PBL Information Resources and Tools for the First Year: Case 3: Mark Montague - I'm just so tired

The following are textbooks of possible interest and are available either in print or online.  To find more books of interest, use the search box below and to the right.  

What more resources? Search Roger.

Google Quick Tip

If you don't know the best patient resources to suggest, what do you do?  Well, if you don't use Medline Plus, Google might be able to help.  There are most likely 2 types of resources you might want to recommend -- government organizations or national organizations dedicated to specific diseases or conditions.  Here's how you identify them:

Put your terms into Google for the condition of disease of interest and add one of the following:

site:gov

site:org

Resources for this case include:

Textbook Suggestions (look left)

Differential Diagnosis Tools

Resources for Interpreting the CBC

Resource Highlight - Up to Date

National or State Organizations - National cancer Institute & Leukemia Society

Drug Information Resources

There is More to Access Medicine than Just Books

Breaking Bad News - a couple of suggestions, the required blog post (and the NEJM article)

Patient Resources - a couple of reliable organizations 

Google Quick Tip - search by domain

Symptoms and differential diagnositic information is often buried in a number of our resources.  However, a few tools (both online and for your smart phone/PDA) have special tools to help with this process.

One book helps explain the thinking process (Symptom to Diagnosis) with topics that include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain.  One book has a list of mnemonics (Collins' book) as well as the symptom info.  Another book (Syed & Rasul's book) is organized by body areas and the last one (DDX of Common Complaints) focuses on the most common symptions and presents the way a doctor might pursue to diagnosis (images & tests).

Also listed below are some of the interactive DDX tools and their advantages.

Online Look-up Tools

Highlighting Up To Date

Up to Date, is a unique resource that provides the clinical picture as well as sometimes, answering the background questions -- the what, when, where, why, how type questions. For example: 

1. Some symptoms or patient complaints are non-specific problems and don't seem to point to a specific problem, making it difficult to narrow down to a manageable differential diagnosis. Try looking up fatigue in some of the online or print resources and you will see what I mean. Try the fatigue search in UpToDate for comparison. 


2. Medical genetics regarding BCR-ABL. A search of BCR-ABL will get you to a diagnosis for this case and a nice encyclopedia like entry on this topic. You may need to revise your search if you need information beyond the medical genetics info.

National organizations

Both government and private organizations often have very useful information for patients as well as physicians.  As a health professional it is good to be aware of the patient sites but probably better to use the professional literature for your own information.

What Else does Access Medicine Offer?

I have categorized this as a background resource which means it is a resource for answering those factual questions you might have -- think what, when, where, how, why type questions.  This is because the main part of Access Medicine is the textbooks.  There are other tools that are very helpful, such as:

• Diagnosaurus, a DDX tool (look for DDX under the quick Reference tab)
• Diagnostic Test (a guide book that you can find under their Quick Reference tab)
• Drugs, a guide to generic or trade names, as well as drug classes
• Quick Dxs & Tx - another book that, like the pocket guide, gives brief details and tips for any number of diseases or conditions
• Guidelines:  Concise guidelines on various diseases and conditions published and collected into a book.

The pocket and guide books in Access Medicine assume a level of education you may not have attained yet.  They are ideally designed for a busy clinical environment where bullet points will help you remember all of the details you have already learned.  So, their brief descriptions may not help you fully flesh out a PBL write up.  When you search Access Medicine, keep that in mind.  If you need brief info, to augment what you already have learned, then okay, but if you need more detailed understanding, make sure you read the textbooks too, e.g., Harrison's, DeGowin's, etc.

Drug Information Resources

Two resources to use for treatment and drug information: Clinical Pharmacology & Micromedex.  Look up the drug options for a general type of disease or a very specific disease.  Both have similar information but work a little differently.  Use the one that you like best - both are great tools.

Already know what drug will be prescribed?  Search it by name.  For example, find out more about imatinib - how does it work?  what are its pharmacokinetics?  what are the contraindications or precautions?  

Breaking Bad News 

Just to gather a couple of resources together on this topic.  This year, your POM exercise on this topic is out of synch with this case, so you may need to do some exploring on this topic on your own.  There are many resources out there on this and I'm sure many of the oncology texts will have some of this info together.  However, I want to point you to 2 that are easily accessible.  

National Organizations - Consumer Health Resources