Category Archives: Clinical Reasoning

Case analysis under the concepts of Diagnostic Improvement,  showing the andcognitive and systemic bias implicated in a Diagnostic problem.

I have a Non-Hodgkin´s lymphoma: a challenge for a correct clinical reasoning process

The three desirable steps in clinical practice

The best scenario in medical diagnosis follows three steps, the first one is the clinical reasoning, the second one to ask for a blood test or an image, and the third and final , to obtain a histological sample.

Continue reading I have a Non-Hodgkin´s lymphoma: a challenge for a correct clinical reasoning process

The second day: a moment for a better calibration in clinical diagnosis

The evaluation of a patient is done in a short time

In the first encounter with a patient, a physician collect data from different sources to get an idea about the problem of the patient, and she or he has to decide about a diagnosis and a therapeutic intervention.  Nobody knows  how senior doctors and interns think and how a model or representation of the clinical condition is Continue reading The second day: a moment for a better calibration in clinical diagnosis

Why do I have shortness of breath? Is it my non Hodgkin lymphoma?

A 50-year-old- man had a diagnosis of mediastinal non-Hodgkin lymphoma. He was receiving a chemotherapy treatment with a significant reduction in the size of the mediastinal lymph nodes.

A week before he started with a fever, a productive cough (mucus and blood) and shortness of breath. He never referred thoracic pain or digestive symptoms.

He had no previous disease. He never smoked.

Continue reading Why do I have shortness of breath? Is it my non Hodgkin lymphoma?

“My legs are very weak and my back hurts so much”

 “My legs are very weak and my back hurst so much”

Author: Lorenzo Alonso

FORO  OSLER

Clinical summary

A 57-years-old-man had a diagnosis of kidney cancer with bone metastases including the spine. He was receiving treatment with immunotherapy. One week before the hospital consultation,   he started with back pain, walking difficulties, a feeling of weakness in both legs, with difficulty in urination. He has  had no fever Continue reading “My legs are very weak and my back hurts so much”