Journal of General Internal Medicine

, Volume 33, Issue 2, pp 226–230 | Cite as

Pivot and Cluster: An Exercise in Clinical Reasoning

  • Jori E. May
  • Reaford J. Blackburn
  • Robert M. Centor
  • Gurpreet Dhaliwal
Clinical Practice: Exercises in Clinical Reasoning


clinical reasoning urticaria whiteboard pivot and cluster 



This case was presented at the annual meeting of the 2016 Alabama chapter of the American College of Physicians (ACP) and at the 2017 national ACP meeting.

Compliance with Ethical Standards

Conflict of Interest

Drs. May, Blackburn, and Centor declare that they have no conflict of interest. Dr. Dhaliwal reports receiving honoraria from ISMIE Mutual Insurance Company and Physicians’ Reciprocal Insurers.


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Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  • Jori E. May
    • 1
  • Reaford J. Blackburn
    • 2
  • Robert M. Centor
    • 1
    • 3
  • Gurpreet Dhaliwal
    • 4
    • 5
  1. 1.Department of Medicine University of Alabama at BirminghamBirminghamUSA
  2. 2.Lake Cumberland Regional HospitalSomersetUSA
  3. 3.Medical ServicesBirmingham VA Medical CenterBirminghamUSA
  4. 4.Department of MedicineUniversity of California San FranciscoSan FranciscoUSA
  5. 5.Medical ServiceSan Francisco VA Medical CenterSan FranciscoUSA

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