Making a Diagnosis…

 

In the previous “I Have a Patient” segment, a patient comes to you already diagnosed with Chronic Kidney Disease. Consider a new scenario, where a patient comes to you without a diagnosis. The patient is concerned about their symptoms and is seeking an answer about why they are feeling unwell. How can you provide a diagnosis while trying to comfort the patient as much as possible?

What do you need to know for situations when you have to diagnosis a patient with an unknown condition?

Outline

  • Review your patient’s symptoms.
  • Consider possible diagnoses from what you learned from the patient and the available information you found in the literature.
  • Apply your knowledge and provide your best diagnosis to your patient.
What Do You Need To Do?

Get a thorough patient history and physical examination.

Review your patient’s symptoms and chief complaint(s).

Search for comparable patients with similar symptoms in the literature.

Make connections by applying your knowledge and the information you find to make the best diagnosis for your patient.

 

Why Is This Important?

Developing the skill of assessing your patient’s symptoms and knowing when to search the literature will help you provide an informed diagnosis to your patient.

 

How Can You Make These Connections?

Take the following quiz to assess how much you know about diagnosing a patient:

Quiz Yourself

Check the appropriate resource to refresh your memory on trusted, well-established information.

Rational Clinical Examination The RCE series are careful systematic efforts to assess the accuracy of items from the patient’s medical history and the clinical examination.

PubMed: MGH Case Reports Search the PubMed database for Massachusetts General Hospital Case Reports to see examples of patient diagnoses and the thought process behind them.

 

Using the Resources

Rational Clinical Examination

Leave this open to Dr. Wyer for input on how to best use RCE.

Need to find good tutorial or information about how to use RCE:

 

PubMed: MGH Case Reports

On the PubMed home page, copy and paste the following search strategy:

n engl j med[Journal] AND Massachusetts General Hospital AND Case

After the term “Case”, use the AND operator and insert any terms relevant to the disease or symptom(s) of interest (ex: AND Diabetes).

Search in the MGH case reports for examples of a diagnostic process specific to your disease or symptom(s).

Below is a general tutorial video for PubMed.

 

For more information please visit the Learning at Your Own Pace tutorials page on the library website – http://library.cumc.columbia.edu/learning-your-pace-tutorials

 

Review The Important Concepts

The following review activity will test your knowledge of diagnosing a patient and the information you learned about in this section:

Diagnosis Review Activity

Summary

Remember the following steps are essential when you need to diagnose a patient:

  1. Conduct a thorough patient history and physical examination.
  2. Evaluate what you know.  Calibration is key.
  3. Choose an appropriate resource to find the information you need: Rational Clinical Examination or PubMed: MGH Case Reports.
  4. Use that resource efficiently to get the information you need quickly.