The audit findings indicate a recurring pattern of suboptimal patient outcomes in managing travel-related gastrointestinal illnesses, suggesting a potential gap in the application of evidence-based practices within the clinic. This scenario is professionally challenging because it requires clinicians to critically evaluate their current diagnostic and treatment protocols against established best practices, potentially necessitating a shift away from familiar approaches. It demands a commitment to continuous learning and adaptation, grounded in scientific literature and professional guidelines, to ensure patient safety and efficacy of care. The pressure to maintain patient flow and manage diverse clinical presentations can also make it difficult to dedicate sufficient time to in-depth evidence review for every case. The best approach involves systematically reviewing the latest peer-reviewed literature and relevant professional guidelines from recognized bodies, such as the World Health Organization (WHO) or national tropical medicine societies, to inform diagnostic criteria and treatment algorithms for common travel-associated gastrointestinal infections. This approach prioritizes the use of up-to-date, scientifically validated information to guide clinical decision-making, ensuring that management strategies are aligned with current understanding of pathogen behavior, antimicrobial resistance patterns, and optimal supportive care. Adherence to evidence-based practice is a fundamental ethical and professional obligation, aimed at providing the highest standard of care and minimizing patient harm. An approach that relies solely on anecdotal experience or the preferences of senior practitioners, without critical appraisal of current evidence, is professionally unacceptable. This can lead to the perpetuation of outdated or ineffective treatments, potentially exposing patients to unnecessary risks or failing to address the underlying pathology effectively. Similarly, adopting treatment protocols based on readily available, but potentially unverified, online resources or manufacturer-provided information without independent critical evaluation risks incorporating biased or incomplete data. This undermines the principle of providing care based on robust scientific evidence and can lead to inappropriate prescribing or diagnostic delays. Professionals should employ a decision-making framework that begins with identifying the clinical problem and the specific patient context. This is followed by a thorough search for the best available evidence, which includes consulting reputable databases, systematic reviews, and clinical practice guidelines. The evidence is then critically appraised for its validity, relevance, and applicability to the patient. Finally, the appraised evidence is integrated with clinical expertise and the patient’s values and preferences to make an informed treatment decision. This iterative process ensures that care is not only effective but also ethical and patient-centered.

Scenario Analysis: This scenario is professionally challenging because it involves a potential conflict between immediate patient needs and the established protocols for managing infectious diseases in a travel medicine context. The clinician must balance the urgency of the patient’s symptoms with the responsibility to prevent the spread of disease and adhere to public health guidelines. Misjudgment can lead to inadequate patient care, public health risks, and regulatory non-compliance. Correct Approach Analysis: The best professional practice involves immediately isolating the patient and initiating a thorough diagnostic workup to identify the specific pathogen responsible for the symptoms. This approach is correct because it prioritizes patient safety by preventing potential transmission to others within the clinic and to the wider community. It also aligns with the core principles of infectious disease management, which mandate prompt identification and containment of potential outbreaks. Adherence to established protocols for suspected infectious diseases, as guided by public health authorities and professional bodies relevant to Latin American travel and tropical medicine, is paramount. This ensures that appropriate diagnostic tests are performed, treatment is initiated promptly based on confirmed findings, and necessary public health notifications are made if a reportable disease is identified. Incorrect Approaches Analysis: Initiating broad-spectrum antibiotic treatment without a definitive diagnosis is professionally unacceptable. This approach fails to address the root cause of the illness, potentially leading to antibiotic resistance, masking of symptoms, and delayed diagnosis of the actual condition. It also bypasses essential diagnostic steps required by public health regulations for certain infectious diseases. Delaying further investigation and advising the patient to self-isolate at home without a clear diagnosis or specific instructions is also professionally unacceptable. This approach neglects the immediate responsibility of the healthcare provider to assess and manage a potentially contagious patient within a controlled environment. It increases the risk of community transmission and fails to provide the patient with appropriate medical care and guidance. Consulting with a colleague informally about the case without documenting the interaction or following formal diagnostic pathways is professionally unacceptable. While collegial consultation can be beneficial, it must be integrated into the formal clinical decision-making process. Relying solely on informal advice without proper investigation and documentation can lead to diagnostic errors and regulatory breaches, as it bypasses established protocols for patient management and record-keeping. Professional Reasoning: Professionals in applied Latin American travel and tropical medicine should employ a systematic decision-making framework. This involves: 1) immediate risk assessment and patient stabilization (including isolation if infectious disease is suspected); 2) thorough history taking and physical examination; 3) appropriate diagnostic testing based on clinical suspicion and epidemiological context; 4) consultation with relevant specialists or public health authorities when necessary; 5) implementation of evidence-based treatment; and 6) meticulous documentation of all findings, decisions, and actions. This structured approach ensures patient well-being, public health protection, and regulatory compliance.

