Classic Presentations Flashcards
A patient presents with a tongue that is red, smooth (loss of lingual papillae) and sore
Glossitis (caused by B12 deficiency)
An obese patient presents with heartburn aggravated by lying down, a nocturnal cough, regurgitation of food and acid and excessive salivation
GORD
A patient experiences intermittent dysphagia for both solids and liquids, regurgitation (particularly at night) and chest pains (spasms). A barium swallow shows a bird-beak appearance
Achalasia
A patient reports feelings of early fullness, bloating, N&V, weight loss and abdominal pain
Gastroparesis
A patient presents with burning upper abdominal pain that improves with eating
Duodenal ulcer
A patient presents with burning upper abdominal pain that is exacerbated with eating
Gastric ulcer
A patient vomits coffee-ground vomit
Upper GI bleed caused by peptic ulcer disease
A female patient complains of abdominal pain, weight loss, diarrhoea and steatorrhoea. On examination the patient has mouth ulcers and angular stomatitis
Coeliac disease
A patient has severe abdominal colicky pain, abdominal distension and tenderness and reduced bowel sounds
Small bowel obstruction (gallstone ileus, Chron’s, strangulated hernia etc)
A patient has epigastric pain that moves into the RIF (McBurney’s point). They also have N&V and a low grade fever. They have rebound tenderness and Roving’s pain (pain in RIF when LIF palpated)
Appendicitis
A child develops viral diarrhoea. The most common cause is…
Rotavirus
A patient presents with food poisoning. The most common cause is…
Campylobacter
Which of the following require a stool culture, stool toxin or stool PCR:
- Salmonella
- C.diff
- Norovirus
- Campylobacter
- Shigella
- E.coli
- Salmonella, campylobacter & shigella = stool culture
- C.diff & E.coli = stool toxin
- Norovirus = Stool PCR
A young patient reports abdominal cramps, diarrhoea, weight loss and painful ulcers in mouth and rectum
Crohn’s disease
A 30 year old patient experiences diarrhoea + bleeding + mucus, increased bowel frequency, night rising, lower abdominal pain, weight loss, urgency, tenesmus and incontinence
Ulcerative colitis
A 60 year old patient presents with left sided abdominal pain, altered bowel habit and nausea
Diverticular disease
A patient presents with bloody diarrhoea and cramping abdominal pain
Infective colitis (C. difficile, Campylobacter, Shigella, E. coli 0157) OR Ischaemic colitis (obstruction, atherosclerosis of mesenteric vessels)
A young woman on the pill presents with fatigue, discomfort, myalgia and loss of appetite. On examination she is found to have jaundice. Blood tests show ↑AST ↑ALT, ↑CRP, ANA +ve, SMA +ve, anti-LKM +ve, ↑IgG
Autoimmune hepatitis
A patient presents with jaundice, N&V, steatorrhoea, ascites, hepatosplenomegaly, spider naevi and caput medusa. LFTs show ↑AST, ↑GGT
Alcoholic liver disease
An obese patient begins to show signs of liver disease
Late stage NAFLD
A middle aged woman presents with fatigue and an itch without a rash. On examination you see xanthelasma, jaundice and hepatosplenomegaly. LFTs show a cholestatic pattern
Primary biliary cirrhosis
A female patient presets with signs of liver disease and joint pain. Examination shows hepatomegaly and a slate grey appearance. TFTs show hypothyroidism and LFTs show↑AST ↑ALT, ↑IgG
Haemochromatosis
A patient presents with signs of liver disease. On examination, Kayser-fleisher rings can be seen in the eyes
Wilson’s disease
A 40 year old, obese female patient presents with RUQ colicky pain (± radiation to shoulder) and N&V
Biliary colic
A 40 year old, obese female patient presents with constant RUQ pain (± radiation to shoulder), fever, vomiting, tenderness, guarding and +ve Murphy’s sign
Acute cholecystitis
A patient presents with Charcoat’s triad (jaundice, fever, RUQ pain), pale stool, dark urine and puritis. LFTs show obstructive jaundice
Ascending cholangitis
A male patient with ulcerative colitis presents with, fatigue, fever, RUQ pain, pruritis and weight loss. Blood tests show cholestatic LFTs
Primary sclerosing cholangitis
A patient presents with severe epigastric pain that radiates to the back, fever, nausea, vomiting, loss of appetite, Grey Turner’s sign (flank bruising) and Cullen’s sign (periumbilical bruising
Acute pancreatitis
A patient with a history of alcohol abuse presents with chronic abdominal pain and steatorrhoea
Chronic pancreatitis
A patient presents with abdominal and back pain, weight loss, jaundice, pale stool and dark urine
Pancreatic cancer
A patient presents with a groin lump that you cannot get above and is non-pulsatile
Femoral hernia
A patient presents with a groin lump that you cannot get above and is pulsatile
Femoral artery aneurysm
A patient with a history of IVDU presents with a groin lump, fever, back pain and a limp
Psoas abscess
A patient presents with a leg that is pale, painful and cold. They report parasthaesia and paralysis in the limb and on examination no pulses can be found
Acute limb ischemia
A patient presents with a leg with the ‘6Ps’ of limb ischemia. They have a PMH of claudication
Acute on chronic limb ischemia
A patient has a relatively normal looking leg but is complaining of extreme pain. There is pain on passive stretch, parasthaeisa and paralysis. Peripheral pulses are present
Compartment syndrome
A patient experiences claudication after short distances. They also report rest pain for >2 weeks that is worse at night and relieved by swinging the foot over the edge of the bed. They also have a non-healing ulcer
Critical limb ischemia
A patient presents with diffuse, constant abdominal pain and N&V. Abdominal exam is unremarkable. They have a PMH of AF. Blood gases show acidosis and lactate is elevated
Mesenteric ischaemia
