Ophthalmology Clinical Decision Making Quiz

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Questions and Answers

What is Evidence Based Clinical Reasoning?

The use of personal experiences in making decisions about patient care

The use of intuition in making decisions about patient care

The conscientious use of current best evidence in making decisions about individual patient care (correct)

The use of traditional beliefs in making decisions about patient care

What is the goal of clinical reasoning?

To evaluate the symptoms and signs

To reach a diagnosis

To develop an appropriate management plan

All of the above (correct)

What is clinical reasoning?

The use of intuition to guide the acquisition of additional information

The use of only initial patient information to form a case representation of the problem

The physician's integration of their own knowledge with initial patient information to form a case representation of the problem (correct)

The acquisition of additional information without revising the problem representation

What should a student learn in clinical reasoning?

All of the above Signup and view all the answers

What does clinical reasoning guide the acquisition of?

Additional information (testing) Signup and view all the answers

What is the physician's use of problem representation based on?

Initial patient information Signup and view all the answers

What should a physician do based on the acquired information in clinical reasoning?

Revise the problem representation Signup and view all the answers

What should a physician repeat until reaching a threshold of confidence in clinical reasoning?

The information gathering-representation revision cycle Signup and view all the answers

What does clinical reasoning guide the physician to support in the end?

A final diagnosis and/or management actions Signup and view all the answers

What is emphasized when examining a patient in clinical reasoning?

Critical thinking Signup and view all the answers

What factors can influence physicians' early diagnostic impressions?

Patient characteristics, characteristics of the illness, medical environment issues Signup and view all the answers

When does the analytical approach in diagnosis kick in?

When the presentation does not fit into a specific illness category Signup and view all the answers

What is emphasized in the development of genuine expertise?

Struggle, sacrifice, honest self-assessment, deliberate practice Signup and view all the answers

What is the purpose of 'deliberate practice' in developing expertise?

Focuses on tasks beyond current level of competence and comfort Signup and view all the answers

What should be further tested for in a patient with a third Subconjunctival Hemorrhage in 3 months?

Blood dyscrasias (coagulation factors, etc.) Signup and view all the answers

What is a possible differential diagnosis for a red eye according to the text?

Conjunctivitis (bacterial, viral or allergic), acute angle closure attack, corneal insult, scleritis, episcleritis, dry eye syndrome Signup and view all the answers

What does the analytical approach in diagnosis involve when uncertainty is high?

Teasing out various possibilities from each other in a systematic search Signup and view all the answers

What is a characteristic of the intuitive approach in diagnosis?

Consciously or subconsciously influenced by patient characteristics and illness characteristics Signup and view all the answers

What is emphasized as necessary for the development of genuine expertise?

Struggle, sacrifice, and honest, often painful self-assessment Signup and view all the answers

What influences physicians' early diagnostic impressions?

Characteristics of the illness, immediate issues in the medical environment, resource issues Signup and view all the answers

What are the 3 evidence-based models of clinical decision making mentioned in the text?

Algorithmic reasoning, pattern recognition, and hypothetico-deductive method Signup and view all the answers

What does algorithmic reasoning involve?

A sequence of questions and logical methods to diagnose conditions Signup and view all the answers

Why may pattern recognition not be efficient for some conditions?

Some conditions have less distinctive features Signup and view all the answers

What is meant by 'differential diagnosis'?

A doctor's list of likely hypotheses and the process of gathering clinical information to determine the actual diagnosis Signup and view all the answers

What are the 5 stages of clinical reasoning mentioned in the text?

Problem identification, hypothesis generation, hypothesis testing, hypothesis review, and developing a management plan Signup and view all the answers

What is the first stage of clinical reasoning according to the text?

Problem identification starts with the case history and understanding the chief complaint to develop hypotheses Signup and view all the answers

How are hypotheses generated in clinical reasoning?

Based on patient profile, doctor's knowledge, and epidemiology Signup and view all the answers

What happens after obtaining clinical information in clinical reasoning?

A diagnosis is made, and some hypotheses are rejected, added, or reinforced Signup and view all the answers

What factors contribute to a doctor's clinical decision-making skills?

Knowledge base, reasoning skills, clinical experience, professional style, attitudes, beliefs, and demeanor with patients Signup and view all the answers

What is the hypothetico-deductive method in clinical decision making?

Involves generating multiple working hypotheses and continually reinforcing, rejecting, or generating new ones until a final diagnosis is reached Signup and view all the answers

Study Notes

Clinical Decision Making and Diagnostic Reasoning in Ophthalmology

There are 3 evidence-based models of clinical decision making: algorithmic reasoning, pattern recognition, and hypothetico-deductive method.
Algorithmic reasoning involves a sequence of questions and logical methods to diagnose conditions, but not every patient fits into the algorithm.
Pattern recognition relies on learned patterns of diseases and visual cues, but may not be efficient for conditions with less distinctive features.
The hypothetico-deductive method involves generating multiple working hypotheses and continually reinforcing, rejecting, or generating new ones until a final diagnosis is reached.
Differential diagnosis refers to a doctor's list of likely hypotheses and the process of gathering clinical information to determine the actual diagnosis.
Clinical reasoning involves 5 stages: problem identification, hypothesis generation, hypothesis testing, hypothesis review, and developing a management plan.
Problem identification starts with the case history and understanding the chief complaint to develop hypotheses.
Hypotheses are generated based on patient profile, doctor's knowledge, and epidemiology.
Hypotheses are tested through further inquiry and tests during the examination sequence.
After obtaining clinical information, a diagnosis is made, and some hypotheses are rejected, added, or reinforced.
Depending on the diagnosis and other factors, a management plan is developed, considering possible treatment options and patient's background.
Factors contributing to a doctor's clinical decision-making skills include knowledge base, reasoning skills, clinical experience, professional style, attitudes, beliefs, and demeanor with patients.

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Description

Test your knowledge of clinical decision making and diagnostic reasoning in ophthalmology with this quiz. Explore evidence-based models of clinical decision making and the stages of clinical reasoning, and understand the factors contributing to a doctor's clinical decision-making skills.