Chronology of disease

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  • The time course of disease or its symptoms offer much more useful information about the timing of management than just the diagnosis itself
  • It gives important clues about the likely pathological process
  • A rapidly deteriorating course may necessitate interventions even before a clear diagnosis is reached.  Resuscitation is a good example of this
  • Similarly abrupt or rapidly evolving symptoms suggest a serious condition
  • It offers prognostic value particularly if it doesn’t change in timely fashion with treatment
  • It determines the likely disposition of the patient e.g. discharge, early followup, admission, transfer to ICU

Helpful questions to ask to determine chronology

  • Did the symptoms build gradually over time or start suddenly?
  • How much have the symptoms changed in severity since they started and over what time?
  • What made you eventually decide to seek medical attention?
  • Have you sought treatment previously and how quickly did it respond?

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