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AssessI, Chpt1
CNRAssessI, Chpt1,Clinical Reasoning, Differential Diagnosis, and E
| Question | Answer |
|---|---|
| Basic health assessment often uses what process of reasoning? | deductive process of reasoning; it moves from a general survey of a body system to specific observations or tests of function |
| An example of deductive process of reasoning? | A specialist, when examines pt w/ hyperthyroidism &conducts a physical examination to test for deep tendon reflexes. Brisk or hyperreflexic findings would lead the fractioned to conclude that a hyperthyroid state is a likely cause for these findings. |
| Advanced assessment builds on the basic health assessment & is performed more often using what process of reasoning? | inductive or inferential process |
| Inductive/ inferential process moves from what kind of information to what kind of information? | moving from a specific physical finding or pt complaint to a more general diagnosis or possible diagnoses based on history, physical findings, and laboratory and diagnostic tests. |
| How does a practitioner use diagnostic reasoning? | The practitioner. Gathers further evidence and analyzes this evidence to arrive at a hypothesis that will lead to a further narrowing of possibilities. |
| Definition of inductive/ inferential process? | is a scientific process in which the practitioner suspects the cause of a pt’s symptoms and signs based on previous knowledge, gathers relevant information, selects necessary tests, and recommends therapy |
| By using diagnostic reasoning, the practitioner accomplishes what 5 things? | 1)determine &focus on what needs to be asked and what needs to be examined; 2)performs examinations and diagnostic test accurately; 3)clusters abnormal findings; 4)analyzes &interprets the findings; 5)develops a list of likely or differential diagnoses |
| The difference between an average and an excellent practitioner is? | the speed and focus used to arrive at the correct conclusion and initiate the best course of tx w/ minimum cost, risk, inconvenience, and delay |
| Presenting symptoms need to be explored with further questions about what 8 factors? | 1)timing/onset,duration & freq 2)anatomical location 3)character/quality 4)setting in which they occur 4) character/quality 5)severity/intensity; 6)aggravating and alleviating factors 7)assoc. symptoms 8) pts’ perceptions of the meaning of the sympt.(s) |
| What is the most significant variable in narrowing the probabilities of a problem? | Age, also consider gender, race, appearance, and presenting problem |
| The hypothesis must then be tested and assessed for what 4 characteristics? | Coherence; Adequacy; Parsimony; and can a competing hypothesis be eliminated |
| Coherence? | are the physiological linkages, predisposing factors and complications for this disease present in the pt? |
| Adequacy? | does the suspected dx encompass all of the pt’s normal and abnormal findings? |
| Parsimony? | is it thee simplest explanation of the pt’s findings? |
| What is the surest way to ensure parsimony? | to ask the pt or the parents why they are seeking care and their understanding of the problem. (this is a crucial step b/c pts must find the tx recommendation acceptable) |
| Why look for a competing hypothesis to eliminate? | to find out if the pt’s sympts could be explained by another illness/ dx |
| Heuristics? | rules of thumb to guide the inductive or inferential process of diagnostic reasoning |
| Salience? | Conspicuous, obvious, important (I think the most salient point is/) |
| A competent practitioner executes what steps? | 1)Id most important cues 2)understand and perform advanced examination techniques 3)Test differential or competing diagnoses (rule in/rule out strategy)4) see a pattern in the information gathered |
| How do you i.d. most important cues? | cues are obtained thorough symptom analysis, functional assessment and history to assess the pt’s beliefs and understanding about the problem |
| How do you understand and perform advanced examination techniques? | special maneuvers and more detailed physical examination more in depth; gold standard diagnostic tests for the identification of a specific disorder |
| How do you test differential or competing diagnoses? | (rule in/rule out strategy) look for the absence/ presence of defining symptoms |
| How do you see a pattern in the information gathered? | pattern/ cluster of findings |
Created by:
moe9288@yahoo.com
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