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Clinical presentations Flashcards

1
Q

Abdominal distension

A 
Intestinal obstruction
Ascites
Intestinal ischaemia
Abdominal mass
Pregnancy
Obesity
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2
Q

RUQ abdominal mass

A

Hepatic: Hepatomegaly
Biliary: Cholangiocarcinoma; Cholecystitis; Gallstones and biliary colic

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3
Q

Epigastric abdominal mass

A

Gastric: Gastric cancer
Pancreatic: Pancreatic abscess (pancreatitis); Pancreatic cancer; Pancreatic pseudocyst (pancreatitis)
Hepatic: Hepatomegaly

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4
Q

LUQ abdominal mass

A

Splenic: Splenomegaly
Gastric: Gastric cancer
Pancreatic: Pancreatic cancer; Pancreatic pseudocyst (pancreatitis); Pancreatic abscess (pancreatitis)
Renal: Hydronephrosis (urinary tract calculi); Renal cell carcinoma; Polycystic kidney disease

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5
Q

Right iliac fossa abdominal mass

A

Gastrointestinal: Appendix mass or abscess (appendicitis); Colorectal carcinoma; Crohn’s disease; Hernias (femoral, inguinal, miscellaneous)
Infection: Tuberculosis
Renal: Renal transplantation
Gynaecological: Ovarian tumour; Ovarian cyst

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6
Q

Suprapubic abdominal mass

A

Urological: Urinary retention; Bladder cancer
Gynaecological: Pregnancy; Fibroids

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7
Q

Left iliac fossa abdominal mass

A

Renal: Renal transplantation
Gynaecological: Ovarian cyst; Ovarian tumour
Gastrointestinal: Diverticular disease; Colorectal carcinoma; constipation; Hernias (inguinal, femoral, miscellaneous); Crohn’s disease

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8
Q

Right/left flank abdominal mass

A

Hydronephrosis (urinary tract calculi)
Renal cell carcinoma
Polycystic kidney disease

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9
Q

Umbilical abdominal mass

A

Gastrointestinal: Periumbilical and umbilical hernia; Gastric cancer; Colorectal carcinoma; Lymphoma (Hodgkin’s and non-Hodgkin’s)
Vascular: Abdominal aortic aneurysm

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10
Q

RUQ abdominal pain

A

Biliary: Gallstones and biliary colic; Cholecystitis
Hepatic: Hepatitis (viral, alcoholic, autoimmune); Hepatocellular carcinoma; Liver abscesses
Gastrointestinal: Colorectal carcinoma

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11
Q

Epigastric abdominal pain

A

Gastric: Peptic ulcer disease and gastritis; GORD; Gastric cancer; Dyspepsia
Pancreatic: Pancreatitis; Pancreatic cancer
Cardiac: Ischaemic heart disease (angina pectoris, acute coronary syndrome, myocardial infarction)

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12
Q

LUQ abdominal pain

A

Splenic: Abscess; Splenomegaly; Splenic rupture (traumatic injury incl. blunt, penetrating, crush and blast); Splenic infarction (cancer, antiphospholipid syndrome, atrial fibrillation/flutter, sickle cell disease)
Gastrointestinal: Colorectal carcinoma

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13
Q

Right/left flank abdominal pain

A

Vascular: Aortic dissection
Renal: Urinary tract calculi; Pyelonephritis (UTI); Renal cell carcinoma; Polycystic kidney disease

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14
Q

Lower abdominal pain

A

Urological: UTI; Urinary retention; Urinary tract calculi
Gynaecological: Ovarian torsion (ovarian cyst); Endometriosis; Ectopic pregnancy; Pelvic inflammatory disease; Ruptured ovarian cyst; Ovarian tumour
Gastrointestinal: Appendicitis; Diverticular disease; Ulcerative colitis; Crohn’s disease; Colorectal carcinoma; Constipation

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15
Q

Central and diffuse abdominal pain

A

Gastrointestinal: Intestinal obstruction; GI perforation (open abdominal surgery incl. laparotomy, laparoscopic abdominal surgery); Functional dyspepsia and IBS
Infectious: Gastroenteritis and infectious colitis; Peritonitis
Vascular: Intestinal ischaemia; Abdominal aortic aneurysm
Metabolic: Diabetic ketoacidosis (DM); Addisonian crisis (adrenal insufficiency); Hypercalcaemia
Haematological: Sickle cell disease
Inflammatory: Vasculitides

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16
Q

Abnormal LFTs: raised aminotransferases

A 
Liver failure
Cirrhosis
Viral hepatitis
Alcoholic hepatitis
Autoimmune hepatitis
Non-alcoholic steatohepatitis (NASH)
Wilson's disease
Sepsis syndromes
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17
Q

Abnormal LFTs: markedly raised ALP

A

Extrahepatic biliary obstruction

Intrahepatic cholestasis

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18
Q

Abnormal LFTs: moderately raised ALP

A

Hepatic: Viral hepatitis; Alcoholic hepatitis; Autoimmune hepatitis; Non-alcoholic steatohepatitis; Amyloidosis; Sarcoidosis; Tuberculosis; Liver abscesses; Sepsis syndromes
Non-hepatic: Pregnancy; Osteomalacia; Paget’s disease of bone; Hyperparathyroidism; Thyrotoxicosis; Diabetes mellitus; Cancer