Scenario Analysis: This scenario presents a professional challenge due to the potential for conflicting patient interests and the need to adhere to strict ethical and professional guidelines regarding patient confidentiality and informed consent, especially in a resource-limited tropical setting where immediate access to specialized care might be difficult. The practitioner must balance the urgency of the situation with the patient’s right to privacy and autonomy. Correct Approach Analysis: The best professional approach involves obtaining explicit, informed consent from the patient for any disclosure of their medical information to their employer. This approach respects the patient’s autonomy and upholds the principle of confidentiality, which is a cornerstone of medical ethics and professional conduct. Specifically, in the context of Latin American medical practice, adherence to national data protection laws and professional medical codes of ethics, which generally mandate patient consent for information sharing, is paramount. The practitioner should explain to the patient the potential implications of sharing this information with their employer, including any impact on their employment status, and document the consent process thoroughly. Incorrect Approaches Analysis: Disclosing the patient’s diagnosis and prognosis to the employer without explicit consent violates patient confidentiality. This breaches ethical obligations and potentially contravenes national data protection laws applicable in Latin American countries, which typically require patient authorization for the release of sensitive medical information. Such an action undermines the trust between patient and practitioner. Suggesting to the patient that they should inform their employer themselves, without offering to facilitate the communication or ensuring the patient understands the implications, can be seen as abdicating professional responsibility. While the patient ultimately decides what to share, the practitioner has an ethical duty to guide and support the patient in making informed decisions about their health information, especially when it impacts their work. Contacting the employer directly to inquire about workplace safety measures without the patient’s consent, even with the intention of protecting the patient, is an overreach. This action bypasses the patient’s right to control their personal health information and could lead to unintended consequences or a breach of trust if the employer perceives the information as being obtained inappropriately. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes patient autonomy and confidentiality. This involves: 1) Clearly understanding the patient’s wishes and concerns. 2) Educating the patient about their rights and the implications of sharing their medical information. 3) Seeking explicit, informed consent for any disclosure. 4) Documenting the consent process and any decisions made. 5) Adhering strictly to relevant national medical ethics codes and data protection legislation. If there are immediate safety concerns that cannot be addressed through consent, professionals should consult with ethics committees or legal counsel within their jurisdiction.

The audit findings indicate a potential gap in the practice’s adherence to established protocols for managing patient information and ensuring continuity of care when practitioners are unavailable. This scenario is professionally challenging because it requires balancing the immediate needs of patients with the imperative to maintain data integrity, privacy, and consistent service delivery, all within the framework of professional conduct and relevant health regulations. The potential for patient harm due to delayed or incomplete information transfer, coupled with the risk of privacy breaches, necessitates a robust decision-making process. The best approach involves proactively establishing a clear, documented protocol for patient handover and information management during practitioner absences. This protocol should detail how patient records are securely accessed, how urgent consultations are managed, and how continuity of care is ensured by designated colleagues or a referral system. This is correct because it aligns with ethical obligations to provide continuous and competent care, as well as regulatory requirements for patient record management and data protection. Such a system minimizes the risk of information loss or misinterpretation, safeguards patient confidentiality, and ensures that patients receive timely and appropriate medical attention, thereby upholding professional standards and patient trust. An incorrect approach would be to rely on informal verbal communication between practitioners. This is professionally unacceptable as it is prone to miscommunication, omission of critical details, and lacks a verifiable record, increasing the risk of patient harm