Case Study: In 1910, a 40 year old patient was admitted to the hospital in an unconscious state. The spouse of the patient told doctors that the patient was breathing excessively, unable to think and talk properly (brain impairment), and unable to walk or run for more than a few minutes. Blood analysis indicated high amount of pyruvate, alpha keto glutamate. An empty bottle of some unknown medication was also found with patient. What do you suspect about this patient's diagnosis? Explain each symptom.
Answers
The diagnostic process proceeds as follows: First, a patient experiences a health problem. The patient is likely the first person to consider his or her symptoms and may choose at this point to engage with the health care system. Once a patient seeks health care, there is an iterative process of information gathering, information integration and interpretation, and determining a working diagnosis. Performing a clinical history and interview, conducting a physical exam, performing diagnostic testing, and referring or consulting with other clinicians are all ways of accumulating information that may be relevant to understanding a patient's health problem. The information-gathering approaches can be employed at different times, and diagnostic information can be obtained in different orders. The continuous process of information gathering, integration, and interpretation involves hypothesis generation and updating prior probabilities as more information is learned. Communication among health care professionals, the patient, and the patient's family members is critical in this cycle of information gathering, integration, and interpretation.