用临床推理解决问题:冠状病毒免疫抑制1例报告

Mahshad Mousavi, Nazanin Mousavi, B. Abdolkarimi
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引用次数: 0

摘要

背景:医学最有趣的部分之一是使用临床推理来解决临床问题。在当今的医学世界,随着科学信息的不断增加和新的诊断和治疗设施的出现,医生管理患者病情的责任变得更加重要。做出正确的决定是一个重要的目标,可以通过拥有足够的信息并适当地使用这些信息来实现。在这个阶段,我们应该遵循成功医生的思维过程,利用书籍和文章中的信息来解决临床问题。本文的目的是提高医生有效利用知识和经验解决临床问题的技能,以提高我们成功履行对患者的责任。方法:临床推理能提高医学生的学习质量,提高学生解决临床问题的能力。在这篇文章中,一名新冠肺炎大流行中的类风湿性关节炎患者出现呼吸窘迫,通过临床推理方法确定并治疗,然后讨论他的治疗方法。本文包括以下内容:根据患者的体征和症状列表,准备一份鉴别诊断列表;修改初始列表,以反映病史和检查结果;指定附加信息以进行正确诊断;最后,决定何时获得的信息足以进行正确的诊断。结果:近年来,临床推理在学生奥林匹克竞赛中越来越受到重视。医学教授应该特别注意把这项技能传授给学生。有必要对这类培训的教学进行规划,并设计测试来评估学生的临床推理能力。因此,这篇文章可以成为那些喜欢研究问题以获得答案的人的有用指南。结论:这篇文章展示了冠状病毒感染的潜在性和威胁生命的程度,以及在与患者打交道的各个阶段,从记录患者病史的最初阶段到治疗结束,临床推理是多么有用。
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Problem-solving with clinical reasoning: A case report of coronavirus in immunosuppressive condition
Background: One of the most interesting parts of medical science is using clinical reasoning to solve clinical problems. In today’s world of medicine, with increasing amounts of scientific information and new diagnostic and treatment facilities, physicians’ responsibility in managing the condition of patients becomes weightier. Making the correct decision is an important goal that can be achieved by having adequate information and using it appropriately. At this stage, we should follow the thought process of successful doctors and use information from books and articles to solve clinical problems. The purpose of this article is to improve the skills of physicians in the effective use of knowledge and experience to solve clinical problems to increase our success in fulfilling our responsibility to patients. Methods: Clinical reasoning enhances the quality of learning and increases the ability of medical students in clinical problem-solving. In this article, a patient with rheumatoid arthritis in the COVID-19 pandemic developed respiratory distress, is identified by the clinical reasoning method and is treated, with his treatment then discussed. This article includes the following: prepare a list of differential diagnoses based on the list of signs and symptoms of the patient; modify the initial list to reflect findings from history and examinations; specify additional information to make a correct diagnosis; and, finally, decide when the information is obtained is sufficient to make the proper diagnosis. Results: In recent years, clinical reasoning has received more attention in student Olympiad competitions. Professors in medical sciences should pay special attention to teaching this skill to students. It is necessary to plan for teaching this type of training and to design tests for evaluating students’ clinical reasoning. This article can thus be a useful guide for those who enjoy working on a problem to get an answer. Conclusion: This article shows how insidious and life-threatening a coronavirus infection can be, and how useful clinical reasoning can be when present in all stages of dealing with the patient, from the initial stages of taking the patient history to the end of treatment.
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