Podcast
Questions and Answers
A naturopathic doctor has just obtained some initial information from a patient about her main concern. What is the next step?
A naturopathic doctor has just obtained some initial information from a patient about her main concern. What is the next step?
- Take action immediately
- Perform physical exams
- Ask more questions
- Consider what information is still needed (correct)
If a practitioner is seeking to obtain valuable medical information while exposing the patient to minimal harm, discomfort or inconvenience, what aspect of the diagnostic process will they engage in?
If a practitioner is seeking to obtain valuable medical information while exposing the patient to minimal harm, discomfort or inconvenience, what aspect of the diagnostic process will they engage in?
- Medical imaging (e.g. CT scan, MRI)
- Physical examination
- History taking (correct)
- Blood tests
In what section of a medical chart would we be most likely to include information about symptoms?
In what section of a medical chart would we be most likely to include information about symptoms?
- Objective
- Subjective (correct)
- Plan
- Assessment
What term is used to describe a mental summary of a practitioner's knowledge of a disease?
What term is used to describe a mental summary of a practitioner's knowledge of a disease?
What single attribute of a test will best help a practitioner determine its value as evidence as it relates to a particular condition?
What single attribute of a test will best help a practitioner determine its value as evidence as it relates to a particular condition?
How might illness scripts most help in creating a differential diagnosis?
How might illness scripts most help in creating a differential diagnosis?
When comparing disease illness scripts, which of the following should you do?
When comparing disease illness scripts, which of the following should you do?
Obsessive compulsive disorder typically begins before age 25. This information is part of what illness script component?
Obsessive compulsive disorder typically begins before age 25. This information is part of what illness script component?
A patient complains of a headache that started with mild pain this morning and has been getting worse over the course of the day with no periods of relief. How would the timing best be described?
A patient complains of a headache that started with mild pain this morning and has been getting worse over the course of the day with no periods of relief. How would the timing best be described?
A portion of a syndrome statement in a patient illness scripts reads as follows: "unilateral headaches with phonophobia". What might the patient have indicated during the intake?
A portion of a syndrome statement in a patient illness scripts reads as follows: "unilateral headaches with phonophobia". What might the patient have indicated during the intake?
What is the purpose of gathering some information about the patient's chief concern before considering a differential diagnosis?
What is the purpose of gathering some information about the patient's chief concern before considering a differential diagnosis?
A naturopathic student intern reads a book whose central thesis is that a condition which is thought to be rare is in fact common. If they are not careful, which cognitive bias may worsen their diagnostic performance as a result?
A naturopathic student intern reads a book whose central thesis is that a condition which is thought to be rare is in fact common. If they are not careful, which cognitive bias may worsen their diagnostic performance as a result?
How should one proceed from the beginning of the encounter through the development of a differential diagnosis?
How should one proceed from the beginning of the encounter through the development of a differential diagnosis?
An intern proposes a diagnosis for one of their patients because "the symptoms all fit". What might the intern have failed to consider that would most help create a strong list of differentials?
An intern proposes a diagnosis for one of their patients because "the symptoms all fit". What might the intern have failed to consider that would most help create a strong list of differentials?
What is the main value of differential diagnosis?
What is the main value of differential diagnosis?
According to the majority of research discussed in class, a number of cognitive biases are consistent with what error(s) when estimating probability in medicine?
According to the majority of research discussed in class, a number of cognitive biases are consistent with what error(s) when estimating probability in medicine?
An intern completes a patient intake and is convinced that the patient they've seen has a rare disease, because "the symptoms match perfectly!" What should the intern's supervisor be most concerned that the intern is doing?
An intern completes a patient intake and is convinced that the patient they've seen has a rare disease, because "the symptoms match perfectly!" What should the intern's supervisor be most concerned that the intern is doing?
You are discussing a patient case with your colleagues at the teaching clinic and voice uncertainty about the probability that your patient with joint pain has Disease X.
