?DVT : Query Deep Vein Thrombosis
?Acute Nephritis
?Angina
?(insert medical term here)
Often I come across the ? phrase in medical notes (electronically and on papers). The queries range from rather vague symptoms/explanation (?constipation) to the more worrying ones like ?PE or ?Placental Abruption.
As a junior, it is very tempting to query just about anything. The easiest trap is to ?(insert common condition) on the basis of association. For example: ?Eczema for a non-specific rash for a patient with history of hay fever or asthma. Yeah, its true that they can co-present in a patient but there are a lot of other differentials for rashes.
If we think that what ever it is we are querying if worth mentioning, then surely it is worth investigating. Do not ever leave it just there.
Let me explain this by giving a scenario.Say a 25y-o Caucasian man came to GP complaining of 3 months history of dry cough and weight loss. Patient mentioned about him working as a builder and does a lot of works outdoor- making him very tired at the end of the day and feeling unwell sometimes. No other complaint otherwise. Generally fit and well.
As the coughing was more of a nuisance for him (I'll be fine with some cough syrup- he said), I prescribed him a cough linctus. ?TB. I was certain he would be fine.
Few months afterwards he was admitted to hospital with haemoptysis. X-ray showed cannonball lesions in both lungs and massive multiple mediastinal lymphadenopathy. AFB test was positive and he was treated promptly with the TB regimen (4 meds).
Looking back at his medical notes, "?TB" flagged up. Everyone questioned why didn't I investigate that further then? Considering that it had already crossed my mind.
This unfortunate guy could have died! He certainly not gonna be happy about his doctor knowing that there was a possibility of TB (?TB) but not taking it any further.
You get what I meant now?
If its worth mentioning then its worth investigating. Anyone who is caught up in situation like that will have to put his feet in his mouth. No way out!
Remember:
i) Do not use ?X just for anything. There are implications
ii) Refer to your senior if in doubt. "?TB, spoken to Resp Consultant- he agreed to have this patient under his list- non urgent referral"
iii) Beware of patient's anxiety "?Diabetes- Patient: Do I have to inject insulin now/soon etc"
?Acute Nephritis
?Angina
?(insert medical term here)
Often I come across the ? phrase in medical notes (electronically and on papers). The queries range from rather vague symptoms/explanation (?constipation) to the more worrying ones like ?PE or ?Placental Abruption.
As a junior, it is very tempting to query just about anything. The easiest trap is to ?(insert common condition) on the basis of association. For example: ?Eczema for a non-specific rash for a patient with history of hay fever or asthma. Yeah, its true that they can co-present in a patient but there are a lot of other differentials for rashes.
If we think that what ever it is we are querying if worth mentioning, then surely it is worth investigating. Do not ever leave it just there.
Let me explain this by giving a scenario.Say a 25y-o Caucasian man came to GP complaining of 3 months history of dry cough and weight loss. Patient mentioned about him working as a builder and does a lot of works outdoor- making him very tired at the end of the day and feeling unwell sometimes. No other complaint otherwise. Generally fit and well.
As the coughing was more of a nuisance for him (I'll be fine with some cough syrup- he said), I prescribed him a cough linctus. ?TB. I was certain he would be fine.
Few months afterwards he was admitted to hospital with haemoptysis. X-ray showed cannonball lesions in both lungs and massive multiple mediastinal lymphadenopathy. AFB test was positive and he was treated promptly with the TB regimen (4 meds).
Looking back at his medical notes, "?TB" flagged up. Everyone questioned why didn't I investigate that further then? Considering that it had already crossed my mind.
This unfortunate guy could have died! He certainly not gonna be happy about his doctor knowing that there was a possibility of TB (?TB) but not taking it any further.
You get what I meant now?
If its worth mentioning then its worth investigating. Anyone who is caught up in situation like that will have to put his feet in his mouth. No way out!
Remember:
i) Do not use ?X just for anything. There are implications
ii) Refer to your senior if in doubt. "?TB, spoken to Resp Consultant- he agreed to have this patient under his list- non urgent referral"
iii) Beware of patient's anxiety "?Diabetes- Patient: Do I have to inject insulin now/soon etc"
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