Chapter 003. Decision-Making in Clinical Medicine (Part 2)

The following three examples introduce the subject of clinical reasoning:  A 46-year-old man presents to his internist with a chief complaint of hemoptysis. The physician knows that the differential diagnosis of hemoptysis includes over 100 different conditions, including cancer and tuberculosis. The examination begins with some general background questions, and the patient is asked to describe his symptoms and their chronology. By the time the examination is completed, and even before any tests are run, the physician has formulated a working diagnostic hypothesis and planned a series of steps to test it. In an otherwise healthy and nonsmoking patient recovering from...