Differential Diagnosis Example

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adocinafewyears

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Hey I am studying the process of performing a differential diagnosis and the steps leading up to it / after it. Can somebody explain to me all of the steps that EMTs/Doctors/administrators/etc. would take in this scenario? I noticed theres a pretty clear ethical issue in it, so if you could elaborate on that too that'd be even better.


44 year old male presents in police custody for laceration to the head and altered mental status. He was at Music Midtown, was observed to be acting “out of it”, then fell and hit his head. He was combative at the scene, refused transport by EMS initially, required physical restraints en route to the hospital. On arrival in the emergency department he is uncooperative, is slurring his words, has evidence of head trauma, and states he wants to leave.

**This is NOT a hw problem or anything. It's for a club of pre-med undergraduate students to understand the process better**
 
Y'all would be better served by shadowing in an ED on a Saturday night and seeing it for yourself.

You think of all the things that could be causing this guy's symptoms. The steps that lead up to the differential is getting what you can of a history and doing what you can of a physical, especially a neuro exam. Then put it all together and see what more information (labs/testing) you want to get. For starters, this guy is getting basic labs, drug screen, alcohol level, and he bought himself a head CT.

There's really no ethical issue. He can say he wants to leave all he wants, he doesn't have the capacity to make that decision right now.
 
Download the app called "prognosis". It has hundreds of different cases you can play through, and at the end it gives you a full on differential diagnosis and what steps should have been taken by the physician to come to the correct diagnosis.

This app was meant for residents / attendings, however, not for a pre-med undergraduate club. This is worse than the blind leading the blind.

I think you guys should spend more time shadowing in the ED rather than trying to tackle your own cases. Leave that for your 3rd and 4th year of medical school.
 
In House they always ruled out MS. Start there
 
Hey I am studying the process of performing a differential diagnosis and the steps leading up to it / after it. Can somebody explain to me all of the steps that EMTs/Doctors/administrators/etc. would take in this scenario? I noticed theres a pretty clear ethical issue in it, so if you could elaborate on that too that'd be even better.


44 year old male presents in police custody for laceration to the head and altered mental status. He was at Music Midtown, was observed to be acting “out of it”, then fell and hit his head. He was combative at the scene, refused transport by EMS initially, required physical restraints en route to the hospital. On arrival in the emergency department he is uncooperative, is slurring his words, has evidence of head trauma, and states he wants to leave.

**This is NOT a hw problem or anything. It's for a club of pre-med undergraduate students to understand the process better**

What do you see as the ethical issue?
 
Trying to do homework on SDN!

but but...

**This is NOT a hw problem or anything. It's for a club of pre-med undergraduate students to understand the process better**

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Wait LOL this guy literally just posted this prompt, got the thread locked, and decided "hey I'll just paste the exact same thing on SDN again"

http://forums.studentdoctor.net/threads/differential-diagnosis-example.1228622/

@WedgeDawg

Well I guess he did add the really believable *not HW* disclaimer
Guys... im an undergrad pre-health engineering student... i have literally no classes right now that are pre-med related... this is not homework... it is for a club that is getting pre-health students to think like physicians... the reason i am posting this is because im not in a class that teaches me how to do it so i am trying to get the opinions of people who would know how to do this... I have no experience in anything like this. hince why i am on SDN. even if this was a lie which it is not i feel like a community like this should give me the benefit of the doubt...
i dont understand why this is so hard to understand
 
Guys... im an undergrad pre-health engineering student... i have literally no classes right now that are pre-med related... this is not homework... it is for a club that is getting pre-health students to think like physicians... the reason i am posting this is because im not in a class that teaches me how to do it so i am trying to get the opinions of people who would know how to do this... I have no experience in anything like this. hince why i am on SDN. even if this was a lie which it is not i feel like a community like this should give me the benefit of the doubt...
i dont understand why this is so hard to understand
Step 1. Get into medical school
Step 2. Become a doctor.
Step 3. Answer this question.
 
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