and violating data protection principles. Another incorrect approach is to assume that patients will simply reschedule or seek care elsewhere without any proactive facilitation from the practice. This fails to meet the ethical duty of care and can lead to significant delays in treatment for urgent conditions, potentially compromising patient outcomes. Finally, a flawed approach of providing a colleague with full, unrestricted access to all patient records without a specific, documented need for that access for continuity of care purposes poses a significant privacy risk and violates data protection regulations. Professionals should employ a decision-making framework that prioritizes patient safety and well-being, followed by adherence to legal and ethical guidelines. This involves anticipating potential disruptions to service, developing comprehensive contingency plans, ensuring all staff are trained on these plans, and regularly reviewing and updating them. When faced with a situation requiring patient information transfer or continuity of care, the professional should always refer to established protocols, prioritize secure and authorized access to information, and ensure clear communication channels are utilized.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for accurate assessment of candidate competency with the practical realities of examination administration and resource allocation. The decision-maker must navigate potential biases, ensure fairness, and uphold the integrity of the qualification without being overly punitive or dismissive of valid concerns. The weighting and scoring of an examination directly impacts its validity and reliability as a measure of competence, and retake policies influence accessibility and the perceived value of the qualification. Correct Approach Analysis: The best professional practice involves a systematic review of the blueprint and scoring, considering feedback from recent examinations and expert consensus. This approach prioritizes evidence-based adjustments to ensure the examination accurately reflects the learning outcomes and the weighting reflects the relative importance of topics in Applied Latin American Travel and Tropical Medicine Practice. Retake policies should be reviewed for fairness, accessibility, and alignment with professional development standards, ensuring they do not unduly penalize candidates while still maintaining the rigor of the qualification. This approach is correct because it is grounded in the principles of psychometric validity and fairness, ensuring the examination serves its intended purpose of certifying competent practitioners. It aligns with the ethical obligation to provide a reliable and valid assessment tool. Incorrect Approaches Analysis: One incorrect approach involves making arbitrary adjustments to blueprint weighting and retake policies based on anecdotal feedback or pressure from a small group of stakeholders without rigorous data analysis. This fails to uphold the integrity of the assessment, potentially misrepresenting the importance of certain topics and creating an unfair barrier for candidates. It disregards the need for evidence-based decision-making in assessment design. Another incorrect approach is to maintain the existing blueprint and retake policies without any review, even in the face of consistent feedback suggesting significant issues. This demonstrates a lack of responsiveness to evolving professional practice and candidate experience, potentially leading to an outdated and ineffective assessment. It fails to meet the ethical responsibility to ensure the qualification remains relevant and accurately reflects current best practices. A further incorrect approach is to implement drastic and unannounced changes to the blueprint weighting and retake policies immediately before the next examination cycle. This would be unfair to candidates who have been preparing based on the previous structure and could lead to widespread confusion and distress. It violates principles of transparency and fairness in assessment. Professional Reasoning: Professionals should employ a structured decision-making framework that includes: 1) Data Gathering: Collect comprehensive feedback on the examination, including candidate performance data, examiner comments, and expert reviews. 2) Analysis: Critically analyze the data to identify specific areas of concern regarding blueprint weighting, scoring, and retake policies. 3) Consultation: Engage with subject matter experts, examination committees, and relevant stakeholders to discuss findings and potential solutions. 4) Evidence-Based Decision Making: Formulate recommendations for adjustments based on psychometric principles and evidence, ensuring alignment with the qualification’s objectives. 5) Transparency and Communication: Clearly communicate any proposed changes to stakeholders well in advance of implementation.

