NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
1. Big 3 Category- stroke, sepsis, lung cancer
Top Misdiagnosis
2. #1 cause of mal- Misdiagnosis
practice
3. What helps form Epidemiology
hypotheses and
create your di-
agnostic reason-
ing?
4. Clinical diagnosis info from pt (subjective) 75%
requires
use that info with ur knowledge of understanding disease + PE is 15%
5. Likelihood Ratios Weights that help you understand how much a physical sign argues for or against
a diagnosis
Possible weights of 0 to infinity
>1 means increased probability of disease
<1 means decreased probability of disease
6. Specificity Proportion of patients without the diagnosis who have the physical sign (e.g.,
positive finding)
ex: me for celiac disease
7. Sensitivity Proportion of patients without the diagnosis who lack the physical sign (i.e., have
a negative result)
8.
, NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
Likelihood Ratio probability of finding in pts with disease / probability of same finding in pts
Definition without disease
9. 2 approach- Intuitive vs Analytical
es to clini-
cal decision-mak-
ing Metacogni-
tion (thinking
about thinking)
10. Experts vs. experts gather less data, but better data, organize better = shorter time to make
Novices accurate diagnosis
what makes a good clinical diagnostician? asking right questions
11. Article: Diagnos- PC- cancer screening (colonoscopy 10 years, FOBT 2 years = survival rate up)
tic Excellence and
Patient Safety - ED- sepsis (more deaths than some cancers) good improvements but more
Strategies and needed
Opportunities
Inpatient- PE (over tested but under diagnosed) better with clinical decision tools
and plasma d-dimer measurement
12. Article: Big 3 di- · 5 vascular events: stroke, MI, venous thromboembolism, aortic aneurysm/dis-
agnostic errors section, arterial thromboembolism
and serious mis- · 5 infections: sepsis, meningitis/encephalitis, spinal abscess, pneumonia, endo-
diagnoses relat- carditis
ed harms are · 5 cancers- lung, breast, colorectal, prostate, melanoma
13. Video: Cather- o Efficiently obtain enough information from patient to make initial differential
ine Lucey- Good diagnosis
clinical diagnosti- o Search memory/resources to identify possible causes of patient's symptoms
cians: o Prioritize the likelihood that a possible disease explains patient's concerns
, NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
o Use tests (carefully) to evaluate their assessments have to be careful and know
and get correct proper information because some tests are harmful, expensive,
wasteful, timely
o Always continue to analyze the success of their diagnoses to improve accuracy
going forward
14. Video: Catherine reorganize their knowledge in a relational way- S&S to syndromes to disease
Lucey- experts:
15. ACL Article: common knee injury in athletes
clinical diagnostic tests and MRI are 2 methods of evaluating ACL injuries
evidence supports clinical diagnostic tests, faster, sooner, cheaper too
gold standard: diagnostic arthroscopy
16. Screening tests to detect asymptomatic and early stage disease
should be highly sen/spec to pick up most cases of true disease and avoid false
positives
targeted toward pop with higher disease prevalence (high positive predictive
value)
safe, cost effective
should screen for diseases in which early identification and treatment have been
demonstrated to improve clinical outcomes
17. HIV Grade A- ages 15-65
18. Cervical Cancer Grade A- ages 21-65
, NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
21-29 cervical cytology every 3 years
30-65 cervival cytology every 3 years and HIV every 5 years
19. Colorectal Can- 45-75
cer
45-49 grade B
50-75 grade A
20. HTN adults 18 and older without known HTN: grade A- office BP
21. Ovarian Cancer Asymptomatic women- against- grade D
22. High value screen less
screening tips
dont screen if living less than 10 yrs
discuss potential downstreams before initial
use higher treshold for positive result
understand basic test characteristics and limitations as well as pts goals/values
23. Role of diagnos- to reduce uncertainty regarding a specific patient diagnosis
tic testing
generally more appropriate for patients you feel have intermediate 10-90% pre
post prob of disease
test characteristics (ex- likelihood ratios) should be considered before ordering
test to help determine whether given test will significantly alter your post test
probability and change your management
24. Incidence Measure of the number of new cases of a characteristic that develop in a popu-
lation in a specified time
Study online at https://quizlet.com/_fh4iml
1. Big 3 Category- stroke, sepsis, lung cancer
Top Misdiagnosis
2. #1 cause of mal- Misdiagnosis
practice
3. What helps form Epidemiology
hypotheses and
create your di-
agnostic reason-
ing?
