Category Archives: Clinical Reasoning

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

A Diagnostic Improvement Analysis: A-50-year old man with abdominal pain and thrombocytopenia.

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
History

A-50-year old man was admitted to the hospital after several visits to the Emergency Department (ED) in a two month period. He was born in Nigeria, but he was living in Spain in the last 15 years, and the last trip to his natal country was 6 years ago. He was married Continue reading 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 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

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.

Continue reading A Clinical Reasoning Exercise: Dysmetria, Nausea, Vomiting, Trouble to Speak

A course of survival for interns and last year medical students. Chapter Four: A List of Important Clinical Entities

 

 

 

 

 

 

 

 

 

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.

Continue reading A course of survival for interns and last year medical students. Chapter Four: A List of Important Clinical Entities

A course of survival for interns and last year medical students. Chapter three: What not to do.

CHAPTER THREE

Every hospital or Health Center has its own routine to teach to the new interns, but believe me or not, Medical Education is such an open activity that sometimes bad habits are maintained inside the system. Continue reading A course of survival for interns and last year medical students. Chapter three: What not to do.