ. ุฅุฐุง ูƒุงู† ุงู„ู…ุฑูŠุถ ูŠุชูˆู‚ู ุนู† ุงู„ู‡ูˆุงุก ุจุนุฏ
117
00:08:30,810 --> 00:08:35,490
ุงู„ู…ุดูŠ ุญูˆุงู„ 100 ูŠุงุฑุงุช ู‡ุฐุง ู‡ูˆ ุงู„ุฌุงู…ุนู‡ 3. ุฅุฐุง ูƒุงู†
118
00:08:35,490 --> 00:08:40,730
ุงู„ู…ุฑูŠุถ ูŠู…ุดูŠ ุจุณุฑุนู‡ ู…ู† ุงู„ู†ุงุณ ููŠ ู†ูุณ ุงู„ุณู†ุฉุŒ ู‡ุฐุง ุฌุงู…ุนู‡
119
00:08:40,730 --> 00:08:45,450
2. ูˆุฅุฐุง ูƒุงู† ุงู„ู…ุฑูŠุถ ูŠุญุตู„ ุนู„ู‰ ุฏุณู†ูŠุงูƒ ูู‚ุท ุจู…ุฌุฑู…
120
00:08:45,450 --> 00:08:51,770
ุงู„ุชุฌุงุฑุจุŒ ู‡ุฐุง ุฌุงู…ุนู‡ 0.
121
00:08:51,770 --> 00:08:51,890
122
00:08:51,890 --> 00:08:52,450
123
00:08:52,450 --> 00:09:00,520
124
00:09:00,520 --> 00:09:05,980
ุงูƒุชุณุงุจ ู„ุฃู„ุฑุฌูŠู† ุงูƒุชุณุงุจ ู„ุฃู„ุฑุฌูŠู† ู„ุฏุฑุงุณุงุช ุชุณู…ู‰
125
00:09:05,980 --> 00:09:09,760
ูƒูˆุฏูˆูŠุฏุฑ.
126
00:09:09,760 --> 00:09:10,360
ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰
127
00:09:10,360 --> 00:09:11,260
ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช
128
00:09:11,260 --> 00:09:11,320
ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰
129
00:09:11,320 --> 00:09:13,420
ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช
130
00:09:13,420 --> 00:09:14,760
ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰
131
00:09:14,760 --> 00:09:18,480
ุฏุฑุงุณุงุช ุชุณู…ู‰ ุฏุฑุงุณุงุช ุชุณู…ู‰
132
00:09:24,480 --> 00:09:27,360
ุงู„ุฏูŠุณู†ูŠุง ู…ูˆุฌูˆุฏุฉ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ
133
00:09:27,360 --> 00:09:29,580
ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„
134
00:09:29,580 --> 00:09:31,480
ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ
135
00:09:31,480 --> 00:09:33,600
ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„
136
00:09:33,600 --> 00:09:34,380
ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ
137
00:09:34,380 --> 00:09:35,160
ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„
138
00:09:35,160 --> 00:09:35,480
ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ
139
00:09:35,480 --> 00:09:35,960
ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„
140
00:09:35,960 --> 00:09:37,900
ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ
141
00:09:37,900 --> 00:09:42,100
ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ ุฃูˆ ููŠ ู…ุฌุงู„ ุงู„ุชุฌุงุฑุจ
142
00:09:54,220 --> 00:09:58,900
ุงู„ุนุดุงุก ูŠุชุฑู†ุญ ุนู†ุฏู…ุง ูŠุฌู„ุณ ุนู„ู‰ ุฃุนู„ู‰ุŒ ูˆู‡ูˆ ุฅุดุนุงุฑ ุนุงู…
143
00:09:58,900 --> 00:10:06,600
ู„ูุชุฉ ุฌุงู†ุจูŠุฉ ู‚ู„ุจูŠ ุบูŠุฑ ู…ูุชุงุญุŒ ูˆุฃูŠุถู‹ุง ู…ุตุงุฏุฑ ุฃุฑุซูˆุจูŠู†ูŠุงุŒ
144
00:10:06,600 --> 00:10:11,680
ููŠ ุจุนุถ ุงู„ุฃุญูŠุงู† ู…ุตุงุฏุฑ ุฃุฎุฑู‰ ุชุณุจุจ ููŠ ุฃุฑุซูˆุจูŠู†ูŠุงุŒ ู…ุซู„
145
00:10:11,680 --> 00:10:12,140
...
146
00:10:12,140 --> 00:10:13,240
...
147
00:10:13,240 --> 00:10:15,740
...
148
00:10:15,740 --> 00:10:21,020
...
