NR511 Case Studies (Week 3 & 6).

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NR511 Case
Studies
(Week 3 & 6)



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NR511 Case Studies (Week 3 & 6)

Part 1:

In Part 1, you are given a patient scenario. Using the information given, answer the following questions:
1. Briefly & concisely summarize the H&P findings as if you were presenting it to your preceptor using
the pertinent facts from the case. Use shorth& where possible & approved medical abbreviations. Avoid
redundancy & irrelevant information.
Example:
 “J.S. is a 34yo male with a CC of acute onset ST x 3 days” [provide additional information from
the history that is relevant].
 “Physical exam is significant for” [provide relevant physical exam findings].
 *Do not simply rewrite the information as it is presented in the case report. This should mimic
how you would present this patient to your preceptor.
2. Provide a differential diagnosis (plural) which might explain the patient’s chief complaint along with a
brief statement of pathophysiology for each.




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Example:




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 Diagnosis #1……… -Pathophysiology statement




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 Diagnosis #2……… -Pathophysiology statement




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 Diagnosis #3……… -Pathophysiology statement
3. Analyze the differential by using the pertinent findings from the history & physical to argue for or




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against a diagnosis. Rank the differential in order of most likely to least likely. (This is where you present
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your argument for EACH DIAGNOSIS in your differential using the patient’s subjective & objective
information that was given).
Example:
Diagnosis # 1, 2, & 3 (provide an analysis for each of the diagnoses listed above). A brief argument as to
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why this condition should be considered plus:
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 -Pertinent positive symptoms which support the diagnosis
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 -Pertinent negative symptoms which support the diagnosis
4. Identify any additional tests &/or procedures that you feel is necessary or needed to help you narrow
your differential. All testing decisions must be supported with an EBM argument as to why it is necessary
or pertinent in this case. If no testing is indicated or needed, you must also support this decision with
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EBM evidence. (This is where you identify, based on what you know thus far, test or test(s) that you
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would perform TODAY which would help you narrow your differential diagnosis).
*Do not list all of the possible tests that can be done. You are being evaluated on your diagnostic
reasoning skills as well your ability to make decisions that are in-line with current practice
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recommendations. Just because a test is available does not mean it needs to be done.
Example:
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Let’s say my differential included bronchitis & pneumonia. In this case, a CXR might be useful in
differentiating the 2 conditions. However, remember that you have to have an EBM argument for this
decision. So make sure you are telling the reader why this is the best choice based on the literature (i.e.,
it is not enough to say the test & cite the author & date). In this instance, my arg Infectious Disease
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Society of America (2012) a CXR is considered the gold st&ard for diagnosing pneumonia.” Keep in mind
that you also need an EBM argument if you decide NOT to test too.

Part 2
In Part 2 you might be given some additional history, exam or test findings. Using this information & the
information in Part 1, answer the following questions:



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