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Problem-based Learning & Finding the Evidence: Case 4: John Harris -- Oooh, my feet!

Books

The following are textbooks of possible interest and are available either in print or online.  

To find more books of interest, use the Roger search box below.

Navigating the Derm Textbooks

An information searching tip from Dr. John Curington:

  1. Get Comfortable with the dermatology terms.  
    When trying to interpret a patient's condition from those bumps, nodules, or blisters (or rather, macules, patches, papules, patches, vesicles, bullae, etc.) they are sporting, it is important to be comfortable with the language of dermatology.  Know the technical term for describing those bumps in question and be specific about the physical location - for example, don't use arm when you are really talking about the elbow.

  2. Use pictorial atlases to narrow things down.  
    There are two types of these books that can be helpful by themselves and even more powerful when used in combination.  These types of books are arranged by:
    • Anatomic location  (elbow, knee, eyes, feet, etc.) - not a very common arrangement of topics.
    • Specific type of lesion, bump, blister, or boil (from eczema to psoriaisis to drug eruptions, etc.) - a more comman arrangement of information.

Dr. C's recommended texts are listed below.

Case 4 : John Harris -- Oooh, my feet!

Background Look Ups -- the What, How, & Why Questions

Don't forget that some of the basic questions can best be answered by some of the textbook resources.  Since you may not always know what is the best one to use (and if the ones I've highlighted on the side don't look appropriate), the collection of textbooks in Access Medicine & StatRef offer the best, quickest way to find resources.

In this case, things like; what is APGAR?  how is it used?  what is Stevens-Johnson?  why does it occur?  Or, what to do when medication errors occur. So many questions but also so many answers.

Don't forget the drug databases as resource to understand more about Stevens-Johnson and questions about drugs.

Differential Diagnosis Tools

Clinical Reasoning Tool

If you have this look up this week, here's your link as well as the links below that will help you work with this tool.  Remember, it will ask you to login, but once done will take you to the tool.

UCSD SOM Clinical Reasoning Tool

DDX Resources

Perhaps your questions this week deal with understanding the different symptoms the patient mentioned.  What do they indicate?  Without some good hunches it is hard to move forward.  There are a number of differential diagnositc tools to help with the process.

Books:

  • Ddx in Primary CareDifferential Diagnosis in Primary Care  (WB 141.5 C712d 2012)  The book lists alphabetically a variety of symptoms.  Each category provides a section on the "approach to diagnosis" and other userful tests to consider.  Some sections have short case presentations to test your skills.
  • Ddx in Primary CareDifferential Diagnosis in Primary Care (WB 39 R231d 2009)  Yep - two books with the same name, different authors.  This book presents information organized by areas of the body
  • Ddx of Common ComplaintsDifferential Diagnosis of Common Complaints  (WB 141.5 S467d)  The book is organized around common presenting complaints.  Sections also include details on associated symptoms, physical findings, diagnostic studies, and presents a summary of these in a handy table format.  Check out their chapter on Skin Problems.  
  • Symptom to Diagnosis is a case-based format filled with algorithms and summary tables.
  • Differential Diagnosis in Internal Medicine and also includes dermatology and rheumatology with an emphasis on pathophysiological aspects.

Online Tools:  Usually just a list, some have brief descriptions

  • Access Medicine's Diagnosaurus
  • Medscape's DDX tool - look for the DDX tab once you've run a search.  (It will require setting up a free account, but this tool is worth the couple minutes to do this.)
  • Wrong Diagnosis.com - an independent web site with a multiple symptom checker.  (It is a .com and it does have advertising -- always be cautious with sites like this.  You need to decide, is this a site I trust?)  

 

Clinical Tools

A few tools do a great deal of the work for you to gather information and re-package it into a nice synthesized statement on a disease or condition.  However, they all have some work to do as not all topics are as fully covered as they could be.  That is the case with Up to Date this week (says a derm specialist) as it does not cover dermatology as well as it should.  The derm specialist recommends Medscape.

Life-long Resources -- Genetics

The following resources are available to everyone without a subscription and for the most part have been developed with government funding.  These tools will be available to you even when you graduate and move on from UCSD. 

Patient Information Resources

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