149
00:10:21,020 --> 00:10:28,570
ุฅุฐุง ูƒุงู†ุช ุงู„ู…ุฑุฃุฉ ู…ุญุทู…ุฉ ููŠ ุณู†ุฉ ุฃูˆ ุนุดุฑุฉ ุฃุดู‡ุฑุŒ
150
00:10:28,570 --> 00:10:34,670
ูŠู…ูƒู†ู‡ุง ุฃูŠุถู‹ุง ุงู„ุญุตูˆู„ ุนู„ู‰ ุฃุฑุซูˆุจูŠู†ูŠุงุŒ ุฅุฐุง ูƒุงู†ุช ุงู„ู…ุฑุฃุฉ
151
00:10:34,670 --> 00:10:34,930
ู…ุญุทู…ุฉ ููŠ ุณู†ุฉ ุฃูˆ ุนุดุฑุฉ ุฃุดู‡ุฑุŒ ูŠู…ูƒู†ู‡ุง ุฃูŠุถู‹ุง ุงู„ุญุตูˆู„ ุนู„ู‰
152
00:10:34,930 --> 00:10:35,490
ุฃุฑุซูˆุจูŠู†ูŠุงุŒ ุฅุฐุง ูƒุงู†ุช ุงู„ู…ุฑุฃุฉ ู…ุญุทู…ุฉ ููŠ ุณู†ุฉ ุฃูˆ ุนุดุฑุฉ
153
00:10:35,490 --> 00:10:36,330
ุฃุดู‡ุฑุŒ ูŠู…ูƒู†ู‡ุง ุฃูŠุถู‹ุง ุงู„ุญุตูˆู„ ุนู„ู‰ ุฃุฑุซูˆุจูŠู†ูŠุงุŒ ุฅุฐุง ูƒุงู†ุช
154
00:10:36,330 --> 00:10:37,010
ุงู„ู…ุฑุฃุฉ ู…ุญุทู…ุฉ ููŠ ุณู†ุฉ ุฃูˆ ุนุดุฑุฉ ุฃุดู‡ุฑุŒ ูŠู…ูƒู†ู‡ุง ุฃูŠุถู‹ุง
155
00:10:37,010 --> 00:10:37,570
ุงู„ุญุตูˆู„ ุนู„ู‰ ุฃุฑุซูˆุจูŠู†ูŠุงุŒ ุฅุฐุง ูƒุงู†ุช ุงู„ู…ุฑุฃุฉ ู…ุญุทู…ุฉ ููŠ ุณู†ุฉ
156
00:10:37,570 --> 00:10:40,710
ุฃูˆ ุนุดุฑุฉ ุฃุดู‡ุฑุŒ ูŠู…ูƒู†ู‡ุง ุฃูŠุถู‹ุง ุงู„ุญุตูˆู„ ุนู„ู‰ ุฃุฑุซูˆุจูŠู†ูŠุงุŒ
157
00:10:40,710 --> 00:10:43,490
ุฅุฐุง ูƒุงู†ุช ุงู„ู…ุฑุฃุฉ
158
00:10:47,410 --> 00:10:51,810
ู„ุงุชูŠุจู†ูŠุง ุนูƒุณ ุงู„ุฃุฑุซูˆุจูŠู†ูŠุง dyspnea on standing or
159
00:10:51,810 --> 00:10:56,850
sitting relieved by lying down like this patient
160
00:10:56,850 --> 00:11:00,970
ุงู„ู„ูŠ ู‡ู…ุง ุนู†ุฏู‡ู… right to left cardiac shunt AV
161
00:11:00,970 --> 00:11:04,650
malformation ููŠ ุงู„ู†ุงุณ ุงู„ู„ูŠ ุนู†ุฏู‡ู… hepato pulmonary
162
00:11:04,650 --> 00:11:10,670
syndrome recurrent PE post pneumonectomy Trypopnea
163
00:11:10,670 --> 00:11:14,850
dyspnea on lying on the affected side relieved by
164
00:11:14,850 --> 00:11:20,680
lying on the healthy side ูˆุงู„ุณุจุจ ุงู„ุนุงู… ู„ู„ุชุฑูŠุจูˆุจู†ูŠุฉ ู‡ูˆ
165
00:11:20,680 --> 00:11:23,660
ุงู„ุงู†ุตุจุงุจ ุงู„ุจู„ูˆุฑูŠ ูˆุงู„ู…ุนุงู†ุงุฉ ุจุงู„ู„ุบุฉ ุงู„ุฑูˆู…ุงุชูŠุฒู…ูŠุฉ
166
00:11:23,660 --> 00:11:29,100
ูˆู…ุนุงู†ุงุฉ ุงู„ุฌุณุฏ ูˆุงู„ุชู†ุฏุจ ูˆุฃุญูŠุงู†ุง ููŠ ู…ุฑูŠุถ ู…ุน
167
00:11:29,100 --> 00:11:34,840
