PA Boards 80: Clinical Pearl - When Things Don't Make Sense
Medgeeks Clinical Review Podcast
Medgeeks
4.7 • 989 Ratings
🗓️ 22 December 2015
⏱️ 10 minutes
🧾️ Download transcript
Summary
You grab the next chart, and notice a chief complaint of abdominal pain. You notice the patient is a 35 year old female. You immediately formulate a differential diagnosis in your head before entering the room. The more you speak with this patient - the more her symptoms don't make sense. So now what? Here's a clinical pearl for you.
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Transcript
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| 0:00.0 | Hey what's going on guys and welcome to episode 80 of the physician assistant boards.com |
| 0:04.8 | podcast today's podcast is really going to be about a clinical pearl that I wanted to share |
| 0:09.8 | it's really about when things don't make sense and this was something that you know I struggled with when I was early on in my career as a PA and even as a student you know |
| 0:20.0 | There are oftentimes where you see a patient and they give you history they present you know what they're feeling |
| 0:26.1 | How long they felt this way and their symptoms just don't seem to make sense and so that's what we're going to discuss today. I'm going to just kind of paint |
| 0:34.8 | you a clinical scenario. Let's pretend you're a family practice clinician right now. |
| 0:38.7 | You're grabbing the next chart and you notice a chief complaint of abdominal pain. It's a 35 year old |
| 0:45.1 | female and you're already formulating a differential diagnosis before you even |
| 0:49.2 | enter the room, right? You have a 35 year old female who has abdominal pain, so right off the top of your head you know you're probably thinking pregnancy |
| 0:55.8 | Maybe gastrointestinalritis maybe cholylythiasis, you know just some things that you should start formulating before you even walk into the room. |
| 1:04.0 | Okay so, but the first thing you need to rule out, right? Any female who can conceive |
| 1:09.0 | should have a pregnancy test to rule out pregnancy. |
| 1:12.0 | So before you go in the nurse provides you with a |
| 1:13.8 | negative pregnancy test so automatically you know okay this patient is not |
| 1:16.9 | pregnant. You walk in you introduce yourself and then you ask the patient how you |
| 1:21.4 | can help. |
| 1:22.8 | She starts describing her abdominal pain, which has been present for about a week. |
| 1:26.5 | It's not really associated with meals. |
| 1:28.6 | It doesn't really seem to be any alleviating or aggravating factors. |
| 1:32.6 | So you ask more questions. |
| 1:33.6 | And her answers are just not consistent |
| 1:36.0 | with anything specific. |
... |
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