PBL Information Resources and Tools for the First Year: Case 21: Nora Vasquez - We knew this day was coming

Electronic books of interest outside of Access Medicine.

Not finding what you need?  Having trouble using one of our resources?  Please let us know.

Ask Karen - you can reach me at 858-534-1199 or at kheskett@ucsd.edu

Ask a Librarian - check out all the ways to reach one of us at the Biomed Library

Ask a UC Librarian - for those late-night questions, chat with a Librarian 24/7

Point of Care Tools

Resources offering clinical information and are designed to answer quickly the questions a clinician might have, these resources present information in a format where vital information is highlighted and pearls of wisdom are offered.  All of the resources below also provide great evidence-based clinical information.  Some are more obvious about the level of evidence they offer, some have a better and easier to use interface, and not one of them is perfect for every question every time.  Being familiar with various resources will serve you well when that time arises where your "favorite" does not offer the information you need. 

The following suggestions highlight only one of their unique qualities, and just for fun, try the suggested topic in a different resource.

Symptoms & DDX Resources

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.

Dr. Gates has found a very helpful text within Access Medicine - Symptoms to Diagnosis: An Evidence Based Guide.  Presented through a series of cases of patients complaining of a specific issue, then walks you through buiding the DDX and prioritizing it, and making the diagnosis.  Unlike the interactive tools that give you list, this text helps explain the thinking process. Topics include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain.  Check out Chapter 1 as an overview of the diagnostic process.  

The books we have include one that 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).

Isabel - is an up and coming tool that is starting to be integrated into the EMR environment.  This free version should be very helpful for many look ups.

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

Online Look-up Tools

DDX Checker Tools

From home grown tools to mnemonics.

Free Resources to Know for Life Beyond UCSD

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. 

Legal Issues within Medicine

Most of the following organizations would come up in a search of MedlinePlus.gov.  Check out these few and if you need more, check out whatelse Medlineplus has to offer.

Just in Case You Missed it in the Book List ... 

Internet Searching Tips

PubMed Searching

PubMed will find just about any of the topics you might have this week and I think most searches can simply use a keyword search.  Is it a search for the physician role in advanced directives?  Or, is it the screening for cognitive impairment & alzheimers?  Or, is it about neurocysticercosis?  Try out your search topic - it may be very simple to do.  A few things to think about also trying (not all of them at the same time  :

• Use Similar articles - get more like the article you found.
• Use an age category if the patient's age is a factor 

UC Library Search Searching Tips

There are several resources regarding advanced directives in the catalog.  In this case, try a title search for power of attorney and you will find some good government documents.

Google Searching

The internet has lots of resources on this topic, but which ones are worth looking at?  Sometimes, you know there are organizations that cover your topic and that can help you find reliable resources on the topic.  For this week's topic, you could do many different searches, and the following are a couple of searches you might perform:

• Know the organization but not the full URL to use?  You can still use what you do know.  For example, try,
  • physician role durable power of attorney ama 

• Know a simple, easy URL?  Really target your results, try,
  • durable power of attorney site:ahrq.gov  
  • durable power of attorney California site:gov   (has some great state government related information)

Finding Videos on the Internet

Sometimes, a picture explains more than words can and moving pictures perhaps even more so.  In this case, the scissor gait can be a little tricky to understand.  A search through the textbook resources will give you a description (I think I like Access Medicine's resources best), but what if you want more?  Well, finding this information on the internet is a little tricky.  Here's a search strategy you might try:

1. Try the textbook resources -- simple search of scissor gait would probably work to get you a description and perhaps some pathophysiology details.
    
2. If the Harrison video doesn't cover it, look elsewhere.  The internet may be a resource since so (so!) many videos exist there.  Going directly to YouTube may work - check it out and see.  Or, to expand beyond YouTube, add the word video to your search query.  
   
   Internet search lesson #1:  Tell Google what you want.  
        Try something like:  gait scissor video.   
   
   Internet search lesson #2:  Word order matters.  
        Since I've already searched I can tell you that both Stanford and the American Academy of Neurology have potential videos for you.  The former a demo and the latter a patient video.  If you stop with the first page of results, you might miss the AAN video.
    
3. After looking at the resources, you might want to refine your search to see if there might be more.  I noticed several synonymous terms paired with gait -- gait disturbance, gait abnormatilies, & gait disorders.  Pull them all in the search like this:
         gait disturbance|abnormalities|disorder video  
   there are no spaces between the pipes (or | ) and the words. The pipe is the same as an OR.

MedlinePlus is a great place to find consumer-friendly materials along with directories, a dictionary & encyclopedia, and more.  Take a look and see what you find - try a variety of topics such as neurological exam, alzheimer's disease, neurocysticercosis, or even cerebral aqueduct.