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Clinical Reasoning Corner: Pre and Posttest Probability – Jack Penner

The Clinical Problem Solvers

For our first post, we are going to talk about two concepts that help us decide whether we treat, test for, or toss specific diagnoses (i.e., Let’s practice with a case: You are called to admit a 72 year-old woman with hypertension, diabetes, and knee replacement seven days prior who presents with acute, pleuritic chest pain and dyspnea.

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Reasoning during the COVID-19 pandemic

The Clinical Problem Solvers

No prior history of atrial fibrillation – just hypertension and diabetes. Had the ED not ordered a chest CT, would I have tested this patient for COVID-19? Decisions have been dichotomized to ”COVID versus not COVID,” and people that have displayed none of the cardinal respiratory symptoms are being diagnosed with the disease.

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Clinical Reasoning Corner: Likelihood Ratios

The Clinical Problem Solvers

Likelihood ratios (LRs), which help us determine how a test changes the probability of a disease, are defined as: For example, say 60% of patients with aortic stenosis have a systolic ejection murmur best heard over the aortic valve area, and only 10% of patients without aortic stenosis have that same murmur.

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Leriche Syndrome

Vascular Physician

To diagnose this condition, your physician may perform screening tests, such as an ankle-brachial index test (ABI). Patients with arterial blockage may have no symptoms. However, the most common symptoms for patients with Leriche Syndrome include hip, thigh, and buttock claudication which may be on both sides.

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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. And you wrote, actually, a beautiful GeriPal blog about it a while ago.

Illness 137
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Whoop! There It Is: A Pertinent Pediatric Pertussis Podcast

PEMBlog

So respiratory complications include apnea, secondary bacterial pneumonia, and pulmonary hypertension. An alternative treatment, you would be trimethoprim sulfamethoxazole for patients who are allergic to macrolides. I’ve had patients say, well, I don’t want tetanus. Children encephalopathy, often due to hypoxia.

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