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    Differential Diagnosis and Clinical Decision Making

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    bkdfiesefll
    The document discusses screening and medical disease screening from a physical therapist's perspective. It notes that screening is used to detect disease before an individual would normally seek care, and is the therapist's responsibility. Yellow and red flags are discussed, with red flags requiring immediate attention or referral. Examples of red flags include neurological deficits, numbness, and growing masses. Yellow flags include depression and anxiety. The physical therapist's role in disease prevention through primary, secondary, and tertiary prevention is described. The difference between medical and physical therapy diagnosis is explained. The clinical decision making and reasoning process is outlined.

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    Differential Diagnosis and Clinical Decision Making

    Uploaded by

    bkdfiesefll
    61 views26 pages
    The document discusses screening and medical disease screening from a physical therapist's perspective. It notes that screening is used to detect disease before an individual would normally seek care, and is the therapist's responsibility. Yellow and red flags are discussed, with red flags requiring immediate attention or referral. Examples of red flags include neurological deficits, numbness, and growing masses. Yellow flags include depression and anxiety. The physical therapist's role in disease prevention through primary, secondary, and tertiary prevention is described. The difference between medical and physical therapy diagnosis is explained. The clinical decision making and reasoning process is outlined.

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    DD Intro lecture 1 (1)

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    The document discusses screening and medical disease screening from a physical therapist's perspective. It notes that screening is used to detect disease before an individual would normally seek care, and is the therapist's responsibility. Yellow and red flags are discussed, with red flags requiring immediate attention or referral. Examples of red flags include neurological deficits, numbness, and growing masses. Yellow flags include depression and anxiety. The physical therapist's role in disease prevention through primary, secondary, and tertiary prevention is described. The difference between medical and physical therapy diagnosis is explained. The clinical decision making and reasoning process is outlined.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    61 views26 pages

    Differential Diagnosis and Clinical Decision Making

    Uploaded by

    bkdfiesefll
    The document discusses screening and medical disease screening from a physical therapist's perspective. It notes that screening is used to detect disease before an individual would normally seek care, and is the therapist's responsibility. Yellow and red flags are discussed, with red flags requiring immediate attention or referral. Examples of red flags include neurological deficits, numbness, and growing masses. Yellow flags include depression and anxiety. The physical therapist's role in disease prevention through primary, secondary, and tertiary prevention is described. The difference between medical and physical therapy diagnosis is explained. The clinical decision making and reasoning process is outlined.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 26

    Differential Diagnosis

    and Clinical Decision Making


    Screening

    It is a method for detecting disease or


    body dysfunction before an
    individual would normally seek
    medical care.
    Screening for referral

     Therapist’s responsibility

     Cost effective

     Treat specifically

     Identifysign and symptoms of systemic disease…shoulder


    and back pain

     Cancer is major part of medical screening


    Reason for Medical Disease
    Screening
    Direct access

    Quicker & sicker

    Signed prescription

    Medical specialization

    Progression of time & disease

    Patient /client disclosure

    Presence of one or more yellow or red flags


    Yellow or Red Flags
    A yellow flag is a cautionary or warning
    symptom that signals " slow down" and
    think about the need for screening.

    A red-flag symptom requires immediate


    attention , either to pursue further
    screening questions and/or tests , or to
    make an appropriate referral .
    RED FLAGS
    Factors that require immediate medical attention
    - Blood in sputum
    - LOC or altered mental status
    - Neurological deficit not explained by monoradiculopathy
    - Numbness or Parasthesia in the perianal region (aka
    saddle anesthesia)
    - Pathological changes in bowel and bladder
    - Patterns of symptoms not compatible with mechanical
    pain (on physical exam)
    - Progressive neurological deficit
    - Pulsatile abdominal mass
    Yellow Flags

