Case analysis under the concepts of Diagnostic Improvement, showing the andcognitive and systemic bias implicated in a Diagnostic problem.
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.
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
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?
A 62-year-old woman had a diagnosis of endometrial cancer. A week before she started with altered mental status, somnolence, together with nausea, vomiting and constipation. She had a fever one day.
Continue reading When to suspect a meningeal carcinomatosis?
Patient identification: male, 57-years-old.
Present diagnosis: metastatic prostate cancer (bones) , under hormonal treatment. Continue reading I have pain in the upper-right-quadrant
Author: Lorenzo Alonso
FORO OSLER
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”