The Diagnostic Conference

A weekly grand round at Portland General Hospital in Seattle, discussing a complex case of fever, bone pain, and heart murmurs.

The Diagnostic Conference

True or false?

John initially questions whether they are dealing with a single unifying diagnosis.

• True
• False

Julie argues strongly against Occam's razor.

• True
• False

Adam points out that patients can have multiple diseases simultaneously.

• True
• False

The patient's repeat biopsy provided immediate and clear answers.

• True
• False

The team concludes that part of the patient's condition was caused by their treatment.

• True
• False

Listen again and complete the sentences

• Adam: I'd love to agree with you, Julie, but Hickam's dictum reminds us that patients can have as many diseases as they damn well please. We shouldn't force a neat narrative just to satisfy our need for ____ .
• John: That said, we can't just defer a diagnosis forever. The man's in agony, and his ____ from Tuesday remains completely perplexing.
• Adam: It's ____ , I'll give you that. But look at the bone lesions. Neither IgG4 nor Castleman disease accounts for those specific lytic areas.
• John: We need to ____ here. What baffles me is how his fever spiked right after we started the new immunosuppressive regimen.
• Julie: I'll update the family and document our ____ in the electronic chart.

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