For your chosen symptom, create a patient. Choose an age and gender for your patient. Assume that you are given the patient’s presenting complaint that they gave the receptionist or the MA when they were put in the room. Please approach the patient from a non-emergent perspective. Do not tell me that your 49-year-old male patient has threatened to commit suicide so you called the mobile crisis team.
Discuss the initial diagnoses you would consider before entering the exam room based on their age, gender, and chief complaint. Make your initial differential broad; include any mental health diagnosis that may be plausible. Then, list what questions you would ask the patient. Makeup answers.
Then discuss how those answers added to, eliminated from and changed your initial differential list.
List additional questions you would have for the patient based on their previous answers and the reasoning process.
Give the answers to those questions and how they influenced your differential. By this time your differential should be much shorter.
Then list what tests you would order for this patient. Make up some findings. Give a rationale for ordering vs. not ordering a test for that patient. Give an overall plan for diagnostic testing with the rationale for each test.
Discuss how the test results support or rule out the diagnoses left on your differential list.
List the top 3 diagnoses you are left with. How likely do you consider each to be? Why?
Please place a copy of the grading rubric at the end of the scenario.
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