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MD2 Core Presentation DDx > Core Presentations DDx > Flashcards

Core Presentations DDx Flashcards

1
Q

Abdominal distension

A

Fat
Fluid: ascites (consider renal, hepatic, cardiac causes, as well as malignancy and infection)
Flatus: may be normal or in setting of SBO/LBO
Faeces
Foetus
Fibroids, large ovarian cyst

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2
Q

Acute upper abdominal pain

A 
Gallstone colic (cholelithiasis/choledocolithiasis)
Acute cholecystitis
Acute cholangitis
Acute pancreatitis
Oesophagitis
Gastritis
ACS
Other cardiorespiratory causes: pericarditis, pneumonia, empyema
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3
Q

Acute central abdominal pain

A

SBO
Abdominal aortic dissection/AAA rupture
Crohn’s disease
Mesenteric artery occlusion (ischaemic bowel)

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4
Q

Acute lateral abdominal pain

A 
Appendicitis
Pyelonephritis
Renal/ureteric colic
Salpingitis
Ruptured ovarian cyst or torsion, endometriosis, etc
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5
Q

Acute lower central (hypogastric) abdominal pain

A 
Cystitis due to bacterial infection
PID
Pelvic endometriosis
Ectopic pregnancy
Mittelschmerz
LBO
Infective colitis
IBD
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6
Q

Anorectal pain

A 
Anal fissure
Haemorrhoids (thrombosed pile)
Perianal abscess/pilonidal sinus and abscess
Proctalgia fugax, coccydynia
Proctitis
Prostatitis (referred)
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7
Q

Localised tenderness in hypogastrium

A

Acute bladder distension

Cystitis

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8
Q

Localised tenderness in RUQ

A

Acute cholecystitis
Acute alcoholic hepatitis
Acute viral hepatitis
Acute liver congestion

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9
Q

Localised tenderness in LUQ

A

Pyelonephritis
Splenic rupture (?delayed)
Splenic infarct

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10
Q

Localised tenderness in epigastrium or central abdomen

A 
Gastritis
Duodenal ulcer (relieved by food)
Gastric ulcer (exacerbated by food)
Pancreatitis
Small bowel infarction
Ruptured or dissecting AAA
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11
Q

Localised tenderness in L or R loin

A

Pyelonephritis
Renal calculus
Ruptured or dissecting AAA

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12
Q

Localised tenderness in L or R lower quadrant

A

Appendicitis
Diverticulitis
Mesenteric adenitis/non-specific abdominal pain
Ectopic pregnancy

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13
Q

Purpura (clotting defects, blood vessel fragility) and petechiae (platelet defects, vasculitis)

A

Trauma
Thrombocytopaenia: ITP, SLE, drug-induced, bone marrow replacement
Pancytopaenia: aplastic anaemia, hypersplenism, myelodysplasia, DIC
Platelet dysfunction: aspirin, NSAIDs, renal failure
Acquired vasculopathy: senile changes, AI vasculitis (Henoch-Schonlein), steroids, vit C deficiency
Acquired coagulopathy: liver disease, vit K deficiency, DIC
Congenital coagulopathy: haemophilia, von Willebrand’s

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14
Q

Gait abnormality

A

Contralateral pyramidal tract lesion: cerebral hemisphere, internal capsule, brainstem or SC
Parkinsonism
Cerebellar lesion: tumours, ischaemia
Dorsal column loss or peripheral neuropathy: vit B12 deficiency, etc
Bilateral upper motor neuron lesion: usually SC
Pelvic girdle and proximal muscle weakness: hereditary muscular dystrophy, etc
Joint, bone, or muscle lesion
Lateral popliteal nerve palsy
Drug effect

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15
Q

Abnormal speech/communication

A

Deafness due to ear disease or 8th cranial nerve lesions
Inattention due to dementia, depression, etc
Dysphasia (sensory or motor, i.e. Wernicke’s or Broca’s)
Dysarthria: cerebellar dysfunction, upper or lower motor neuron lesion
Dysphonia (or aphonia): vocal cord dysfunction

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16
Q

Acute confusion

A 
Septicaemia: UTI, URTI, etc
Hypoxia
Alcohol withdrawal, thiamine deficiency
Post-ictal state
Hypothyroidism/thyrotoxicosis
Hypoglycaemia
Adrenal failure: Addison's disease, ACTH deficiency
Frontal lobe lesion: ischaemia, tumour, abscess
Drug effect
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17
Q

Alcohol abuse

A

3 Qs and 3 Ds
Q: quantity, quality,
D: duration, dependence, damage

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18
Q

Altered bowel habit (increase in constipation or diarrhoea or both alternating)

A

Change in diet
Colonic carcinoma
Drug-induced: opioids, anti-HTN, aluminimum alkalis, laxatives
Depression
Immobility
Cerebral or spinal cord lesion
Metabolic: hypothyroidism, hyperthyroidism, hypercalcaemia, hypokalaemia

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19
Q

Altered conscious state

A 
H
A
D
H
I
M
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20
Q

Amenorrhoea

A 
Pregnancy
Normal menopause
Premature ovarian failure
PCOS
Hyperprolactinaemia: macro-/micro-adenoma, idiopathic
Thyrotoxicosis
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21
Q

Anorexia

A

?

