Many medical nouns need adjectives
Last week on twitter I wrote a series of tweets about necessary qualifiers. Here are the tweets which represent an incomplete sample of the problem:
1st tweet on importance of qualifiers w/ “diagnoses”
Do not label the patient as COPD exacerbation without saying why: Differential includes acute bronchitis, pneumonia, pneumothorax, left side heart failure, anemia, opiates, PE etc.
2nd qualifier tweet – Never tell me the patient has CKD without giving me the stage and the cause. Corollary – do not give me the eGFR for patients with AKI – the estimates do not work with increasing creatinine levels
3rd qualifier tweet – when the patient has diabetes mellitus – identify type and duration – type I and type 2 have some different associated problems – duration suggests looking for certain complications. Mention known complications
4th qualifier tweet – don’t label the patient CHF – rather heart failure with modifiers – systolic dysfunction (provide the ejection fraction), or valvular or preserved ejection fraction or right heart failure – perhaps some others –
5th qualifier tweet – cirrhosis – secondary to (alcohol, hep C or whatever), previously known complications and report MELD score with labs
These examples are very important, at least in my mind. Just in case I have not made my point, the reason for these examples comes from seeing lists of “diseases” in the past ...
Source: DB's Medical Rants - Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
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