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  #1  
Old 02-02-2013
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Question Negative symptoms in PN!

If patient has fatigue and I asked SIGECAPS and ALL answers were negative should I write about It in PN in order to prove that I have excluded depression?
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  #2  
Old 02-03-2013
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If depression one of the differential, then these are important pertinent negative, you need to write.
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Old 02-03-2013
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Fatigue has extremly wide differential. So I will have a lot of pertinent negatives. Time for PN is limited. Any ideas how to solve this problem???
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  #4  
Old 02-04-2013
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friend
put 3 differentials for fatigue based on ur case
now this could range
from mysenthia gravis
depression
chronic fatigue syndrome
normal grief
diabetes mellitus
diabetes inspidus
anemia of all types
hypothyroidism
narcolepsy
sleep apnea
u name it
based on those 3 ddxs put
pertinent negatives like
for mysenthia no diplopia
no dysphagia
no increased fatigue at the end of the day
no snoring at night
no polyuria or polydipsia
no appetite or weight changes
no constipation , cold intolerance, hoarseness
no history of bleeding
no lightheadedness
no palpitations
no chest pain
no dyspnea
etc etc
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Goblin (02-04-2013)
  #5  
Old 02-04-2013
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I agree with add1; you have to select the most probable differential diagnosis- say 3, & go through them.
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  #6  
Old 02-04-2013
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If during patient interview I have asked Pt about hoarseness and cold/hot intolerance and he said - NO. Should I ask him about skin changes, hair changes, heart racing, constipation etc? Or just go to next differential?
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