Aditya’s Razor

Aditya “Dity” Chawla

Ganiat “Ola” Mumuney

Guilford “Ford” Parsons

Scene I

• Cast (in order of appearance)– Doctor

• Frequent cognitive errors• Distracted

– Patient• WebMD-savvy• Frequent urination

Scene I (Discussion)

• After visit– Back pain intensified

• What were the doctor’s mistakes?– Clouded judgment (family friend)– Biased by previous diagnosis (pt’s father)– Overly casual

• What about the patient?– Misuse of jargon

Scene II

• Cast (in order of appearance)– Doctor

• Asks open-ended questions• Focuses on the patient

– Patient• Really likes milk

SOAP Note (EMR.PPT)

• Subjective– CC: back pain– HPI: insomnia, just started lifting– Fam: Father DOE– Allergies: none– Meds: multivitamin

• Objective– PE: back pain, RL quadrant

SOAP Note (EMR.PPT)

• Assessment– (Class Differential Diagnosis)

• Plan– Blood work– Patient to return in 1 week

Scene II (Discussion)

• Doctor– Did not dwell on family ties– Questions: open/closed– Efficient+Effective collection of information

• Noticed the polyuria!

Differential Diagnosis

Discussion

• Patient not bothered by insomnia• Milk (Ca2+) + polyurea + unrelenting unilateral

back pain = kidney stones• DOE: from anemic genetic trait• Blood test

– Ca2+ levels (kidney stones?)– Hb levels (b-thalassemia?)

Diagnosis

• Depression– Caused the lifting

• Caused the increased milk intake– Caused the kidney stones

» Caused the back pain