Clinical reasoning questions.
78 clinical reasoningquestions from the bank — open to read. Pick one and practice it out loud; a coach note comes back in seconds.
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A 52-year-old presents to the ED with sudden onset chest pain. Walk me through your initial assessment and what you'd want to know first.A 28-year-old presents with three months of fatigue, intermittent joint pain, and a rash on sun-exposed areas. Walk me through your differential.A 65-year-old returns to clinic with worsening shortness of breath on exertion over six weeks. What tests do you order and why?A 45-year-old smoker presents with a single episode of bright red rectal bleeding. Walk me through how you'd risk-stratify them.You're a hospitalist. Overnight, a patient on your service has new-onset confusion. Walk me through your response.A 35-year-old presents with chronic headaches that have worsened in pattern over a month. Walk me through your history-taking.A 70-year-old presents with new-onset atrial fibrillation. Walk me through what could be driving it.A 30-year-old returns with a positive home pregnancy test and abdominal pain. Walk me through your workup.A 60-year-old with diabetes presents with a foot ulcer that's red and warm. Walk me through risk stratification.A patient you're seeing in primary care reports an episode of transient unilateral vision loss yesterday. Walk me through your next move.A 25-year-old presents with palpitations that come and go over the past several months. Walk me through your initial history.A 50-year-old presents with new bilateral lower-extremity edema over two weeks. Walk me through your differential.A patient's outpatient ECG shows a new left bundle branch block. Walk me through your decision-relevant workup.A 78-year-old falls at home and presents with hip pain. Walk me through how you'd stratify risk before imaging.A clinic patient reports new severe back pain with progressive lower-extremity weakness over 48 hours. Walk me through your response.A 19-year-old presents with abdominal pain and vomiting. Walk me through your initial history.A 40-year-old presents with night sweats and unintentional weight loss over three months. Walk me through your differential.A 22-year-old returns with a positive monospot but persistent symptoms at five weeks. Walk me through what else you'd consider.A 55-year-old with hypertension and family history of stroke presents for an annual visit. Walk me through cardiovascular risk stratification.A patient with chronic heart failure reports new weight gain of 6 pounds in a week and worsening dyspnea. Walk me through your response.A 70-year-old presents with hematuria. Walk me through what you'd ask first.A 35-year-old returns with three months of insomnia, weight loss, and tachycardia. Walk me through your differential.A patient with a remote history of breast cancer returns with persistent back pain. Walk me through what changes about your workup.A 40-year-old presents with calf swelling and tenderness three weeks after a long flight. Walk me through risk stratification.A patient on warfarin reports a sudden severe headache. Walk me through your response.A 45-year-old presents with persistent cough lasting 8 weeks. Walk me through your history-taking.An elderly patient on multiple medications presents with confusion and reduced oral intake over a week. Walk me through what you'd consider.A patient with rheumatoid arthritis on methotrexate presents with new fever. Walk me through your workup considerations.A 60-year-old presents with chest pain that's atypical but with multiple cardiac risk factors. Walk me through risk stratification.A pediatric patient presents with high fever and a non-blanching rash. Walk me through your immediate response.A 32-year-old presents with acute onset right upper quadrant pain that started after a fatty meal. Walk me through your initial history.A 26-year-old presents with three days of dysuria and urinary frequency. Walk me through your differential.A 58-year-old with no prior medical history presents with new-onset tremor. What initial tests would you order and why?A 42-year-old presents with first-time seizure witnessed by family. Walk me through how you'd risk-stratify this patient.You're working urgent care. A patient with known asthma presents with worsening shortness of breath and speaks only in short phrases. Walk me through your response.A 48-year-old presents with acute onset severe diarrhea after attending a picnic yesterday. Walk me through your initial history.A 68-year-old presents with progressive dysphagia to solids over six weeks with weight loss. Walk me through your differential.A 34-year-old presents with acute knee swelling after no trauma. What diagnostic tests would help you most and why?A 72-year-old on anticoagulation for atrial fibrillation falls and hits their head but has no loss of consciousness. Walk me through risk stratification.A patient in your clinic develops sudden-onset facial droop and slurred speech during the visit. Walk me through your immediate response.A 29-year-old presents with sudden-onset severe unilateral eye pain and blurred vision. Walk me through your initial assessment.A patient hands you an AI chatbot printout listing three rare diagnoses that contradict your working diagnosis of GERD. Walk me through how you'd reason through the list clinically.During a telehealth visit, a 58-year-old reports two