ู…ุฎุงุทุฑ ู‚ู„ุจ ุงู„ูŠุณุงุฑ ู…ุฎุงุทุฑ ู‚ู„ุจ ุงู„ูŠุณุงุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ
168
00:11:34,840 --> 00:11:39,380
ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ
169
00:11:39,380 --> 00:11:45,420
ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ
170
00:11:45,420 --> 00:11:46,360
ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ
171
00:11:46,360 --> 00:11:46,520
ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ ู…ุฎุงุทุฑ
172
00:11:46,940 --> 00:11:50,560
ุนู„ูŠู†ุง ุฃู† ู†ุนุชุจุฑ ุฃู† ู‡ู†ุงูƒ ุจุฑูˆู†ูƒูˆุณุจุงุฒู… ูˆุนู†ุฏู…ุง ูŠุจุฏุฃ
173
00:11:50,560 --> 00:11:56,460
ูŠุจุฏุฃ ุงู„ุดุฎุต ุจุงู„ูƒุญุฉ ูŠุฌุจ ุฃู† ู†ููƒุฑ ููŠ ุงู„ุงุญุชูŠุงุทุงุช
174
00:11:56,460 --> 00:11:59,360
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
175
00:11:59,360 --> 00:12:00,380
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
176
00:12:00,380 --> 00:12:01,560
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
177
00:12:01,560 --> 00:12:03,440
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
178
00:12:03,440 --> 00:12:04,500
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
179
00:12:04,500 --> 00:12:04,680
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
180
00:12:04,680 --> 00:12:08,120
ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช ุงู„ุงุฎุชู„ุงูุงุช
181
00:12:08,120 --> 00:12:09,280
ุงู„ุงุฎุชู„ุงูุงุช
182
00:12:12,960 --> 00:12:15,760
ู…ุซู„ ุงู„ู€ Upper Airway Obstruction ุงู„ู€ foreign body
183
00:12:15,760 --> 00:12:19,060
ุฃู†ุฌูŠูˆุฏูŠู…ุง ุงู„ุชูˆุชุฑ ู†ูŠู…ูˆ ุซูˆุฑุงูƒุณ ุงู„ุจู„ู…ูˆู†ุฑูŠ ุฃู…ุจูˆู„ูŠุฒู…
184
00:12:19,060 --> 00:12:22,420
ุซุงู„ุซู‹ุง
185
00:12:22,420 --> 00:12:27,040
ุฅุดุนุงุฑ ุงู„ู€ chest pain if
186
00:12:27,040 --> 00:12:29,860
any pain in a case with history of a present
187
00:12:29,860 --> 00:12:34,500
illness the pain we have to clarify the details of
188
00:12:34,500 --> 00:12:40,680
the pain ูˆู„ุงุฒู… using the secrets site ุงู„ู€ S site
189
00:12:40,680 --> 00:12:44,580
where is the pain ุงู„ู€ onset When did it start?
