
Primary Care Differential Diagnosis Assistant
Generate evidence-based differential diagnoses with prioritized primary care workup plans
What You Can Do
You can input clinical presentations (symptoms, vital signs, exam findings, labs) and receive structured differential diagnoses ranked by prevalence and danger in primary care populations. The skill generates prioritized workup plans that guide which tests to order first, helping you balance diagnostic accuracy with efficiency and cost-effectiveness while ensuring serious diagnoses are never missed.
Features
identifies key clinical features that narrow your differential diagnosis
ranks diagnoses by both frequency in primary care and clinical severity
generates step-wise diagnostic strategies that minimize unnecessary testing
applies outcomes research and current prevalence data specific to primary care
handles both acute complaints (chest pain, dyspnea, syncope) and subacute conditions (persistent cough, fatigue, weight loss)
distinguishes drug-induced symptoms from disease (ACE-I cough, SSRI hyponatremia, steroid hyperglycemia)
manages elderly and polymorbid patients where drug interactions and comorbidities confound interpretation
justifies specialty referral decisions with systematic reasoning
Example Output
Input: 42-year-old with 2 weeks of productive cough, low-grade fever, no dyspnea
Output:
- Top Differentials: Community-acquired pneumonia (CAP), acute bronchitis, viral upper respiratory infection, pertussis (if unvaccinated)
- Pivotal Findings: Fever + productive cough + infiltrate on CXR → pneumonia more likely
- Initial Workup: Chest X-ray (rule out infiltrate), CBC with differential, viral PCR panel
- If CXR normal: Consider pertussis serology, spirometry if cough persists >3 weeks
Input: 68-year-old with new-onset fatigue, pale conjunctiva, glossitis
Output:
- Top Differentials: Iron deficiency anemia, vitamin B12 deficiency, hypothyroidism, heart failure
- Pivotal Findings: Glossitis + pale conjunctiva + normal MCV (or macrocytic) → B12 deficiency likely
- Initial Workup: CBC, peripheral smear, ferritin, B12, folate, TSH, reticulocyte count
- Next steps if B12 low: Parietal cell antibodies, Schilling test consideration, gastroenterology referral if indicated
What's Included
- SKILL.md instruction file with clinical reasoning framework:
- Pivotal findings checklist for 15+ common primary care presentations (chest pain, dyspnea, abdominal pain, syncope, headache, vertigo, cough, fatigue, edema, weight loss):
- Evidence-based differential diagnosis templates ranked by prevalence and danger:
- Cost-effective workup flowcharts showing which tests to order first by presentation:
- Red flag criteria reference for distinguishing benign from serious diagnoses requiring urgent action:
Who It's For
- Physician Assistants in primary care, family medicine, and urgent care settings
- Primary care physicians seeking systematic diagnostic decision support
- Residents and medical students developing diagnostic reasoning skills
- Nurse practitioners managing undifferentiated primary care presentations
- Clinical educators teaching diagnostic workup methodology
Best For
- Acute complaint evaluation (chest pain, dyspnea, abdominal pain, syncope, headache)
- Chronic or subacute symptom workup (persistent cough, fatigue, edema, weight loss, joint pain)
- Abnormal lab or imaging findings requiring differential diagnosis before action
- Medication side effect versus disease differentiation decisions
- Pre-specialty referral documentation and clinical reasoning justification







