The main objectives with the description and the analysis of this case is to show possible biases in the diagnostic process under the opinion of the analyst, searching for human cognitive and system aspects that could be improved. We do not know the real situation under which the attending physician had to act during the care of this patient
A Diagnostic Improvement Analysis: A-50-year old man with abdominal pain and thrombocytopenia
Clinical Reasoning: A blood test cannot be ordered on itself
Clinical case
Mark, a 70-year-old man, had a previous diagnosis of metastatic kidney cancer and a mild hypertension. He just finished his cancer treatment two months ago. Suddenly, he started to feel in a very bad condition, with fever, disorientation, chills and oligoanuria. He has to go to the Emergency Department (ED). Continue reading Clinical Reasoning: A blood test cannot be ordered on itself→
A Clinical Reasoning Exercise: Dysmetria, Nausea, Vomiting, Trouble to Speak
Clinical Case
A-52-year-old man with a previous diagnosis of an esophageal carcinoma , went to the hospital with nausea, vomiting and constipation. He had no fever or abdominal pain. The physical examination showed no bowel movements. The neurologic examination showed a gait disturbance, dysmetria and difficulty speaking properly. A nasogastric tube was inserted and a big amount of liquid was extracted from the stomach.
A course of survival for interns and last year medical students. Chapter Four: A List of Important Clinical Entities
Every doctor has his or her own list of clinical situations or diseases that are always in their minds, trying to answer quickly and effective in a patient with signs or symptoms compatible with them. Usually, they are important clinical entities located in uncommon places in the body or with a very low prevalence.
A-67-year-old woman had a previous abdominal surgery after a diagnosis of a right colon cancer a year ago. She was also diagnosed with high blood pressure.