190
00:12:45,160 --> 00:12:49,560
sudden vs gradual ุงู„ู€ character charred, dull
191
00:12:49,560 --> 00:12:55,200
aching, burning, stabbing, heavy, tightness,
192
00:12:55,600 --> 00:12:58,660
radiation of the pain, does the pain move anywhere
193
00:12:58,660 --> 00:13:01,720
else, radiated to the left arm, radiated to the
194
00:13:01,720 --> 00:13:06,360
lower jaw, to the back, associated symptoms
195
00:13:10,160 --> 00:13:17,120
ุงู„ุซุงู†ูŠุฉ ู‡ูŠ ุงู„ุบุซูŠุงู† ูˆุงู„ู‚ูŠุก ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
196
00:13:17,120 --> 00:13:19,900
ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
197
00:13:19,900 --> 00:13:24,860
ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
198
00:13:24,860 --> 00:13:27,040
ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
199
00:13:27,040 --> 00:13:27,440
ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
200
00:13:27,440 --> 00:13:28,680
ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
201
00:13:28,680 --> 00:13:34,440
ูˆุงู„ุตุฏุงุน ูˆุงู„ุตุฏุงุน
202
00:13:34,440 --> 00:13:35,920
ูˆุงู„ุตุฏุงุน
203
00:13:58,260 --> 00:14:02,200
ุทุจุนู‹ุง ุงู„ู€ severity of the pain on a scale ุทุจุนู‹ุง from
204
00:14:02,200 --> 00:14:09,880
0 to 10 how severe the pain is history
205
00:14:09,880 --> 00:14:15,200
of a presenting complaint radiation
206
00:14:15,200 --> 00:14:19,660
dyspnea it is exertional, orthopnea, paroxysmal,
207
00:14:19,760 --> 00:14:24,720
nocturnal dyspnea ุงู„ู€ dyspnea it is exertional
208
00:14:26,830 --> 00:14:31,030
ุฃูˆุฑุซูˆุจู†ูŠุง BND ุจูŠุฑุฒูˆุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
209
00:14:31,030 --> 00:14:33,170
ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
210
00:14:33,170 --> 00:14:34,690
ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
211
00:14:34,690 --> 00:14:37,490
ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
212
00:14:37,490 --> 00:14:42,330
ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
213
00:14:42,330 --> 00:14:45,730
ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
214
00:14:45,730 --> 00:14:52,710
ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ุฏูŠุณู†ูŠุง ุจูŠุฑุฒูˆุฒู…ุงู„
215
00:14:52,710 --> 00:14:55,790
ู†ูƒุชูˆุฑ
216
00:14:55,980 --> 00:15:01,560
ู‡ูˆ ูŠุณุชูŠู‚ุธ ุจุนุฏ 30 ุฏู‚ูŠู‚ุฉ ุฅู„ู‰ 1 ุณุงุนุฉ ูŠูˆู…ูŠู‹ุงุŒ ู„ุฐู„ูƒ
217
00:15:01,560 --> 00:15:06,900
ู‡ุฐุง ุฃูƒุซุฑ ู…ู…ูƒู† ุฃู† ูŠูƒูˆู† ุซุงู†ูˆูŠู‹ุง ู„ูุดู„ ู‚ู„ุจูŠ ุฅุฐุง ุฐู‡ุจ
218
00:15:06,900 --> 00:15:09,760
ุงู„ู…ุฑูŠุถ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
219
00:15:09,760 --> 00:15:09,780
ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
220
00:15:09,780 --> 00:15:10,140
ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
221
00:15:10,140 --> 00:15:10,180
ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
222
00:15:10,180 --> 00:15:13,100
ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
223
00:15:13,100 --> 00:15:13,320
ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
224
00:15:13,320 --> 00:15:13,660
ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ ุฅู„ู‰ ุงู„ู†ุงุณ
225
00:15:13,660 --> 00:15:17,480
ุฅู„ู‰ ุงู„ู†ุงุณ
226
00:15:17,480 --> 00:15:24,700
ุฅู„ู‰
227
00:15:28,630 --> 00:15:33,290
ุงู„ุฃุฒู…ุฉ ุฅุฐุง ูƒุงู†ุช ุงู„ู€ BND ุซุงู†ูˆูŠุฉ ู„ู„ุฃุฒู…ุฉ ุชุนุงู„ุฌู‡ุง
228
00:15:33,290 --> 00:15:42,410
ุจุงุณุชู†ุดุงู‚ ุณุงู„ุจูˆุชุงู…ูˆู„ ุจุงุณุชู†ุดุงู‚ ูˆุฅุฐุง
229
00:15:42,410 --> 00:15:48,010
ูƒุงู† ุงู„ุดุฎุต ู…ุฑุชุจุท ุจุดูƒู„ ุขุฎุฑ ุจุฃุฑุซูˆู…ูŠุง ุฃูˆ ุฅุดุนุงุฑ ุฃุณู„ุญุฉ
230
00:15:48,010 --> 00:15:51,870
ุงู„ู„ู…ุจ ุงู„ุฃุณูู„ ุงุฑุชุจุท ุจุญุฑุงุฑุฉ ุงู„ููŠุฑูˆุณ ุงู„ุฌุงุบูˆู„ุงุฑูŠ ุฃูƒุซุฑ
231
00:15:51,870 --> 00:15:57,330
ุงุณุชุญุงู„ุฉ ุจุฑุฒูŠุฒู…ุงู„ ู†ูƒุชูˆุฑู†ุงู„ูŠ ุฏูŠุณู†ูŠุง ุซุงู†ูˆูŠุฉ ู„ู„ุฌุงู†ุจ
232
00:15:57,330 --> 00:16:03,530
ุงู„ุฃุณูู„ ุจุฑูุฑุงู„ ุฃุฏูŠู…ุฉ ู…ู‡ู…ุฉ ุฃูŠุถู‹ุง ููŠ ุญุงู„ุฉ
233
00:16:03,530 --> 00:16:10,210
ุงู„ุจุฑูŠูƒุงุฑุฏูŠุชุณ ุฃูˆุณุชุฑูƒู†ุฏุฑูŠุชุณ ูˆุงู„ุชู‡ุงุจ ุฑุฆุฉ ุงู„ูˆู‚ุชุŒ ุงู„ูˆู‚ุช
234
00:16:10,210 --> 00:16:15,350
ุฏู‚ูŠู‚ุฉุŒ ุฏู‚ูŠู‚ุฉุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ
235
00:16:15,350 --> 00:16:17,210
ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ
236
00:16:17,210 --> 00:16:19,270
ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ
237
00:16:19,270 --> 00:16:23,990
ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑุŒ ุฃุดู‡ุฑ Retrosternal pain, most
238
00:16:23,990 --> 00:16:28,350
likely cardiac, angina, myocardial infarction,
239
00:16:28,430 --> 00:16:32,450
myocarditis, pericarditis,
240
00:16:34,230 --> 00:16:39,550
mediastinal like esophagitis or malignancy, aortic
241
00:16:39,550 --> 00:16:43,230
dissection and aneurysm, esophagitis, esophageal
242
00:16:43,230 --> 00:16:49,510
spasm Peripheral chest pain secondary to the ู†ูŠู…ูˆ
243
00:16:49,510 --> 00:16:52,990
ุซูˆุฑุงูƒุณุŒ ุงู†ูุงู‚ุดู†ุŒ ุจุงู„ู…ู†ูˆุฑูŠ ุงู†ุจูˆู„ูŠุฒู…ุŒ ู…ุงุณูƒูˆู„ุงุฑ
244
00:16:52,990 --> 00:16:57,790
ูƒูˆุฑูŠุชุงู„ุŒ chest painุŒ sometimes breast disorderุŒ
245
00:16:57,790 --> 00:17:00,830
and sometimes a neurologic like intervertebral
246
00:17:00,830 --> 00:17:04,610
disc prolapse or herpes. Anxiety can cause also
247
00:17:04,610 --> 00:17:07,690
peripheral chest pain. The onset is very
248
00:17:07,690 --> 00:17:12,750
important. ู…ูุงุฌุฆุŒ Retrostenal chest pain in
249
00:17:12,750 --> 00:17:15,010