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19
Q

Abnormal LFTs: raised GGT

A

Substance use disorder: alcohol

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20
Q

Abnormal LFTs: raised bilirubin

A

Hyperbilirubinaemia

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21
Q

Abnormal lung function tests (obstructive)

A

Asthma

COPD

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22
Q

Abnormal lung function tests (restrictive)

A

Intrinsic: Pulmonary fibrosis (idiopathic, rheumatoid arthritis, SLE, systemic sclerosis, ankylosing spondylitis, extrinsic allergic alveolitis, pneumoconiosis, drugs)
Extrinsic: Kyphoscoliosis; Neuromuscular (Guillain-Barré syndrome, MND); Obesity

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23
Q

Metabolic acidosis: normal anion gap

A

Normal anion gap: loss of bicarbonate
High anion gap: Decreased renal acid excretion (CKD); increased acid production (lactic acidosis: sepsis syndromes; ketoacidosis: diabetic; aspirin overdose)

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24
Q

Respiratory acidosis: central depression

A

Drugs: Opiate overdose; Poisoning (TCAs, benzodiazepines, methanol, iron, lithium, digoxin); substance use disorder: drugs, alcohol
Respiratory centre depression

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25
Q

Respiratory acidosis: neuromuscular

A

Muscular dystrophy
MND
Guillain-Barré syndrome
Myasthenia gravis

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26
Q

Respiratory acidosis: respiratory

A

COPD

Asthma

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27
Q

Metabolic alkalosis

A

Gastrointestinal H+ loss: Nausea and vomiting
Renal H+ loss: Primary hyperaldosteronism
Intracellular H+ shift: Hypokalaemia

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28
Q

Respiratory alkalosis: central stimulation

A 
Anxiety: generalised anxiety disorder
Pain: palliative care
Fever
Pregnancy
CNS: Traumatic injury incl. blunt, penetrating, crush and blast; Stroke (ischaemic and haemorrhagic); Infection; Cancer
Drugs: Aspirin overdose
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29
Q

Respiratory alkalosis: respiratory

A 
Pulmonary embolism
Asthma
COPD
Pneumonia
Cardiac failure
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30
Q

Arthralgia: monoarthritis

A

Degenerative: Osteoarthritis
Inflammatory: Rheumatoid arthritis; Vasculitides; SLE; Sarcoidosis; Behçet’s disease; Seronegative arthritides (UC, Crohn’s, ankylosing spondylitis, psoriatic arthritis, reactive arthritis)
Infection: Septic arthritis
Metabolic: Crystal arthropathy (gout, pseudogout)
Traumatic injury (incl. blunt, penetrating, crush and blast)

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31
Q

Arthralgia: oligoarthritis

A

Infection: Infective endocarditis
Inflammatory: Seronegative arthritides (reactive arthritis, UC, Crohn’s, ankylosing spondylitis; psoriatic arthritis); Rheumatoid arthritis; Vasculitides; SLE; Sarcoidosis; Behçet’s disease; Sjögren’s syndrome
Degenerative: Osteoarthritis

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32
Q

Arthralgia: polyarthritis

A

Degenerative: Osteoarthritis
Inflammatory: Rheumatoid arthritis; Seronegative arthritides (UC, Crohn’s, ankylosing spondylitis, psoriatic arthritis, reactive arthritis); Vasculitides; SLE; Sarcoidosis; Behçet’s disease; Sjögren’s syndrome
Infection: Bacterial (Lyme disease, gonorrhoea); Viral (infectious mononucleosis, HIV); Post-infective (rheumatic fever)
Metabolic: Crystal arthropathy (gout, pseudogout); Haemochromatosis
Haematological: Sickle cell disease
Cancer

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33
Q

Ascites: exudative

A

Infection
Pancreatitis
Malignancy

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34
Q

Ascites: transudative

A

Hepatic: Cirrhosis
Cardiac: Cardiac failure; Constrictive pericarditis
Renal: CKD; Nephrotic syndrome
Ovarian: ovarian tumour

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35
Q

Ascites: haemorrhagic

A

Malignancy
Traumatic injury (incl. blunt, penetrating, crush and blast)
Acute pancreatitis

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36
Q

Back pain

A

Malignancy: Multiple myeloma; Metastases; Lymphoma; Leukaemia; CNS tumours
Mechanical: Osteoarthritis; Osteoporosis; Spondylosis and spondylolisthesis of the spine; spinal fracture; traumatic injury (incl. blunt, penetrating, crush and blast)
Infection: Osteomyelitis; Discitis of the spine
Inflammatory: Ankylosing spondylitis; Psoriatic spondylitis; Reactive arthritis; Enteropathic arthritis

