<ul><li>the most difficult, complex & challenging of all the healing arts </li></ul><ul><li>Frontline of medicine; we shou...
<ul><li>Most useful guide to learning/memorizing diagnosis esp. to uncommon diseases is to remember 3 keypoints(triads/tet...
<ul><li>5 Self-imposed questions </li></ul><ul><li>What is the probability diagnosis? </li></ul><ul><li>What serious d/o m...
<ul><li>P- probability </li></ul><ul><li>R – red flag </li></ul><ul><li>O – often missed </li></ul><ul><li>M – masquerades...
<ul><li>MDs experience & perspective of the disease </li></ul><ul><li>HX taking & PE: gathering info, allocating prioritie...
<ul><li>Disadvantage: MD is familiar with what is common that the important rare cause of a presenting symptom may be over...
<ul><li>Common pitfalls </li></ul><ul><li>Includes simple, non-life threatening d/o that can be easily overlooked </li></u...
<ul><li>Utilize a type of fail safe mechanism to avoid missing the diagnosis of different d/o </li></ul>
<ul><li>Depression </li></ul><ul><li>DM </li></ul><ul><li>Drugs-self abuse; alcohol, caffeine, nicotine, narcotics </li></...
<ul><li>Spinal dysfunction </li></ul><ul><li>UTI </li></ul>
<ul><li>For undifferentiated case-consider whether the patient has a hidden agenda for the presentation </li></ul><ul><li>...
<ul><li>Interpersonal conflict in the family </li></ul><ul><li>Identification of sick/diseased friends </li></ul><ul><li>F...
<ul><li>Hiccough </li></ul><ul><li>1)probability DX: food& alcoholic excess. </li></ul><ul><li>2) serious d/o not to be mi...
<ul><li>http://crisbertcualteros.page.tl </li></ul>
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A Safe diagnostic strategy

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A safe diagnostic strategy
Murtagh' Family Practice

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A Safe diagnostic strategy

  1. 2. <ul><li>the most difficult, complex & challenging of all the healing arts </li></ul><ul><li>Frontline of medicine; we shoulder responsibilty of early diagnosis of illness </li></ul>
  2. 3. <ul><li>Most useful guide to learning/memorizing diagnosis esp. to uncommon diseases is to remember 3 keypoints(triads/tetrads) </li></ul><ul><li>Ex. Menstrual dysfunction + obesity + hirsutism = PCOS </li></ul><ul><li>Ex. Vertigo + vomiting + tinnitus = Menierre’s Syndrome </li></ul><ul><li>Ex. Fatigue + muscle weakness + cramps = hypokalemia </li></ul>
  3. 4. <ul><li>5 Self-imposed questions </li></ul><ul><li>What is the probability diagnosis? </li></ul><ul><li>What serious d/o must not be missed? </li></ul><ul><li>What condition are often missed? (the pitfalls) </li></ul><ul><li>Could this patient could have one of the masquerades in medical practice? </li></ul><ul><li>Is this patient try to tell me something else? </li></ul>
  4. 5. <ul><li>P- probability </li></ul><ul><li>R – red flag </li></ul><ul><li>O – often missed </li></ul><ul><li>M – masquerades </li></ul><ul><li>P – patient wants to </li></ul><ul><li>T – tell me something </li></ul>
  5. 6. <ul><li>MDs experience & perspective of the disease </li></ul><ul><li>HX taking & PE: gathering info, allocating priorities, making hypothesis & developing Dx based onacquired epidemiological knowledge </li></ul>
  6. 7. <ul><li>Disadvantage: MD is familiar with what is common that the important rare cause of a presenting symptom may be overlooked. </li></ul><ul><li>High-index of suspicion: it comes with experience  not to miss serious life threatening disorder </li></ul><ul><li>Serious d/o always be considered: Ca, AIDS, meningitis, meningococcal & MI….. </li></ul>
  7. 8. <ul><li>Common pitfalls </li></ul><ul><li>Includes simple, non-life threatening d/o that can be easily overlooked </li></ul><ul><li>Ex. Dental carries as a cause of abdominal pain </li></ul><ul><li>Ex. Allergies to whole variety of everyday contacts, foreign bodies </li></ul><ul><li>Ex. Dermatomal pain pattern caused by Herpes Zoster prior to eruption of rash </li></ul>
  8. 9. <ul><li>Utilize a type of fail safe mechanism to avoid missing the diagnosis of different d/o </li></ul>
  9. 10. <ul><li>Depression </li></ul><ul><li>DM </li></ul><ul><li>Drugs-self abuse; alcohol, caffeine, nicotine, narcotics </li></ul><ul><li>Anemia </li></ul><ul><li>Thyroid & other endocrinologic d/o; hyper/hypothyroidism, Addison;s disease </li></ul>
  10. 11. <ul><li>Spinal dysfunction </li></ul><ul><li>UTI </li></ul>
  11. 12. <ul><li>For undifferentiated case-consider whether the patient has a hidden agenda for the presentation </li></ul><ul><li>We should be sensitive to patients needs & feelings </li></ul><ul><li>Ex. Tiredness- represent a plea for help inanxious patient </li></ul>
  12. 13. <ul><li>Interpersonal conflict in the family </li></ul><ul><li>Identification of sick/diseased friends </li></ul><ul><li>Fear of malignancy </li></ul><ul><li>STI – AIDS </li></ul><ul><li>Impending coronary/ stroke </li></ul><ul><li>Sexual problem </li></ul><ul><li>Crippling arthritis </li></ul><ul><li>Financial problems </li></ul>
  13. 14. <ul><li>Hiccough </li></ul><ul><li>1)probability DX: food& alcoholic excess. </li></ul><ul><li>2) serious d/o not to be missed: neoplasia </li></ul><ul><li>3) pitfalls: alcohol excess, smoking, PUD </li></ul><ul><li>4) masquerades: depression, DM, drugs, anemia </li></ul><ul><li>5) tell me something: emotional causes always to be considered </li></ul>
  14. 15. <ul><li>http://crisbertcualteros.page.tl </li></ul>

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