W1

Question 1

Diagnostic process includes?

Answer 1

hypothesis, information gathering, integration and interpretation

Question 2

Red flag?

Answer 2

A warning sign or symptom that may indicate a serious or potentially life threatening medical condition

Question 3

Examples of red flags?

Answer 3

Changes in mental status, severe chest pain, severe shortness of breath, suicidal ideation

Question 4

Chain of diagnostic process?

Answer 4

obtain some information from the patient (history taking, patient centered interviewing) ->
consider what might be going on and what information you still need in order to take action (illness scripts, differential diagnosis, probability, evidence, testing thresholds, treatment thresholds) <->
get this information (history taking, patient centered interviewing, physical exams) ->
take appropriate action (testing thresholds, treatment thresholds, probability, evidence)

Question 5

What are symptoms?

Answer 5

Subjective, self-reported, experienced by patient, not-directly measurable. Includes nausea, fatigue, pain, dizziness.

Question 6

Does history taking have a high diagnostic value?

Answer 6

Yes

Question 7

Is history taking expensive and harmful?

Answer 7

No, history taking is inexpensive and harmless

Question 8

Define symptom?

Answer 8

Manifestation of a disease reported by the patient

Question 9

What aspects history taking includes?

Answer 9

Past and present personal medical history, family history, social history and current medications

Question 10

Patient-centered interviewing focuses on?

Answer 10

Patients ideas, feelings of their illness and the impact their condition has on their functioning and their expectations

Question 11

Define sign?

Answer 11

Manifestation of the disease perceived by the clinician

Question 12

What is sign?

Answer 12

Objective, observable, measurable.

Question 13

How are signs identified?

Answer 13

Physical exams, lab tests and medical imaging

Question 14

Example of a sign?

Answer 14

Dermatomal rash, a sign of varicella zoster virus reactivation aka shingles

Question 15

Examples of physical exams?

Answer 15

Auscultation, inspection, percussion, palpation…

Question 16

Define premature closure?

Answer 16

Failing to consider reasonable alternatives after an initial diagnosis is made.
cognitive bias of the physician > leads to diagnostic errors

Question 17

What is differential diagnosis (ddx)?

Answer 17

Systematically considering and ruling out various possible medical conditions or diseases that could explain patient’s signs and symptoms
(the process by which clinicians consider some possible causes of the patient’s signs and symptoms before making a final diagnosis)

Question 18

Clinically relevant memory is accessed in _______

Answer 18

illness scripts

Question 19

Difference btw disease illness scripts and patient illness scripts?

Answer 19

Disease illness scripts: to learn and to compare and contrast conditions
Patient illness scripts: to facilitate differential diagnosis

Question 20

Illness scripts include______

Answer 20

Predisposing conditions, clinical features and mechanism of the illness

Question 21

What is probability?

Answer 21

Likelihood of different conditions

Question 22

Define prevalence?

Answer 22

Proportion of individuals in a specific population who have a particular condition or disease at a given point in time.
Ex: Prevalence of hypertension in adults is 22.6% in Canada in 2018

Question 23

How evidence is gathered?

Answer 23

Through patient history, physical exams and testing

Question 24

The value of a piece of evidence is well-represented by a likelihood ratio (LR).
True or False

Answer 24

True

Question 25

Define incidence?

Answer 25

Rate at which new cases of a specific medical condition or disease occur within a defined population over a specified period. (New cases per unit of population)
Ex: the rate of new cases of chlamydia among women was 429 per 100,000 population compared to a rate of 311 per 100,000 among men in Canada from 2010 to 2019