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37
Q

Bradycardia

A 
Physiological: Physical fitness; Sleep
Cardiovascular: Ischaemic heart disease (angina pectoris, acute coronary syndrome, myocardial infarction); Cardiomyopathy; Myocarditis; Heart block; Congenital heart disease
CNS: Raised intracranial pressure
Endocrine: Hypothyroidism
Electrolyte disturbance: Hyperkalaemia; Hypokalaemia
Infection: Lyme disease
Drugs
Hypothermia
Eating disorder: Anorexia nervosa
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38
Q

Breast lump

A

Benign: Physiological; Fibroadenoma; Breast cysts; Mastitis/breast abscesses; Benign ductal disease (duct ectasia and papilloma); Lipoma
Malignant: Breast cancer

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39
Q

Breast pain

A

Cyclical: Physiological; Contraceptives; HRT
Non-cyclical: Breast cancer; Benign ductal disease (duct ectasia and papilloma); Mastitis/breast abscesses; Pregnancy; HRT
Extra-mammary: Chest wall pain; Spinal disorders

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40
Q

Calf swelling/pain

A

Unilateral: DVT; Peripheral vascular disease (acute and chronic limb ischaemia); Cellulitis and erysipelas; Trauma (compartment syndrome); Traumatic injury (incl. blunt, penetrating, crush and blast); Lymphoedema
Bilateral: Hypoalbuminaemia; Lymphoedema; Varicose veins; Peripheral vascular disease (acute and chronic limb ischaemia); Cardiac failure

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41
Q

Cerebellar signs (e.g. ataxia, dysdiadochokinesia)

A

Vascular: Stroke (ischaemic and haemorrhagic); TIA
Infection: Meningitis; Encephalitis; TB
Inflammatory: Sarcoidosis; Multiple sclerosis; Guillain-Barré syndrome; Coeliac disease
Toxic: Chemotherapy; Substance use disorder (alcohol)
Metabolic: Vitamin B12 deficiency; Thiamine deficiency
Endocrine: Hypothyroidism
Malignancy: CNS tumours; Metastases; Paraneoplastic syndromes
Hereditary
Degenerative: Wilson’s disease

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42
Q

Chest pain

A

Cardiovascular: Ischaemic heart disease (angina pectoris, acute coronary syndrome, myocardial infarction); Cardiac failure; Pericarditis; Cardiomyopathy; Aortic dissection
Respiratory: Pulmonary hypertension; Sarcoidosis; Pneumothorax; Lung cancer; Asthma; COPD; Pulmonary embolism; Pneumonia
Gastrointestinal: Pancreatitis; GORD; Peptic ulcer disease and gastritis
Musculoskeletal: Vasculitides; Traumatic injury (incl. blunt, penetrating, crush and blast)
Neurological: Spinal radiculopathy; Varicella zoster
Psychiatric: Anxiety disorder (panic disorder); Depressive disorder

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43
Q

Clotting profile abnormalities: abnormal APTT

A 
Haematological: Haemophilia; Von Willebrand's disease; Antiphospholipid syndrome
Drugs
Vitamin K deficiency
Liver failure
Disseminated intravascular coagulation
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44
Q

Clotting profile abnormalities: abnormal PT and INR

A

Drugs
Vitamin K deficiency
Liver failure
Disseminated intravascular coagulation (DIC)

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45
Q

Clubbing

A

Cardiovascular: Congenital heart disease; Infective endocarditis
Respiratory: Lung cancer; Bronchiectasis; Idiopathic pulmonary fibrosis; TB
Gastrointestinal: Crohn’s disease; UC; Cirrhosis; Lymphoma; Coeliac disease

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46
Q

Confusion (acute)

A

Vascular: TIA; Stroke (ischaemic and haemorrhagic)
Infection: Intracranial (meningitis, encephalitis); Extracranial (pneumonia, UTI)
Metabolic: Liver failure; CKD; Electrolyte disturbance (hypercalcaemia, hyponatraemia); Hypoxia (type 1 and 2 respiratory failure; Nutritional (vitamin B12 deficiency)
Endocrine: Hypoglycaemia; Hypothyroidism; Thyrotoxicosis; Adrenal insufficiency
Neurological: Post-ictal seizure
Neoplastic: CNS tumours
Drugs: Alcohol misuse; Drug misuse; Opiate overdose; Poisoning (TCAs, benzodiazepines, methanol, iron, lithium and digoxin)
Psychiatric: Psychotic disorders; Bipolar affective disorder
Trauma: Head injury; Intracranial haemorrhage

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47
Q

Constipation

A

Gastrointestinal: Obstruction (diverticular disease, hernia, colorectal carcinoma, UC, Crohn’s); Anorectal disease (anal fissure, rectal prolapse); Functional dysplasia and IBS
Endocrine: Diabetes mellitus; Hypothyroidism; Hypercalcaemia
Neurological: Parkinson’s disease; MS; Spinal cord injury
Drugs
Psychiatric: Anorexia nervosa
Diet: Low fibre intake; Poor fluid intake
Post-operative
Immobility

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48
Q

Cough

A

Infection: Pneumonia; TB; Upper respiratory tract infection
Respiratory: Asthma; COPD; Bronchiectasis; Lung cancer
Cardiovascular: Cardiac failure
Gastrointestinal: GORD
Drugs

