B Case 4 Tutorial - Headache & Fever 1
Tut9 Case B Case 4 tutorial - Headache _ Fever 2
Learning outcomes 1. Outline issues related to making an early medical diagnosis in a common but serious condition 1. outline sources of uncertainty in the patient, the doctor and in the doctor-patient relationship 2. acknowledge the limits of current biomedical knowledge for the diagnosis and treatment of the disease 2. Interpret information about the accuracy of clinical signs and diagnostic tests 3. be able to obtain and interpret information on the accuracy of clinical signs and diagnostic tests in terms of test predictive values 4. relate how changing disease prevalence or altered diagnostic test parameters may alter test accuracy 5. be able to use a test appropriately to diagnose or exclude a given condition 3. Describe the underlying mechanisms involved in the acute inflammatory response to infection 6. interpret the acute phase reactants found in a patient with acute inflammation 7. list the stimuli that result in acute inflammation 8. describe the gross and microscopic changes present in the acute inflammatory response 9. describe the formation and function of fluid exudate and cellular exudate 10. identify the major cytokines involved in each step in the acute inflammatory response 4. Compare the relative importance of bacteria and viral pathogens in the aetiology of meningitis 11. Describe the pathogenesis of invasive meningococcal disease 12. outline the use of antibiotics in the prophylaxis and the treatment of acute infective conditions 13. demonstrate the role of laboratory tests for the differential diagnosis of acute bacterial and viral infections 14. discuss the role of vaccination for the prevention of acute microbial diseases 5. Demonstrate the strategies employed to control infectious diseases in the population and in the community. 15. describe the role of environmental and socioeconomic factors that impact on the risk of infectious disease. 1 6. outline the role of surveillance in identifying an emerging infectious disease problem 16. identify the major issues involved in the development of vaccines and the implementation of vaccination programmes 17. identify the principles of outbreak control and the need with certain diseases to notify the local medical officer of health
Content:
Take a history from the patient
Patient’s Problem List headache that persists and feeling feverish
Exploration of Patient’s Problems (History of the presenting complaint) Medical Perspective Sequence of events drink on wendesday headache on thursday feverish on friday thirwsty like the flo
Symptom analysis
Relevant Systems review
Patient’s Perspective Ideas and concerns
Effects on Functioning
Background Information Past Medical History annual flu
Drug History and Allergies (good to do this here so you don’t forget) none none
Family History
Social, Life-style and Occupational History
Review of Systems Analysis of the History and Problem Re-formulation Physical Examination (as far as we go in year 2)
task 1
what concerns you about the case list all causes for headache and fever.
reorder with what is most serious how can you rule out causes what patients can you send come