Differential Diagnosis Advisor for Primary Care
Systematically prioritize differential diagnoses with structured clinical reasoning for primary care
What You Can Do
You can develop comprehensive differential diagnoses by anchoring on the chief complaint, applying systematic reasoning to competing diagnoses, and identifying red flags that suggest serious pathology. The skill helps you organize complex clinical information, prioritize diagnostic possibilities based on prevalence and risk, and document your reasoning for medicolegal protection and clinical clarity.
Features
Structure the chief complaint with key clinical context to focus diagnostic thinking
Systematically identify warning signs suggesting serious or life-threatening diagnoses
Rank differentials by prevalence, patient risk factors, and disease likelihood
Consider multiple plausible diagnoses rather than anchoring on the first impression
Suggest appropriate next steps based on differential ranking and clinical uncertainty
Generate structured notes supporting your diagnostic approach for teaching and medicolegal clarity
Handle confusing symptom clusters and multiple comorbidities systematically
Distinguish urgent red flag presentations from subacute diagnostic dilemmas
Example Output
Example 1: Chest Pain Presentation
Problem: 42-year-old male with 2 hours of substernal chest pressure, diaphoresis, no prior cardiac history.
Differential (ranked):
- Acute Coronary Syndrome — Red flags: pressure quality, diaphoresis, male age. Immediate: EKG, troponin, aspirin decision.
- Pulmonary Embolism — Consider: recent travel, leg swelling, tachycardia. Test if clinical suspicion rises.
- Aortic Dissection — Lower probability but catastrophic if missed. Assess BP differential, tearing quality.
Red Flags Present: Diaphoresis, substernal location, male sex
Next Steps: 12-lead EKG within 10 minutes, troponin, CXR, consider cardiology consultation based on EKG findings.
Example 2: Abdominal Pain with Comorbidities
Problem: 67-year-old female with diffuse abdominal pain, nausea, history of diabetes and chronic kidney disease.
Differential (ranked):
- Acute Abdomen (surgical) — Red flags: severe pain, peritoneal signs. Imaging priority: CT abdomen/pelvis.
- Diabetic Ketoacidosis — CKD increases risk; check glucose, pH, anion gap immediately.
- Medication Effect — On metformin; assess renal function and lactate for lactic acidosis.
Red Flags Present: Peritoneal tenderness, vomiting, altered kidney function
Next Steps: Stat labs (metabolic panel, lactate, lipase), urgent imaging, IV access, consider hospital admission.
What's Included
- SKILL.md instruction file with core diagnostic framework:
- Problem Statement Template: Structured format for anchoring clinical presentations
- Red Flag Checklist: Domain-specific warning signs by system (cardiovascular, abdominal, neurologic, infectious)
- Differential Ranking Worksheet: Prevalence and risk-based prioritization guide
- Diagnostic Testing Algorithm: Decision tree for appropriate imaging and lab sequencing
- Documentation Framework: Clinical reasoning template for EHR integration and teaching notes
Who It's For
- Primary care physicians (MDs, DOs) managing undifferentiated acute presentations
- Resident physicians developing diagnostic reasoning skills
- Urgent care or retail clinic providers evaluating patients without prior history
- Hospitalists on admission evaluating complex multisystem presentations
- Clinical educators teaching diagnostic decision-making to trainees
Best For
- Chest pain, dyspnea, and cardiovascular presentations
- Abdominal pain with unclear etiology or atypical features
- Headache and neurologic complaints
- Fever of unknown origin and undifferentiated infectious presentations
- Complex cases with multiple comorbidities creating diagnostic confusion
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