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49
Q

Central cyanosis

A

Infection
Respiratory: Asthma; Pneumothorax; Right to left pulmonary shunt
Cardiac: Right to left cardiac shunt; Cardiac failure
Haematological: Sickle cell disease; Thalassaemia

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50
Q

Peripheral cyanosis

A

Arterial thrombosis
Sepsis syndromes
Raynaud’s phenomena

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51
Q

Decreased consciousness

A

Vascular: Subdural haemorrhage; Subarachnoid haemorrhage; Extradural haemorrhage; Stroke (ischaemic and haemorrhagic)
Infection: Meningitis; Encephalitis
Trauma: Head injury
Hypoxia: Cardiac arrest; Sepsis syndomes; Type 1 respiratory failure; Type 2 respiratory failure
Metabolic: Hypoglycaemia; Liver failure; CKD; Electrolyte disturbance (hypernatraemia, hyponatraemia, hyperkalaemia, hypokalaemia, hypercalcaemia)
Neurological: Raised intracranial pressure; Epilepsy
Malignancy: Space occupying lesion
Drugs

52
Q

Diarrhoea

A

Gastrointestinal: Infection (gastroenteritis and infectious colitis; Inflammatory bowel disease (UC and Crohn’s); Malabsorption (coeliac disease, pancreatic insufficiency); Malignancy (colorectal carcinoma, gastric cancer); Diverticular disease; Overflow diarrhoea
Endocrine: Thyrotoxicosis; Diabetes mellitus
Drugs

53
Q

Diplopia

A

Monocular: Lens (cataracts), Retina (macular degeneration)
Binocular: Wernicke’s encephalopathy; Neurological (cranial nerve palsies, ophthalmoplegic migraine); Endocrine (thyroid ophthalmoplegia); Neuromuscular (Miller Fisher syndrome, myasthenia gravis)

54
Q

Dizziness/blackouts (loss of consciousness)

A

Vasovagal syncope
Cardiovascular: Arrhythmia (bradycardia, tachycardia); Outflow obstruction (aortic stenosis, cardiomyopathy, pulmonary embolism); Hypotension; Ischaemic heart disease (angina pectoris, acute coronary syndrome, myocardial infarction); Aortic dissection
Neurological: Epilepsy; Stroke; TIA
Metabolic: Hypoglycaemia

55
Q

Dysarthria

A

Cerebellar: MS; Stroke; CNS tumours
Bulbar and pseudo bulbar: MND; MS
Extrapyramidal: Parkinson’s disease
Drugs: Substance use disorder (alcohol)

56
Q

Dyspepsia

A

Oesophageal: GORD; Oesophageal cancer
Gastroduodenal: Functional dyspepsia; Peptic ulcer disease and gastritis; Gastric cancer; Hiatus hernia
Biliary: Gallstones and biliary colic; Cholecystitis
Drugs: Substance use disorder (alcohol)
Psychiatric: Generalised anxiety disorder; Depressive disorder

57
Q

Dysphagia

A

Intraluminal: Foreign body
Intramural: Achalasia; GORD; Malignancy (pharyngeal cancer, oesophageal cancer, gastric cancer); Scleroderma; Radiotherapy
Extramural: Retrosternal goitre; Lung cancer; Lymphadenopathy; Aortic aneurysm
Neuromuscular: Stroke; Guillain-Barré syndrome; MND; Myasthenia gravis

58
Q

Dysphasia

A

CNS tumours
Stroke
Dementia

59
Q

Dysuria

A

Urinary tract: Urethritis; Urinary tract calculi; Bladder cancer; UTI
Vaginal: Candidiasis; Bacterial vaginosis
Prostatic: Benign prostatic hyperplasia; Epididymitis and orchitis

60
Q

Facial nerve palsy (bilateral)

A

Autoimmune: Guillain-Barré syndrome; Myasthenia gravis
Infection: Lyme disease; HIV
Sarcoidosis
MND

61
Q

Facial nerve palsy (unilateral)

A

Infection: TB; Otitis media; Varicella zoster
Inflammation: Sarcoidosis; Lymphoma
Idiopathic: Bell’s palsy
Traumatic injury (incl. blunt, penetrating, crush and blast)
Vascular: Stroke
Malignancy: Cholesteatoma; Acoustic neuroma

62
Q

Fatigue

A 
Infection
Endocrine: Hypothyroidism; Adrenal insufficiency; Diabetes mellitus
Cardiac: Cardiac failure
Renal: CKD
Hepatic: Liver failure
Malignancy
Anaemia: normocytic, macrocytic, microcytic
Obesity
Drugs
Psychiatric: Depressive disorder
63
Q

Upper gastrointestinal bleeding

A

Bleeding disorders: Thrombocytopaenia; Haemophilia
Swallowed blood: Haemoptysis; Epistaxis
Oesophageal: GORD; Oesophageal varices; Mallory-Weiss tear; Oesophageal cancer
Gastric: Peptic ulcer disease and gastritis; Gastric cancer
Drugs

64
Q

Goitre

A

Hypothyroidism
Graves’ disease
Thyroid nodule
Thyroid cancer

65
Q

Groin swelling

A

Scrotal: Hydrocoele; Varicocoele
Femoral: Hernia; Saphena varix
Inguinal: Hernia; Lymph nodes
Skin: Lipoma; Epidermoid and pilar cysts (sebaceous cysts)

