week 2

Question 1

disease illness script

Answer 1

-representation of a condition in the mind of a practitioner
-vary between practitioners
-tend to have the following components:
–>epidemiology
–> time course
–> clinical presentation (signs and symptom; i.e. syndrome)
–> mechanism/pathophysiology
-some resources may recommend additional components

Question 2

components of a disease illness script? (4)

Answer 2

–>epidemiology
–> time course
–> clinical presentation (signs and symptom; i.e. syndrome)
–> mechanism/pathophysiology

Question 3

signs + symptoms =

Answer 3

syndrome

Question 4

3 main parts of epidemiology

Answer 4

1. demographics
   2.risk factors
2. exposures

Question 5

epidemiology

Answer 5

1. demographics
   -age, sex
   -race/ethnicity
   -socioeconomic status
   2.risk factors
   -including pre-existing conditions
2. exposures
   -including travel, occupational, hobbies, sexual, drugs, medications, pets, close contacts

Question 6

time course

Answer 6

-duration
–> hyper acute, acute (couple of days), subacute, chronic (>3 months)
-persistence/pattern
–> constant (i.e. stable, progressive)
–> episodic (i.e. waxing and waning, intermittent)

Question 7

clinical presentation

Answer 7

-most important signs and symptoms (evidence)
-can use “classic” presentation but note that these can be misleading (probability)

Question 8

high quality disease illness scripts

Answer 8

-disease illness scripts
–> use medical terminology and categories
–> will change over time with experience and research
-multiple disease illness scripts can be compared and contrasted

Question 9

comparing and contrasting disease illness scripts

Answer 9

Create a table with illness scripts in adjacent columns or rows

compare clinical syndromes

Question 10

processing and patient illness scripts

Answer 10

-the diagnostic process is improved (efficiency and precision) with good problem representation
-problem representation
–> create a problem list
–> process this list
-emphasize the most valuable evidence and de-emphasize less valuable evidence
-abstract the patients concerns into medical language
–>finalize the problem representation in a way that it can be compared with disease illness scripts

Question 11

components of a disease illness script vs components of patent illness script

Answer 11

disease:
–>epidemiology
–> time course
–> clinical presentation (signs and symptom; i.e. syndrome)
–> mechanism/pathophysiology

patient:
–>epidemiology
–> time course
–> clinical presentation (syndrome statement)
–> other important medical history

Question 12

patient illness script

Answer 12

-a concise representation of the patients concern that allows matching with a disease illness script
-similar to the disease illness script and has the following components:
–>epidemiology
–> time course
–> clinical presentation (syndrome statement)
–> other important medical history
-provide a strong foundation fro good medical record-keeping

Question 13

epidemiology (patient illness script)

Answer 13

1. demographics
   -age, sex
   -typically excludes race/ethnicity, socioeconomic status, physical characteristics (i.e. obesity)
   –>these tend to promote bias more than they help with diagnosis
   2.risk factors and other relevant items from past medical history
2. exposures
   -including people, occupational, hobbies, drugs, medications

Question 14

clinical presentation (patient illness script)

Answer 14

-focus on most important signs and symptoms
-exclude:
-elements already mentioned in previous sections
-findings of little relevance
-past medical history that is unconnected to the chief complaint
-previous diagnosis (unless they were clearly correct)

Question 15

simple problem list –> processed problem list –> patient illness script

Answer 15

patients description –> medical terminology –> epidemiology, time course, syndrome, other history

Question 16

accurate problem representation

Answer 16

patients concerns must be translated into medical terminology

Question 17

help to develop a differential diagnosis list

Answer 17

compare disease illness scripts with patient illness scripts