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22
Q

Anuria/oliguria

A

?

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23
Q

Sudden (secs-hours) onset back pain

A

Mechanical: strains, tear, crushing of ligaments/disc/vertebrae
Posterior lumbar disc prolapse
Anterior lumbar disc prolapse
Spondylolisthesis: spondylolysis, congenital malformation of articular process, OA of posterior facet joints
Central disc protrusion

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24
Q

Bone pain

A

?

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25
Q

Breast lump

A 
Benign fibrous mammary dysplasia
Fibroadenoma
Cyst
Acute or chronic abscess
Fat necrosis or sclerosing adenosis
Carcinoma infiltrating ductal cancer or invasive lobar cancers
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26
Q

Breast pain (mastalgia)

A

?

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27
Q

Calf pain

A

?

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28
Q

Chest pain

A 
Musculoskeletal injury or inflammation
ACS: angina, STEMI, NSTEMI
Pericarditis
Dissecting aortic aneurysm
Oesophagitis and oesophageal spasm
PE/infarction
Pneumothorax
Pneumonia with pleurisy
Referred cervical root pain
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29
Q

Chronic confusion or cognitive impairment

A 
Alzheimer's disease
Vascular (multi-infarct) dementia
Lewy body dementia
Huntington's disease
CJD
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30
Q

Cough

A 
APO due to LHF (pink frothy sputum)
Mitral stenosis (pink frothy sputum)
COPD
Chronic asthma
Chronic bronchitis
Acute bronchitis: viral, bacterial
Pneumonia
Pulmonary TB
Lung abscess
Lung carcinoma
ILD
Post-nasal drip
GORD
Drugs (ACEIs)
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31
Q

Dizziness

A

Postural hypotension: anti-HTNs, hypovolaemia, dehydration, diabetic autonomic neuropathy, DA agonists, Addison’s disease
Anaemia
Hypoxia (including hyperventilation as a cause)
Carotid sinus hypersensitivity
Epilepsy
Drug effect: sedative, anti-HTNs, alcohol

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32
Q

Double vision

A 
Oculomotor (3rd nerve) paresis: intra-cavernous or posterior communicating artery aneurysm, meningioma, tentorial pressure cone, diabetes mellitus, syphilis, and brainstem ischaemia
Trochlear paresis
Abducens paresis
Myasthenia gravis
Graves' disease
Orbital cellulitis
Tumour
INO (usually due to MS, sometimes vascular)
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33
Q

Dysphagia

A

?

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34
Q

Dysuria

A

?

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35
Q

Ear pain

A

?

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36
Q

Epistaxis

A

?

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37
Q

Erectile dysfunction

A

?

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38
Q

Eye pain

A

?

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39
Q

Facial pain

A

?

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40
Q

Facial swelling

A

?

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41
Q

Faecal incontinence

A

?

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42
Q

Falls

A

?

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43
Q

Fatigue

A

?

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44
Q

Fever

A

?

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45
Q

Haematemesis

A

?

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46
Q

Haematuria

A

?

47
Q

Haemoptysis

A 
Acute bronchitis: viral, bacterial
Pneumonia
PE/infarction
Lung carcinoma
Pulmonary TB
Lung abscess
Bronchiectasis
Wegener's granulomatosis
Pulmonary AVM
Goodpasture's syndrome
48
Q

Acute headache

A 
Meningitis
Low CSF pressure
SAH
Intracranial haemorrhage
Head injury with cerebral contusion
Acute closed angle glaucoma
Sinusitis
Tension headache
Bilateral migraine
49
Q

Hoarseness

A 
Inhaled steroids
Chronic laryngitis
Vocal nodules
Laryngeal carcinoma
Vocal cord paresis
Functional hoarseness
Myxoedema
Acromegaly
Granulomas (e.g. in TB, sarcoid, syphilis, GPA)
50
Q

HTN

A

?

51
Q

Hypotension

A

?

52
Q

Inguinoscrotal lumps

A

?

53
Q

Inguinoscrotal pain

A

?

54
Q

Itch

A

?

55
Q

Jaundice

A

?

56
Q

Jaw pain

A

?

57
Q

Joint pain

A

?

58
Q

Joint swelling

A

?

59
Q

Laceration

A

?

60
Q

Leg pain

A

?

61
Q

Lethargy

A

?

62
Q

Loin pain

A

?

63
Q

Loss of hearing

A

?

64
Q

Malaise

A

?

