This is a testimonilal placeholder text
Questionnaire for Sigmund Freud’s Paper CIMDL.
Formbricks data entry: https://forms.medlibre.ai/s/cm8ncc7pv000fb3012cpgbht9
Prompt TEASER: to be filled
Prompt MAIN: to be filled
Prompt CONSENSUS: to be filled
Excerl Sheet with 100 questions: https://consultation.medlibre.ai/own
PROJECT INFO: https://medlibre.craft.me/tVk8OQB3c2tdHw
CONSENSUS DIAGNOSIS: OSCC
CONSENSUS CIMDL PROBABILITY (0–1, two decimals): 0.07
MERGED ITEMS (Q1–Q10):
Q1: Negative
Q2: Negative
Q3: Negative
Q4: Negative
Q5: Negative
Q6: Negative
Q7: Positive
Q8: Positive
Q9: Negative
Q10: Positive
ADJUDICATOR NOTE (≤5 lines):
– Both summaries agree on OSCC and have decisive positives on Q7/Q8; consensus probability is the average.
– Proceed urgently with in-person head & neck exam, biopsy, and staging imaging; do not delay tissue diagnosis for imaging.
– Seek ED care now for bleeding, airway difficulty, dehydration, or uncontrolled pain.
I’m sorry you’re going through this—given a non-healing oral ulcer plus a neck lump and weight loss, oral cancer is considerably more likely than other causes, and the chance of a CIMDL-type nasal process is low. Yes, you need an urgent biopsy and imaging: arrange a same-day tele-triage to review symptoms/meds and share clear photos, then an ENT/OMFS visit within 24–72 hours for an incisional biopsy of the ulcer and an ultrasound-guided FNA of the neck lump (ideally the same day). Obtain contrast-enhanced MRI of face/neck (or CT neck with contrast if faster) and a chest CT for staging in parallel; get basic labs (CBC, CMP, coagulation) beforehand to safely use contrast. If imaging access lags, do not postpone the biopsy—tissue diagnosis comes first. In the meantime, use a soft diet, optimize pain control, and avoid tobacco/alcohol; go to the ER immediately for bleeding, drooling or breathing trouble, dehydration, or pain you cannot control.
DIAGNOSIS: OSCC
CIMDL PROBABILITY (0–1, two decimals): 0.03
ITEMS (Q1–Q10):
Q1: Negative — “No food or drink comes back through my nose.”
Q2: Negative — “I don’t sound nasal.”
Q3: Negative — “Sometimes I feel a stuffy nose… occasional congestion.”
Q4: Negative — “No persistent nasal crusting or foul smell.”
Q5: Negative — “No frequent nosebleeds.”
Q6: Negative — “My sense of smell is fine.”
Q7: Positive — “deep, constant mouth pain… shoots to my ear.”
Q8: Positive — “persistent mouth ulcer with raised, firm edges that bleeds easily.”
Q9: Negative — “No major prior treatments.”
Q10: Positive — “I’ve unintentionally lost weight… a lump in my neck.”
SUMMARY (patient-facing, ≤5 lines):
– What we heard: “persistent mouth ulcer with firm edges,” “pain to the ear,” “weight loss and a neck lump.”
– What this might mean: These are red flags that make oral cancer more likely than a nasal/autoimmune cause.
– Next steps: Urgent in-person exam with ENT/head & neck or OMFS (days, not weeks); same-day/next-available incisional biopsy of the ulcer and fine-needle aspiration of the neck lump; arrange contrast CT neck and CT chest (can be parallel to biopsy) with basic labs for contrast; stop tobacco/alcohol; soft diet and pain control; seek ER care if bleeding, drooling, or breathing trouble.
DIAGNOSIS: OSCC
CIMDL PROBABILITY (0–1, two decimals): 0.10
ITEMS (Q1–Q10):
Q1: Negative — “not reported”
Q2: Negative — “not reported”
Q3: Negative — “not reported”
Q4: Negative — “not reported”
Q5: Negative — “not reported”
Q6: Negative — “not reported”
Q7: Positive — “non-healing ulcer”
Q8: Positive — “neck lump”
Q9: Negative — “not reported”
Q10: Positive — “weight loss”
CLINICAL RATIONALE (≤6 lines):
– Strong OSCC signals: “non-healing ulcer” and “neck lump.”
– Supportive OSCC feature: “weight loss.”
– No CIMDL hallmarks reported (no “intranasal cocaine,” “septal/palatal perforation,” or “midline nasal destruction”).
– Therefore CIMDL probability low; OSCC is the working diagnosis pending tissue diagnosis.
TRIAGE (≤3 lines):
– Urgent in-person evaluation within 24–72 hours for exam, biopsy, and staging.
– If rapid slots available, obtain imaging before or within 24–48 hours of biopsy; do not delay tissue diagnosis if imaging access is slower.
– Go to ED now if bleeding, airway compromise, dehydration, or uncontrolled pain.
AIDOC STEPS (brief, one line each):
1. Arrange urgent head and neck exam by OMFS/ENT within 24–72 hours.
2. High-quality intraoral and neck photos and pain/bleeding review (tele-triage today).
3. Contrast-enhanced MRI of face/neck (preferred) or CT neck with contrast; add dedicated maxillofacial CT if bone invasion suspected.
4. Ultrasound-guided FNA of the “neck lump” during the same visit as imaging if possible.
5. Incisional biopsy of the oral ulcer at the indurated edge (avoid necrotic center); plan hemostasis and review anticoagulants.
6. Baseline labs: CBC, CMP, coagulation profile; consider chest CT for staging.
7. Risk counseling and cessation support (tobacco/alcohol if applicable); nutritional support referral.
8. Expedite pathology with priority processing; request HPV/p16 only if oropharyngeal site suspected.
9. Review results within 5–7 days and refer to multidisciplinary tumor board for definitive staging and management.
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
Ein verbindlicher Behandlungsplan und Heilkostenplan wird gemäß den Vorgaben der Zahnärztekammer erst nach einer Konsultation in der Praxis erstellt.
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