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.
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.
A-72-year-old man with a previous diagnosis of Chronic Obstructive Pulmonary Disease had a diagnosis of pneumonia after three days with high fever, cough and a productive sputum. He stayed at the hospital and started with antibiotics, enoxaparin, and oxygen, with a favourable clinical evolution. The doctor ordered a new X-ray but the patient started with dyspnea during his journey to the radiology department. Can you suggest a reason for that?