65
Q

Malaena

A

?

66
Q

Muscle cramps

A

?

67
Q

Generalised muscle weakness

A

?

68
Q

Regional muscle weakness

A

?

69
Q

Nausea

A

?

70
Q

Neck lump

A

?

71
Q

Neck pain

A

?

72
Q

Neck stiffness

A

?

73
Q

Night sweats

A

?

74
Q

Nocturia

A

?

75
Q

Pallor

A

?

76
Q

Palpitations

A

?

77
Q

Perianal pain

A

?

78
Q

Perianal lump

A

?

79
Q

Peripheral oedema

A

?

80
Q

Polydipsia

A

?

81
Q

Polyuria

A

?

82
Q

Rash

A

?

83
Q

Rectal bleeding

A

?

84
Q

Red eye

A

?

85
Q

Seizure

A

?

86
Q

Sensory disturbance

A

?

87
Q

Skin lumps and ulcers

A

?

88
Q

Shoulder pain

A

?

89
Q

Sore throat

A

?

90
Q

Sweating

A

?

91
Q

Generalised swelling

A

?

92
Q

Regional swelling

A

?

93
Q

Syncope

A

?

94
Q

Tinnitus

A

?

95
Q

TLOC

A

?

96
Q

Tremor

A

?

97
Q

Urinary frequency

A

?

98
Q

Urinary incontinence

A

?

99
Q

Vertigo

A

Vertebrobasilar insufficiency (brainstem ischaemia)
BPVV
Meniere’s disease
Vestibular neuronitis
Middle ear disease
Reversible drug toxicity: alcohol, barbiturates, phenytoin
Wernicke’s encephalopathy: thiamine deficiency (usually in alcoholism)
Ototoxic drugs: streptomycin, gentamicin, kanamycin, phenytoin, quinine, orsalicylate
Brainstem ischaemia or infarction
Posterior fossa tumour
MS
Migraine
Temporal lobe epilepsy
Ramsay Hunt syndrome due to herpes zoster

100
Q

Vision loss?

A

?

101
Q

Vomiting

A

?

102
Q

Weight gain

A

?

103
Q

Weight loss

A

?

104
Q

Wheeze/stridor

A

?

105
Q

Constipation

A 
Change in diet: low-fibre, poor fluid intake
Change in lifestyle or environment
Immobility
Drug-induced: opioids, anti-HTNs, aluminium alkalis
Anal fissure
Haemorrhoids
Hypothyroidism
Rectal tumour
Colonic carcinoma
Hypercalcaemia
External pelvic mass compression
106
Q

Recurrent diarrhoea with no blood in stools, no fever

A 
IBS
Faecal impaction with overflow
Malabsorption: coeliac disease, lactose intolerance, pancreatic disease, Whipple's procedure
Drug-induced: laxative abuse, magnesium alkalis, Abx, hypotensive agents, alcohol
HIV
Diabetic autonomic neuropathy
Thyrotoxicosis
Carcinoid syndrome
107
Q

Watery diarrhoea

A 
Traveller's diarrhoea
ETEC (commonest)
Vibrio cholera
Rotavirus
Norwalk virus
108
Q

Dysentry (acute bloody diarrhoea +/- mucus)

A 
Campylobacter enteritis
Shigella (bacillary) dysentery
EIEC
EHEC
Entamoeba histolytica
109
Q

Bloody flux (recurrent diarrhoea with blood +/- mucus)

A 
Crohn's disease
UC
Colonic carcinoma
Colorectal carcinoma
Diverticular disease/diverticulitis
110
Q

Sudden diarrhoea, fever and vomiting

A

Viral gastroenteritis (usually Norwalk virus)
Rotavirus
Abx-induced bacterial opportunists (e.g. C. diff)
Food poisoning/toxins (Salmonella typhimurium; from meat)
Clostridium perfringens (from meat; incubation 8-16 hrs)
Staphylococcus aureus (from meat; incubation

111
Q

Back pain (onset over days to months)

A

Lumbar spinal stenosis: due to facet joint OA
Spinal tumours: primary in SC/meninges/nerve roots, secondary from lung/breast/prostate/thyroid/kidney/lymphoma/myeloma
Pyogenic spinal infection: usually of disc space due to staphylococcus, Salmonella typhi
Spinal TB: abscesses, cord compression, psoas abscess

112
Q

Chronic back pain (onset over years)

A

Kyphotic pain
Scoliotic pain
Idiopathic scoliosis of thoracic or lumbar spine

113
Q

Subacute headache

A

Raised ICP due to tumour, hydrocephalus, cerebral, abscess
Encephalitis
GCA

114
Q

Chronic and recurrent headache

A 
Tension headache
Migraine
Cluster headache
Cervical root headache
Eye strain
Drug side effect (e.g. nitrates)

MD2 Core Presentation DDx (2 decks)

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