SUMMARY

Chief complaint

Which part of diagnosis development corresponds to identifying the problem in general problem solving?

Expressed in general terms

How is the chief complaint usually expressed in diagnosis development?

Data collection

What is the diagnosis development equivalent of collecting relevant data in general problem solving?

History, physical examination, and additional tests

Through what three primary means is data collection performed during diagnosis development?

Framing

What is the process of putting a collected medical problem into a clinical syndrome or summary called?

Accurate presentation

Which step of general problem solving is equivalent to framing in diagnosis development?

Preliminary diagnosis and differentials

What two elements are developed during the formulate hypotheses stage of diagnosis development?

Formulate hypotheses

Which general problem solving step corresponds to developing a preliminary diagnosis and differentials?

Management plan

What is developed during the plan ways to test or treat stage of diagnosis development?

Diagnostic, therapeutic, and education

What are the three core components of a medical management plan?

Plan ways to test or treat

Which general problem solving step corresponds to developing a management plan?

Medical interventions

What is the diagnosis development equivalent of implementation in general problem solving?

Implementation

Which general problem solving step corresponds to medical interventions?

Evaluating outcomes and follow-ups

What is being done when a physician interprets results in diagnosis development?

Interpret results

Which general problem solving step corresponds to evaluating outcomes and follow-ups?

System 1

Which reasoning system is described as Intuition?

System 2

Which reasoning system is described as Analytical Reasoning?

Effortless judgment

What is the primary characteristic of System 1 clinical reasoning?

Slow, methodical, and exhaustive

What three characteristics define System 2 clinical reasoning?

Memorized associations

From where does System 1 derive its subconscious judgments?

Subconscious

Is System 1 reasoning considered conscious or subconscious?

Complex cases beyond expertise

In what specific clinical scenario is System 2 reasoning typically used?

Pattern recognition

System 1 uses heuristics and what other primary cognitive tool?

Herpes zoster rash

What is an example of a condition often diagnosed using System 1 pattern recognition?

Heuristics

Besides pattern recognition, what are the primary mental shortcuts used in System 1?

Data gathering

System 2 utilizes the hypothetico-deductive model and what other specific activity?

Hypothetico-deductive model

What specific reasoning model is associated with System 2?

Representativeness

Which heuristic involves judging a diagnosis based on its similarity to a mental prototype?

Missing atypical variants

What is the potential error associated with the representativeness heuristic?

Similarity to a mental prototype

What is the basis for judging a diagnosis when using representativeness?

Availability

Which heuristic involves judging probability based on how easily prior similar cases are recalled?

Recall bias

What is the primary potential error when using the availability heuristic?

Catastrophic rare cases

What type of cases, besides recently publicized ones, often trigger recall bias in the availability heuristic?

Recently publicized cases

What type of cases, besides catastrophic ones, often trigger recall bias in the availability heuristic?

Anchoring

Which heuristic involves sticking to an initial diagnosis despite receiving new contradictory data?

Stickiness

What is the informal term used to describe the anchoring heuristic?

Premature closure

What is the specific potential error where a physician fails to gather critical data due to anchoring?

Failing to gather critical data

What specific clinical failure is associated with anchoring and premature closure?

Simplicity

Which heuristic involves seeking a unifying diagnosis for all symptoms?

Occams Razor

What is the common name for the simplicity heuristic?

Neglecting unexplained symptoms

What is a potential error when a physician over-relies on the simplicity heuristic?

Neglecting significant findings

What specific clinical error, besides neglecting unexplained symptoms, occurs with the simplicity heuristic?

Probabilistic

Which approach to prioritizing differentials focuses on disorders that are most common or prevalent?

Primary Impression

In the probabilistic approach, what is the specific term for the most common or prevalent disorder?

Ideal approach

How is the utility of the probabilistic approach described for most clinical encounters?

Prognostic

Which approach prioritizes serious conditions that must-not-miss?

Rule-outs

In the prognostic approach, what are serious, must-not-miss conditions called?

Safety

The prognostic approach is described as vital for what specific aspect of clinical care?

Ruling out MI in chest pain

What is a classic example of using the prognostic approach to prioritization?

