with Guaranteed Pass Solutions 2025-
2026 Edition.
Big 3 Category- Top Misdiagnosis - Answer stroke, sepsis, lung cancer
#1 cause of malpractice - Answer Misdiagnosis
What helps form hypotheses and create your diagnostic reasoning? - Answer Epidemiology
Clinical diagnosis requires - Answer info from pt (subjective) 75%
use that info with ur knowledge of understanding disease + PE is 15%
Likelihood Ratios - Answer Weights that help you understand how much a physical sign argues
for or against a diagnosis
Possible weights of 0 to infinity
>1 means increased probability of disease
<1 means decreased probability of disease
Specificity - Answer Proportion of patients without the diagnosis who have the physical sign
(e.g., positive finding)
ex: me for celiac disease
Sensitivity - Answer Proportion of patients without the diagnosis who lack the physical sign
(i.e., have a negative result)
Likelihood Ratio Definition - Answer probability of finding in pts with disease / probability of
,Experts vs. Novices - Answer experts gather less data, but better data, organize better =
shorter time to make accurate diagnosis
what makes a good clinical diagnostician? asking right questions
Article: Diagnostic Excellence and Patient Safety - Strategies and Opportunities - Answer PC-
cancer screening (colonoscopy 10 years, FOBT 2 years = survival rate up)
ED- sepsis (more deaths than some cancers) good improvements but more needed
Inpatient- PE (over tested but under diagnosed) better with clinical decision tools and plasma d-
dimer measurement
Article: Big 3 diagnostic errors and serious misdiagnoses related harms are - Answer · 5
vascular events: stroke, MI, venous thromboembolism, aortic aneurysm/dissection, arterial
thromboembolism
· 5 infections: sepsis, meningitis/encephalitis, spinal abscess, pneumonia, endocarditis
· 5 cancers- lung, breast, colorectal, prostate, melanoma
Video: Catherine Lucey- Good clinical diagnosticians: - Answer o Efficiently obtain enough
information from patient to make initial differential diagnosis
o Search memory/resources to identify possible causes of patient's symptoms
o Prioritize the likelihood that a possible disease explains patient's concerns
o Use tests (carefully) to evaluate their assessments have to be careful and know and get
correct proper information because some tests are harmful, expensive, wasteful, timely
o Always continue to analyze the success of their diagnoses to improve accuracy going forward
Video: Catherine Lucey- experts: - Answer reorganize their knowledge in a relational way- S&S
to syndromes to disease
ACL Article: - Answer common knee injury in athletes
clinical diagnostic tests and MRI are 2 methods of evaluating ACL injuries
,gold standard: diagnostic arthroscopy
Screening tests - Answer to detect asymptomatic and early stage disease
should be highly sen/spec to pick up most cases of true disease and avoid false positives
targeted toward pop with higher disease prevalence (high positive predictive value)
safe, cost effective
should screen for diseases in which early identification and treatment have been demonstrated
to improve clinical outcomes
HIV - Answer Grade A- ages 15-65
Cervical Cancer - Answer Grade A- ages 21-65
21-29 cervical cytology every 3 years
30-65 cervival cytology every 3 years and HIV every 5 years
Colorectal Cancer - Answer 45-75
45-49 grade B
50-75 grade A
HTN - Answer adults 18 and older without known HTN: grade A- office BP
Ovarian Cancer - Answer Asymptomatic women- against- grade D
, discuss potential downstreams before initial
use higher treshold for positive result
understand basic test characteristics and limitations as well as pts goals/values
Role of diagnostic testing - Answer to reduce uncertainty regarding a specific patient diagnosis
generally more appropriate for patients you feel have intermediate 10-90% pre post prob of
disease
test characteristics (ex- likelihood ratios) should be considered before ordering test to help
determine whether given test will significantly alter your post test probability and change your
management
Incidence - Answer Measure of the number of new cases of a characteristic that develop in a
population in a specified time
Occurrence of new cases of a disease
Prevalence - Answer Proportion of a population who have a specific characteristic in a given
time period or particular point in time regardless of when they first developed the characteristic
Number of existing cases of a disease
Cancer genetics - Answer Cancer is a genetic disease—that is, cancer is caused by certain
changes to genes that control the way our cells function, especially how they grow and divide
Germline changes are found in every cell of the offspring; only ~10% of cancers are from
germline changes
Genetic changes that occur after conception are called somatic (or acquired) changes. Most
cancers develop from somatic changes