Clinical Reasoning & Differential Diagnosis Flashcards
DIsease
A disturbance of structure or function
Asymptomatic Disease
HTN, disease is present but not symptomatic
Subjective data
changes in the body perceived by the patient, Lab tests that were done at a previous visit
Classification of Disease:Metabolic
Disturbances of cellular energy processes
Classification of Disease: Neoplastic
Characterized by abnormal cell growth
Disease Risk Factor Categories:Disease-associated
Past illnesses that increase risk
Disease Risk Factor Categories: Treatment-associated
Surgical, transfusions, medications, allergies & adverse reactions, immunizations
Natural History of Disease (A-F)
A)Biologic onset of the condition B) Pathologic evidence of disease detectable by screening C)Signs and Symptoms of disease D)Health care sought E) Diagnosis of Disease F) Treatment of Disease
Preclinical- natural history of disease
A) Biologic onset of the condition
B) Pathologic evidence of disease detectable by screening
They don’t know they have it-Screenings
Clinical- natural history of disease
C)Signs and symptoms of disease
D) Health care sought
E) Diagnosis of Disease
Outcome-natural history of disease
F) Treatment of disease
Components of a patient problem
- Location
- Character or quality
- Severity
- Timing: onset, frequency, duration
- Sequence of symptoms
- Aggravating/ alleviating factors
- Associated factors and treatments
Deductive Reasoning with example
from general to specific
example: “Im tired–> hypothyroid”
Inductive Reasoning
from specific to general- uses probability theory
example: “Its probably this….lets order this test”
Critical Decision-making steps
Synthesis of relevant info Prediction of outcomes Examination of assumptions Generation of options Identification of patterns Choice of actions
Differential Diagnosis
Consideration of possible causes that account for clinical manifestations
What are differential diagnosis based on?
Clinical hx, social hx, family hx, physical exam
Constructing a differential diagnosis 1-5
- )Data acquisition
- )Accurate problem representation
- )Develop differential diagnosis
- ) Prioritize the differential diagnosis
- ) Test your hypotheses
Differential Diagnosis steps 1) Data acquisition 2) Accurate problem representation
1) Identify most important cues (cause, timeline, label for cluster of symptoms)
2) Understand & preform advanced examination techniques (Risks)
Differential Diagnosis step 3) Develop a complete framed differential diagnosis
Develop a list of possible causes (lists from textbooks, anatomic framework, organ/system framework)
Differential Diagnosis step 4) Prioritize the deferential diagnosis
Prioritize the list: possible probabilistic prognostic pragmatic
Possibilistic approach
all known causes treated as equally likely
Probabilistic approach
consider those that are more likely first
Prognostic approach
consider most serious first