myocardial infarctionุŒ ู†ูŠู…ูˆ ุซูˆุฑุงูƒุณุŒ ุจุงู„ู…ู†ูˆุฑูŠ
250
00:17:15,010 --> 00:17:16,430
ุงู†ุจูˆู„ูŠุฒู…ุŒ
251
00:17:19,400 --> 00:17:26,660
ุงู„ู†ู…ูˆ ุซูˆุฑุงูƒุณ ุจุทูˆู„ุฉ ููŠ ุงู„ุชุนุจูŠุฑ ู…ุซู„ ุงู†ุฌูŠู†ูŠุง ุจุนุฏ
252
00:17:26,660 --> 00:17:32,280
ุงู„ุงู†ูุฌุงุฑ ูˆุงู†ูุฌุงุฑ ุฃูˆุณููŠุฌูŠุง ูˆุงู†ูุฌุงุฑ ู…ุณุชู…ุฑ ุจุฑูŠูƒุงุฑุฏูŠุชุณ
253
00:17:32,280 --> 00:17:40,640
ู…ุงุณูƒุฑูˆุณูƒุฑูŠุชุงู„ ูˆ G.I. ุฏูˆุฑุฉ ุงู„ุงู†ุฌูŠู†ูŠุง ุนุงุฏูŠุฉ ุฃู‚ู„ ู…ู†
254
00:17:40,640 --> 00:17:44,040
20 ุฏู‚ูŠู‚ุฉ ุฅุฐุง ูƒุงู†ุช ุญุฑุงุฑุฉ ุงู„ุญุฑุงุฑุฉ ุงู„ุชุฑุณุชูŠุฑู†ุงูŠุฉ
255
00:17:44,040 --> 00:17:47,620
ุชุณุชุบุฑู‚ ุฃูƒุซุฑ ู…ู† 30 ุฏู‚ูŠู‚ุฉ ูู‡ูŠ ุฃูƒุซุฑ ู…ู† ุญุฑุงุฑุฉ
256
00:17:47,620 --> 00:17:49,240
ุงู„ุงู†ูุงุฑูƒุณูŠุง
257
00:17:51,040 --> 00:17:54,220
characteristic and severity
258
00:17:54,220 --> 00:18:00,360
stabbing chest pain pleural and sometimes pleuritic
259
00:18:00,360 --> 00:18:03,460
chest pain that aggravated by taking deep
260
00:18:03,460 --> 00:18:09,500
inspiration hemoptysis
261
00:18:09,500 --> 00:18:13,140
hemoptysis is another also symptom we have to ask
262
00:18:13,140 --> 00:18:16,760
about the volume of the hemoptysis
263
00:18:16,760 --> 00:18:24,030
coughing up blood ูˆุงู„ุณุฑุนุฉ ุฅุฐุง ูƒุงู†ุช 100 ml ุฃูˆ ุฃู‚ู„
264
00:18:24,030 --> 00:18:28,650
ุฎู„ุงู„ 24 ุณุงุนุฉ ูู‡ูŠ ุฃูƒุซุฑ ู…ู…ูƒู† ุชูƒูˆู† ุซุงู†ูˆูŠุฉ ุจุงู„ู†ุณุจุฉ ู„ูŠ
265
00:18:28,650 --> 00:18:35,830
ุฃู†ู‡ุง ู‡ู…ุจุชุณุณุงุช ุตุบูŠุฑุฉ ู…ุฏุฑุนุฉ ู…ู† ุฃูƒุซุฑ ู…ู† 100 ู…ู„ ุฅู„ู‰ 400
266
00:18:35,830 --> 00:18:41,970
ู…ู„ ุฎู„ุงู„ 24 ุณุงุนุฉ ูู‡ูŠ ู…ุฏุฑุนุฉ ูˆู…ุฏุฑุนุฉ ูˆู…ุฏุฑุนุฉ ูˆู…ุฏุฑุนุฉ
267
00:18:41,970 --> 00:18:43,610
ูˆู…ุฏุฑุนุฉ ูˆู…ุฏุฑุนุฉ ูˆู…ุฏุฑุนุฉ
268
00:18:46,930 --> 00:18:54,670
ุฃุญูŠุงู†ู‹ุง 100 ู…ู„ ููŠ ุณุงุนุฉ ู…ุญูุธุฉ ุจู„ุฏ ุชุนุชุจุฑ ู…ุตุงุฑู
269
00:18:54,670 --> 00:19:02,430
ุงู„ู‡ูŠู…ูˆุจุชุงุณูŠุณ ูˆูŠุญุชุงุฌ ุฅุนุงุฏุฉ ุงู„ุชุนุงู…ู„ ูˆู…ุนุงู„ุฌุฉ ุฃูŠุถู‹ุง
270
00:19:02,430 --> 00:19:10,670
ุงู„ู€ Wheeze ู…ุง ูŠุนุชุจุฑ ุดุนุงุฑุงุช ูˆ ุดุนุงุฑ ุงู„ู€ Wheeze ูŠุนุชุจุฑ ุดุนุงุฑุงุช
271
00:19:10,670 --> 00:19:15,830
ูˆุดุนุงุฑ ุงู„ู€ Wheeze ูŠุฌุจ ุฃู† ู†ุณุฃู„ ุนู† ุชุบูŠูŠุฑ ุฏูŠุฑูˆู†ุงู„ 9 ู…ุฑุงุช
272
00:19:15,830 --> 00:19:21,700
ูˆ WheezingุŒ ุฃุฑุซูˆุจุงู†ูŠุงุŒ B and D'sุŒ ุจู„ูˆุฑ ู„ูŠู…ุจู‰
273
00:19:21,700 --> 00:19:25,240
swellingุŒ chest painุŒ and wheezeุŒ ุซู… ูŠุฌุจ ุฃู† ู†ุณุฃู„
274
00:19:25,240 --> 00:19:31,080
ุนู† ุฅุดุนุงุฑุงุช ู…ุฌู„ุณูŠุฉ ู…ุซู„ ุงู„ุญุฑุงุฑุฉุŒ ุงู„ู†ุงุชุณูˆูŠุชุฒุŒ
275
00:19:31,080 --> 00:19:39,400
ุงู„ูˆุงุชู„ูˆุณุŒ ุงู„ุงู†ูˆุฑูƒุณูŠุงุŒ ูˆู‚ุตุฉ ุงู„ู…ุณุงูุฑ ุฃูˆ ุงู„ุงู†ุชู‚ุงู„ ู…ุน
276
00:19:39,400 --> 00:19:40,800
ู…ุฑูŠุถ
277
00:19:47,380 --> 00:19:53,720
