Classic Presentations Flashcards
White plaques on the oral mucosa which can be rubbed off with a painless, red base underneath
Oral candidiasis
Raised, sharply defined white patches found on the oral mucosa which cannot be rubbed off
Leukoplakia
Raised, sharply defined red patches found on the oral mucosa which cannot be rubbed off
Erythroplakia
40 year old presents with numerous “finger like” projections in and around the mouth
Squamous cell papilloma
55 year old smoker develops a non-healing ulcer on his lip
Squamous cell carcinoma
Slow growing, painless, firm single nodular mass over the parotid gland
Pleomorphic adenoma
Colicky, postprandial pain and swelling in the mouth
Salivary gland stone
Red, smooth and sore tongue
Glossitis
Obese patient presents with burning in the chest that is exacerbated by bending/lying down, acid reflux and nocturnal cough
GORD
Adult patient presents with intermittent dyspagia and regurgitation of undigested food, especially at night
Achalasia
20 year old presents with haematemesis following a night out
Mallory-Weiss tear
A 65 year old, male heavy drinker and smoker who has previously been diagnosed with Barrets oesophagus presents with progressive dysphagia, weight loss and lymphadenopathy
Oesophageal cancer
- Squamous cell carcinoma = related to diet and smoking
- Adenocarcinoma = associated with Barrett’s oesophagus
Patient with known liver disease presents with violent haematemesis
Oesophageal varices
50 year old presents with heartburn, acid reflux, bad breath, nausea and dysphagia
Hiatus hernia
Patient presents with early satiety, nausea and vomiting, weight loss, bloating, abdo pain and loss of appetite
Gastroparesis
Postprandial epigastric pain, relieved by food + nausea, bloating, belching
Duodenal ulcer
Postprandial epigastric pain worsened by food + nausea, bloating, belching
Gastric ulcer
60 year old male presents with epigastric pain, nausea and vomiting, anorexia and weight loss
Gastric cancer - mainly adenocarcinoma
60 year old presents with dyspepsia, epigastric discomfort, gastric bleeding, fatigue, low-grade fevers, nausea, constipation, weight loss, anaemia & recurrent RTIs
Gastric lymphoma
Periumbilical pain (usually vaguely in centre of abdomen) which eventually moves and becomes localized in the RIF in the first few hours + nausea, vomiting & anorexia
Appendicitis
30 year old woman with non-specific symptoms such as diarrhoea/steatorrhoea, abdo pain, angular stomatitis/mouth ulcers and weight loss +/- an itchy, symmetrical rash on the scalp, shoulders, buttocks, elbows and knees
Coeliac disease
60 year old with a past medical history of AF presents with moderate-to-severe colicky or constant and poorly localised pain out of proportion to physical signs
Acute mesenteric ischemia
60 year old with a history of hypertension and hyperlipidaemia presents with postprandial pain which is moderate-to-severe colicky or constant poorly localised pain + weight loss and a fear of eating
Chronic mesenteric ischemia
70 year old with a history of atherosclerosis and arrhythmia presents with severe left iliac fossa pain, bloody stool and nausea and vomiting
Ischemic colitis
Lump which is worst on coughing, disappears when lying down, and can be pushed back in
Hernia
Patient presents with severe diffuse colicky abdominal pain, EARLY vomiting, LATE constipation and decreased tinkling bowel sounds
Small bowel obstruction
A patient with a history of peptic ulcers presents with acute abdominal pain and guarding, rigidity, fever and tachycardia
Peritonitis
A patient post-op for abdominal surgery presents with lack of bowel movements and absent bowel sounds
Ilius
May present with rectal bleeding/diarrhoea/abdominal pain/mucous discharge but are most often incidental findings on colonoscopy
Colonic polyps (adenoms)
A 60 year old man presents with tiredness (shown on bloods to be caused be caused by anaemia) and weight loss
Colorectal cancer -majority are adenocarcinomas
A 70 year old obese patient presents with non-specific left sided lower abdominal pain and no other symptoms or concerning factors
Diverticular disease (symptomatic diverticulosis)
An obese older patient presents with LIF pain (exacerbated by eating and diminished by defecation or flatus), constipation and pyrexia
Diverticulitis
Patient presents with severe diffuse colicky abdominal pain, LATE vomiting, EARLY constipation and tinkling bowel sounds
Large bowel obstruction
An elderly patient presents with sudden onset colicky lower abdominal pain with gross abdominal distension and a failure to pas either flatus or stool + tympanic abdomen on examination
