Can you solve this clinical case?
Q. 1 – Which of these would be in your initial differential diagnosis workup? (Select all that apply)
Using the Isabel DDx Generator would have yielded this differential for the initial signs and symptoms presented:
Recently the patient has noticed an occasional dull ache in the calf even when sitting and has developed foot numbness. He suffered from angina for many years, but, following a mild myocardial infarction 4 years ago, he has not had the same chest pain unless he ‘pushes himself’ or becomes very ‘upset’.
He smokes 30/day and drinks 4 units of alcohol per week. He takes low-dose aspirin daily.
On examination both femoral pulses are present, but the left pedal pulse is absent.
Q. 2 – With this new information which is the most likely diagnosis? (Select one)
Commentary
This is a very interesting case and shows how Isabel can help you focus your thoughts more quickly and think objectively. Note how the first list of suggestions based on just ‘cramping calf pain’ shows 6 red flag diagnoses. These are diagnoses which can severely harm your patient if not treated within 48 hours. This shows you immediately how this presentation could be quite serious and your index for suspicion should be raised. For the additional history, note how the negative feature has been entered. The additional clinical features have helped Isabel ‘narrow down’ and the correct final diagnosis is highlighted as ‘more likely’.
Would you be more likely to use Isabel to help with your differential diagnosis having done this quiz?