A Safe Diagnostic Strategy (PROMPt)

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A Safe Diagnostic Strategy (PROMPt) by Mind Map: A Safe Diagnostic Strategy (PROMPt)

1. 5. Patients Wants to Tell Always has to consider in the case of undifferentiated illness, whether the patient has a 'hidden agenda' for the presentation.

1.1. - Patient wants MC - Patient just want someone to talk to - Affection towards the GP

2. 2. Red Flags Diagnosis of exclusion that must be ruled out to avoid fatality. 3 things ; Major infection, Vascular, and Cancer

2.1. i..e Same headache patient. Infection - Meningitis Vascular - SAD/SDH Cancer - Brain CA

3. 4. Masquerades A type of fail-safe mechanism to avoid missing the diagnosis of these disorders. Patient with a thousand list of problems is where these checklist is useful.

3.1. D - Depression D - Drugs D - Diabetes S - Spine A - Anaemia T - Thyroid U - Urine

3.1.1. Others; CKD Malignant Disease HIV/AIDS Bacterial Infx Viral Infx Neurological Dilemmas Connective Tissue disorders

4. 1. Probable Diagnosis (Most) Based on Doctor's perspective and experience with regards to prevalence, incidence and natural history of the presenting disease.

4.1. I.e Patient comes to you with Headache. Most probable diagnosis? Migraine, Tension headache, Viral dengue and others based on experience.

5. 3. Often Missed Epidemiological knowledge is a great asset for GP, however it can be a disadvantage in that they are so familiar with common cases, yet, rare cases were overlooked. Hence, keep in mind these rare diagnosis.

5.1. Other rare causes of headache i.e Cluster headache, Sinusitis, Temporal arthritis, Head trauma, Otitis Media, Glaucoma, Gingivitis, Head Trauma, Explosive headache

6. 6. Concept of diagnostic Triads Remember three to four key points to the condition which can provide useful diagnostic tool.

6.1. Dagnostic triads for life-threatening conditions (examples) DxT fever + rigors + hypotension septicaemia DxT fever + vomiting + headache meningitis DxT fatigue + dizziness ± syncope cardiac arrhythmia DxT fever + drooling + stridor (child) epiglottitis DxT headache + vomiting + altered consciousness subarachnoid haemorrhage (SAH) DxT abdominal pain + amenorrhoea + abnormal vaginal bleeding ectopic pregnancy DxT fatigue + dyspnoea on exertion + dizziness cardiomyopathy

6.2. Examples of diagnostic triads DxT angina + dyspnoea + blackouts aortic stenosis DxT menstrual dysfunction + obesity + hirsutism - polycystic ovarian syndrome DxT malaise + night sweats + pruritus Hodgkin lymphoma DxT abdominal pain + diarrhoea + fever Crohn disease DxT vertigo + vomiting + tinnitus Ménière syndrome DxT dizziness + hearing loss + tinnitus acoustic neuroma DxT fatigue + muscle weakness + cramps hypokalaemia