clinical reasoning Flashcards

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1
Q

name of a specific disease or disease process - is it a:
a. diagnosis
b. prognosis
c. treatment option

A

a. diagnosis

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2
Q

probable course and outcome of a disease or disease process - is it a:
a. diagnosis
b. prognosis
c. treatment option

A

b. prognosis

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3
Q

ways in which a disease or disease process may be managed - is it a:
a. diagnosis
b. prognosis
c. treatment option

A

c. treatment option

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4
Q

true or false - is acupuncture, weight loss and physiotherapy a treatment option?

A

true - treatment options do not just include medications and surgery, it’s anything that could be used to manage a disease/disease process and its clinical signs

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5
Q

“I don’t know what the skill is so I don’t know I can’t do it” - is this an example of:
a. unconscious incompetence
b. conscious incompetence
c. conscious competence
d. unconscious competence

A

a. unconscious incompetence

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6
Q

“I know what the skill is and have attempted to do it and failed” - is this an example of:
a. unconscious incompetence
b. conscious incompetence
c. conscious competence
d. unconscious competence

A

b. conscious incompetence

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7
Q

“I can perform the skill, but I will fail if I don’t concentrate” - is this an example of:
a. unconscious incompetence
b. conscious incompetence
c. conscious competence
d. unconscious competence

A

c. conscious competence

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8
Q

“I can perform the skill without even thinking about it” - is this an example of:
a. unconscious incompetence
b. conscious incompetence
c. conscious competence
d. unconscious competence

A

d. unconscious competence

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9
Q

decisions made without thinking about the process - is it:
a. pattern recognition
b. analytical reasoning

A

a. pattern recognition

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10
Q

decisions that require conscious step by step reasoning - is it:
a. pattern recognition
b. analytical reasoning

A

b. analytical reasoning

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11
Q

you will hear vets referring to their “differentials” and their “differentials list”. what do these terms refer to?

A

all the different diseases that could explain the animal’s clinical signs (when in a differentials list, usually ordered from most to least likely (see image for potential hyperthyroidism example)

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12
Q

You are presented with a pregnant cow that is in sternal recumbency in a field. You immediately believe the cow has ketosis (is using ketone bodies for energy due to limited availability of glucose).

How well does pattern recognition work in this situation?
a. very well
b. less well; pattern recognition could easily result in the wrong answer

A

b. less well; pattern recognition could easily result in the wrong answer

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13
Q

what is clinical reasoning?

A

the process of integrating information to make diagnoses, treatment options and prognoses

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14
Q

true or false - clinical reasoning involves looking for patterns in data

A

true

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15
Q

true or false - successful pattern recognition involves large amounts of clinical experience

A

true

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16
Q

true or false - clinical reasoning can occur consciously or unconsciously

A

true (remember the two types - pattern recognition vs analytical reasoning)

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17
Q

true or false - pattern recognition is not true clinical reasoning

A

false - it just needs to be used under appropriate circumstances, and is more prone to being affected by bias

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18
Q

true or false - bias is only present in non-analytical reasoning

A

false - it’s more common in pattern recognition, but can still occur with analytical reasoning if we are not careful

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19
Q

true or false - running routine diagnostic tests is an appropriate step when it is not clear what is wrong with the patient

A

false - they’re invasive (eg blood tests), and/or pose risk and stress to our patients, as well as costing money without justification

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20
Q

is pattern recognition more likely to work when:
a. it is easy to test for the differential diagnoses
b. there are many possible causes for the clinical sign

A

a. it is easy to test for the differential diagnoses

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21
Q

is pattern recognition more likely to work when:
a. the disease is common
b. the disease is rare

A

a. the disease is common

22
Q

is pattern recognition more likely to work when:
a. the clinical signs are unique for the disease
b. only a few clinical signs aren’t typical

A

a. the clinical signs are unique for the disease (if even a few of the clinical signs of the disease aren’t consistent with the diagnosis, you risk making the wrong one)

23
Q

requires a large amount of clinical experience and knowledge to be successful - is it:
a. analytical reasoning
b. pattern recognition

A

b. pattern recognition

24
Q

requires the condition to have unique clinical characteristics to be successful - is it:
a. analytical reasoning
b. pattern recognition

A

b. pattern recognition

25
Q

the reasoning process is systematic -
a. analytical reasoning
b. pattern recognition

A

a. analytical reasoning

26
Q

the reasoning process is quick - is it:
the reasoning process is systematic -
a. analytical reasoning
b. pattern recognition

A

b. pattern recognition

27
Q

the reasoning process is conscious - is it:
a. analytical reasoning
b. pattern recognition

A

a. analytical reasoning (pattern recognition is unconscious)

28
Q

identifying urgent problems - what does the ABC of triage stand for?