66
Q

Gynaecomastia

A 
Physiological: Puberty (growth disorder)
Malignancy: Testicular cancer
Endocrine: Thyrotoxicosis; Hypogonadism
Hepatic: Cirrhosis
Renal: CKD
Drugs
67
Q

Haematuria

A

Bladder: Bladder cancer
Kidney: UTI; Urinary tract calculi; Glomerulonephritis; Polycystic kidney disease; Renal cell carcinoma
Urethra: Urethritis
Prostate: Benign prostatic hyperplasia; Prostate cancer
Haematological: Haemophilia; Thrombocytopaenia; Sickle cell disease
Traumatic injury (incl. blunt, penetrating, crush and blast)
Drugs

68
Q

Haemoptysis

A

Respiratory: Malignancy (lung cancer); Infection (TB, pneumonia, abscess); COPD; Bronchiectasis; Vasculitides; Traumatic injury (incl. blunt, penetrating, crush and blast)
Cardiovascular: Pulmonary embolism; Pulmonary hypertension; Cardiac failure
Coagulopathy: Thrombocytopaenia

69
Q

Headache (acute)

A

Traumatic injury (incl. blunt, penetrating, crush and blast)
Infection: Meningitis; Encephalitis
Acute closed-angle glaucoma
Hypertension
Vascular: Haemorrhage (subarachnoid, subdural, extradural)

70
Q

Hemiparesis

A

Vascular: Haemorrhage (subdural, extradural); Stroke
Neurological: Epilepsy; MS; CNS tumours; Migraine
Infection: Cerebral abscess

71
Q

Hepatomegaly

A

Hepatic: Hepatitis; Cirrhosis; Liver abscesses; Liver cysts
Biliary: Primary biliary cirrhosis; Primary sclerosing cholangitis
Cardiac: Constrictive pericarditis; Cardiac failure
Malignancy: Metastases; Hepatocellular carcinoma
Infiltration: Amyloidosis; Sarcoidosis; Haemochromatosis

72
Q

Hyperbilirubinaemia (unconjugated)

A

Overproduction: Haemolytic anaemia; Gallstones and biliary colic
Impaired hepatic uptake: Cardiac failure; Drugs
Impaired conjugation: Gilbert’s syndrome
Neonatal jaundice

73
Q

Hypercalcaemia

A

Sarcoidosis
Primary hyperparathyroidism
Cancer
Multiple myeloma

74
Q

Hyperkalaemia

A

Increased release: Metabolic acidosis; Diabetes mellitus

Reduced excretion: Renal (CKD); Endocrine (adrenal insufficiency); Drugs

75
Q

Hypernatraemia

A

Decreased water intake: Acute confusion; Dementia
Non-renal water loss: Diarrhoea; Fever; Burns injury
Renal water loss: Hypercalcaemia; Diabetes insipidus
Sodium excess: Primary hyperaldosteronism

76
Q

Hypoalbuminaemia

A

Reduced synthesis: Liver failure; Malnutrition
Increased losses: Nephrotic syndrome; Protein-losing enteropathy (coeliac disease, UC, Crohn’s); Burns injury Bullous skin lesion (pemphigoid)

77
Q

Hypocalcaemia

A

Low PTH: Thyroidectomy
High PTH: Vitamin D deficiency (CKD, liver failure, osteomalacia); Metastases; Acute pancreatitis; Sepsis syndromes; Drugs

78
Q

Hypoglycaemia

A

Sepsis syndromes
Adrenal insufficiency
Malnutrition
Drugs: Substance use disorder (alcohol)

79
Q

Hypokalaemia

A

Renal losses: Diuretics
Gastrointestinal: Nausea and vomiting; Diarrhoea
Endocrine: Cushing’s syndrome; Primary hyperaldosteronism

80
Q

Hyponatraemia

A

Hypovolaemic: GI losses (diarrhoea, nausea and vomiting, intestinal obstruction); Renal losses (CKD, adrenal insufficiency, drugs); Burns injury
Euvolaemic: Endocrine (hypothyroidism, adrenal insufficiency); SIADH (respiratory = pneumonia, lung cancer; neurological = CNS tumours, head injury; drugs
Hypervolaemic: Cardiac (cardiac failure); Hepatic (cirrhosis); Renal (nephrotic syndrome, CKD)

81
Q

Hypotension

A

Volume depletion: Haemorrhage (GI bleeding, traumatic injury); GI losses (diarrhoea); Renal losses (diabetes insipidus, diabetes mellitus, acute kidney injury); Burns injury
Infection: Sepsis syndromes
Autonomic failure: Neurodegenerative (Parkinson’s disease); Neuropathy (diabetes mellitus, Guillain-Barré syndrome)
Drugs

82
Q

Hypoxia (type 1 respiratory failure)

A 
Asthma
COPD
Pulmonary embolism
Pneumothorax
Pneumonia
Idiopathic pulmonary fibrosis
Acute respiratory distress syndrome
83
Q

