differential diagnosis: Flashcards
1
Q
What is the differential diagnosis?
A
- it is the process by which clinicians consider some possible causes of the patient’s signs and symptoms before making a final diagnosis.
2
Q
How do we come up with a differential diagnosis?
A
- after obtaining some information from the patient, compare this information to one’s understanding of different conditions to generate multiple hypotheses about what might be going on.
3
Q
what happens if differential diagnosis is not done deliberately?
A
- people tend to fail to consider options after arriving at an initial guess. this involves considering that you may have been wrong.
4
Q
Why is it bad to go with your initial guess?
A
- especially for beginners this is wrong too often.
- the most common conditions are typically not the most serious so the consequences of missing a serious diagnosis are higher.
5
Q
what are initial guesses subject to?
A
- the availability heuristic.
6
Q
what is the availability heuristic?
A
the tendency to use information that comes to mind quickly and easily.
7
Q
what does the availability heuristic favour?
A
- it favours recent or more memorable experiences.
8
Q
why do we not make a list of all possibilities?
A
- Aka possibilism.
- it is technically impossible to list all conditions.
- it takes a long time and tends to be a confusingly long list without the extra possibilities adding value.
- can lead to unnecessary testing and diagnostic workup.
- people sometimes use mnemonics as frameworks for generating differentials (VINDICATE) but even these tend to lead to excessively long lists.
- ultimately you can add differentials later anyway if they become more reasonable to consider.
9
Q
What are the 3 P’s to consider?
A
- probability: what is most likely?
- Prognosis; must-not-miss conditions- which conditions are worse if left unconsidered?
- pragmatism: what conditions have the best benefit; harm ratio?
10
Q
When do we start considering conditions?
A
- generally is done after gathering a bit of information about the chief concern.
- this will let you work with a more holistic sense of the patient’s concern.
- will allow you to better compare it with your disease illness scripts.
11
Q
what happens if you start considering too early?
A
- the list will tend to be pointlessly long.
12
Q
what does differential diagnosis allow for?
A
- that the initial beliefs about the diagnosis were incorrect, facilitating better decision making.
13
Q
what is differential diagnosis aided by?
A
- appropriate problem representation.
