What illnesses are impossible to have a confirmed diagnosis on?
As I understand it, there are some illnesses out there that can only be diagnosed based on ruling out everything else. So my question is, what illnesses can someone have when all tests still show up normal?
Currently I’m studying medicine and as far as I know this is the topic after dehydration which we are doing now. I was hoping to get a little knowledge before hand but I haven’t got the books yet and the internet seems to be failing me? Thanks!
There are some diseases which can only be positively diagnosed after death and autopsies because there are currently no lab tests to use for positive diagnosis.
Parkinson’s disease and some of the parkinsonian conditions are a good example although that may change by the time you are out of med school. Look also at differential diagnoses.One problem is that the name Parkinson’s or Parkinson disease is actually a collection of syndromes with varying symptoms, rates of progression and differing genetic and environmental triggers. Not to mention the related parkinsonian conditions which may or may not be l-dopa responsive.
Lab tests are usually conducted in a suspected PD DX to rule out other conditions.
If doctors could recognize precursor symptoms of conditions such as PD, treatments and therapies might be started much earlier and that might delay onset of some symptoms and progression of others for considerable time.
Lewy body disease is an excellent example. Certain symptoms can overlap with PD and AD. Does a person have Parkinson’s disease with dementia (PDD)? Lewy Body disease? Alzheimer’s? Dementia? Other mental illness may be seen to manifest symptoms which can be associated with several conditions some emotional/psychological and some chemical imbalance.
There are many conditions which are very difficult to diagnose especially when they occur in infants as you can read at the link below. I”m not going to cut and paste since the article is quite clear with additional links.
Here’s a cardiac condition very difficult to diagnose:
Some conditions are simply difficult to diagnose in the early stages. The problem is that without a positive early diagnosis the patient risks death or other debilitating conditions. A simple example is appendicitis. Or how about the headaches or nausea associated with meningitis which are usually seen as the flu?
Diagnostics are very difficult simply because patients may need to go years back to find the precursor symptoms (PD is a great example) or be reluctant to tell the doctor embarrassing issues which they don’t think are related.
All patients should be encouraged to come to that first appointment (unless it is the emergency room) with a printed list of symptoms dating back several years if they still persist. And an extended blood relative family medical history plus a list of medications including OTCs which they have taken in recent.
Several autoimmune conditions are difficult to diagnose because they can be confused with another condition. Examples include Scleroderma and Lupus. Digestive disorders fall into the same category because symptoms overlap.
Oddly enough some of the cancers are also difficult to diagnose although I am still at a loss to understand exactly why. Breast cancer, lung cancer and colon cancer have been misdiagnosed as simply health issues for years.
Rare disorders are difficult to diagnose because most physicians simply aren’t familiar with the symptoms and assume other causes.
I think you would be better served with difficult rather than impossible. If the disease or condition has a name, someone has diagnosed it.
Listening is key.The difference between a teen and an infant is huge. One can tell you the other cannot communicate except to indicate pain. Knowing the questions to ask is so important. Telling patients to come with written lists is another.
Too often doctors rely on patients to provide the best clues. That isn’t always possible. Better diagnostic check lists would be of significant value. Diagrams could be included. Frequent revisions would be required.With a check list, the doctor is reading and thinking about both the questions and the answers and the patient is listening and responding.
Consider also that ‘impossible to confirm diagnoses” might actually refer to diagnoses which can’t be diagnosed by physical exam alone.
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