We want to develop here real clinical situations with a patient, enhancing the importante of the cognitive and systemic aspects involved in a clinical decision. We believe this way is the best to teach clinical practice.
The replacement of a biliary catheter and the Boeing 737 Max:: An example of a system failure?
A 60-years-old woman had a diagnosis of colon cancer with liver metastases. During her follow-up the bilirrubin level increased and a sonogram showed a common bile duct obstruction. At this point she Continue reading The replacement of a biliary catheter and the Boeing 737 Max: An example of a system failure?
A 81-years-old woman with several diagnoses( cardiac failure, atrial fibrillation, back pain) and plenty of medication (more than 20 drugs daily) went to the Family Physician because of high fever (38 centigrades) and productive cough , Her physical examination Continue reading Cognitive Bias. Upper Urinary Tract Infection: A Dark Drawer?
A 62-year-old woman went to the Emergency Department(ED) with a colicky pain located in the abdominal right upper quadrant with irradiation to periumbilical area, starting two days before, with
Continue reading Resist and not give up: the key to fighting premature closure
CLINICAL CASE
A 75-year-old man with a diagnosis of biliary adenocarcinoma started, during his stay at the hospital, with a non-productive cough when lying down, but stopping when standing up.
Continue reading Clinical case: non-productive cough at bedtime, disappears upon rising
CLINICAL CASE
Patient: A 68-year-old male patient, with high blood pressure under control
Previous Diagnosis: Follicular lymphoma (2013) stage IIA, treated with chemotherapy, three years ago. He had two recurrences rescued with chemotherapy and a third one spreading to the nodes and bone marrow.
Continue reading A silent enemy that you have to look for. Without symptoms there is no diagnosis
A 59-year-old woman was receiving treatment with radiotherapy and weekly cisplatin, after a diagnosis of cervical cancer. After three weeks her platelet level was under 20.000 and she was put under
Continue reading Pseudothrombocytopenia: a system analysis for a good detective