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5th (Final year) > Common Medical Presentations > Flashcards

Common Medical Presentations Flashcards

1
Q

ACS presentation?

A

Central crushing chest pain
Radiates to Neck/left arm
Assoc. Nausea, SOB, Sweating
CVD risk factors
Brought on at rest

Unstable angina: crescendo angina

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2
Q

Angina presentation?

A

Cardiac-type chest pain
Present of exertion
Relieved on rest

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3
Q

Aortic dissection presentation?

A

Tearing chest pain
Very sudden onset
Radiates to back
Pain may be in other sites such as arms, legs, back and head

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4
Q

Pericarditis presentation?

A

Retrosternal/pleuritic chest pain
Relieved by sitting forward
May radiate to shoulder

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5
Q

Cardiac chest pain differentials?

A

ACS
Angina
Aortic dissection
Pericarditis

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6
Q

Pulmonary embolism presentation?

A

Pleuritic chest pain
SOB +/- haemoptysis
R/Fs inc. Long haul flight, recent surgery, immobilisation, malignancy

Signs include: Raised RR, low sats, tachycardia and tachypnoea.

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7
Q

Pneumothorax presentation?

A

Sudden onset chest pain
SOB if large enough
R/Fs tall/thin, marfans, COPD/Asthma

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8
Q

Respiratory chest pain presentations?

A

Pulmonary embolism
Pneumothorax

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9
Q

GORD presentation?

A

Retrosternal burning chest pain
Related to meals, lying and straining
Water brash

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10
Q

Anxiety/Panic attack presentation?

A

Tight chest pain, SOB, sweating, dizziness, palpitations, feeling of impending doom.

Anxious personality/GAD/PD

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11
Q

Chest pain Hx SR?

A

SOCRATES

General
- Fevers
- Weight loss
- Lethargy
- Eating & Sleeping
- Waterworks & Bowel

Cardiorespiratory
- Palpitations
- SOB/wheeze
- Cough +/- production
- Haemoptysis
- Leg swelling

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12
Q

MSK chest pain presentation?

A

Sharp chest pain
Exacerbated by movement and inspiration
Can point to where it is worse
Exacerbated by pressure over that area

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13
Q

Breathlessness Hx inc. SR?

A

OPERATE

Onset (sudden or gradual)
Progression
Exacerbating
Relieving factors
Associated symptoms
Timing (intermittent or continuous
Ever happened before?

Breathlessness
- Normal vs current exercise tolerance
- Orthopnoea
- Paroxysmal nocturnal dyspnoea
- Diurnal/season variation

General SR
- Fevers
- Night sweats
- Weight loss
- Lethargy
- E&D?

Cardiorespiratory SR
- Chest pain
- Palpitations
- Cough +/- production (inc. haemoptysis)
- Leg swelling

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14
Q

Chest pain Ddx?

A

MI
Angina
Aortic Dissection
Pericarditis
Pulmonary embolism
Pneumothorax
GORD
Anxiety/Panic
MSK

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15
Q

Breathlessness Ddx?

A

MI
HF
Pneumonia
Asthma
COPD
Pneumothorax
Pulmonary Embolism
Pulmonary Fibrosis

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16
Q

HF presentation?

A

SOB
Orthopnoea
Paroxysmal nocturnal dyspnoea
Pink frothy sputum
Peripheral oedema
Cardiac Hx

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17
Q

Pneumonia presentation?

A

Acute SOB, cough and sputum
Systemic symptoms e.g. fever

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18
Q

Asthma presentation?

A

Intermittent wheeze
Diurnal presentation
Nocturnal cough
Exacerbating factors: pets, exercise

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19
Q

COPD presentation?

A

Chronic SOB
Sig. smoking Hx
Chronic sputum production

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20
Q

Pulmonary fibrosis presentation?

A

Progressive SOB over long period on exertion (exertional dyspnoea)
Dry cough

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21
Q

Abdo pain Hx?

A

SOCRATES

General SR
- Fever
- Weight loss
- Night sweats
- Lethargy
- E&D

GI
- Dysphagia
- N&V
- Dyspepsia
- Odynophagia
- Bowel habit
- Blood/mucus
- Waterworks

Gynaecological/Menstrual

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22
Q

Appendicitis presentation?

A

Younger
Periumbilical pain, moves to RIF
Anorexia
Pain on movement, staying very still

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23
Q

Gallstones presentation?

A

Biliary colic
- intermittent RUQ pain
- Worse with food

Cholecystitis
- Continuous RUQ pain
- Fevers
- Murphys sign

Cholangitis
- Jaundice
- Fevers/Rigors
- RUQ pain

24
Q

Pancreatitis presentation?

A

Severe epigastric/central pain
Radiates to the back
Relieved by sitting forward
Vomiting

25
Q

Gastritis/Peptic ulcer presentation?

A

Epigastric pain
Related to meals
Nausea
Heartburn - possibly
R/Fs - NSAIDS, Alcohol, Spicy foods

26
Q

Diverticulitis presentation?

A

Elderly
LIF pain
Pyrexia
Tachycardia
N&V
Change in bowel habit

27
Q

Bowel obstruction presentation?

A

Vomiting,
Abdo distension,
Constipation
Colicky pain

28
Q

Renal colic presentation?

