scholarly journals Differential diagnosis and clinical decision-making in physical therapy: Case report of a complex dizzy patient

2017 ◽  
Vol 4 (1) ◽  
pp. 2
Author(s):  
Eric G Johnson ◽  
Chethan Akkur Channe Gowda ◽  
Ahmad A Alharbi
Keyword(s):  
Decision Making ◽  
Differential Diagnosis ◽  
Case Report ◽  
Physical Therapy ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Dizzy Patient

scholarly journals Clinical Decision Making in Hypotonia and Gross Motor Delay: A Case Report of Type 1 Spinal Muscular Atrophy in an Infant

2013 ◽  
Vol 93 (6) ◽  
pp. 833-841 ◽  
Author(s):  
Kirsten Hawkins Malerba ◽  
Jan Stephen Tecklin
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Physical Therapy ◽  
Spinal Muscular Atrophy ◽  
Clinical Decision Making ◽  
Muscular Atrophy ◽  
Clinical Decision ◽  
Gross Motor ◽  
Motor Delay

Background and PurposeChildren often are referred for physical therapy with the diagnosis of hypotonia when the definitive cause of hypotonia is unknown. The purpose of this case report is to describe the clinical decision-making process using the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II) for an infant with hypotonia and gross motor delay.Case DescriptionThe patient was a 5-month-old infant who had been evaluated by a neurologist and then referred for physical therapy by his pediatrician. Physical therapist evaluation results and clinical observations of marked hypotonia, significant gross motor delay, tongue fasciculations, feeding difficulties, and respiratory abnormalities prompted necessary referral to specialists. Recognition of developmental, neurologic, and respiratory abnormalities facilitated clinical decision making for determining the appropriate physical therapy plan of care.OutcomesDuring the brief episode of physical therapy care, the patient was referred to a feeding specialist and diagnosed with pharyngeal-phase dysphasia and mild aspiration. Continued global weakness, signs and symptoms of type 1 spinal muscular atrophy (SMA), and concerns about increased work of breathing and respiratory compromise were discussed with the referring physician. After inconclusive laboratory testing for metabolic etiologies of hypotonia, a genetics consult was recommended and confirmed the diagnosis of type 1 SMA at 9 months of age.DiscussionPhysical therapists use clinical decision making to determine whether to treat patients or to refer them to other medical professionals. Accurate and timely referral to appropriate specialists may assist families in obtaining a diagnosis for their child and guide necessary interventions. In the case of type 1 SMA, early diagnosis may affect outcomes and survival rate in this pediatric population.

Clinical Problem Solving: Decreased Level of Consciousness and Unexplained Hydrocephalus

2022 ◽  
pp. 194187442110567
Author(s):  
Naomi Niznick ◽  
Ronda Lun ◽  
Daniel A. Lelli ◽  
Tadeu A. Fantaneanu
Keyword(s):  
Decision Making ◽  
Differential Diagnosis ◽  
Clinical Decision Making ◽  
Clinical Problem ◽  
Clinical Decision ◽  
Decision Making Process ◽  
Clinical Problem Solving ◽  
Level Of Consciousness ◽  
History Of

We present a clinical reasoning case of 42-year-old male with a history of type 1 diabetes who presented to hospital with decreased level of consciousness. We review the approach to coma including initial approach to differential diagnosis and investigations. After refining the diagnostic options based on initial investigations, we review the clinical decision-making process with a focus on narrowing the differential diagnosis, further investigations, and treatment.

Pain Emergencies and Complications of Pain Treatments

2019 ◽  
pp. 221-240
Author(s):  
Isaac Tong ◽  
R. Jason Yong ◽  
Beth B. Hogans
Keyword(s):  
Decision Making ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Clinical Assessment ◽  
Associated Factors ◽  
Clinical Decision Making ◽  
Acute Chest Pain ◽  
Clinical Decision ◽  
Common Occurrence ◽  
Pain Characteristics

Chapter 13 reviews some common pain-associated emergencies and also discusses some complications of pain treatments that require immediate attention. Pain is a common occurrence in emergent illness, and some complications of pain treatments require emergent management. Chest pain is an excellent example of clinical decision-making following a process of organized, rapid pain assessment and then diagnostic and treatment reasoning based on the findings and observations of the clinical assessment. Providers assessing patients for acute chest pain elicit basic pain characteristics of region, quality, severity, and timing as well as usually associated factors and then pursue testing and treatment for elements in the differential diagnosis accordingly. The chapter illustrates this same process applied to conditions of acute abdominal, limb, headache, and spine emergencies. In the second part of the chapter, emergencies arising in the context of pain treatments are discussed, including overdose and withdrawal from opioids, benzodiazepines, and other pain-active medications as well as pump and device complications.

Impact of electrodiagnostic (EMG/NCS) tests on clinical decision-making and patient perceived benefit in the outpatient physical therapy practice

2020 ◽  
Vol 24 (1) ◽  
pp. 170-174
Author(s):  
Mohini Rawat ◽  
Dimitrios Kostopoulos ◽  
Konstantine Rizopoulos ◽  
William Dodson ◽  
Kathy Blair ◽  
...  
Keyword(s):  
Decision Making ◽  
Physical Therapy ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Perceived Benefit

scholarly journals Maxillofacial Prosthesis for Combined Intra and Extra-Oral Defect – A Case Report

2021 ◽  
Vol 10 (8) ◽  
pp. 550-554
Author(s):  
Rajiv Dharampal Bhola ◽  
Sweta Gajanan Kale Pisulkar ◽  
Surekha Anil Dubey Godbole ◽  
Hetal Satish Purohit ◽  
Anjali Bhoyar Borle
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Upper Lip ◽  
Facial Prosthesis ◽  
Maxillofacial Prosthesis ◽  
Facial Defects ◽  
Cancerous Lesion ◽  
Orbital Defects

Combined intra and extra oral defects can be stated as those facial defects which have an intraoral communicating route. Midfacial defects are aptly classified into 2 major categories by Marunick et al. 1 as midline midfacial defects in which the nose and / or upper lip defects are included; and the second major group was lateral defects in which the cheek and orbital defects are categorized. However, defects which include combinations of the above-mentioned defects are in existence. Midfacial defects which are acquired, present themselves often with severe disfigurement of structures and hence show impaired function. It is a meticulous task to rehabilitate the defects which are caused as a result of cancerous lesion resection as they are huge. Such post resection lesions frequently are rehabilitated by a facial prosthesis to maintain function as well as the appearance in the normal form. In adjunction to the facial prosthesis, an intraoral prosthesis which constitutes of an obturator is also required to regain the natural speech and pattern of swallowing. Fabrication of such facial prosthesis not only requires the artistic capability but also excellent clinical decision making of the prosthodontist. Mode of retention of the combined prosthesis should also be kept in mind while fabricating as it is also a difficult task to retain them because of the size and weight of the same. Moreover the prosthesis should also be secured in its place with these aids which can also prove as a challenge. This case report states rehabilitating a large surgically resected midfacial defect with the assistance of a “3-piece prosthesis” which constitutes a sectional intraoral obturator along with maxillary and mandibular extraoral facial prosthesis.

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