Furthering the clinical enquiry

Anatomical

• Consider all proximate structures to the organ of interest (e.g. uterus > bladder)
• Ask questions related to that organ (e.g. dysuria, frequency, haematuria etc)

repeat for each organ

Neuroanatomical

• Consider all structures with similar innervation (e.g. stomach > gallbladder)
• Ask questions related to that organ (e.g. jaundice, dark urine

repeat for each organ

Physiological

• Consider all structures related physiologically (e.g. adrenal > pituitary)
• Ask questions related to that organ (e.g. headache, visual change)

repeat for each organ

Pathology

• Consider the time scale of the symptoms and correlate with a pathology (e.g. chronic > neoplastic)
• Ask questions that are known causes or risk factors for the pathology (e.g. smoking > lung cancer)
• Ask questions that are common symptoms of that pathology (e.g. infection > fever)
• Ask questions that are known complications of the pathology (e.g. atherosclerosis > history of myocardial infarction)

Consider those conditions which demonstrate the best fit of data consistent with the anatomy, physiology and pathology.

Commence targeted investigations to confirm this.

see

Summary of pathological processes

Surgical Pathology

Assessing organ dysfunction - clinically

Assessing organ function

"A few observations and much reasoning leads to error; many observations and a little reasoning to truth"
Alexis Carrell

"You know my method. It is founded upon the observation of trifles’
Sherlock Holmes

"If you don’t think of the diagnosis you’ll never make it."
Anon

"More is missed from not looking than not knowing"
Prof. Thomas Macrae

"If there is a fault in us bred of familiarity it is, I believe, the old fault of omitting to probe sufficiently deeply into causes; the fault of accepting the fact of common symptoms without trying to explain them."
Jon A Ryle

"A man must cultivate the habit of careful observation and of cautious thinking"
Paget