- Ariana points out that patients with joint pain are diagnosed with Disease X 14% of the time in a primary care setting
- Bradley mentions that 60-70% of patients with Disease X have joint pain similar to what your patient described to you
- Carla claims that the prevalence of Disease X in Canada is 1-2% of the population, according to recent statistics
- Danaka adds that government statistics on the lifetime prevalence of Disease X in Canadians is 30%.
Assuming all of them are correct, which is the best to use for a pretest probability?
You are discussing a patient case with your colleagues at the teaching clinic and voice uncertainty about the probability that your patient with joint pain has Disease X.
- Ariana points out that patients with joint pain are diagnosed with Disease X 14% of the time in a primary care setting
- Bradley mentions that 60-70% of patients with Disease X have joint pain similar to what your patient described to you
- Carla claims that the prevalence of Disease X in Canada is 1-2% of the population, according to recent statistics
- Danaka adds that government statistics on the lifetime prevalence of Disease X in Canadians is 30%.
Assuming all of them are correct, which is the best to use for a pretest probability?
A patient describes her headaches as "all over" her head. They are accompanied by nausea and occasional vomiting which can occur first thing in the morning. She has been feeling tired lately and has been making more mistakes at work.
Thinking of differentials, you consider the following facts:
- These are some of the classic symptoms of a brain tumor
-Headaches occur in about 50% of patients with brain tumors
- Cognitive dysfunction occurs in about 35% of patients with brain tumors
- In general practice, one study found that 0.1% of people presenting with headache had primary brain tumors
Which option is closest to the most reasonable pretest probability that this patient has a brain tumor?
A patient describes her headaches as "all over" her head. They are accompanied by nausea and occasional vomiting which can occur first thing in the morning. She has been feeling tired lately and has been making more mistakes at work. Thinking of differentials, you consider the following facts:
- These are some of the classic symptoms of a brain tumor -Headaches occur in about 50% of patients with brain tumors
- Cognitive dysfunction occurs in about 35% of patients with brain tumors
- In general practice, one study found that 0.1% of people presenting with headache had primary brain tumors
Which option is closest to the most reasonable pretest probability that this patient has a brain tumor?
Which of the following would make for the best reference class for use in estimating a pretest probability?
Which of the following would make for the best reference class for use in estimating a pretest probability?
You are investigating the evidence involved in the diagnosis of infectious mononucleosis. You find the following data: -Which of the following combinations of findings should you avoid applying (i.e. you should apply evidence from only one of the findings)?
You are investigating the evidence involved in the diagnosis of infectious mononucleosis. You find the following data: -Which of the following combinations of findings should you avoid applying (i.e. you should apply evidence from only one of the findings)?
You are reading an article about the diagnosis of infectious mononucleosis and see the following likelihood ratios: - Which LR represents the minimum information you would need to move your estimate of the probability from approximately 10% to less than 1%?
You are reading an article about the diagnosis of infectious mononucleosis and see the following likelihood ratios: - Which LR represents the minimum information you would need to move your estimate of the probability from approximately 10% to less than 1%?
With which pretest probability would your estimate of the probability change the most If you applied evidence with an LR of 5?
With which pretest probability would your estimate of the probability change the most If you applied evidence with an LR of 5?
A naturopathic doctor claims that the treatment they recommend for CIN 1 (a condition where there are slightly abnormal cervical cells) is effective. They say that 75% of the women they treat who have CIN 1 find that their condition resolves. Before deciding how persuasive this evidence should be, what further piece of information would be most important to consider?
A naturopathic doctor claims that the treatment they recommend for CIN 1 (a condition where there are slightly abnormal cervical cells) is effective. They say that 75% of the women they treat who have CIN 1 find that their condition resolves. Before deciding how persuasive this evidence should be, what further piece of information would be most important to consider?
You are looking for diagnostic evidence in the literature and are having difficulty finding likelihood ratios. What should you look for in order to be able to calculate likelihood ratios?
You are looking for diagnostic evidence in the literature and are having difficulty finding likelihood ratios. What should you look for in order to be able to calculate likelihood ratios?
