Case 41 Part 1



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What's inside?


 

External exam



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Discussion Questions


 

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1. What is your assessment of the history?
 
 
2. What is the differential diagnosis of fluid weight gain?
 
 
3. The history is provided by the family. How can you tell which parts might be more reliable and which parts might be less reliable?
 
 
4. What is the differential diagnosis of a cause of death here?
 
 
5. What conditions on your list would be dependent on receipt of medications?
 
 
6. Whose responsibility is it to ensure the patient leaves rehab with prescriptions?
 
 
7. How do you interpret the family’s self-efficacy given that an entire week passed without them getting the new, required medications? Would they be “right” to blame the physician for being unable to get ahold of the new medications?
 
 
8. What steps can a family take with an “unresponsive” provider? What other interpretations are there than that the provider was “unresponsive”? What practical, procedural, accidental or inadvertent reasons might cause a provider to seem “unresponsive”?
 
 
9. If, on further exploration, the provider stated that she provided the necessary prescriptions to the family at the time of discharge, how would this change your interpretation of the history? Would you think the family was lying? What other interpretations might there be?
 
 
10. What role might guilt or anger play in a family’s decision to request an autopsy (when they are responsible for the care of a loved one, but the loved one dies)?
 
 
11. What’s your assessment of the physical exam?
 




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