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.
Ruth was a 54-year-old woman with a malignant tumor for which she received treatment with a tyrosine kinase inhibitors. She was having the drug for a month without a problem. But one day she started with diarrhea, confusion and agitation.
A 65-year-old woman went to Medical Oncology with upper left abdominal pain and on the left shoulder. He had been suffering from this pain for about 6 months before a road accident, but had increased in the last month, without nausea or vomiting. Three years earlier she had a diagnosis of colon adenocarcinoma, but there were no data of recurrence in the last visit.
Continue reading Upper left abdominal pain: the origin may be in the spleen
CLINICAL DIAGNOSIS: Lymphedema, cellulitis
FINAL DIAGNOSIS: Thrombosis in the inferior vena cava and right iliac vein
TYPE OF DIAGNOSTIC ERROR: Delayed Diagnosis
Continue reading Inferior Caval Vena Thrombosis: Diagnostic Reasoning
A 74-year-old woman went to the emergency room for lower extremity pain. There were no pathological data except for arthroscopic deformities in the knees. Analgesic treatment was indicated with an opioid drug.
María is a 64 year-old woman. She works very hard at home, even with her daily back pain. She had a diagnosis of polineuropathy in relation to diabetes lasting for 20 years, causing pain in both legs. In the last year the pain has increased and is more intense on her right hip, it seems to be different, but her doctor associates the pain with her usual spine problems.. Continue reading RCA: a change in the pain
He was my patient. A serious and educated 55- year-old man with a diagnosis of metastatic colon cancer waiting to start chemotherapy. I started my usual physical examination, normal conjuntival coloration, normal heart sounds, but something keeps my attention: no ventilation in the left basal lung. No signs of pleural effusion or atelectasia. No dyspnea or thoracic pain. I asked for a thoracic X-ray but nothing attracts my attention.