Hypoxia (type 2 respiratory failure)

A

Respiratory: Asthma; COPD; Obstructive sleep apnoea
Central depression: Respiratory centre depression; Drugs (opiate overdose, poisoning)
Neuromuscular: Guillain-Barré syndrome; MND; Myasthenia gravis; Muscular dystrophy
Musculoskeletal: Flail chest (traumatic injury); Kyphoscoliosis

84
Q

Jaundice

A

Pre-hepatic: Congenital haemolysis (sickle cell disease, thalassaemia); Acquired haemolysis (malaria)
Hepatic: Infection (viral hepatitis, liver abscesses, sepsis syndromes); Autoimmune (autoimmune hepatitis); Hepatic (cirrhosis); Malignancy (metastases); Hereditary (Wilson’s disease, haemochromatosis); Drugs (alcohol misuse)
Obstructive: Drugs; Pancreatic cancer; Primary biliary cirrhosis; Primary sclerosing cholangitis; Gallstones and biliary colic

85
Q

Hyperbilirubinaemia (conjugated)

A

Hepatocellular dysfunction: Infection (viral hepatitis, liver abscesses, sepsis syndromes); Hepatic (cirrhosis, non-alcoholic steatohepatitis, alcoholic hepatitis); Autoimmune (autoimmune hepatitis); Malignancy (hepatocellular carcinoma); Infiltration (amyloidosis, sarcoidosis, lymphoma); Hereditary (Wilson’s disease, haemochromatosis); Drugs
Obstruction: Gallstones and biliary colic; Pancreatic cancer; Primary biliary cirrhosis; Primary sclerosing cholangitis; Drugs

86
Q

Nausea and vomiting

A

Gastrointestinal: GORD; Peptic ulcer disease and gastritis; Cholecystitis; Pancreatitis; Gastroenteritis and infectious colitis; Appendicitis; Intestinal obstruction; Peritonitis
Endocrine: Diabetic ketoacidosis; Addisonian crisis; Hypercalcaemia
Neurological: Raised intracranial pressure; Meningitis; Migraine; Head injury
Ophthalmological: Acute closed-angle glaucoma
ENT: Vestibular neuritis and labyrinthitis
Pregnancy
Drugs: alcohol misuse; drug misuse; poisoning; paracetamol overdose

87
Q

Anterior triangle neck swellings

A

Moves with swallow: Thyroglossal cysts; Thyroid nodules; Goitre
Fixed with swallow: Salivary gland tumour; Lymphadenopathy; Lymphoma

88
Q

Posterior triangle neck swellings

A

Lymphadenopathy

Lymphoma

89
Q

Night sweats

A

Infection: Infective endocarditis; Osteomyelitis; TB; HIV
Endocrine: Thyrotoxicosis; Phaeochromocytoma; Menopause; Carcinoid syndrome
Malignancy: Lymphoma; Solid tumours
Drugs: Poisoning (TCAs, benzodiazepines, methanol, iron, lithium and digoxin)

90
Q

Nipple discharge

A

Milky: Late pregnancy; Puberty (growth disorder); Lactation; Duct ectasia; Prolactinoma
Purulent: Breast abscess
Serous: Early pregnancy; Breast cancer
Blood-stained: Mastitis; Breast cancer

91
Q

Oedema (ankle/pitting)

A 
Cardiac: Cardiac failure
Hepatic: Cirrhosis; Liver failure
Renal: Nephrotic syndrome; CKD
Endocrine: Hypothyroidism
Lymphoedema
Drugs
92
Q

Palpitations

A

Anaemia
Cardiac: Arrhythmia (supraventricular tachycardia, ventricular tachycardia, atrial fibrillation/flutter); Permanent pacing; Valvular disease (mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, tricuspid regurgitation); Cardiomyopathy
Endocrine: Phaechromocytoma; Hypoglycaemia; Thyrotoxicosis
Psychiatric: Panic disorder; Generalised anxiety disorder; Depressive disorder; Somatisation
Fever
Pregnancy
Drugs: alcohol misuse; drug misuse

93
Q

Pancytopaenia

A

Autoimmune: SLE
Hypersplenism: Splenomegaly
Aplastic anaemia: Infection (HIV); Drugs (chemotherapy, hormone therapy and biological agents); Radiotherapy
Megaloblastic anaemia: Macrocytic anaemia
Marrow infiltration: Myelofibrosis; Metastases; Lymphoma; Leukaemia; Multiple myeloma
Sepsis syndromes

94
Q

Papilloedema

A

Raised intracranial pressure
Optic nerve: Optic neuritis (MS); Infiltration (sarcoidosis, lymphoma, CNS tumours)
Globe: Glaucoma; Posterior uveitis
Vascular: Central retinal vein occlusion; Malignant hypertension

95
Q

Peripheral neuropathy

A

Endocrine: Diabetes mellitus; Hypothyroidism
Infection: Varicella zoster; Lyme disease; HIV
Inflammation: Vasculitides
Autoimmune: Guillain-Barré syndrome; Rheumatoid arthritis
Renal: CKD
Malignancy: Multiple myeloma
Nutritional: Vitamin B12 deficiency
Drugs: Substance use disorder (alcohol)

