S2D: The Symptom to Diagnosis Podcast

Explore the complexities of diagnosing a sore throat beyond strep throat. The hosts discuss key differential diagnoses like viral infections and the importance of thorough testing, especially in healthcare workers. Learn about the Centor score for effective strep testing and the critical recognition of rare conditions like Lemierre syndrome and acute HIV. The conversation also touches on the nuances of antibiotic response and how presenting symptoms can guide diagnosis. Practical clinical tips take center stage, making this a must-listen for aspiring medical professionals!

A clinical case follows a 60-year-old woman with dramatic weight loss and a complex medical history. The discussion covers systematic evaluation steps, key baseline tests, and when to image or scope. They explore metabolic causes like severe hyperglycemia from pancreatic insufficiency and practical treatment considerations. Practical pitfalls and high-yield exam findings are highlighted.

They dig into distinguishing wheeze from stridor using acoustic clues and why that changes urgency. A case of progressive dyspnea leads to a surprising diagnosis of tracheal stenosis after prior intubation. Practical checklists cover acute stridor causes, ACE‑inhibitor angioedema timing, and when to escalate care. Common pitfalls and high‑yield signs for asthma, COPD, and refractory symptoms are highlighted.

Jennifer Pisano, infectious disease specialist and antibiotic stewardship leader at the University of Chicago. She breaks down COVID clinical phases and anosmia. They compare antigen versus PCR testing. Treatment timing, monoclonal antibodies, vaccine prevention, and ACE2-related multisystem effects are explored.

Sarah Stein, pediatric dermatologist and associate professor at the University of Chicago, breaks down how to approach rashes like a pro. Short, practical rules: identify the primary lesion, note secondary changes, recognize reaction patterns, and consider distribution and history. Case-based talk covers tense blisters, bullous pemphigoid workup, classic rash fingerprints, and common diagnostic pitfalls.

Discover the complexities of hyponatremia as hosts dive into intriguing cases, including a seizure linked to colonoscopy prep. Learn about the differentiating factors in diagnosing various types—hypovolemic, euvolemic, and hypervolemic. Gain insights into crucial lab interpretations, from serum osmolality to urine tests. The discussion reveals the pitfalls of misdiagnosing SIADH and emphasizes the importance of assessing hydration misconceptions. Finally, explore treatment risks and the delicate balance in correcting sodium levels.

A clinical case about an older patient with constipation leads into a compact guide to causes of high calcium. Listeners get a clear framework: PTH-related vs malignancy vs vitamin D and other causes. Practical points cover when surgery is warranted, pitfalls like milk-alkali and thiazide effects, and acute management steps for dangerous hypercalcemia.

Delving into the multifaceted world of fatigue, the discussion features a challenging case of a man with long-term exhaustion. Essential distinctions between fatigue and other symptoms are emphasized, as well as the importance of thorough sleep history and lifestyle factors. Potential causes such as sleep apnea and anemia are explored, with a surprising diagnosis of celiac disease revealing the underlying issue. The hosts also tackle common misconceptions about fatigue and provide practical tips for clinicians to improve diagnosis.

This episode dives into the intriguing case of hematuria, starting with a surprising presentation of reddish-brown urine after a hike. The discussion touches on differential diagnoses, exploring the implications of color and potential causes like rhabdomyolysis. Key principles for evaluation are outlined, emphasizing that common issues can present in unusual ways. Imaging reveals a ureteral stone as the culprit, reminding listeners that hematuria assessments are crucial, even with anticoagulation. Clinical pearls and misconceptions are tackled, making for an insightful clinical conversation.

Dive into the discomfort of dysuria with a case study of a 67-year-old man. Explore the diagnostic maze, distinguishing between cystitis and prostatitis. Discover the key signs that indicate pyelonephritis and the importance of pelvic exams for women. Uncover the link between penile discharge and STIs. Learn how atypical presentations in the elderly can mislead diagnoses and why thorough histories are essential. Finally, understand the crucial aspects of managing urosepsis and the conditions that necessitate urine cultures.