i can't do cases

[murfettie]

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multiple choices - fine.
i'm not a great MC taker, but if i study more I do better, the end.

but these cases with a bunch of symptoms
- can't figure out what caused what
- i also come up with the least likely possible cause, like.. you know, Goodpoasture all the way kind..

can't remember all the associated stuff I learned 2 weeks, ago..
nothing gets incorporated before it is puked out after a test
not sure what to do.

 

[Stixman28]

Better practice. That's going to be every test for the rest of your life.

It gets easier as you learn more, and as you learn similar concepts in a different way.

 

[ManaPool]

Start spitting out differentials until someone says "ya, maybe"

 

[Wordead]

Draw up your own differentials, flow chart style. Or read up to date - there's usually a nice easy section on "workup for X symptom". That usually gets you thinking the right way.

It's hard initially, because the way we're taught is, "This is So and So disease", here are the symptoms and not the other way around. You have to teach yourself. It gets easier though.

Oh, and epidemiology is helpful. You should know what the top causes of common conditions are.

 

[Dr Love]

Yea I agree with what others have said. Once you go through all the organ systems then you will look at up to date or clinical books and look at the question in another way. Instead of saying bronchitis causes a cough you will learn that when a patient complains of a cough, think of bronchitis, pneumonia, reflux, side effect of ACE inhibitors, etc.

 

[PACERS14]

what year are you?

i think everyone feels this way early on. you'll get better with experience at narrowing your differential with practice (and you should get tons of practice during clinical years)

im just a humble third year and i can definitely see myself as making progress in case-type reasoning, making a reasonable differential, and starting to think about management

 

[achamess]

Be systematic. Strip the substance from the decoration.

As you read a case problem, list all the symptoms on a piece of paper. Write out any important epidemiogical/identifying info (ex. 24 year old, IV drug user, etc.)

Now, with this information on your piece of paper, look at the symptoms. Find the most prominent one (or focus on the chief complaint). Now use that to make a differential diagnosis. It won't be great, but just get someone out there. If you need help, use a DDx program like Diagnosaurus. Now use the list of sx that you made to help you winnow down that DDx. Use any lab values or radiographs to help eliminate possibilities.

Eventually, there will be some 'key' piece of info that will distinguish one option from the others.

Practice this process fully during your studying. When you take tests, you'll have less time, but the process still applies. Extract the important parts. This reframes the problem and makes it accessible. Then start trying to solve it.