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Problem-based Learning & Finding the Evidence: Case 10: Marjorie Smith -- Progressive Periodic Pesky Palpitaitons


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Marjorie Smith -- Progressive Periodic Pesky Palpitations

Some of these resources you may use regularly, but check out the breadth of resources available. We often have more than one resource that will address your questions, each in its own way.


Resources for this Case

Textbooks (look left)

DDX Resources -- Redux

Featured Resources :  Natural Medicine, Database --Redux

Selected Look Up Tools -Textbooks and Drug Resources

Synthesized Decision Support Tools -- Up to Date & DynaMed

Another Place to Look - Other than PubMed Databases


Patient Information Resources




You may not need these for the beginning of the case, but here are a couple that could prove useful as you advance to the clerkships.  For more on mobile resources - see that online guide.

ePSS from AHRQ app image 

Calculate  [Free ]
Calculate is a next-generation clinical calculator and decision support tool for mobile devices and is freely available to the medical community. It is focused on highlighting tools which impact clinical practice and serve to impact diagnosis, treatment or determining prognosis.

Go to Play Store Go to iTunes App Store Go to Windows Store Go to mobile web site
IDdx app image 

MedCalc, [Free]
A collection of clinical calculators on a variety of topics based on the research literature so you know where the risk assessment is derived from.

Go to mobile web site

Natural Medicines Database

Sometimes, an internet search will help you understand what your patients are finding out on the web.  But when it comes time for finding good evidence about those items, we have a really great resource for you on alternative, complementary, or integrative medicine: Natural Medicines.  

Natural Medicines

Natural Medicines Comprehensive Database the information aims for evidence-based practice principles and uses as many references as they can find on their topics.  Links to the references allows you to put your EBMI skills to good use in evaluating that component - typed of study and levels of evidence.  The interface does a good job at calling attention to possible interactions and the possible strength of the interactions.  Search or browse the resource.


See what they have for guarana.  Look for the Professional Monograph for the details.  The others would give you info on specific products.

Where Else to Find Info on Herbs & Supplements?

DDX & Symptom Checker Resources

Passing along a Tip from Dr. Gates regarding a DDX & Symptom Checker 

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 a 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.  

Also listed below are some of the interactive DDX tools.

Online & Print Books

Ddx in Primary CareDifferential Diagnosis in Primary Care 

(WB 141.5 C712d 2008)  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 2007)  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.

Interactive Tools

Synthesized Decision Support Tools

Decision Support Tools 

Some of your favorite tools are the ones that give you a clinical overview as well as specific clinical details. If you have not checked out DynaMed Plus before, this would be a good week to look at it from palpitations to atrial fibrillation and more.  DynaMed has quite a few images and that may appeal to some of you - see what they have regarding atrial fibrillation.   

Selected Look-up Tools: Textbooks

Textbook Resources

I'm sure you are very familiar with the first one on this list, but how about the others? If the answer is not in Access Medicine what do you do?  Each of these 3 collections of textbooks have a few similar texts but also some unique coverage of other topics.  I think MDConsult has the best search results page - it provides a bit more detail about your term within the context of the paragraph it is found and it is clear about the results from textbooks as those from the other resources available in that tool. 

Don't forget, knowing your question (background or more clinical) can help you know which resource to try.

Last tidbit - all three of these resource have great results for echocardiogram, event, & holter monitoring.  You might also like the info on holiday heart. Check one or more of these out.

Another Place to Look - Other than PubMed Databases

Once your question starts to bridge over to the bioengineering field, there are other databases to use to see the development and research being conducted.  If your question was about electrocardiographic monitoring devices, One of the following resources might give you a picture different that PubMed provides.

Selected Look-up Tools: Drug Resources

Drug Information Resources

From beta blockers to coumadin to many more, if your question concerns a drug or you need to know the drug to use, try one of the following sources.  Don't forget you can search for the condition or disease in question.  Micromedex has some nice overview tools along with the drug information.

The following 2 resources are the only online drug resources approved by USD Medical Center.

MedlinePlus: Information Tool for Patients

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 for smoking cessation.

Search MedlinePlus: