Features

Real-world scenarios demonstrating how Sushruta Health enhances clinical decision-making for students and practicing clinicians.

Differential Diagnosis

SCENARIO (Clinical Evaluation)

35-year-old software engineer presents with a 2-hour history of central, crushing chest pain. He is diaphoretic and anxious. No significant past medical history.

Potentially life-threatening condition. Prioritize assessment of airway, breathing, and circulation (ABCs).

Differential Diagnosis (Ranked):

Acute Coronary Syndrome (ACS): (High Probability) - Rationale: Classic presentation of crushing chest pain, diaphoresis.
Pulmonary Embolism (PE): (Moderate Probability) - Rationale: Can present with acute chest pain, but typically pleuritic.
Aortic Dissection: (Low Probability but Critical) - Rationale: Must be considered in any severe chest pain, especially if radiating to the back.
Gastroesophageal Reflux Disease (GERD): (Low Probability) - Rationale: Common cause of chest pain, but less likely given the severity and diaphoresis.

Recommended Next Steps:

Obtain 12-lead ECG immediately. Check cardiac enzymes (Troponin). Administer MONA (Morphine, Oxygen, Nitrates, Aspirin) as per protocol.

Ask a Question

SCENARIO (Case Discussion)

Patient is a 42-year-old woman complaining of headaches for the past 3 months. She describes them as a 'dull ache' all over her head, occurring 3-4 times a week.

Suggested Follow-up Questions (to rule out red flags):

Is this the worst headache of your life? - Rationale: Screens for subarachnoid hemorrhage.
Are there any associated neurological symptoms like vision changes, weakness, or numbness? - Rationale: Screens for intracranial pathology.
Is the headache worse in the mornings or with coughing/straining? - Rationale: Screens for raised intracranial pressure.
What is your stress level like? Any changes in sleep patterns? - Rationale: Explores features of tension-type headache, the most common diagnosis.

Draft Management Plan (DMP)

SCENARIO (Case Discussion)

Patient is a 28-year-old male with a 4-day history of high-grade fever, retro-orbital pain, and myalgia. CBC shows leukopenia and thrombocytopenia (platelets 80,000). NS1 antigen test is positive.

Draft Management Plan (for uncomplicated Dengue Fever)

Symptomatic Treatment: Prescribe Paracetamol for fever and pain. AVOID NSAIDs (like Ibuprofen, Diclofenac) due to risk of hemorrhage.
Hydration: Advise adequate oral fluid intake (oral rehydration salts, juice, water). Monitor for warning signs of dehydration.
Patient Education (Warning Signs): Instruct patient to return immediately if they experience severe abdominal pain, persistent vomiting, bleeding from any site, or lethargy.
Follow-up: Daily monitoring of platelet count and hematocrit is recommended until stable.

Draft H&P (History & Physical)

SCENARIO (Case Discussion)

Patient is a 22-year-old college student with a painful, red, swollen area on his right shin for 3 days. Denies trauma. On examination, there is a 5x7 cm erythematous, tender, non-fluctuant plaque with ill-defined borders on the anterior aspect of the right lower leg.

Draft H&P Note

Chief Complaint: Painful red rash on right leg.

History of Present Illness: The patient is a 22-year-old male who presents with a 3-day history of a painful, erythematous, and swollen lesion on his right shin. The onset was spontaneous, without any preceding trauma. He denies fever, chills, or other systemic symptoms.

Physical Examination: Vitals: Afebrile, hemodynamically stable. Lower Extremity: On the anterior aspect of the right shin, there is a 5x7 cm, tender, warm, erythematous plaque with indistinct borders. No fluctuance, purulent discharge, or signs of crepus noted.

Assessment: Cellulitis of the right lower extremity.

Plan:

Prescribe a course of oral antibiotics (e.g., Cephalexin).
Advise leg elevation to reduce swelling.
Instruct patient to mark the borders of the erythema to monitor for spread.
Follow up in 48-72 hours or sooner if symptoms worsen.