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《临床医学导论》期末复习重点内容名词解释：1、循征医学2、批判性思维3、刻画诊断法4、希波克拉底誓言5、误诊6、临床随机对照试验（RCT）第一篇医学篇1、我国卫生改革的目的和基本原则是什么？2、当前我国医改面临的重大问题是什么？医学专门分科与发展1、“医学教育全球最低基本要求”是什么？2、怎样实施科学教育与人文教育的高度融合？第二篇医生与病人篇1、病人有何权利和义务？2、病人角色的认同有几个阶段？第三篇临床篇第五章临床诊断思维1、临床诊断思维的三个程序2、正确的诊断从哪里来（五驾马车）第六章循证医学与批判性思维1、循证医学实践的“五部曲”2、循证医学治疗学中的“个体化原则”IntroductionToClinicalMedicineChoices:1.Thefollowingdisorderscancausebleedingdiseases:(④)①Bloodvesselwallsdisorder②Plateletfunctionornumberdisorder③Coagulationfactorsdisorder④Allabove2.Themostlycommonseenanemiais(②)①Thalassemia②IronDifferentiationDisorder③HaemolyticAnemia④AplasticAnemia3.Themostlycommonseenpathologicalproteinuriais(①)①Glomerularproteinuria②Tubularproteinuria③Histicproteinuria④Posturalproteinuria4,Whatisthepossiblecomplicationdiagnosiswhenadiabetesmellituspatientwithketonebodies(+)inhisurine?(④)①Renalfailure②Glucosuria③Infection④Ketoacidosis5.TheessenceofEvidenceBasedMedicineis(④)①Methodsofgatheringinformation②Evaluationofinformationefficacy③Skillsofmedicine-decision④Allabove6.ThebasicprinciplesofthePhysicians’Charterare:(④)①Principleofprimacyofpatients'welfare②Principleofpatients'autonomy③Principleofsocialjustice④Allabove7.Threefoundationscientifictheoriesin20centuryare:(③)①A/Principleofenergyconversationandinvertion;B/Darwinism;C/Celltheory②A/HumanGenomeProject;B/Manhattanproject;C/Apollomooncraftproject③A/Quantumtheory;B/Theoryofrelativity;C/Theoryofgene④A/DNAstructuremodel;B/RevivalofLearning;C/Bio-psycho-socialMedicalModel8.Threediscoveriesofnaturesciencein19thcenturyare:(①)①A/Principleofenergyconversationandinvertion;B/Darwinism;C/Celltheory②A/HumanGenomeProject;B/Manhattanproject;C/Apollomooncraftproject③A/Quantumtheory;B/Theoryofrelativity;C/Theoryofgene④A/DNAstructuremodel;B/RevivalofLearning;C/Bio-psycho-socialMedicalModelExplanation1.Evidencebasedmedicine1)Practiceofusingrelatedinformationasmuchaspossible,bycautiously,preciselyandwiseverificationandevaluation,makingmedicine-decision.2)FOundingfatherisPro.DavidSackett,Canadianepidemiologist,firstestablished：“EBMisanewideafornewmodelofclinicalpractice“3)From1992，thenewconceptofEBMhasbeengraduallyappliedinclinicalmedicinefields.2.CriticalthinkingCriticalthinkingistheintellectuallydisciplinedprocessofactivelyandskillfullyconceptualizing,applying,analyzing,synthesizing,and/orevaluatinginformationgatheredfrom,orgeneratedby,observation,experience,reflection,reasoning,orcommunication,asaguidetobeliefandaction.Initsexemplaryform,itisbasedonuniversalintellectualvaluesthattranscendsubjectmatterdivisions:clarity,accuracy,precision,consistency,relevance,soundevidence,goodreasons,depth,breadth,andfairness.1)Criticalthinkingisimportantattributeforsuccessinthe21stcentury.2)Weneedtoidentifyexpectedbehaviorsandsubtasksassociatedwithcriticalthinkinganddevelopoperationaldefinitions.3)Weneedtocompletetaskanalyses,defineintermediategoals,anddevelopevaluationmethods.4)Weneedtoidentifybestmethodsofinstructionforeachaspectofthecriticalthinkingprocess.3.Scoreddiagnosis－Detaileddescription,fromcommonfeaturestoindividualityofonecertaindiseasethroughthefollowingwayanalyzingthesymtoms:1）Inducement诱因2）Onset起病3）Position部位4）Character性质5）Degree程度6）Releaseway缓解方式7）Duration持续时间8）Course病程9）Irradiation放散部位10）Associatedsymptoms4.HippocraticOathBefore2500year,establishedbythefatherofwestmedicine:Hippocratic,afamousancientGreekdoctor.CoreoftheHippocraticOath:Servespatientswholeheartedly,“forbidsallharmsandinappropriatebehaviorstopatients”1)Gratefultotheinstructor2)Tryones’besttoseekthebenefitforthepatients3)Commitillegalactivitiesinnoway4)Keepsecretsandrespectindividualprivacy.5.Misdiagnose误诊Veryseriousterm,notonlyinacademicbutalsosocialandlegalterm.Definition:Diagnosisnotyetcorrect,ornotyetcompletecorrect.ClassificationofMisdiagnose：1)Non-defectMisdiagnose非过失性误诊2)DefectMisdiagnose过失性误诊6.Randomizingcontroltrial（RCT）临床随机对照试验AccordingtoEBMdemands,toevaluatethedrugandnon-drugtreatmentefficacyandsafety,trialisdesignedandprocessedincludingprospective,multicenter,largesamplestargetingprognosiscriterions.From1980s，manyRCTsevaluateandre-evaluateseriesofdrugsforimportantdiseases,correctandupdatemanyconfusedandwrongideas,overwritesometreatmentstrategies.Questions第一篇医学篇1.AimsandPrinciplesofReforminHealthsystem（一）Aims：Toenhancethevigor,mobilizetheenthusiasm,improvethequaqlityandefficacyandservethepeople.（二）Principles：1)People’sneedasthefirstneed2)People’svoiceasthefirstsignal.3)People’sbenefitsasthefirstbenefits4)People’ssatisfactionasthefirststandard.2.Whataretheseriousproblemsinthereformofhealthsystem?(一)Healthcareerdevelopmentunbalancedalloverthecountry.(二)Healthdevotionbygovernmentseriouslyinsufficient.(三)Medicalservicesystemandmodeldon’tchangewiththehealthservicerequirementchanges.（四）Healthresourcesstationwithoutreason（五）Medicalserviceexpensesincreasetoofast.医学专门分科与发展1.“Internationalstandardsofbasicmedicaleducation：1999,WorldFederationforMedicalEducation（WFME）inCopenhagenconferenceestablishedtherequiredcapacityofdoctorssallovertheworld.Qualifieddoctorshouldhavesuchcapacitiesasfollowing:1)Patie