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A lupus awareness and educational program from the American College of Rheumatology

The Lupus Initiative’s library of case studies includes both traditional case studies and interactive case studies.

Traditional Case Studies

Preview Lost in Translation (Preview PDF)

A 38-year-old Mexican woman presents with complaints of fatigue, nausea, and vomiting as well as weight loss.

A Blizzard of Symptoms (Preview PDF)

An 18-year-old Black woman has been admitted to the hospital with fever, fatigue, and dyspnea upon exertion.

Young and Uninsured (Preview PDF)

A 25-year-old Black man presented to the emergency department complaining of fatigue, productive cough, dyspnea on exertion, fever, recent weight loss, myalgias, arthralgias, poor sleep, and a painful rash on his legs.

Pregnancy at Risk (Preview PDF)

An 18-year-old White, pregnant woman, at 12-weeks gestation is admitted for evaluation of a diffuse skin rash.

Closeup of a woman's hand touching water

PIVOT: Interactive Case Studies

Practice Improvement using Virtual Online Training (PIVOT) provides experiential learning, tests skills in real-time, and offers feedback. The cases teach the skills necessary to recognize the early symptoms and signs of lupus, think through an appropriate differential diagnosis, and perform an initial evaluation to diagnose—or rule out—lupus. Watch this short video to learn more.

[music]

Speaker: P-I-V-O-T, PIVOT, that’s practice improvement using virtual online training, a medical evaluation simulation. Students and practitioners take a learning journey to accurate diagnosis. New users easily create accounts. Returning users simply log in. Use the dashboard to pick up where you left off, or click ‘new case’ to meet your patient and get started. She’s presenting complex symptoms, what’s the right diagnosis? Find and follow the eight clues, they’re key to solving your case.

You’ll start with either the differential diagnosis using the slider, adjust the probability of potential diagnosis 0% to 100%. On activity log, list your selections helping you track the progress or you’ll go immediately to your patient’s history. The chief complaint, and medical, social, and family history. Correctly choosing critical information, records clues in the screen top panel along with the points awarded.

In some cases, a clue will enable you to rethink the probability of your diagnosis. Keep finding clues by reviewing systems, perhaps see if your patient is having shortness of breath or go ahead with the physical exam. PIVOT cases contain helpful media including video, images, and sounds. Once you’ve identified all eight clues, order lab tests. It’s time for your final decision, but don’t expect any help from us.

One of PIVOT’s best features, each case ends with a complete debrief. Get your score. Compare your decisions to those of expert clinicians. Hear your patient firsthand, receive detailed feedback and provide your own. Interactive, illustrated, information-rich, that’s PIVOT, improving clinical reasoning, increasing medical accuracy, and making learning come alive.

[00:02:46] [END OF AUDIO]

[música]

Interlocutor: P-I-V-O-T, PIVOT. Quiere decir mejora de la práctica mediante capacitación virtual en línea, una simulación de evaluación médica. Los estudiantes y los profesionales emprenden un viaje de aprendizaje hacia un diagnóstico preciso. Los usuarios nuevos crean cuentas fácilmente. Los usuarios recurrentes simplemente inician sesión. Utilice el panel para continuar donde dejó la última vez, o haga clic en ‘caso nuevo’ para conocer a su paciente y comenzar. Presenta síntomas complejos, ¿cuál es el diagnóstico correcto? Encuentre y siga las ocho pistas. Son clave para resolver su caso.

Comenzará con el diagnóstico diferencial usando el control deslizante. Ajuste la probabilidad de diagnóstico potencial entre 0% y 100%. En el registro de actividad, enumere sus selecciones para llevar un seguimiento del progreso. De lo contrario, irá inmediatamente al historial de su paciente. La queja principal y los antecedentes médicos, sociales y familiares. Al elegir correctamente la información crítica, registra pistas en el panel superior de la pantalla junto con los puntos otorgados.

En algunos casos, una pista le permitirá repensar la probabilidad de su diagnóstico. Siga buscando pistas revisando los sistemas. Quizás vea si su paciente tiene dificultad para respirar. De lo contrario, continúe con el examen físico. Los casos PIVOT contienen herramientas útiles que incluyen videos, imágenes y sonidos. Una vez que haya identificado las ocho pistas, solicite pruebas de laboratorio. Es hora de tomar su decisión final, pero no espere recibir nuestra ayuda.

Una de las mejores características de PIVOT es que cada caso termina con un informe completo. Obtenga su puntaje. Compare sus decisiones con las de los médicos expertos. Escuche a su paciente de primera mano. Reciba comentarios detallados y proporcione el suyo. Interactivo, ilustrado, rico en información, eso es PIVOT. Mejora el razonamiento clínico, aumenta la precisión médica y hace que el aprendizaje cobre vida.

[00:02:46] [FIN DEL AUDIO]

I'm Feeling Winded

This case study involves a 36-year-old Native American woman brought to the emergency department due to progressive breathing trouble.

LAUNCH CASE STUDY

Please help us assess and improve this case study by completing the survey.

TAKE THE SURVEY

Why Are My Legs Swelling?

A 24-year-old Black woman reports to an urgent care clinic complaining of progressive swelling in her legs for the past month.

LAUNCH CASE STUDY

Please help us assess and improve this case study by completing the survey.

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I Don't Have Time for a Headache!

A 19-year-old Black man with a history of hypertension, reports to an urgent care clinic complaining of an “on and off ” headache for the past 3 days.

LAUNCH CASE STUDY

Please help us assess and improve this case study by completing the survey.

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Consuela Morales Cultural Competency Case

A 34-year-old woman with SLE has come to see her primary care physician for follow-up care. She has been feeling very tired and has gained 10 pounds in the past month. Her ankles are also very swollen.

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Please help us assess and improve this case study by completing the survey.

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See below for access to the study guide

CLICK HERE FOR STUDY GUIDE

Jeannie Johnson Cultural Competency Case

Jeannie Johnson is a 22-year-old white woman who has been referred by her primary care physician to a rheumatologist at the medical center in a large city about 50 miles from her home for an evaluation for SLE.

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Please help us assess and improve this case study by completing the survey.

TAKE THE SURVEY

See below for access to the study guide

CLICK HERE FOR STUDY GUIDE

Michael Thompson Cultural Competency Case

Mr. Michael Thompson is a 30-year-old African American man. He presents in the Emergency Room at 10 PM with complaints of fever for the past several days (it has now gone up to 40 degrees C/104 F).

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Please help us assess and improve this case study by completing the survey.

TAKE THE SURVEY

See below for access to the study guide

CLICK HERE FOR STUDY GUIDE

PIVOT: Case Simulations

The following two interactive case studies offer medical education in a simulated gaming format aimed to teach students, residents, fellows, and practicing physicians about the clinical reasoning processes and pitfalls in the diagnosis of common lupus, specifically focusing on health disparities and the heterogeneity of clinical manifestations. To teach this, we incorporated proven educational principles, multimedia content using actual patient images, professional user-interface design, and unique gaming elements.

Access by launching a case study below and signing up for a complimentary PIVOT account.*
*Already have a PIVOT account? Launch a case study below and log in as a returning user.

CASE STUDY: Ingrid

36 year old female elementary school teacher with history of systemic lupus erythematosus (SLE) presents with new lower extremity swelling and worsening of her lupus rash.

Launch Case Study

CASE STUDY: Natalia

39 year old woman presents with fatigue, fevers, and joint pain and swelling.

Launch Case Study

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