ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Case History versus definitive diagnosis in clinical practice: The risk of being misinformed.

Updated on August 13, 2013

History taking is important in clinical diagnosis as it helps a clinician to arrive at a tentative and possible differential diagnosis which will serve as a guide to confirmatory diagnosis. Therefore, any mistake in the history of a clinical case can pose a serious problem in diagnosis. The common mistake encountered, in Veterinary practice, is that of misinformation by a client. This is usually the case because the patients, unlike in human practice, cannot speak for itself so their owners or keepers speak on their behalf while a Veterinarian doctor has no way of confirming the history expect via his experience, training, skills, and expertise. However, the ethics of the profession is that no matter how knowledgeable a veterinarian may be, he/she should not doubt or argue with his client but should listen carefully and ask questions without disagreement. It is then left for the doctor to determine the truth from what he or she was told in line with the nature of the case and clinical signs, if any, and other laboratory test among others. Yet any mistake in the case history may make the diagnosis difficult especially if the doctor is not experienced enough to know what to do.

It is known that most of the pet owners may not always be with their pets all time so they may not really know when and how a case started but they try as much as they can to narrate what the observed. There are many instances in which there are misinformation in a case history but let us use this case as an example. A client brought a bitch (Bull mastiff) to a clinic with a case of recurrent vaginal prolapse and he wanted a hysterectomy to be done and the prolapsed vagina repaired.

The chief Surgeon suspected that the prolapse may have occurred because the eight months old bitch may have been mounted by a large stud. However, the client’s case history claimed that the bitch was not breed and no male was around and the bitch was kept indoors so it was not possible that the bitch was mounted and insisted on surgery. A hormonal test carried out revealed a hormonal imbalance and in as much as it suggested pregnancy it can as well be false pregnancy since the owner insisted on the bitch not pregnant. The chief surgeon recommended for an ultrasonography to determine if the bitch was pregnant so the surgery could be avoided. The result did not reveal any pregnancy however the bladder was so filled that it well covered the uterus.

Since the result did not reveal any pregnancy, the bitch was prepared for surgery. It was on entry into the abdominal cavity that the chief surgeon saw fetuses and stopped the procedure as it was unethical. The client was called and informed but he doubted that the bitch could not have been pregnant but he later recalled that upon his arrival in the State, in which he brought the bitch for treatment, some weeks earlier he had stopped at a friend’s house and his friend had a large male dog.

The technologist that performed the ultrasonography claimed that since the pregnancy was less than a month, it was not easy to pick it through trans-abdominal ultrasonography coupled with the filled bladder. He said, trans-rectal would have been the best option. The prolapsed vagina was repaired. This case showed why any mistake in case history may make diagnosis and treatment difficult.

Comments

    0 of 8192 characters used
    Post Comment

    No comments yet.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)