S.H.E - 心還是熱的
The story of horse, tiger and zebra
This afternoon when we were discussing about the differential diagnosis for a case, the preceptor told us about the story of horse, tiger and zebra.
The story started like this…
Preceptor: What should you include in your differential diagnosis? The horse, the common causes should be on top of your list. But we don’t forget the tiger, the disease that can kill your patient acutely. MI, is a tiger but masks as a horse, common but can kill you.
Student: How do we know what to put first?
Preceptor: Depends on the patient’s condition. If he looks okay, not in respiratory distress, can tell you the grandmother story then probably you should put horses on top of your list.
Student: Then what’s with the zebra?
Preceptor: Zebra is rare disease. Zebra, looks like horse, but is rarer. You wouldn’t put Lady Windermere Syndrome on top of your list if your patient complains of having sore throat. When you exclude all others, zebra would be your choice.
Neale Donald Walsch once said, “Life begins at the end of your comfort zone.”
So, pulmonary is down, next is nephrology!
Life is too ironic to fully understand. It takes sadness to know what happiness is. Noise to appreciate silence & absence to value presence.
Never Meant To Be
It is all about DISCIPLINE!
A simple little world.
Regenerative medicine, really impressive with the work!
sometimes I feel like I am so dumb when I cannot answer the questions during the clinic session. what’s the complication of influenzae? Give me 4 reasons on why do we need to treat strep pharyngitis. What can cause weight loss? Questions like these push me to work even harder, I hope i can answer all these without cracking my head