4. Clinical diagnosis info from pt (subjective) 75%
requires
use that info with ur knowledge of understanding disease + PE is 15%
5. Likelihood Ratios Weights that help you understand how much a physical sign argues for or against
a diagnosis
Possible weights of 0 to infinity
>1 means increased probability of disease
<1 means decreased probability of disease
6. Specificity Proportion of patients without the diagnosis who have the physical sign (e.g.,
positive finding)
ex: me for celiac disease
7. Sensitivity Proportion of patients without the diagnosis who lack the physical sign (i.e., have
a negative result)
8.
, NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
Likelihood Ratio probability of finding in pts with disease / probability of same finding in pts
Definition without disease
9. 2 approach- Intuitive vs Analytical
es to clini-
cal decision-mak-
ing Metacogni-
tion (thinking
about thinking)
10. Experts vs. experts gather less data, but better data, organize better = shorter time to make
Novices accurate diagnosis
what makes a good clinical diagnostician? asking right questions
11. Article: Diagnos- PC- cancer screening (colonoscopy 10 years, FOBT 2 years = survival rate up)
tic Excellence and
Patient Safety - ED- sepsis (more deaths than some cancers) good improvements but more
Strategies and needed
Opportunities
Inpatient- PE (over tested but under diagnosed) better with clinical decision tools
and plasma d-dimer measurement
12. Article: Big 3 di- · 5 vascular events: stroke, MI, venous thromboembolism, aortic aneurysm/dis-
agnostic errors section, arterial thromboembolism
and serious mis- · 5 infections: sepsis, meningitis/encephalitis, spinal abscess, pneumonia, endo-
diagnoses relat- carditis
ed harms are · 5 cancers- lung, breast, colorectal, prostate, melanoma
13. Video: Cather- o Efficiently obtain enough information from patient to make initial differential
ine Lucey- Good diagnosis
clinical diagnosti- o Search memory/resources to identify possible causes of patient's symptoms
cians: o Prioritize the likelihood that a possible disease explains patient's concerns
, NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
o Use tests (carefully) to evaluate their assessments have to be careful and know
and get correct proper information because some tests are harmful, expensive,
wasteful, timely
o Always continue to analyze the success of their diagnoses to improve accuracy
going forward
14. Video: Catherine reorganize their knowledge in a relational way- S&S to syndromes to disease
Lucey- experts:
15. ACL Article: common knee injury in athletes
clinical diagnostic tests and MRI are 2 methods of evaluating ACL injuries
evidence supports clinical diagnostic tests, faster, sooner, cheaper too
gold standard: diagnostic arthroscopy
16. Screening tests to detect asymptomatic and early stage disease
should be highly sen/spec to pick up most cases of true disease and avoid false
positives
targeted toward pop with higher disease prevalence (high positive predictive
value)
safe, cost effective
should screen for diseases in which early identification and treatment have been
demonstrated to improve clinical outcomes
17. HIV Grade A- ages 15-65
18. Cervical Cancer Grade A- ages 21-65
, NURS 752 Exam 3 (Final)
Study online at https://quizlet.com/_fh4iml
21-29 cervical cytology every 3 years
30-65 cervival cytology every 3 years and HIV every 5 years
19. Colorectal Can- 45-75
cer
45-49 grade B
50-75 grade A
20. HTN adults 18 and older without known HTN: grade A- office BP
21. Ovarian Cancer Asymptomatic women- against- grade D
22. High value screen less
screening tips
dont screen if living less than 10 yrs
discuss potential downstreams before initial
use higher treshold for positive result
understand basic test characteristics and limitations as well as pts goals/values
23. Role of diagnos- to reduce uncertainty regarding a specific patient diagnosis
tic testing
generally more appropriate for patients you feel have intermediate 10-90% pre
post prob of disease
test characteristics (ex- likelihood ratios) should be considered before ordering
test to help determine whether given test will significantly alter your post test
probability and change your management
24. Incidence Measure of the number of new cases of a characteristic that develop in a popu-
lation in a specified time