ุนุดุงู† ู†ุชุญุฏุซ ุนู† ู‚ุตุฉ
278
00:19:53,720 --> 00:20:04,720
ู‚ุตุฉ
279
00:20:04,720 --> 00:20:08,800
ู‚ุตุฉ
280
00:20:08,800 --> 00:20:19,440
ู‚ุตุฉ ุฏุฑุงุฌ ู‡ุณุชูˆุฑูŠ ู‡ูˆ ุงู„ู…ุณุชุฎุฏู… ููŠ ู…ุฏุนูˆู… ุนุงุฏูŠุฉ ูŠุฃุฎุฐ
281
00:20:19,440 --> 00:20:25,640
ุงู†ู‡ูŠุงุฑ ู…ุซู„ ุจุฑูŠููŠู†ุชุฑ ุฃูˆ ุฑู„ูŠูุฑ ู…ุซู„ ุฑูŠุณูƒูˆ ุงู†ู‡ูŠุงุฑ
282
00:20:25,640 --> 00:20:30,300
ุณุงู„ุจูŠุชุงู…ูˆู„ ุงู†ู‡ูŠุงุฑ ุฃูˆ ุงุณุชูŠุฑูˆูŠุฏ ุงู†ู‡ูŠุงุฑ ุฃูˆ ุฃูˆู„ุงุฑ
283
00:20:30,300 --> 00:20:37,560
ุงุณุชูŠุฑูˆูŠุฏ ุฏูŠุงุฑูˆุชูƒุณ ุงู†ุชูŠุจูŠูˆุชูƒุณ ุฃุญูŠุงู†ู‹ุง ุฃูƒุณุฌูŠู† ุฃูˆ
284
00:20:37,560 --> 00:20:41,380
ุฃูƒุณุฌูŠู† ููŠ ุงู„ู…ู†ุฒู„ Medication that can cause
285
00:20:41,380 --> 00:20:43,400
respiratory side effects, we have to ask about
286
00:20:43,400 --> 00:20:45,860
beta-glucan, non-steroidal anti-inflammatory drugs
287
00:20:45,860 --> 00:20:48,420
which can cause a proper constriction ุงู„ ACE
288
00:20:48,420 --> 00:20:53,280
-inhibitor ู…ู…ูƒู† ุชุนู…ู„ dry cough ุงู„ cytotoxic agent
289
00:20:53,280 --> 00:20:56,020
ุงู„ู„ูŠ can cause interstitial lung disease like
290
00:20:56,020 --> 00:21:01,140
ุงู„ู…ูŠุซูˆุชุฑูƒุณูŠุช ูˆุงู„ุงู…ูŠูˆุฏุฑูˆู† if the patient in oral
291
00:21:01,140 --> 00:21:03,580
contraceptive pills with increased risk of
292
00:21:03,580 --> 00:21:08,620
pulmonary embolism ูˆุงู„ุนู†ู ุฃูŠุถู‹ุง ู„ุฏูŠู†ุง
293
00:21:08,620 --> 00:21:14,800
ุชู‚ุฑูŠุจู‹ุง family history
294
00:21:14,800 --> 00:21:18,700
of asthma, lung cancer, cystic fibrosis, recent
295
00:21:18,700 --> 00:21:23,360
contact with others who were unwell, viral
296
00:21:23,360 --> 00:21:29,630
infection, pneumonia, TB social history smoking how
297
00:21:29,630 --> 00:21:33,370
many cigarette a day ูŠุนู†ูŠ we have to mention also
298
00:21:33,370 --> 00:21:36,630
how many pack year
299
00:21:36,630 --> 00:21:39,810
calculate it by multiplying the number of
300
00:21:39,810 --> 00:21:45,610
cigarette if it is twenty by the number of
301
00:21:45,610 --> 00:21:50,120
years ูŠุนู†ูŠ if the patient is smoking one pack of
302
00:21:50,120 --> 00:21:54,640
cigarette per day for the last five years we can
303
00:21:54,640 --> 00:21:59,080
mention the patient's smoking history five pack
304
00:21:59,080 --> 00:22:05,640
year alcohol how many units a week recreational
305
00:22:05,640 --> 00:22:11,040
drug use cannabis living situation in house flat
306
00:22:11,040 --> 00:22:14,790
ventilated there is a stair home oxygen or not
307
00:22:14,790 --> 00:22:20,690
who's live with the patient any care input daily
308
00:22:20,690 --> 00:22:26,110
activity also we have to mention ุงู„ occupation of
309
00:22:26,110 --> 00:22:28,670
