Illness Scripts

Question 1

definition of illness script

Answer 1

organized mental summary of provider’s knowledge of a disease, “mental cue cards”

Question 2

Five components of an illness script

Answer 2

1. Fault
2. Enabling conditions
3. Consequences
4. Time course of disease
5. Management

Question 3

How to use illness scripts in diagnosis

Answer 3

identify biomechanical causes, who gets this disease, disease time course, clinical presentation

Question 4

epidemiology of strep pharyngitis

Answer 4

ages 5-15 and adults in contact with kids

Question 5

Severity of strep pharyngitis

Answer 5

severe

Question 6

Quality of strep pharyngitis

Answer 6

burning, raw

Question 7

Associated sxs of strep pharyngitis

Answer 7

fever > 100.4, pharyngeal and tonsillar erythema, tonsillar hypertrophy, palatal petechiae, no UR sxs

Question 8

tx of strep pharyngitis and viral pharyngitis

Answer 8

strep: abx, supportive care
Viral: supportive care

Question 9

Epidemiology of viral pharyngitis

Answer 9

all ages, most under 5 caused by a variety of viruses

Question 10

Quality of viral pharyngitis

Answer 10

aching, sore

Question 11

Associated symptoms of viral pharyngitis

Answer 11

low grade fever (if any), cough, rhinorrhea, hoarseness, nasal congestion, HA

Question 12

Building an illness script before seeing the patient

Answer 12

look up history, lab results, imaging; ask nurse about noninvasive tests such as UA or rapid strep;

Question 13

Building an illness script during patient encounter

Answer 13

prioritize and direct questions, tailor PE, anticipate complications/associated sxs

Question 14

Building an illness script after patient exam

Answer 14

present top three diagnoses, suggest ordering labs or imaging, recommend consults and tx plans

Question 15

VINDICATE mnemonic

Answer 15

Vascular, Iatrogenic, Neoplasm, Drugs, Inflammatory/Infections/immune, Congenital, Anatomical, Trauma, Environment/Endocrine