Logical Approach to Clinical Reasoning

Cards Based on Maddison J. (2022). 'Logical approach to Clinical Problem Solving' [Lecture], POS: Clinical Practice.

  • Created by: ZoeCouch
  • Created on: 21-10-22 20:16
What is type I clinical reasoning?
pattern-recognition: develop a list of illness scripts
1 of 25
What is type II clinical reasoning?
Problem based solving via analytical reasoning
2 of 25
When does type I clinical reasoning work best?
- works for common diseases with typical presentations
- when there are only a few possibilities to remember
- possibilities can be easily ruled in/out by diagnostics
- when clinical pattern for disease is unique
3 of 25
Pros of type I clinical reaosning?
- doesn't need to be taught
- quick (if correct)
- cost effective (if correct)
4 of 25
Cons of type I clinical reasoning?
- needs limited #options
- doesn't work for atypical presentations
- difficult for uncommon disorders
- dependent on previous Dx and clinical signs matching
- depends on experience, memory
-risk tunnel vision
- risk confirmation bias
- no clear alternate
5 of 25
What is type II analytical reasoning?
Logical clinical problem solving (LCPS)
6 of 25
When to use LCPS?
- inexperience
- uncommon disorder
- atypical disease presentations
- safety check for pattern recognition
7 of 25
Steps to LCPS?
1) Define the problem
2) Define system (and how involved)
3) Define Location
4) Define the lesion
8 of 25
Why should you make a problem list?
- makes clinical signs explicit
- makes vague specific
- prevent overlooking less obvious but crucial clinical signs
- clarify any difference in chronology of signs
- allows possibility of multiple disorders
9 of 25
What do you do to define the system?
1) major body system
2) primary or secondary
3) Local or systemic
10 of 25
What is a primary problem?
pathology is in that system e.g. neoplasm, infection, inflammation
11 of 25
What is secondary problem?
Pathology outside the system is affecting the way the system is functioning e.g. affects of hypoxia, electrolyte changes, toxins on organs.
12 of 25
How do you differentiate treatment of structural and functional primary disease?
Surgical treatment = structural
Medical treatment = functional
13 of 25
What happens if incorrect definition of problem or system?
- endangering patient by delaying or incorrect diagnosis
- wasted time
- wasted money
- impaired client-vet trust
14 of 25
When defining the lesion, what acronym can help you?
15 of 25
What does DAMNIT stand for?
- Degenerate / Developmental
- Anomalous/ Autoimmune
- Metabolic / Mechanical/ Mental
- Nutritional/ Neoplasia
- Inflammatory/ Infection/ Ischemic/ Immune/ Inherited/ Iatrogenic/ Idiopathic
- Traumatic
16 of 25
Description of Degenerate Disease?
Gets worse over time, or with ageing.
17 of 25
Description of developmental disease?
Congenital: hypoplasia of organs, anagenesis etc
18 of 25
Examples of Metabolic Disease?
Hormone imbalances, enzyme deficiencies etc
19 of 25
Examples of mechanical disease?
pressure, thermal injury, ionising radiation
20 of 25
Description of mental disease?
pyschological, behavioural
21 of 25
2 types of Neoplasm?
Benign neoplasms, malignant neoplasm (non-metastatic versus metastatic)
22 of 25
Differentials prioritised via?
geographic location
23 of 25
Pros of LCPS?
- avoid confirmation bias
- avoid tunnel vision
- helps chunk differentials
- ensures appropriate history taken
24 of 25
What MUST you do with LCPS?
Must ensure full and transparent communication with owners about appropriate diagnostics and treatment required
25 of 25

Other cards in this set

Card 2


What is type II clinical reasoning?


Problem based solving via analytical reasoning

Card 3


When does type I clinical reasoning work best?


Preview of the front of card 3

Card 4


Pros of type I clinical reaosning?


Preview of the front of card 4

Card 5


Cons of type I clinical reasoning?


Preview of the front of card 5
View more cards


No comments have yet been made

Similar Medicine resources:

See all Medicine resources »See all POS (Clinical Practice) resources »