Clinical Diagnostics & Treatment Protocols

Clinical DX requires systematic approach combining Hx, PE, and diagnostic workup. The DDx process begins w/ chief complaint (CC) and evolves through pattern recognition and probabilistic reasoning.

## History Taking Framework

OPQRST for pain assessment: Onset (sudden vs gradual), Provocation/Palliation, Quality (sharp/dull/burning), Region/Radiation, Severity (1-10 NRS), Timing (constant/intermittent). Always assess ROS across major organ systems. SAMPLE for emergency: Signs/Sx, Allergies, Medications, PMHx, Last meal, Events preceding.

Red flags requiring immediate eval: sudden severe HA w/ neck stiffness (r/o SAH), chest pain w/ diaphoresis and dyspnea (r/o ACS), acute abd pain w/ rigidity (r/o peritonitis), unilateral leg swelling w/ pain (r/o DVT/PE), new focal neuro deficits (r/o CVA).

## Physical Examination Systematic Approach

VS interpretation: HR normal 60-100 bpm, tachycardia >100 suggests hypovolemia/sepsis/pain/anxiety. BP classification per ACC/AHA: normal <120/80, elevated 120-129/<80, HTN Stage 1 130-139/80-89, Stage 2 >=140/>=90. Orthostatic hypotension: SBP drop >=20 or DBP drop >=10 within 3min of standing suggests volume depletion.