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Jason Carter

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I enjoyed the challenge of Jason Carter’s case because of the complexity and common symptom often seen in primary care. I thought I did ok on history, but I missed quite a few pertinent questions, a... ccording to the experts. As I began to gather the subjective components, I found myself creating bias. Jason had common symptoms associated with a heart failure diagnosis, such as progressive dyspnea, orthopnea, and weight gain. Therefore, I started seeking confirmation bias in the diagnostic reports. His physical exam was challenging because of some of the signs I had never experienced in my nursing career. I have never witnessed JVD or hepatojugular reflex, so I was glad the experts pointed it out, but I wish they would have included Jason’s picture of his JVD. I was proud I identified the S3 heart sound. Sometimes, the sounds are very challenging to hear, especially when they are abnormal. However, his S3 was a very clear “gallop.” By the end of his physical exam, I had the diagnosis of heart failure already in my head as the leading diagnosis, so I am guilty of confirmation bias. I also found myself creating a “Semmelweis Reflex” bias with my omission of differentials. For example, ...........................................................CONTINUED......................................... [Show More]

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