Scott Stern - Symptom to Diagnosis An Evidence Based Guide, Third Edition

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In memory of Kim Michele Stern
Scott Stern

For Sarah, Ben, and Amelia
Adam Cifu

In memory of my father, Robert Seidman
Diane Altkorn

Jean-Luc Benoit, MD

Associate Professor of Medicine

Section of Infectious Diseases and Global Health

University of Chicago

Chicago, Illinois

AIDS/HIV Infection

Philip Hoffman, MD

Professor of Medicine

Section of Hematology-Oncology

University of Chicago

Chicago, Illinois

Bleeding Disorders

(Coauthored with Diane Altkorn)

Matthew Kalscheur, MD

Cardiovascular Medicine Fellow

University of Wisconsin Hospital and Clinics

Madison, Wisconsin

Hypotension

(Coauthored with Scott Stern)

Wei Wei Lee, MD

Assistant Professor of Medicine

Section of General Medicine

University of Chicago

Chicago, Illinois

Sore Throat

(Coauthored with Adam Cifu)

Amber Pincavage, MD

Assistant Professor of Medicine

Section of General Medicine

University of Chicago

Chicago, Illinois

Dysuria

(Coauthored with Adam Cifu)

Elizabeth Schulwolf, MD

Assistant Professor of Medicine

Division of Hospital Medicine

Loyola University Medical Center

Maywood, Illinois

Screening and Health Maintenance

(Coauthored with Diane Altkorn)

Sachin Shah, MD

Assistant Professor of Medicine

Section of General Medicine

University of Chicago

Chicago, Illinois

Hematuria

(Coauthored with Diane Altkorn)

Sarah Stein, MD

Associate Professor of Medicine

Section of Dermatology

University of Chicago

Chicago, Illinois

Rash

(Coauthored with Adam Cifu)

Our goal in creating Symptom to Diagnosis was to develop an interesting, practical, and informative approach to teaching the diagnostic process in internal medicine. Interesting, because real patient cases are integrated within each chapter, complementing what can otherwise be dry and soporific. Informative, because Symptom to Diagnosis articulates the most difficult process in becoming a physician: making an accurate diagnosis. Many other textbooks describe diseases, but fail to characterize the process that leads from patient presentation to diagnosis. Although students can, and often do, learn this process through intuition and experience without direct instruction, we believe that diagnostic reasoning is a difficult task that can be deciphered and made easier for students. Furthermore, in many books the description of the disease is oversimplified, and the available evidence on the predictive value of symptoms, signs, and diagnostic test results is not included. Teaching based on the classic presentation often fails to help less experienced physicians recognize the common, but atypical presentation. This oversight, combined with a lack of knowledge of test characteristics, often leads to prematurely dismissing diagnoses.