Pragmatic

Which approach favors conditions that are most responsive to available treatment?

Low-risk, symptomatic relief

In what two types of clinical scenarios is the pragmatic approach typically used?

Possibilistic

Which approach treats all known causes as equally likely?

Not useful or practical

How is the utility of the possibilistic approach described for clinical practice?

Subjective

Which SOAP component includes the chief complaint and history of present illness?

Identifying data, CC, HPI, ROS, PMH, FMH, and Social History

What are the seven standard history components found in the Subjective section?

Lifestyle Vital Signs

Which specific vital signs are documented in the Subjective rather than Objective section?

Objective

Which SOAP component includes anthropometrics and physical exam findings?

General survey and vital signs

Besides PE and labs, what two standard survey components are in the Objective section?

Laboratory and imaging results

Where in the SOAP note are objective diagnostic test results documented?

Assessment

Which SOAP component includes the problem list?

Problem List

What component of the Assessment section contains both Biomedical and Psychosocial issues?

Biomedical and Psychosocial

What are the two specific categories of problems included in the Assessment problem list?

Primary Impression and Differentials

Besides the problem list, what two diagnostic elements are in the Assessment?

Plan

Which SOAP component contains the therapeutic and diagnostic orders?

Diagnostic Plan, Therapeutic Plan, and Patient Education

What are the three main sub-components of the Plan section?

Patient Education/Supportive Plan

Which part of the Plan involves informing and supporting the patient regarding their care?

Fee-for-service

Which payment scheme pays the physician based on the number of services provided?

Overuse of clinical interventions

What is the clinical implication or risk of a fee-for-service model?

Capitation

Which payment scheme provides a fixed payment per patient per year?

Global budget management

What does the capitation model encourage physicians or organizations to perform?

Reduces low-benefit use

What is the ideal outcome of capitation regarding resource utilization?

Fixed Salary

Which payment scheme pays the same amount regardless of the clinical effort?

Incentive to see fewer patients

What is the potential negative clinical implication of a fixed salary model?

Sensitivity

What measure is computed as True Positives divided by the sum of True Positives and False Negatives?

True Positives / (True Positives + False Negatives)

What is the formula for Sensitivity?

SnNOut

What is the mnemonic for Sensitivity?

Sensitive test, when Negative, rules Out disease

What does the mnemonic SnNOut stand for?

Specificity

What measure is computed as True Negatives divided by the sum of False Positives and True Negatives?

True Negatives / (False Positives + True Negatives)

What is the formula for Specificity?

SpPIn

What is the mnemonic for Specificity?

Specific test, when Positive, rules In disease

What does the mnemonic SpPIn stand for?

Positive Predictive Value

What measure is computed as True Positives divided by Total Positives?

True Positives / Total Positives

What is the formula for PPV?

Probability patient has disease if test is positive

What is the clinical interpretation of PPV?

Negative Predictive Value

What measure is computed as True Negatives divided by Total Negatives?

True Negatives / Total Negatives

What is the formula for NPV?

Probability patient is disease-free if test is negative

What is the clinical interpretation of NPV?

Significant/Conclusive

How is a change to post-test probability described if the LR+ is greater than 10?

Greater than 10

What LR+ value indicates a significant or conclusive change to probability?

Less than 0.1

What LR- value indicates a significant or conclusive change to probability?

Moderate change

What is the significance of a test result with an LR+ between 5 and 10?

Small change

What is the significance of a test result with an LR+ between 2 and 5?

Minimal change

What is the significance of a test result with an LR+ between 1 and 2?

No diagnostic value

What is the diagnostic significance of a Likelihood Ratio equal to 1.0?

1.0

What specific Likelihood Ratio value indicates a test has no diagnostic value?

Below Test Threshold

In what probability range is a disease considered ruled out?

Ruled out

What is the clinical status of a disease if the probability is below the test threshold?

No further testing or treatment

What is the physicians appropriate action if the probability is below the test threshold?

Between Thresholds

In what probability range does a physician request further diagnostic testing?

Uncertainty

What is the clinical state when probability falls between thresholds?