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Medical Practice

Diagnosing Disease

Arriving at a diagnosis involves analysis and synthesis—two aspects of logic. The physician identifies all the problems raised after hearing the patient's complaints, performing a physical exam, and receiving lab findings. Most physicians try to place the medical problem they are dealing with into one of several syndromes. A syndrome is a group of symptoms associated with any disease process, which constitutes together a picture of the disease.

The syndrome incorporates a hypothesis concerning a tissue, organ, or organ system. For example, congestive heart failure will produce a wide variety of symptoms, all of which are connected to the single pathophysiological mechanism, namely inadequacy of the heart muscle. Similarly, identifying a syndrome usually narrows down the number of possibilities for an illness and suggests ordering relevant clinical and lab studies.

Making a diagnosis is more difficult if one cannot categorize the patient's signs and symptoms. Nevertheless, the same logical approach, starting with the symptoms, proceeding to the physical findings, and lab results will usually lead to a diagnosis.

Diagnosing disease can prove at times very challenging and require considerable intellectual and physical effort. With the advances in laboratory and imaging technology, the task has been made much easier, but there are times when even these modalities do not provide satisfying answers. The physician should not hesitate to consult a specialist to help establish a probable diagnosis.

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