A

Spasms of loin to groin pain
Nausea and vomiting
Cannot lie still

29
Q

Ectopic pregnancy presentation?

A

Iliac fossa (either side) increasing (shoulder tip pain)
Amenorrhoea/pregnancy
Spotting

30
Q

Gastroenteritis presentation?

A

Nausea and Vomiting
Fever
Diarrhoea
Dehydration
Recent travel/dodgy food

31
Q

Abdo pain common Ddx?

A

Appendicitis
Gallstones (and related disease)
Pancreatitis
Gastritis/PUD
Diverticulitis
Bowel obstruction
Renal colic
Ectopic pregnancy
IBD
Gastroenteritis

32
Q

Change in bowel habit Ddx?

A

Colon Ca
Gastroenteritis
IBD
IBS
Coeliac disease
Thyrotoxicosis
Hypothyroidism
Bowel obstruction
Diverticulitis
Overflow constipation

33
Q

Change in Bowel habit Hx?

A

OPERATE

Onset
Progression
Exacerbating
Relieving
Associated Symptoms
Timing
Ever happened before?

Stool
- How much
- How often
- Consistency, colour, blood/mucus

GI SR
- Weight loss, Night sweats, Lethargy
- Fever
- E&D

  • Dysphagia
  • Odynophagia
  • Dyspepsia
  • N&V
  • (BH)
  • Waterworks
  • Abdo pain
  • Abdo distension
34
Q

Colon Ca. Presentation?

A

Elderly
Blood in stool
Weight loss & Anaemia
Change in BH

35
Q

Gastroenteritis presentation?

A

Acute Diarrhoea
N&V

36
Q

IBD Presentation?

A

Blood/Mucus in stool
Abdo Pain
Weight loss
Diarrhoea Mostly

37
Q

IBS Presentation?

A

Fluctuates between Diarrhoea and Constipation
Associated with stress/anxious personality
Crampy abdo pain and bloating. Abdo pain reliveed of defecation

38
Q

Coeliac disease presentation?

A

Diarrhoea/Steatorrhoea
Anaemia symptoms
Abdo discomfort

39
Q

Hyperthyroidism presentation?

A

Diarrhoea
Heat intolerance
Irritability
Tremor
Oligo/menorrhoea

40
Q

Hypothyroidism presentation?

A

Constipation
Cold intolerance
Lethargy
Menorrhagia

41
Q

Rectal bleeding Hx?

A

OPERATE
- Bleeding - fresh, on tissue
- Mucus

General SR
- Weight loss, Night sweats, Lethargy
- Fever
- E&D

GI
- Dyspahgia
- Odynophagia
- Dyspepsia
- Nausea & Vomiting
- Abdo pain
- Abdo distension
- BH
- Waterworks

42
Q

Rectal bleeding Ddx?

A

Anal fissure
Haemorrhoids
Diverticular haemorrhage
Distal polyp/malignancy
Inflammatory bowel disease
Haemorrhagic infective Gastroenteritis
Angiodysplasia
Proximal polyp or malignancy
Haemorrhagic peptic ulcer/gastritis
Oesophageal varices

43
Q

Anal Fissure presentation?

A

Bleeding on defecation
Bright red on paper
Intense pain
Constipation

44
Q

Haemorrhoids presentation?

A

Bleeding on defecation
Bright red on paper
Constipation
Pruritis

45
Q

Diverticular haemorrhage presentation?

A

Sudden painless rectal bleeding
Elderly

46
Q

Distal polyp/maignancy

A
  1. Alternating bowel habit
  2. Weight loss
  3. Urgency/Tenesmus
  4. Anal discomfort /pruritis
47
Q

Inflammatory Bowel Disease presentation?

A
  1. Blood mixed with stool
  2. Mucus
  3. Diarrhoea
  4. Abdo pain
  5. Weight loss
48
Q

Haemorrhagic infective gastroenteritis presentation?

A
  1. Acute diarrhoea and vomiting
  2. Hx of high risk food intake
49
Q

Angiodysplasia presentation?

A
  1. Elderly
  2. Painless
  3. Subtle
50
Q

Proximal polyp/malignancy presentation?

A
  1. Weight loss
  2. Anaemia symptoms
51
Q

Haemorrhagic peptic ulcer/gastritis presentation?

A
  1. Gastritis symptoms
  2. Haematemesis
  3. R/Fs: NSAIDS, Alcohol, Spicy food
52
Q

Oesophageal Varices presentation?

A
  1. Hx of liver disease/alcoholism
  2. Encephalopathy of alcohol withdrawal
  3. Haematemesis
53
Q

Haematemesis Ddx?

A
  1. Oesophageal varices
  2. Mallory-Weiss tear
  3. Peptic ulcer haemorrhage/haemorrhagic gastritis or oepsophagitis
54
Q

Mallory Weiss Tear presentation?

A
  1. Multiple vomits before haeamatemesis
  2. Typically before drinking
55
Q

Peptic ulcer haemorrhage, gastritis/oesophagitis haemorrhage presentation?

A
  1. Prev. gastritis
  2. R/Fs e.g. NSAIDS alcohol, spicy foods

5th (Final year) (34 decks)

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