I'm so grateful to be a physician in the RU-vid era to see such incredible medical teaching in this amazing channel. I thought that I might ask you Dr. Strong if you're preparing on some textbooks for the stuff you are teaching but after watching this video, I can see that this can't be made 'in books'. Thanks so much! ❤️❤️
Thank you for the kind words! I actually have written about 1/3-1/2 of a manuscript for both a mini-textbook on ABGs and one on ECGs, but I could never find the time and motivation to finish them since RU-vid has always seemed to be a better means to distribute the information.
wow what an amazing doctor, not only does he know how to deliver the information in a very clear and comprehensive way but also has charisma, hats off 🙇♀👒
These videos are amazing. I'm doing a masters in advanced clinical practice . I didn't understand the lectures on differential diagnosis but these videos make so much sense and will help me write my essay. Thank you
Great video, I love how you make medicine logical. As a medical student this is something I have really struggled with. Medicine just seems like a tsunami of information that requires recall of disjointed facts. So learning everything has been so depressing and challenging because I just can't remember that many facts. But when there is structure and logic, it makes it so much better. I wish everyone taught medicine like you do. Keep it up and continue with the videos please!
This is a wonderful video, it really helps a lot to organize my thoughts and ideas during rotation or studying. Your videos are fantastic, really help me understand a lot.
Thank you Dr Strong! I nearly decided not to watch this but I am glad I did. In someway I could see my difficulty then, differential diagnosis is , how can one comprehend if one does not know enough disease or conditions to be included in DDX , I think human might go by pattern, then form hypothesis, then start asking history to rule out or support hypothesis. In someway one has to know enough of disease or condition in order to be effectively form DDX , otherwise if all one has is a hammer :).
Tqsm sir I am a big fan of u and ua content which is dealth in a great systemic manner And in a understood able way ,ua Really doing a great job sir keep it up
So, now after watching the video, I understood out that making a distinction between those two terms is actually helpful, because you can combine those as the process continues. For example in this case, we have to rearrange the differential because of the abscense of signs and sintoms of asthma, bradiarrythmias and psiquiatrich disorders; but also because of the discovering of new ones, such as: Haemodinamic instability and bilateral crackles. So, now we could add the framework for haemodinamic instability to the differential and reorganize it: PTE, CHF, Pericarditis/Pericardial Tamponade, HMO, Infection, Aortic rupture. Given these new diseases to consider, how would you rearrange it and why?
Thanks so much for putting this content online! I have a question though: how would you create a diagnostic framework for a patient that presents with multiple symptoms (i.e. fever, dyspnea, cough, diarrhea). I've been working on a case in which an immunsupressed patient had these symptoms, but coming up with a diagnostic framework for each symptom seems to create way to much work. Thank you for your time!
Thanks for the wonderful presentation. However, I would like to know if it's the differential diagnoses that you base on to choose which particular tests and examinations to perform.
Generally yes. This is partly discussed in a subsequent video in this specific series: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-22cP33v4--k.html
One risk factor that is often overlooked is gender. Males are more susceptible to heart attacks than woman however , after 60 years the ratio becomes equal. And why arent his Medicines considered relavent . Wouldn't that mean we will find out if the medicines are actually working to control HT and fast HR? I am just a curious Med Student and really enjoyed your video for Differtial Dx. I Dx him right after the HPC and the Hx.😂. But loved the way you explained the framework. Ill give it a crack. Thank you for the amazing work. Edit my Dx was ACS, particularly Silent MI based on DM . Diff Dx were After the vital signs . I did put Cardiogenic Shock and Tachyrhythmia as two likely ones. 😢
Hi Eric, thank you for this new series. What would you suggest for those who want to dive deeper into this sort of content? I'm quite confident that the content of these videos will be a valuable synthesis of many readings and clinical experience of yours, but I always find that I need to have reading material as a complement.
Unfortunately, there really isn't a great, truly introductory, text on the field of clinical reasoning. There are solid books like Symptom to Diagnosis by Stern et al, and Frameworks in Internal Medicine by Mansoor - though they focus more on the approach to specific problems rather than a discussion of the clinical reasoning process. Learning Clinical Reasoning by Kassirer is more for an intermediate learner, and has some really nice case-based discussions. And for advanced folks (residents and beyond), Medical Decision Making by Sox, et al is great (and will be a source for some of my videos in part 3 of this series), but is relatively math heavy. I like it, but much of it is too abstract to be clearly applicable at the bedside.
Yes - if either it's sufficiently fast enough, lasts long enough, and/or the patient already has an occult cardiomyopathy that isn't able to tolerate such a rate or (for a-fib or a-flutter) to tolerate the loss of the atrial kick. In the case from the video, since the patient has developed hemodynamic compromise from a rhythm with a rate of 160 (which isn't that fast for a 40 something year old), you could speculate that it's either VT (which is less well tolerated than SVTs at equivalent rates), and/or the patient has an occult cardiomyopathy related to their hypertension or undiagnosed CAD. Obviously, an ECG would go a long way to better understanding what's going on with him.
Sir but I had doubt about Crackles on Auscultation ,which could actually help include new diagnoses in DDx which could be pneumonia or pulmonary edema Am I ryt sir pls clear me here sir,,
Crackles have a long list of possible etiologies. Certainly unilateral crackles would be more suggestive of pneumonia, but the bilateral nature of these is suggestive of a more diffuse process. Symmetric pulmonary edema can be either cardiogenic (e.g. acute decompensated heart failure) or non-cardiogenic (e.g. ARDS). In this case, the concurrently elevated JVP points to cardiogenic pulm edema - which basically means pulm edema related to an elevated left ventricular end diastolic pressure (LVeDP), which itself has a ton of causes, from tachyarrhythmias to ACS and subsequent LV failure, to hypertensive emergency.