Scenario Analysis: This scenario is professionally challenging because it requires a candidate to balance the need for thorough preparation with the practical constraints of time and available resources, all while adhering to the specific requirements of the Applied Latin American Travel and Tropical Medicine Practice Qualification. Misjudging the timeline or the effectiveness of preparation resources can lead to a candidate feeling underprepared, potentially impacting their performance and future practice, and ultimately failing to meet the qualification’s standards. Careful judgment is required to select a realistic and effective preparation strategy. Correct Approach Analysis: The best professional approach involves a structured, phased timeline that prioritizes core knowledge acquisition and then moves to application and refinement. This begins with a comprehensive review of the official syllabus and recommended reading materials, allocating dedicated time blocks for each topic. Subsequently, candidates should engage with practice questions and mock examinations, simulating the actual exam conditions to identify knowledge gaps and refine time management skills. This phased approach ensures a solid foundation is built before testing application, mirroring effective learning methodologies and aligning with the qualification’s objective of assessing practical competence. This strategy directly addresses the need for both breadth and depth of understanding, as well as practical application, which are implicit in the qualification’s design. Incorrect Approaches Analysis: One incorrect approach involves solely relying on a last-minute cramming strategy, dedicating minimal time to each topic and attempting to absorb information in the days immediately preceding the examination. This fails to allow for deep understanding, retention, or the development of critical thinking skills necessary for applying knowledge in a practical context. It is ethically questionable as it does not represent a genuine commitment to acquiring the necessary competence for tropical medicine practice. Another incorrect approach is to focus exclusively on practice questions without a foundational understanding of the core syllabus. While practice questions are valuable for assessment, they are most effective when used to reinforce and test knowledge gained from studying the subject matter. Without this foundation, candidates may memorize answers without truly understanding the underlying principles, leading to an inability to adapt to novel scenarios or apply knowledge flexibly, which is a failure to meet the qualification’s intent. A further incorrect approach is to over-rely on a single, unverified resource without cross-referencing or consulting the official syllabus. This risks acquiring incomplete or inaccurate information, as unofficial resources may not cover all required topics or may present information in a misleading way. This approach lacks diligence and fails to ensure comprehensive preparation, potentially leading to a misrepresentation of competence. Professional Reasoning: Professionals preparing for specialized qualifications should adopt a systematic and evidence-based approach to their learning. This involves understanding the learning objectives of the qualification, identifying reliable and comprehensive resources, and structuring their study time effectively. A decision-making framework should prioritize understanding over rote memorization, application over passive reception of information, and self-assessment over blind confidence. This ensures that preparation is not just about passing an exam, but about developing the necessary skills and knowledge for competent professional practice.

Scenario Analysis: This scenario presents a professional challenge due to the potential for rapid deterioration of a patient’s condition in a remote tropical setting, where diagnostic resources are limited and immediate access to advanced medical care is not guaranteed. The clinician must balance the urgency of the situation with the need for accurate diagnosis and appropriate management, considering the specific epidemiological context of Latin America and the principles of tropical medicine. This requires a strong foundation in biomedical sciences to interpret clinical signs and symptoms in light of potential infectious agents and their pathophysiology, integrated with practical clinical decision-making under resource constraints. Correct Approach Analysis: The best professional practice involves a systematic approach that begins with a comprehensive clinical assessment, including a detailed history and physical examination, to identify key signs and symptoms suggestive of specific tropical diseases. This is followed by the judicious selection of readily available diagnostic tests that can confirm or rule out the most probable diagnoses, considering the patient’s travel history and local epidemiology. Management should then be initiated based on confirmed diagnoses or strong clinical suspicion, with a clear plan for monitoring and escalation of care if the patient’s condition changes. This approach is ethically sound as it prioritizes patient well-being through evidence-based practice and resource-appropriate care. It aligns with the principles of good medical practice, emphasizing thoroughness and a structured diagnostic pathway. Incorrect Approaches Analysis: One incorrect approach involves immediately initiating broad-spectrum antibiotic therapy without a clear diagnostic hypothesis or confirmation. This is professionally unacceptable because it can lead to antibiotic resistance, mask underlying diagnoses, and potentially cause adverse drug reactions without addressing the root cause of the illness. It bypasses the crucial step of differential diagnosis informed by biomedical sciences. Another incorrect approach is to rely solely on symptomatic treatment without attempting to identify the underlying cause. While symptomatic relief is important, neglecting the diagnostic process in a tropical setting where many serious infections present with non-specific symptoms is a significant ethical and professional failing. This can result in delayed or missed diagnoses of life-threatening conditions, such as severe malaria, dengue hemorrhagic fever, or typhoid fever, leading to poor patient outcomes. A third incorrect approach is to over-rely on advanced diagnostic techniques that are not available in the setting, leading to delays in initiating potentially life-saving treatment. While understanding advanced diagnostics is part of biomedical science, practical application in resource-limited environments requires prioritizing accessible and relevant investigations. This approach fails to adapt clinical practice to the realities of the practice environment. Professional Reasoning: Professionals should employ a diagnostic reasoning framework that integrates knowledge of tropical diseases, their pathophysiology (biomedical sciences), and clinical presentation. This involves forming a differential diagnosis based on the patient’s symptoms, signs, and epidemiological context. The next step is to prioritize investigations that are feasible, accessible, and most likely to yield a definitive diagnosis or significantly narrow down the possibilities. Treatment decisions should be guided by confirmed diagnoses or strong clinical suspicion, with continuous reassessment of the patient’s condition and a plan for referral or evacuation if necessary.

