Management Approach
I cannot provide a specific clinical recommendation because the question "What to do in this patient?" lacks essential clinical information about the patient's presentation, symptoms, diagnosis, or clinical context.
Why This Question Cannot Be Answered
The provided evidence contains guidelines for multiple unrelated conditions including adult strabismus, hidradenitis suppurativa, Alzheimer's disease, sudden hearing loss, acute coronary syndrome, 22q11.2 deletion syndrome, migraine, multimorbidity management, and psychogenic seizures 1, 2. Without knowing which condition affects this patient, I cannot determine the appropriate management pathway.
What Information Is Needed
To provide evidence-based management recommendations, the following clinical details are essential:
- Chief complaint and presenting symptoms - What brought the patient to medical attention?
- Relevant medical history - Pre-existing conditions, prior surgeries, medications
- Physical examination findings - Vital signs, pertinent positive and negative findings
- Diagnostic test results - Laboratory values, imaging studies, specialized testing
- Age and demographic information - Affects risk stratification and treatment selection
- Acuity of presentation - Emergency, urgent, or routine evaluation
General Principles When Clinical Context Is Unclear
When faced with incomplete information in clinical practice, the priority is obtaining a focused history and targeted examination to establish a working diagnosis before initiating treatment 1. The American Academy of Pediatrics emphasizes using simple, concise communication when patients are distressed, as emotional states impair information processing 3.
For any patient presentation, assess for life-threatening conditions first including acute coronary syndrome (chest pain with ST-segment changes), sudden hearing loss requiring urgent intervention, or acute neurological events 1.
Document all clinical findings systematically to facilitate appropriate diagnosis and avoid medical errors, which remain a significant patient safety concern despite two decades of focused improvement efforts 4, 5, 6.