96
Q

Petechiae and purpura

A

Infection: Meningococcal septicaemia (meningitis, infective endocarditis, sepsis syndromes)
Inflammation: Vasculitides; SLE; Rheumatoid arthritis
Haematological: Clotting profile abnormalities
Musculoskeletal: Ehlers-Danlos syndrome
Drugs
Amyloidosis

97
Q

Exudative pleural effusion

A

Infection: Pneumonia; TB
Inflammation: SLE; Sarcoidosis; Vasculitides
Malignancy: Lung cancer; Mesothelioma
Traumatic injury (incl. blunt, penetrating, crush and blast)
Gastrointestinal: Pancreatitis

98
Q

Transudative pleural effusion

A

Cardiac: Cardiac failure; Constrictive pericarditis
Hepatic: Liver failure
Renal: Nephrotic syndrome; Peritoneal dialysis
Endocrine: Hypothyroidism
Ovarian: Meig’s syndrome (ovarian tumour)
Hypoalbuminaemia

99
Q

Polydipsia

A

Endocrine: Primary hyperaldosteronism; Diabetes insipidus; Diabetes mellitus
Drugs
Psychogenic polydipsia

100
Q

Polyuria

A

Endocrine: Diabetes insipidus; Diabetes mellitus
Drugs
Psychogenic polydipsia

101
Q

Postural hypotension

A

Volume depletion: Hypotension; Sepsis syndromes; Diabetes insipidus; Adrenal insufficiency
Autonomic: Neurodegenerative (Parkinson’s disease); Neuropathy (diabetic)
Drugs

102
Q

Proximal myopathy

A

Endocrine: Thyrotoxicosis; Hypothyroidism; Osteomalacia; Cushing’s syndrome
Infection: HIV; Influenza
Inflammation: Vasculitides; Idiopathic inflammatory myopathies (incl. polymyositis, dermatomyositis)
Hereditary: Muscular dystrophies
Drugs: Substance use disorder (alcohol)

103
Q

Raised inflammatory markers: CRP

A

Infection
Inflammation
Malignancy

104
Q

Raised inflammatory markers: ESR

A 
Infection
Inflammation
Autoimmune
Malignancy
Renal: CKD; Nephrotic syndrome 
Haematological: Anaemia
Obesity
105
Q

Raised jugular venous pressure

A

Non-pulsatile: Superior vena cava obstruction
Pulsatile: Cardiac (right heart failure, tricuspid regurgitation, constrictive pericarditis); Respiratory (COPD, cor pulmonale); Abdominal (ascites, pregnancy

106
Q

Seizure

A

Vascular: Subarachnoid haemorrhage; Stroke
Infection: Brain abscess; TB; HIV; Meningitis; Encephalitis
Inflammation: MS; Vasculitides; SLE; Sarcoidosis
Trauma: Head injury
Metabolic: Hypoxia (T2RF, T1RF); Hypoglycaemia; Electrolyte disturbance (hyperkalaemia, hypokalaemia, hypernatraemia, hyponatraemia)
Drugs: Substance use disorder (alcohol)
Malignancy: Brain metastases; CNS tumours
Neurological: Epilepsy
Degenerative: Alzheimer’s dementia
Endocrine: Thyrotoxicosis

107
Q

Sensory disturbance

A

Neuropathy: Mononeuropathy (carpal tunnel syndrome); Radiculopathy (spinal); Polyneuropathy (endocrine = diabetes mellitus; drugs = alcohol misuse; nutritional = vitamin B12 and folate deficiency; infection = syphilis, HIV; inflammation = vasculitides)
Spinal cord: CNS tumours; Cervical spondylosis; MS
Brainstem: Stroke; TIA; CNS tumours; Brain abscess
Thalamic: Stroke; TIA; CNS tumours; Brain abscess
Epilepsy
Migraine
Drugs:

108
Q

Spastic paraparesis

A

Vascular: Spinal cord infarction
Infection: TB; Syphilis; AIDS myelopathy (HIV); Epidural abscess
Inflammation: MS; Sarcoidosis; Paraneoplastic syndromes
Malignancy: CNS tumours
Hereditary: MND
Traumatic injury (incl. blunt, penetrating, crush and blast)

109
Q

Splenomegaly

A

Massive: Malignancy (chronic myeloid leukaemia, myelofibrosis, lymphoma; Infection (HIV)
Moderate: Haematological (haemolytic anaemia, thalassaemia, sickle cell disease, hereditary spherocytosis); Hepatic (cirrhosis); Infection (infective endocarditis, infectious mononucleosis, TB, malaria, HIV); Inflammation (SLE, rheumatoid arthritis); Traumatic injury (incl. blunt, penetrating, crush and blast); Malignancy (lymphoma, multiple myeloma, metastases)

110
Q

Sweating

A

Endocrine: Diabetic autonomic neuropathy Thyrotoxicosis; Hypoglycaemia; Menopause; Phaeochromocytoma; Carcinoid syndrome
Infection: TB; HIV
Malignancy: Lymphoma
Psychiatric: Panic disorder; Drug misuse
Alcohol withdrawal