This scenario presents a professional challenge due to the inherent complexities of addressing health disparities within a specific geographic and demographic context. The practitioner must navigate the intersection of population health data, epidemiological trends, and the ethical imperative of health equity, all while operating within the framework of Latin American public health initiatives and tropical medicine best practices. Careful judgment is required to ensure interventions are not only scientifically sound but also culturally sensitive and equitable. The best professional approach involves a comprehensive, multi-faceted strategy that prioritizes community engagement and culturally appropriate interventions. This entails working collaboratively with local health authorities and community leaders to understand the root causes of health inequities, such as socioeconomic factors, access to healthcare, and environmental determinants. Interventions should be designed to address these underlying issues, leveraging epidemiological data to target high-risk populations and tailor public health messages and services to be accessible and relevant to the specific cultural contexts of the region. This aligns with the principles of health equity, which advocate for the fair distribution of health resources and opportunities, and the ethical obligation to serve vulnerable populations effectively. An approach that focuses solely on disease surveillance and reporting, without actively engaging the community or addressing social determinants of health, is professionally unacceptable. This fails to acknowledge the broader factors contributing to health disparities and limits the effectiveness of interventions to mere symptom management. It neglects the ethical responsibility to promote well-being beyond the absence of disease. Another professionally unacceptable approach is to implement standardized, top-down health programs without considering local variations in disease prevalence, cultural practices, or access to resources. This can lead to ineffective or even harmful interventions that do not meet the specific needs of the population and can exacerbate existing inequities by failing to reach those most in need. It demonstrates a lack of understanding of the principles of applied tropical medicine and population health in diverse settings. A third professionally unacceptable approach is to prioritize interventions based on perceived economic impact or ease of implementation, rather than on the greatest need or potential for improving health equity. This approach is ethically flawed as it suggests that certain populations or health issues are less deserving of attention or resources, directly contradicting the core tenets of health equity. Professionals should employ a decision-making framework that begins with a thorough assessment of the local context, including epidemiological data, socioeconomic conditions, and cultural norms. This should be followed by collaborative planning with stakeholders, including community members and local health officials, to co-design interventions that are evidence-based, culturally appropriate, and equitable. Continuous monitoring and evaluation are crucial to adapt strategies and ensure they are achieving their intended health equity outcomes.

Scenario Analysis: This scenario presents a professional challenge rooted in the intersection of cultural sensitivity, patient autonomy, and the ethical imperative to provide comprehensive care within the context of Latin American travel medicine. The physician must navigate potential cultural norms regarding family involvement in decision-making while upholding the patient’s right to self-determination and ensuring they receive medically appropriate advice. The complexity arises from balancing respect for cultural practices with the fundamental ethical principles of informed consent and beneficence, particularly when a patient’s choices might have significant health implications for themselves and potentially others. Correct Approach Analysis: The best professional approach involves a direct, respectful, and culturally sensitive conversation with the patient, focusing on understanding their concerns and providing clear, unbiased information about the risks and benefits of vaccination. This approach prioritizes the patient’s autonomy and right to make informed decisions about their own health. It involves actively listening to the patient’s reservations, exploring the underlying reasons for their reluctance (which may be influenced by family beliefs or misinformation), and then offering tailored education. This aligns with the ethical principles of autonomy and beneficence, ensuring the patient is empowered to make a decision that is both informed and aligned with their values, while also receiving medically sound guidance. This also reflects principles of health systems science by acknowledging the social determinants of health and the importance of patient-centered care within a broader health context. Incorrect Approaches Analysis: One incorrect approach involves deferring the decision solely to the patient’s family without a thorough discussion with the patient themselves. This violates the principle of patient autonomy, as it bypasses the individual’s right to make decisions about their own body and health. It also risks misinterpreting family wishes as the patient’s own, potentially leading to a decision that is not truly in the patient’s best interest. Another incorrect approach is to dismiss the patient’s concerns outright and insist on vaccination without further exploration. This demonstrates a lack of cultural sensitivity and disrespect for the patient’s perspective. It fails to build trust and can lead to non-adherence or a feeling of coercion, undermining the therapeutic relationship and the effectiveness of the consultation. A third incorrect approach is to provide information about vaccination risks without equally emphasizing the benefits and the risks of not vaccinating, or to present information in a way that subtly pressures the patient towards a specific decision. This compromises the principle of providing balanced and unbiased information, which is fundamental to informed consent. It shifts the focus from empowering the patient to making a choice to influencing their choice, which is ethically problematic. Professional Reasoning: Professionals should employ a shared decision-making model. This involves: 1) Eliciting the patient’s preferences and values. 2) Providing clear, balanced, and understandable information about all available options, including the risks and benefits of each, and the implications of no treatment. 3) Exploring the patient’s understanding and addressing any misconceptions. 4) Collaboratively agreeing on a course of action that respects the patient’s autonomy and aligns with their values and medical best practice. In situations involving potential cultural influences, it is crucial to inquire about family involvement in decision-making respectfully, while always reaffirming the patient’s ultimate right to decide.