Volvulus (either sigmoid or caecal)
A classic appendicitis patient presents with RIF pain and fever but when you operate the appendix is fine - what else can mimic appendicitis
Meckel’s diverticulum
2 year old presents with watery diarrhoea, pyrexia and vomiting. Similar symptoms have been occurring in other children in their nursery
Rotavirus
Normally fit and healthy adult presents with diarrhoea and explosive vomiting + pyrexia during the winter
Noravirus
Patient presents with watery diarrhoea and abdominal cramps or nausea and vomiting 1-6 hours after eating leftover curry from the night before
Gastroenteritis caused by bacillus cereus
Patient presents with nausea, explosive vomiting, abdominal cramps/pain, headache, weakness and diarrhoea 1-6 hours after eating funny tasting cheese
Gastroenteritis caused by staph aureus
Patient presents with bloody diarrhoea, abdominal pain, fever, headache, nausea, and/or vomiting 2-14 days after eating undercooked meat and raw milk
Gastroenteritis caused by campylobacter
Patient presents with diarrhoea, fever, abdominal cramps and vomiting 12-48 hours after eating a dish containing raw eggs and pink chicken
Gastroenteritis caused by salmonella
Patient presents with intense abdominal cramps and watery diarrhea but no fever or vomiting 12-48 hours after eating food that was left to sit for a few hours before being eaten
Gastroenteritis caused by clostridium perfringens
Patient presents with bloody diarrhoea and stomach cramps 2-14 days after going to a petting zoo
Gastroenteritis caused by E. coli 0157
5-10 days after a child presents with with abdominal cramps, bloody diarrhoea and a mild fever, they begin to develop blood in the urine with a decreased urine output and anaemia
Hemolytic–uremic syndrome (often after E. coli 0157 infection)
A patient presents with diarrhoea containing blood and mucus + abdominal cramps and high fever after changing the nappy of a baby with similar symptoms
Shigellosis (caused by shigella) - also called dysentery
A 27 year old patient presents with long standing abdominal cramps, diarrhoea and weight loss =/- mouth ulcers
Chron’s disease
A 35 year old patient presents with long-standing bloody diarrhoea + mucus, increased bowel frequency and urgency, tenesmus and weight loss
Ulcerative colitis
22 year old woman presents with abdominal pain, bloating, mucus in stool and feeling of incomplete emptying for several months. She has a PMH of anxiety
IBS
Patient presents with anal pain on defecation and some fresh blood
Anal fissures
Patient presents with perianal pain and bleeding, faecal incontinence and a palpable mass
Anal cancer
Patient presents with painless fresh bleeding on defecation
Haemorrhoids
An IVDU patient presents with fatigue, nausea, vomiting, poor appetite and RUQ pain +/- jaundice
Hepatitis
A 25 year old woman with rheumatoid arthritis and type 1 diabetes (or other autoimmune conditions) who is taking the pill begins feeling tired and generally unwell, has muscle pain, low appetite, bloating, diarrhoea, nausea and puritius
Autoimmune hepatitis
A patient with a history of alcohol excess presents with persistent fatigue, malaise, RUQ pain and hepatomegaly
Alcoholic fatty liver disease
An obese, diabetic patient without a history of alcohol excess presents with persistent fatigue, malaise, RUQ pain and hepatomegaly
Non-alcoholic fatty liver disease
Patient with known liver disease presents with oedema, ascites, easy bruising, poor concentration and memory, bleeding oesophageal varices, jaundice, pruritis, spider naevi, bruising, finger clubbing and hepatomegaly
Cirrhosis
A patient with known cirrhosis begins to have increased jaundice, ascites and RUQ pain and starts to lose weight. Radiology shows a mass in the liver
Hepatocellular carcinoma
A 45 year old woman with a history of gallstones, thyroid disease, and Crohn’s diseasepresents with fatigue, puritis and RUQ pain
Primary biliary cirrhosis
A patient with ulcerative colitis presents with tiredness and abdominal discomfort with abnormal LFTs that eventually leads to itching, jaundice and hepatomegaly and splenomegaly
Primary sclerosing cholangitis
A patient who works in the aviation industry and used to work in the rubber industry presents with jaundice, weight loss, RUQ pain, pruritis, hepatomegaly, splenomegaly and a palpable gallbladder
Cholangiocarcinoma
A 55 year old woman presents with fatigue, weight loss, weakness, joint pain, hepatomegaly, hypothyroidism and a slate grey or bronze appearance
Haemachromatosis
A 19 year old presents with a dramatic personality change, signs of liver disease and Kayser-fleisher rings
Wilson’s disease
