Health Information and Ideas Sharing and Exchange
Guidelines and Format
on

Individual Health Management

Hypothetical Patient Management
Sequential Patient Management/Case Study

Health Information and Ideas Sharing and Exchange needed for:

Hypothetical Patient Management

Patient with a complaint of breast pain
Patient with a complaint of breast lump
Patient with a complaint of nipple discharge

Tasks

To present and discuss clinical management issues in hypothetical patients with breast disorders by

1. supplying the triggers with hypothetical data and then
2. answering the guide questions provided.

Who can contribute

Health Care Providers

Format

Hypothetical Patient Management in Breast Disorders
Chief Complaint (The Health Problem)
Example: Chief Complaint (Breast Pain)
(Name and Title of Contributor)

Trigger 1

Patient with complaint of "The Health Problem"

Questions:

1. What is "The Health Problem"?
2. What are the possible causes of "The Health Problem"?

Organs/Tissues Involved

General Condition/Disorder
(E.g., Trauma, Cancer, Infection, etc.)

Specific Condition/Disorder

3. What do you think are the more common/least common general and specific condition causing the health problem?

General Condition/Disorder
(E.g., Trauma, Cancer, Infection, etc.)

Specific Condition/Disorder

More Common

Least Common

4. Select one common general or specific condition and diagram the pathophysiology leading to the health problem.

The Health Problem
Trigger 2

Pertinent history
Age, sex / Chief complaint / When noted / Associated symptoms
Physical examination:

Questions:

1. What is your primary and secondary diagnosis?

Primary diagnosis: _____________________________________________
Secondary diagnosis: ___________________________________________

2. What are the bases for your primary and secondary diagnoses?

Demonstrate use of pattern recognition with pathophysiology and prevalence.

Signs/Symptoms/Pathophysiology Prevalence data

Primary diagnosis
 Secondary diagnosis

 3. Do you need more data (sign/symptom) to firm up your primary and secondary diagnoses?

If yes, what? How will it firm up your diagnosis?
[ Data asked for either not available or normal. Facilitator may supply other data.]

4. Do you need a paraclinical diagnostic procedure?

If yes, why? If no, why?
Demonstrate use of
1. certainty/uncertainty of primary and secondary diagnoses
2. plan of management for primary and secondary diagnoses
3. others

5. If you need a paraclinical diagnostic procedure, what will you recommend? Why?

Give at least 3 options and then compare using benefit, risk, cost, and availability factors. Then select one demonstrating priority on the primary diagnosis. Shotgun policy is NOT acceptable.

Benefit

Risk

Cost

Availability

Option 1

Option 2

Option 3

6. Suppose the patient agreed to your recommendation of the paraclinical diagnostic procedure and suppose it was done.

What results will firm up your primary diagnosis?
What results will make you shift to your secondary diagnosis as the primary diagnosis?

 The Health Problem
 Trigger 3.

A paraclinical diagnostic procedure was done.
A ___________________________________ was done.
[Here is the picture/reading/result of the paraclinical diagnostic procedure.]

Questions (as applicable):

1. Examine the result of the paraclinical diagnostic procedure and then interpret.

Decide whether the result is informative or non-informative.
Informative, why? Non-informative, why?

 2. After the paraclinical diagnostic procedure, what is now your primary and secondary diagnosis? Why?

Demonstrate use of pattern recognition with pathophysiology and prevalence.

Diagnostic Procedure/Signs/Symptoms/Pathophysiology Prevalence data

Primary diagnosis
Secondary diagnosis

 3. Do you need to firm up your diagnosis before you proceed to treatment?

If yes, how?
What data do you need?
History?
Physical exam?
Other diagnostic procedure?
Observation and monitoring?
[Data asked for either not available or normal. Facilitator may supply other data.]

 4. What is your pretreatment primary and secondary diagnoses?
 5. State the goals of treatment for your primary diagnosis?
 6. Decide on a treatment modality after comparing the options based on benefit, risk, cost, and availability factors.

Benefit

Risk

Cost

Availability

Nonoperative
(specific procedure in mind)

Operative
(specific procedure in mind)

8. Describe the things need to be done during the pretreatment, intratreatment, and posttreatment phase.
7. Decide how you would evaluate the results or outcome of your proposed treatmnt.

 The Health Problem
Trigger 4

The diagnosis of the patient's health problem is
____________________________________________

Questions:

1. Advice the patient and relatives on the pathophysiology of the disease. Use diagram.
2. Advice the patient and relatives on screening of the disease.
3. Advice the patient and relatives on early detection of the disease.

The Health Problem
Trigger 5

A case write-up of a patient with a complaint of "The Health Problem".
DIAGNOSIS IS NOT SPELLED OUT!
Signs and symptoms
Course in the management
Paraclinical diagnostic procedures done
Treatment
Outcome

Questions:

1. Study the case and then decide on the primary and secondary diagnoses.

Give bases for your diagnoses using pattern recognition with pathophysiology and prevalence

2. Study the case and then

2.1 Comment on the outcome of treatment.

Were the goals of treatment achieved? Yes, why? No, why?

2.2 Describe the prognosis after treatment.

Recurrence, survival, quality of life
Pathophysiology of the disease leading to physical disability and death

Criteria to be used in deciding which contributions are eligible for publication

Directions:

Go to Individual Patient Management to see entries from contributors.

Click to go back to:

HIISE-Guidelines and Format
GS I TeleBreast Program Development Status

GS I email: gs1pgh@mail.upm.edu.ph
RJoson email: rjoson@pacific.net.ph