Scenario Analysis: This scenario presents a common challenge in tropical medicine practice: a patient with a constellation of symptoms that could indicate multiple, potentially serious, conditions prevalent in Latin America. The professional challenge lies in efficiently and accurately narrowing down the differential diagnosis while considering the patient’s limited access to advanced diagnostics and the potential for rapid disease progression. The urgency of the situation, coupled with the need for cost-effectiveness and patient safety, demands a systematic and evidence-based approach to diagnostic reasoning and imaging selection. Correct Approach Analysis: The best approach involves a structured diagnostic reasoning process that prioritizes common and treatable conditions based on the patient’s clinical presentation, epidemiological context, and initial laboratory findings. This starts with a thorough history and physical examination to generate a broad differential diagnosis. Subsequently, targeted, low-cost investigations like basic blood work (e.g., complete blood count, liver function tests, malaria smear if indicated by travel history and symptoms) are crucial for initial stratification. Imaging selection should then be guided by the most likely diagnoses and the availability of resources. For suspected visceral involvement or complex presentations, ultrasound is often the first-line imaging modality in resource-limited settings due to its portability, cost-effectiveness, and ability to visualize abdominal organs. Interpretation of imaging should be performed by a qualified practitioner or in consultation with a radiologist, correlating findings with clinical and laboratory data. This systematic, tiered approach ensures that investigations are relevant, cost-effective, and contribute meaningfully to diagnosis and management, aligning with ethical principles of beneficence and non-maleficence, and practical considerations of resource allocation in tropical medicine. Incorrect Approaches Analysis: An approach that immediately jumps to advanced imaging like a CT scan without a clear clinical indication or prior basic investigations is professionally unsound. This is because it bypasses essential steps in diagnostic reasoning, potentially leading to unnecessary costs, radiation exposure, and delays in initiating appropriate treatment for more common conditions. It fails to adhere to the principle of judicious resource utilization and may not be feasible or accessible in many Latin American practice settings. Another incorrect approach would be to rely solely on a single diagnostic test without considering the broader clinical picture or other potential diagnoses. For instance, ordering only a serological test for a specific tropical disease without considering other symptoms or performing initial blood work could lead to a missed diagnosis or a false sense of security if the test is negative but the patient’s condition worsens. This demonstrates a failure in systematic diagnostic reasoning and can violate the duty of care to thoroughly investigate a patient’s symptoms. Finally, interpreting imaging findings in isolation without correlating them with the patient’s clinical presentation and laboratory results is a significant professional failing. Imaging is a tool to support clinical diagnosis, not replace it. Misinterpreting findings or failing to integrate them into the overall clinical context can lead to incorrect diagnoses, inappropriate treatment, and potentially harmful outcomes for the patient, violating the principle of providing competent medical care. Professional Reasoning: Professionals should employ a diagnostic reasoning framework that begins with a comprehensive clinical assessment, including a detailed history and physical examination, considering the patient’s travel history and local epidemiology. This forms the basis for developing a differential diagnosis. Investigations should then be ordered in a stepwise manner, starting with low-cost, high-yield tests that help stratify risk and narrow down the possibilities. Imaging selection should be guided by the most probable diagnoses and the availability of appropriate technology, prioritizing modalities that offer the best diagnostic yield for the suspected conditions in the given resource setting. Interpretation of all diagnostic data must be integrated with the clinical picture to arrive at a definitive diagnosis and guide management. Continuous reassessment of the diagnostic plan based on new information is also critical.