1. What are the four main steps of differential diagnosis? Explain each step briefly.
Answer: The four main steps are: 1) Identify the chief complaint and the most likely
diagnosis. 2) Generate a list of differential diagnoses based on the patient's history,
physical examination, and diagnostic tests. 3) Narrow down the list by applying clinical
reasoning and evidence-based practice. 4) Confirm the final diagnosis and initiate
appropriate management.
2. What are some common sources of diagnostic error in primary care? How can they be
prevented or minimized?
- Answer: Some common sources of diagnostic error are: 1) Cognitive biases, such as
anchoring, confirmation, availability, and premature closure. 2) Inadequate history taking,
physical examination, or documentation. 3) Misinterpretation or overreliance on
diagnostic tests. 4) Poor communication or collaboration with patients, colleagues, or
specialists. 5) System-related factors, such as time pressure, workload, interruptions, or
lack of resources. They can be prevented or minimized by: 1) Using structured
approaches, such as mnemonics, checklists, or algorithms. 2) Seeking feedback,
consultation, or second opinions. 3) Engaging in reflective practice and continuing
education. 4) Establishing rapport and shared decision making with patients. 5)
Advocating for quality improvement and patient safety initiatives.
3. What are some key components of a comprehensive health assessment in primary
care? Give an example of how you would conduct one for a new patient.
- Answer: Some key components of a comprehensive health assessment are: 1)
Biographical data, such as name, age, gender, occupation, marital status, and ethnicity.
2) Reason for visit, such as chief complaint, history of present illness, or preventive care.
3) Past medical history, such as chronic conditions, medications, allergies,
immunizations, surgeries, hospitalizations, and family history. 4) Review of systems,
such as screening for symptoms or problems in each body system. 5) Physical
examination, such as inspection, palpation, percussion, auscultation, and special tests
for each body region or system. 6) Psychosocial assessment, such as mental status,
mood, coping skills, stressors, social support, substance use, and lifestyle behaviors. 7)
Functional assessment, such as activities of daily living (ADLs), instrumental activities of
daily living (IADLs), mobility, cognition, and safety. An example of how to conduct one for
a new patient is:
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