MODULE 1 Flashcards
DIAGNOSTIC REASONING TYPES OF HISTORIES H&P
<p>Augenblick diagnosis</p>
<p>"blink of an eye diagnosis"
based on intuition
high failure rate</p>
<p>2 types of decision making</p>
<p>1-Intuitive
| 2-Analytical (more time and effort, less error)</p>
<p>Points to consider</p>
<p>RANGE of explanations
MAINTAIN suspicion
NARROW the differential</p>
<p>HISTORY P Q R S T</p>
<p>Precipitating/palliating factors Quality/ Quantity Region/Radiation Severity/ associated Symptoms Timing/ Temporal descriptors</p>
<p>SENSITIVITY</p>
<p>% positive when condition present (when sick)</p>
<p>SPECIFICITY</p>
<p>% negative when condition absent (when healthy)</p>
<p>PRETEST PROBABILITY</p>
<p>PREVELANCE IN POPULATION</p>
<p>LIKELIHOOD RATIO</p>
<p>HOW RELIABLE?
that a positive test represents an accurate positive result and that a negative test represents an accurate negative result</p>
>1 = ASSOCIATED WITH PRESENCE OF ILLNESS <1 = ASSOCIATED WITH ABCENSE
<p>BAYES THEOREM</p>
<p>standard for basing a clinical decision on available evidence</p>
<p>DIAGNOSTIC CONSIDERATIONS</p>
<p>PROBABILITY + PROGNOSIS
| MOST LIKELY + MOST LIFE THREATENING</p>
<p>types of histories</p>
<p>COMPREHENSIVE VS FOCUSED</p>
<p>COMPREHENSIVE</p>
<p>H & P
| WELL VISIT</p>
<p>FOCUSED</p>
<p>SOAP
| PROBLEM FOCUSED</p>
<p>SUBJECTIVE</p>
<p>SYMPTOMS:
| WHAT THE PATIENT REPORTS</p>
<p>OBJECTIVE</p>
<p>SIGNS:
| WHAT CAN BE MEASURED AND OBSERVED</p>
COMPREHENSIVE HISTORY
CHIEF COMPLAINT PRESENT ILLNESS HISTORY (MEDICAL & SURGICAL) FAMILY HISTORY PERSONAL HISTORY SOCIAL HISTORY ROS
ROS
GENERAL SKIN HEENT NECK BREAST LUNG CARDIAC GI URINARY GENITAL MUSKULOSKELETAL PERIPHERAL VASCULAR NEURO HEMATOLOGIC ENDOCRINE PSYCH
CLINICAL REASONING
IDENTIFY ABNORMALS LOCALIZE CLUSTER HYPOTHESIZE TEST
SCREENING TESTS
USED TO LOCATE INDIVIDUALS IN EARLY STATE OF DISEASE, NOT DIAGNOSITIC=INDICATE FURTHER TESTING