111
Q

Sinus tachycardia

A

Physiological: Exercise; Pain; Fever; Pregnancy
Cardiovascular: Myocardial infarction; Cardiac failure; Constrictive pericarditis; Hypotension; Sepsis syndromes
Respiratory: Pulmonary embolism; Asthma; COPD
Endocrine: Thyrotoxicosis; Phaechromocytoma
Psychiatric: Generalised anxiety disorder; Panic disorder
Drugs

112
Q

Supraventricular tachycardia

A

Atrioventricular: Wolff-Parkinson-White syndrome
Atrial: Atrial fibrillation/flutter

113
Q

Ventricular tachycardia

A

Ischaemic heart disease (angina pectoris, acute coronary syndrome, myocardial infarction)
Cardiomyopathy
Electrolyte disturbance: Hyperkalaemia; Hypokalaemia

114
Q

Testicular pain and swelling

A 
Epididymitis and orchitis
Testicular torsion
Strangulated inguinal hernia
Testicular cancer
Varicocoele
Hydrocoele
Traumatic injury (incl. blunt, penetrating, crush and blast)
115
Q

Thrombocytopaenia

A

Increased splenic sequestration: Hypersplenism (splenomegaly)
Reduced platelet production: Pregnancy; Drugs (alcohol misuse, chemotherapy, hormone therapy and biological agents); Malignancy (multiple myeloma, myelofibrosis, lymphoma, leukaemia); Nutritional (vitamin B12 and folate deficiency)
Increased platelet destruction: Autoimmune (immune thrombocytopaenic purpura, SLE, rheumatoid arthritis, antiphospholipid syndrome); Infection (EBV = infectious mononucleosis, hepatitis C, HIV, malaria); Liver failure; Disseminated intravascular coagulation (DIC); Drugs

116
Q

Thyrotoxicosis

A

Graves’ disease
Thyroid nodules
Thyroiditis
Drugs

117
Q

Tinnitus

A

Auditory: Presbyacusis (sensorineural hearing loss); Otosclerosis (sensorineural hearing loss); Acoustic neuroma; Drugs
Vascular: Stroke
Neurological: MS

118
Q

Tremor

A

Essential tremor
Parkinson’s disease
Cerebellar: Stroke; Infection (TB, HIV, varicella zoster); MS; Vasculitides; CNS tumours
Endocrine: Hypoglycaemia; Thyrotoxicosis; Phaeochromocytoma
Psychiatric: Generalised anxiety disorder
Drugs: Alcohol withdrawal; Opiate withdrawal; Antidepressants

119
Q

Urinary frequency

A

Infection: UTI; Urethritis (gonorrhoea, chlamydia)
Bladder: Diabetic autonomic neuropathy; Urinary tract calculi; Bladder cancer; Stress incontinence
Prostate: Benign prostatic hyperplasia; Prostate cancer
Pregnancy
Drugs

120
Q

Urinary incontinence

A

Stress incontinence: Childbirth; Transurethral resection of the prostate
Urge incontinence: Spinal cord compression (incl. cauda equina); Spinal cord injury; Bladder cancer; Bladder outflow obstruction; Stroke; MS
Overflow incontinence: Bladder outflow obstruction

121
Q

Urinary retention

A

Outflow obstruction: Intraluminal (urinary tract calculi); Intramural (urethral stricture); Extramural (benign prostatic hyperplasia, constipation, pregnancy)
Infection: UTI; Urethritis (gonorrhoea, chlamydia); Genital herpes
Neurological impairment: Spinal cord injury; Diabetic autonomic neuropathy; MS; CNS tumours; Metastases
Traumatic injury (incl. blunt, penetrating, crush and blast)
Post-operative
Drugs

122
Q

Urinary urgency

A

Infection: UTI; Urethritis (gonorrhoea, chlamydia)
Bladder: Bladder cancer; Stress incontinence; Urinary tract calculi
Prostate: Benign prostatic hyperplasia; Prostate cancer
Pregnancy

123
Q

Visual field defect

A 
Stroke
TIA
CNS tumours
MS
Traumatic injury (incl. blunt, penetrating, crush and blast)
124
Q

Weight loss

A

Gastrointestinal: Peptic ulcer disease and gastritis; Ulcerative colitis; Crohn’s disease; Coeliac disease
Infection and immunology
Cancer
Endocrine: Thyrotoxicosis; Diabetes mellitus; Adrenal insufficiency
Cardiac: Cardiac failure
Respiratory: Bronchiectasis; Idiopathic pulmonary fibrosis; Cystic fibrosis
Renal: CKD
Rheumatological: Rheumatoid arthritis; Giant cell arteritis
Neurological: Stroke; Dementia; Parkinson’s disease; MND
Psychiatric: Depressive disorder; Anorexia nervosa; Bipolar affective disorder
Drugs: Alcohol misuse; Drug misuse

125
Q

Wheeze

A

Anaphylaxis
Respiratory: Asthma; COPD; Bronchiectasis; Lung cancer
Cardiac: Cardiac failure
Foreign body

.► SEMIOLOGIA - JP (52 decks)

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