Clinico-pathological

Conference
Introduction

 The idea was first practiced in Boston, in 1900 by a Harvard

internist, Dr. Richard C. Cabot

 It is a teaching tool that illustrates the logical, measured

consideration of a differential diagnosis used to evaluate
patients
 A well-chosen CPC is a powerful and dynamic teaching tool
that offers clinical-pathologic correlation and competence of
clinicians

 The main objective of CPC is to emphasize on measured,

logical progression from a patient's presentation to a narrowed
differential diagnoses rather than focusing on a final diagnosis.
Steps in CPC

 Selecting a case
 Preparing and presenting the case
 Discussing the case
 Presenting the ultimate diagnosis
 Case summary
Selecting the case

 Cases that have an unusual presentation of common diagnosis

or typical presentation of unusual diagnosis make a good case
for CPC presentation.

 The case for CPC should have the element of relevance,

solvability, and could be discussed.
 Discriminating information must be available to allow
thoughtful, logical discussion and consideration of differential
diagnoses.

 Cases that have interesting and educational differential

diagnoses should be selected.
Preparing and presenting the case

 The chief complaint, the history of present illness, past medical

and surgical histories, social histories, medications, and
allergies are important elements and should be provided.

 Vital signs and physical examination are provided at an

appropriate level of detail

 Diagnostic studies obtained are presented in the order in

which it was collected.
 The presenter does not interpret the data rather he allows the
discussant to interpret those data.

 It may be appropriate to withhold a confirmatory test obtained as

long as the case is solvable based on the other information
presented.

 The case should be presented clearly, concisely, and succinctly.

After the case is presented, the discussant is introduced before he
begins his discussion.
Discussing the case

 Discussant discusses the case.

 He will analyze and interpret the data provided by the

presenter. He evaluates the case summarizing the salient
features and relating these features to a list of differential
diagnoses in his opinion.

 Contribution from the audience is invited by the moderator to

add to the list of provisional diagnoses.
Presenting the ultimate diagnosis

 At the end, the presenter will give the final diagnosis and
factors involved in the final diagnosis. He will present the
details of the management of the case.

 The CPC is all about the processes in which a case is presented

that allow the discussant to guide the audience to a tentative
final diagnosis. To reveal the final diagnosis is the job of the
presenter.
Case summary

 At the end, a brief discussion of final diagnosis and

management should be presented.

 Multiple speakers can be involved in one case presentation. At

the end, audience are invited for question answer session and
share their views and expertise.
ADDITIONAL

 If rare case then textual details about the diagnosis

 If routine common case then quick summary about the
diagnosis
 Add interesting case reports or studies about the diagnosis
Presentation skills

 Dress code and composure

 Command over the language and fluent
 Background knowledge
 Make the session interactive.
  “If you do not think of it, you will never diagnose it”
Thank you