days of new unilateral calf swelling and tenderness. Walk me through what you can and can't assess remotely, and your next move.A CT done for abdominal pain incidentally shows an 8 mm solid pulmonary nodule in a 55-year-old former smoker. Walk me through how you'd decide what happens next.A 70-year-old faints while standing at a long ceremony, recovers within a minute, and feels fine in your office. Walk me through how you'd decide between reassurance, workup, and admission.A patient who started a GLP-1 receptor agonist for weight loss three months ago presents with persistent vomiting and epigastric pain. Walk me through your differential.An AI early-warning system flags your ward patient as high risk for sepsis, but they look well at the bedside. Walk me through how you'd reconcile the alert with your exam.An asymptomatic 52-year-old brings in a smartwatch notification suggesting an irregular heart rhythm. Walk me through what testing, if any, you'd order before acting on it.A 30-year-old presents with two weeks of low back pain after moving apartments, with a normal neuro exam and no red flags. Walk me through what tests you'd order and why.An 82-year-old on twelve medications presents after their third fall this year. Walk me through your history, starting with what you'd prioritize.A 48-year-old's blood pressure is 150/95 at a single office visit and they feel well. Walk me through how you'd decide whether and when to start treatment.A 26-year-old with vague fatigue requests 'a full-body workup with every test' after watching health content online. Walk me through how you'd take the history and decide what's actually indicated.Routine labs in an asymptomatic 40-year-old show liver enzymes about three times the upper limit of normal. Walk me through your differential and first-pass workup.A 42-year-old presents to the ED with sudden onset severe headache that started 90 minutes ago. Walk me through your initial assessment and what concerns you most.A 55-year-old with hypertension presents with left-sided weakness that resolved completely after 20 minutes. Walk me through your risk stratification.A 33-year-old woman presents with a six-week history of progressive weakness in her legs and numbness in her feet. Walk me through your differential diagnosis.A 68-year-old on warfarin falls at home and hits their head. They seem fine but their family brought them in. Walk me through your assessment.A 19-year-old college student presents with fever, severe headache, and neck stiffness that started this morning. Walk me through your immediate next steps.A 58-year-old presents with progressive dysphagia to solids over three months and a 15-pound weight loss. Walk me through your workup priorities.A 72-year-old with COPD presents with increasing dyspnea and a productive cough over four days. Walk me through your decision to admit versus discharge.A 26-year-old presents with sudden onset right lower quadrant pain and missed her last period. Walk me through your initial diagnostic approach.A 48-year-old presents with jaundice and dark urine noticed over the past week. Walk me through your differential diagnosis.A postoperative patient on day two develops a fever of 38.8°C. Walk me through your diagnostic approach.A 61-year-old diabetic presents with nausea and vomiting but denies abdominal pain. Their glucose is 520. Walk me through your assessment.A 37-year-old presents with a three-week history of persistent cough and night sweats. They recently immigrated from Southeast Asia. Walk me through your workup.A 75-year-old presents with syncope that occurred while standing in church. Walk me through the key historical features you need to establish.A 29-year-old with no past medical history presents with sudden onset flank pain radiating to the groin. Walk me through your initial diagnostic steps.A 66-year-old on dialysis develops altered mental status during a session. The nurse calls you urgently. Walk me through your response.A 40-year-old presents with progressive bilateral hand numbness that's worse at night and relieved by shaking the hands. Walk me through your clinical reasoning.A 53-year-old presents with a two-month history of hoarseness. They don't have a cold and otherwise feel well. Walk me through your approach.A 31-year-old pregnant woman at 32 weeks presents with a severe headache and her blood pressure is 168/110. Walk me through your immediate management.A 44-year-old with known cirrhosis presents with increasing abdominal girth and new confusion. Walk me through your assessment priorities.A 23-year-old presents with a painful swollen right calf after a long international flight. Walk me through your diagnostic reasoning.A 56-year-old presents with crushing chest pain that started 30 minutes ago. Their ECG shows ST elevations in leads II, III, and aVF. Walk me through your next steps.A 38-year-old presents with recurrent episodes of palpitations, tremor, and sweating that last about 20 minutes. Walk me through your differential.A 70-year-old presents with painless hematuria noticed this morning. They have a 40 pack-year smoking history. Walk me through your workup strategy.A 47-year-old presents with a two-week history of progressive lower back pain and now reports new urinary retention. Walk me through your assessment.A hospitalized patient develops acute shortness of breath on postoperative day five after hip replacement. Walk me through your clinical reasoning.