the patient regarding respiratory history taking
310
00:22:28,670 --> 00:22:31,970
is very important ุงู„ patient ุงู„ู„ูŠ ุดุบุงู„ ููŠ ุงู„ chip
311
00:22:31,970 --> 00:22:36,610
yard construction ุงู„ plumber ู…ู…ูƒู† risk of
312
00:22:36,610 --> 00:22:39,680
asbestosis ุงู„ู†ุงุณ ุงู„ู„ูŠ ุจูŠุดุชุบู„ูˆุง ููŠ ุงู„ู…ู†ุงุฌู… ูˆุงู„ู€
313
00:22:39,680 --> 00:22:43,040
Miners ุงู„ู€ Pneumoconiosis ูˆุงู„ู€ Farmer ุจูŠูƒูˆู† ุนู†ุฏู‡ู…
314
00:22:43,040 --> 00:22:46,940
risk of having extrinsic allergic alveolitis ูŠุนู†ูŠ
315
00:22:46,940 --> 00:22:50,400
ุงู„ patient with hobbiesุŒ also paired fancierุŒ
316
00:22:50,400 --> 00:22:53,460
allergic extrinsic alveolitisุŒ ุงู„ุงุณู… ุงู„ู‚ุฏูŠู… ุงู„ู„ูŠ
317
00:22:53,460 --> 00:22:57,460
ู‡ูˆ ุงุณู…ู‡ุง ุงู„ุฌุฏูŠุฏ ุงู„ู„ูŠ ู‡ูˆ hypersensitivity pneumonia
318
00:22:57,460 --> 00:23:01,680
travel history high risk area for tuberculosis or
319
00:23:01,680 --> 00:23:08,020
recent long flight pulmonary embolism ุงู„ู€ Systemic
320
00:23:08,020 --> 00:23:13,120
Inquiry ุชุดุบู‘ู„ ุชูุนูŠู„ ุดุฑุญ ู‚ุทุน ุฃุฎุฑู‰ ู„ู„ู…ุดุงูƒู„ ู„ุดุฑูƒุงุช
321
00:23:13,120 --> 00:23:18,400
ุฃุฎุฑู‰ ู…ู† ุงู„ุฌุณู… ู…ู…ูƒู† ุชูƒูˆู† ุงู„ุฃุดูŠุงุก ู…ุง ุฐูƒุฑู‡ุง ุงู„ู€
322
00:23:18,400 --> 00:23:22,560
patient ูˆุจุงู„ุชุงู„ูŠ ู…ู‡ู… ุฌุฏู‹ุง ุฃู† ุชุณุฃู„ ุนู† Systemic
323
00:23:22,560 --> 00:23:27,120
Inquiry ุทุจุนู‹ุง ููŠ ุงู„ู€ History Taking ุจุชุงุนุฉ ุงู„ู€ ุงู„ู€
324
00:23:27,120 --> 00:23:29,540
ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€
325
00:23:29,540 --> 00:23:29,580
ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€
326
00:23:29,580 --> 00:23:30,520
ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€
327
00:23:30,520 --> 00:23:31,280
ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€
328
00:23:31,280 --> 00:23:31,540
ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€
329
00:23:31,540 --> 00:23:33,810
ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ุงู„ู€ ask the patient about these
330
00:23:33,810 --> 00:23:38,710
symptoms so we have to ask from GI, appetite,
331
00:23:39,050 --> 00:23:43,710
nausea, vomiting, dysphagia, weight loss, urinary,
332
00:23:44,070 --> 00:23:48,170
volume of urine, frequency, dysuria, urgency ูˆ
333
00:23:48,170 --> 00:23:51,370
ุงู„ู€ CNS ููŠ ุงู„ู€ vision headache, motor or sensory
334
00:23:51,370 --> 00:23:54,630
disturbance ูˆ ุงู„ู€ musculoskeletal wound and joint
335
00:23:54,630 --> 00:24:00,090
pain ูˆ muscle pain ูˆ ุฃูŠ skin rash or skin breaks
336
00:24:00,090 --> 00:24:05,460
or ulcer or lesion ุจู‡ุฐู‡ ุงู„ุทุฑูŠู‚ุฉ ู†ุชู…ูƒู† ู…ู† ุฅุบู„ุงู‚
337
00:24:05,460 --> 00:24:15,120
ุงู„ู…ุดุงุฑูƒุฉ ู†ุดูƒุฑ ุงู„ู…ุฑูŠุถ ุซู… ู†ุฌุฑุญ ุชุงุฑูŠุฎ ุงู„ู…ุฑูŠุถ ุดูƒุฑุง