Different possible diagnosis should be listed in the order of priorities, i.e. the most likely diagnosis on top of the list and the least likely diagnosis at the end of the list
The differential diagnosis must include only those conditions that are relevant to the presenting problem(s)
Discussion of Differential Diagnosis
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A logical approach to the discussion of a given list of possible diagnoses will require a careful analysis of the history, the physical findings, and the appropriate investigation relevant to the presenting problem(s) before arriving at a plausible final diagnosis
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Discussion of the differential diagnosis must start from the bottom of the list
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This will permit a step by step exclusion of the least likely conditions
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The diagnosis must be confirmed by laboratory and other diagnostic tests and procedure
Diagnostic hypothesis – where, then what?
- Where?
- Muscle
- NMJ
- Peripheral nerve
- Spinal cord
- Brain
- Brain stem, cerebellum, thalamus, basal ganglia, cortex/lobe
Diagnostic hypothesis – where, then what?
- What?
- eg spinal cord syndrome:
- Compression
- Disc
- tumour
- Demyelination
- Stroke…
Whats
- Inherited vs acquired
- Vascular
- Inflammatory
- Neoplastic
- Traumatic
- Allergic
- Metabolic
- Endocrine
- Drugs
- Iatrogenic
- Psychiatric
- Mechanical/Structural
- Degenerative
- Deficiency
- Sleep-related
- Physiological
What do you think is wrong?
- •Brain tumour (headache)
- •Multiple sclerosis (tingling)
- •Parkinson’s (tremor)
- •Alzheimer’s (forgetfulness)
- •Epilepsy (faints)
What are you hoping for from this consultation?