A

A - airway
B - breathing
C - circulation
*these must be addressed first as they endanger life

29
Q

order these issues from most to least severe - skin grazing and bruises, difficulty breathing, broken leg

A
  1. difficulty breathing (most likely to endanger his life)
  2. broken leg
  3. skin grazing and bruising (least severe)
30
Q

order these problems from most to least specific - reduced appetite, vomiting, abdominal discomfort

A
  1. vomiting (most specific)
  2. abdominal discomfort
  3. reduced appetite (least specific)
31
Q

Where might you find the information required to “define” and “refine” at each step of the clinical reasoning process?
a. The clinical history
b. The clinical examination
c. Initial diagnostic test results
d. All of the above

A

d. All of the above

32
Q

When prioritising a problem list, what do you base your problem ranking on?
a.. Chronological order in which problems developed
b. Specificity and sensitivity
c. The owner’s level of concern
b. Urgency and specificity

A

b. Urgency and specificity

33
Q

what is the first step in the Maddison approach to clinical reasoning?
a. define and refine the system
b. define the lesion
c. define and refine the problem
d. define the location

A

c. define and refine the problem

34
Q

what is the second step in the Maddison approach to clinical reasoning?
a. define and refine the system
b. define the lesion
c. define and refine the problem
d. define the location

A

a. define and refine the system

35
Q

what is the third step in the Maddison approach to clinical reasoning?
a. define and refine the system
b. define the lesion
c. define and refine the problem
d. define the location

A

d. define the location

36
Q

what is the fourth step in the Maddison approach to clinical reasoning?
a. define and refine the system
b. define the lesion
c. define and refine the problem
d. define the location

A

b. define the lesion

37
Q

Which of these clinical problems is most urgent?
a. Dyspnoea (difficulty breathing)
b. Sneezing
c. Vomiting
d. They are equally urgent

A

a. Dyspnoea (difficulty breathing) - remember the ABC abbreviation of triage; Airway, Breathing, Circulation)

38
Q

if the body system involvement is primary, does that mean it’s:
a. structural
b. functional

A

a. structural

39
Q

if the body system involvement is secondary, does that mean it’s:
a. structural
b. functional

A

b. functional

40
Q

a dog is vomiting because it ate a pile of rubbish and it’s stomach is distended - is this a result of:
a. primary (structural) disease
b. secondary (functional) disease

A

a. primary (structural) disease

41
Q

a dog is vomiting because of damage to the stomach from a virus - is this a result of:
a. primary (structural) disease
b. secondary (functional) disease

A

a. primary (structural) disease

42
Q

a dog is vomiting because it ate a bone that has become stuck in its intestine - is this a result of:
a. primary (structural) disease
b. secondary (functional) disease

A

a. primary (structural) disease

43
Q

the dog is vomiting because it is acidotic - is this an example of:
a. primary (structural) disease
b. secondary (functional) disease

A

b. secondary (functional) disease

44
Q

a dog is vomiting because it has motion sickness - is this an example of:
a. primary (structural) disease
b. secondary (functional) disease

A

b. secondary (functional) disease

45
Q

muscle weakness due to muscle loss, muscle trauma, infection of the muscle… is this an example of
a. primary (structural) muscular disease
b. secondary (functional) muscular disease

A

a. primary (structural) muscular disease

46
Q

muscle weakness due to low blood sugar, poor oxygen delivery, low potassium… is this an example of:
a. primary (structural) muscular disease
b. secondary (functional) muscular disease

A

b. secondary (functional) muscular disease

47
Q

vomiting due to intestinal worms.. is this an example of:
a. local disease
b. systematic disease

A

a. local disease

48
Q

what is best detected through visualisation such as imaging or cytology/histopathology?
a. primary (structural) disease
b. secondary (functional) disease

A

a. primary (structural) disease

49
Q

what is best detected through the use of blood tests?
a. primary (structural) disease
b. secondary (functional) disease

A

b. secondary (functional) disease

50
Q

Marama is presented with Ilse, an 8-year-old Dobermann. The owner tells Marama that Ilse has had two recent episodes in which she became “dizzy” and then collapsed. Based on these problems, Marama should next:
a. Refine the problems
b. Prioritise the problem list
c. Define the body system
d. Refine the body system

A

a. Refine the problems - it is unclear what is meant by “dizzy” and “collapse”. marama needs a better understanding of the problem/s before she can undertake further steps