Interactive Case Study · Nikkie the NP’s Classroom

Interactive Case Study

Quick Case 🩺

A 34-year-old female presents with 4 days of persistent nausea and vomiting. She’s having trouble keeping food and fluids down and is feeling increasingly weak. No diagnostic testing has been completed yet.

Before jumping to labs, imaging, or a diagnosis, think through the presentation.

What’s on your differential? What are the top 3 conditions that could actually explain why she is having nausea and vomiting?

What else do you want to know?

Think about the history questions that could completely change your differential.

Pregnancy possibility? LMP? Abdominal pain? Diarrhea? Fever? Urinary symptoms? Medications? Cannabis use? Sick contacts? Recent food or travel? Previous abdominal surgery? Headache or neurologic symptoms?

And don’t forget the “what could I absolutely not miss?” diagnoses.

The differential isn’t a list of everything that might be abnormal. It’s an organized supportive list that are the most likely causes of your chief complaint

💡 Think chief complaint → differential → history & physical →refine differentials→ diagnostics

Your diagnostic testing should help you rule in or rule out the diagnoses you’re already considering, not create your differential for you.

Drop your responses in the comments!

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Interactive Case Study