    Depression
    Anxiety
    Malingering/Non-Organic Pain
    Past Medical History

    Personal or family history of cancer


    Recent (last 6 weeks) infection
    Recent history of trauma such as motor
    vehicle accident or fall (fracture; any age) or
    minor trauma in older adult with
    osteopenia/osteoporosis
    History of immunosuppression (e.g., steroids,
    organ transplant, HIV)
    History of injection drug use (infection
    Clinical Presentation
    No known cause/insidious onset
    Cyclical presentation: Better/worse/better
    Weight loss/gain within 10-21days
    Unrelieved by rest/positional change
    Unrelieved by PT intervention
    Persist longer than expected
    Growing mass
    Unable to alter symptoms during
    examination
    Cont…
    Postmenopausal vaginal bleeding
    Bilateral symptoms:
    ◦ Edema
    ◦ Numbness/tingling
    ◦ Clubbing
    ◦ Skin rash
    Change in muscle tone or ROM for individuals
    with neurological symptoms (CP, SCI, TBI,
    MS)
    Pain pattern
    Back or shoulder pain
    Pain with full and painless ROM
    Night pain
    Constant and intense
    Poorly localized
    Vascular/ neurological/ musculoskeletal/
    emotional
    Associated Signs and
    Symptoms
    Recent report of confusion (or
    increased confusion
    Presence of constitutional symptoms
    Proximal muscle weakness
    Joint pain with skin rashes, nodules
    Physical Therapist Role in
    Disease Prevention
     Primary Prevention:
    Stopping the processes) that lead to the development of diseases),
    illness(es), and other pathologic health conditions through
    education, risk-factor reduction, and general health promotion

     Secondary Prevention:
    Early detection of disease(es), illnesses), and other pathologic
    health conditions through regular screening; this does not prevent
    the condition but may decrease duration and/or severity of
    disease and thereby improve the outcome, including improved
    quality of life

     Tertiary Prevention:
    Providing ways to limit the degree of disability while improving
    function in patients/clients with chronic and/or irreversible
    diseases
    DIAGNOSIS BY THE
    PHYSICAL THERAPIST
    It is the policy of the (APTA) that PT shall
    establish a diagnosis for each patient.
    PTs use diagnostic labels that i d e n tify the
    impact of a condition on function at the level
    of the system (especially the movement
    system) and the level of the whole person.
    The PT is qualified to make a diagnosis
    regarding primary NMS conditions though
    we must do so in accordance with the state
    practice act.
    How do you dignose your
    patients?
    Clinical Decision Making/ Clinical
    Reasoning process
    It is a process by which a health care
    provider take objective data acquired
    from an actual patient and integrate it
    with factual knowledge from text
    books and medical literature to either
    make a diagnosis or develop a
    treatment plan.
    Clinical Reasoning process
    It is not a simple skill
    Interpretation of subjective data
    Evaluation of the accuracy and validity of
    data.
    Synchronize individual pieces of data into
    higher order groups
    Determination of the relevance of
    scientific literature for a specific clinical
    situation.
    Clinical Reasoning process
    Criticalevaluation of the arguments for
    and against the diagnosis.
    Application of biostatistics
    Integration of different types of
    knowledge into a complete decision
    making process
    Guide to physical therapy practice
    Difference b/w medical and
    physical therapy diagnosis
    Medical diagnosis
    Based on the pathologic or pathophysiologic
    state at the cellular level.

    Physical therapy diagnosis


    Based on Model of disablement : impairment
    ,functional limitation or disability.
    Diagnosis

    A label encompassing a cluster of sign


    & symptoms commonly associated
    with a disorder or syndrome or
    category of impairment ,functional
    limitation or disability.
    A list of possible diagnosis which may explain
    the patient’s presentation
    It should include those diagnosis in which either
    its likelihood is high enough or the danger if it
    should be missed is high enough, in order to
    warrant immediate testing to investigate that
    specific diagnosis
    It may include additional diagnoses whose
    likelihood is low enough to not warrants
    immediate testing, but which have not been
    completely ruled out
    It is prioritized in descending order of
    likelihood.
    Differential diagnosis

    A process of identifying all of the possible


    diagnoses that could be connected to the signs,
    symptoms, and lab findings, and then ruling
    out diagnoses until a final determination can
    be made.

    List of diaganosis
    THANKS

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