#26 A 85F with AMS Part 2: Hoofbeats Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 24 October 2018

⏱️ 27 minutes

🔗️ Recording | iTunes | RSS

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Summary

Dissect a working diagnosis through a process of validation! Time Stamps: * Your collective differential [0:40] * The test results (that you asked for) are in... [2:13] * The hospital course, and the diagnosis (or is it?) [7:10] * Validating a diagnosis: Base rate, adequacy, and coherence [8:30] * Revisiting the differential [14:44] * What to do when there is no final diagnosis? [17:39] For full show notes: https://www.coreimpodcast.com/2018/10/24/hoofbeats-85f-with-acute-ams-part-2/ (https://www.coreimpodcast.com/2018/10/24/hoofbeats-85f-with-acute-ams-part-2/) Tags: Clinical reasoning, Diagnostic Uncertainty Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	Hi everyone John Huang here and welcome back to another episode of hoofbeats, where we challenge you to solve
0:13.5	diagnostically difficult real world cases alongside experienced clinicians.
0:17.3	And as always, I'm here with my partner, Cindy Fang.
0:20.0	Thank you, Jean.
0:21.2	So two weeks ago, we challenged you to solve the case of an 85-year-old woman who presented with psychotic symptoms just after being discharged from a hospitalization for complicated diverticulitis.
0:33.7	And we asked you to not just solve the case, but to commit to your diagnosis by submitting
0:39.1	them through the Human DX platform.
0:42.1	And honestly, Cindy, I wasn't too sure how this would play out. People are busy. The
0:46.9	app takes a full minute to download. So we were pleasantly surprised and
0:51.2	really appreciative of the number and quality of responses that we got.
0:55.6	Collectively, you all came up with no fewer than 39 distinct diagnoses, right, to explain her findings.
1:02.4	Many of these were common common which we also appreciate.
1:05.0	This segment is called hoofbeats after all. Some were new at least to me.
1:09.2	Cindy have you ever heard of anti biomania?
1:12.5	No, I have not.
1:13.7	Apparently that's a term.
1:15.0	I googled it, so it's true.
1:16.9	Can confirm that it's real.
1:18.9	And I'm going to be using that term a lot more
1:21.0	in the future if I can help it. Mostly though the diagnoses
1:24.4	tended to fall into three broad categories. CNS process, infection, adverse
1:30.4	effective in medication that was given or withheld,
	...

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