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Clinical Reasoning
Work through 59 clinical reasoning cases and 106 differential diagnoses, from presenting features to a prioritised differential, targeted investigation and safe next step.
Explore MedNextClinical Reasoning
Work through 59 clinical reasoning cases and 106 differential diagnoses, from presenting features to a prioritised differential, targeted investigation and safe next step.
MedNext clinical-reasoning exercises are educational. They support deliberate practice and do not replace patient-specific assessment or senior review.
Sample reasoning case: the problem representation
A taste of what is inside. Every one of the 59 cases trains the same habit: turn a messy story into a one-line problem representation, then match it against illness scripts.
Vignette. A 28-year-old woman presents with three weeks of increasing breathlessness and palpitations. She has lost weight despite a good appetite, feels persistently hot and describes loose stools. On examination she is tachycardic with a fine tremor and a small, smooth goitre.
Step 1, build the problem representation. Compress the case into one line using semantic qualifiers: a young woman with a subacute, multi-system hypermetabolic syndrome (weight loss with preserved appetite, heat intolerance, tachycardia, tremor) plus a goitre. That single sentence is what an experienced clinician reasons from, not the full transcript.
Step 2, match against illness scripts. A hypermetabolic syndrome with a goitre fits the script for hyperthyroidism, and the age and diffuse goitre make Graves disease the leading hypothesis. Competing scripts, such as an anxiety disorder or phaeochromocytoma, are raised or lowered by the discriminating features (weight loss with a goitre argues for thyroid disease).
Step 3, the safe next step. Confirm with thyroid function tests (a suppressed TSH with a raised free T4) before treatment, and identify any red flags such as thyroid storm. The full case then walks the targeted investigation and management. This is a taste of what is inside; the full interactive tool is in the MedNext app.
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