Achievement 4 by @gkamjom Task : Applying Markdowns

Hello to you all stemians. Hope your day is moving well. Today we are going to move to achievement4 , whose objective is to master markdown. I am going to include the various markdown I know in this writing .
So our subject will be on

MEDICAL APPROACH TO DIAGNOSE A PATIENT COMPLAINING OF PAIN AT THE RIGHT ILIAC FOSSA

First I will explain what the term right iliac fossa means. In the image👈🏽👈🏽 You will see that the term is an anatomatical region in the abdominal pelvic cavity and in that region we can have the appendix, the ceacum the ascending colon and even some part of the small intestine.

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Of course after paying your consultation fees , you will go in the office and the doctor will welcome you with a great smile.
After that these will be the order of his approach

• IDENTIFICATION :
  The doctor will include in his report your name , surname , sex , age , origin , residence , profession , religion, matrimonial status , race e.c.t.

• REASON FOR CONSULTING :
  The doctor will then note down your main complain or the main reason that pushed you to come to the hospital, which will be; pain accentuated at the right iliac fossa . Of course as a patient who lacks medical terms you will say maybe that you are feeling pains at your right side. But the doctor will write it differently in the report.

• HISTORY OF THE SICKNESS :
  For every functional sign you mention example nausea , constipation , vomiting the doctor will explain the history like when it started , for how long, the evolution e.c.t
  And for the pain , the doctor will have to characterize the pain by including place , intensity, type , irradiation, periodicity, continuous or non-continuous , calming factors, aggravating factors, triggering factors , associated signes , antalgique position.
  Usually for this kind of pain is an abdominal pain quickly increasing, epigastric or para ombilical at the beginning and later localised in the right iliac fossa, the pain is increased when you cough or when you mobilize the abdomen.

• BACKGROUND : the doctor will ask your background in family, medical, surgeries, trauma , immunology, allergies, toxic, social, professional, gynaecology, obstetrics on the sickness you are presenting or even others.

• REVIEW OF SYSTEMS : first the doctor will research general signs like fever , asthenia, general pain. Then depending on your main complain, for this case he will check digestive signes like; vomiting, diarrhea , constipation, pains. Before reviewing the other systems of the body.

• PHYSICAL EXAMINATION :
  The doctor will take note on the following;
  1.General state
  2.General signs: weight, height, aterial blood pressure, temperature, respiratory frequency, cardiac frequency.
  3.IPPA(Inspection, Palpation, Percussion, Auscultation)
  4.Pelvic touch( which consist of vaginal and rectal touch)
  For this case association signs detected will likely be, hyperthermia, tachycardia , tachypnea
  Inspection of the mouth can be associated with coated white tongue .
  Palpation : we will detect , MC BURNEY sign , BLUMBERG sign , ROVSING sign , COPE'S PSOAS test
  Percussion; normal unless other associated sickness
  Auscultation; normal
  Pelvic touch positive ( pain at the right)

• SYNDROME SUMMARY : a syndrome is a group of signs and symptoms that defines it.
  For this we have Acute infected Abdomen

• HYPOTHESIS AND DIAGNOSIS :

SYMPTOMS	VALUE
1.Abdominal pain migrating towards the RIF(right iliac fossa	1
2.Pain on palpation of the RIF	2
3.Pain at the decompression of the RIF	1
4.Anoxeria	1
5.Nausea and Vomiting	1
6.Temperature>37.3°c	1
7.Hyperleucocytosis>10000	2
8.Polynuclease neutrophils	1
TOTAL	.../10

Score<5 ; less probable appendicitis
Score inbetween 5-6 ; possible diagnosis of appendicitis
Score inbetween 7-8; appendicitis very probable
Score>9 ; appendicitis confirmed

• COMPLEMENTORY EXAMINATIONS

1. BLOOD NUMERATION to check hyperleucocytosis
2. Abdominal échographie to check the inflammation of the appendix
   These examinations will help you confirm your diagnosis.

Here are links to my previous achievements:
Achievement 1 : Introduce yourself on steemit by @gkamjom

Achievement 2 @gkamjom Task: Basic Security on Steem

Achievement 3 by @gkamjom-Assignment: Content Protocol

CC:
@juichi