Study

Question 1

What is a disease illness script?

Answer 1

representation of a condition in the mind of a practitioner

Question 2

what are the components of a disease illness script?

Answer 2

• epidemiology
• time course
• clinical presentation
• mechanisms/pathophysiology

Question 3

Epidemiology

Answer 3

• demographics - age, sex, race/ethnicity. socioeconomic status
• risk factors - pre-existing conditions
• exposures - travel, work, hobbies, medications

Question 4

Time Course

Answer 4

• duration - hyperacute, acute, subacute, chronic
• persistence/pattern - constant (stable, progressive), episodic (waxing and waning, intermittent)

Question 5

Clinical Presentation

Answer 5

signs and symptoms

Question 6

what do you need in disease illness scripts to make it high quality?

Answer 6

• use medical terminology and categories
• will change over time with experience and research

Question 7

what are the components of a problem representation

Answer 7

• create a problem list
• process this list - emphasize the most valuable evidence and de-emphasize less valuable evidence
• finalize the problem representation in a way that it can be compared with disease illness scripts

Question 8

what is a patient illness script

Answer 8

a concise representation of the patient’s concern that allows matching with a disease illness script

Question 9

components of a patient illness script

Answer 9

• epidemiology
• time course
• clinical presentation
• other important medical history

Question 10

what do you exclude in the epidemiology for patient illness script compared to the disease illness script?

Answer 10

typically exclude race/ethnicity, socioeconomic status, physical characteristics

Question 11

Differential diagnosis

Answer 11

the process by which clinicians consider some possible causes of the patient’s signs and symptoms before making a final diagnosis

Question 12

why not just go with your first guess instead of differential diagnosis?

Answer 12

initial guesses are particularly subject to the availability heuristic

Question 13

why not just make a list of all possibilities?

Answer 13

• technically impossible
• takes a long time and lead to confusingly long list

Question 14

a different approach: 3 Ps

Answer 14

Probability: what is most likely?
Prognosis: “must-not-miss” conditions
Pragmatism: what conditions have the best benefit:harm ratio if treated

Question 15

What is probability?

Answer 15

how likely something is, usually expressed on a scale of 0-100%