A 45-year-old patient had a diagnosis of malignant melanoma with two axillary lymph nodes with metastases. He was treated with adjuvant subcutaneous Interferon, but he started with an episode of acute abdominal pain. His oncologist was challenged….
Availability bias is present in Medicine when we select and option as the more likely just because comes faster to our mind, related to previous experiencies.
TRALI : Transfusion-related acute lung injury (TRALI) is a clinical syndrome with a low prevalence, that presents as acute hypoxemia and noncardiogenic pulmonary edema during or after blood transfusion. The clinical picture and X-ray findings are similar to other diseases with specific treatment.
How these two concepts are related?
Bone pain is a symptom not a diagnosis, but the difficult task is to disentangle the etiology. Some locations are more prone to problems such as back pain or thoracic pain. Another difficult task is to read a plain X-ray because subtle changes can be key for a diagnosis. Bone metastases are a frequent origin of bone pain and usually the clinical behaviour, with pain with a difficult control and several visits to the emergency department, is the key element for a correct diagnosis.
Cancer diagnosis is difficult in the primary care setting because many symptoms are common for tumors and benign conditions. This is more complicated with healthy patients or for young people.
A large analysis of data implemented in UK is the base for the development of a tool called “QCancer” , a model for men and women that estimate risks of multiple cancers according to baseline risk factors, patterns of symptoms and specific clinical conditions.
The tool is available free at www.QCancer.org
Disorientation and agitation are common in old patients inside the hospital and they are treated with sedative and hypnotic very often. As a consequence a low level of consciousness is common in this population. But sometimes the reason is more subtle. Many patients are treated with analgesic patches located in different subcutaneous areas. When they are located on the back they could be undetected and the patient will have a high probability for overdose.