DDX Flashcards
What is the botanical differential diagnosis for hepatitis?
Ceanothus americanus
Ganoderma lucidum
Glycyrrhiza glabra
Curcuma longa
Arctium lappa
Leptandra virginica
Scutellaria baicalensis
Taraxacum officinale (root)
Silybum marianum
Schisandra chinensis
“Constantly Gulping Gin Causes ALT/AST to Suddenly Skyrocket”
What is the differential diagnosis for proteinuria?
Physiologic causes:
Fever
Congestive heart failure
Tubulointerstitial causes:
Franconi’s syndrome
Primary glomerular dysfunction:
Membranous glomerulonephritis
Interstitial nephritis
Post-streptococcal glomerulonephritis
IgA nephropathy
Secondary glomerular dysfunction:
Systemic disease (SLE, diabetes, sickle cell anemia, polycystic kidney disease)
Infectious disease (UTI, HIV, hepatitis B/C, bacterial endocarditis)
Medications (NSAIDs,, heavy metals)
Cryoglobulinemia
Vascular causes:
Hypertension
Hemolytic uremic syndrome
Thrombotic thrombocytopenic purpura
Medium or small vessels vasculitis*
Overflow:
Multiple myeloma
Amyloidosis
Waldenstrom’s macroglobulinemia
What is the botanical differential diagnosis for hemorrhage?
Capsella bursa-pastoris
Cinnamomum zelynicum
Geranium maculatum
Hamamelis virginiana
“Cuts Cause Great Hemorrhage
What is the botanical differential diagnosis for gastroenteritis?
Berberis aquifolium/vulgare
Commiphora myrrh
Hydrastis canadensis
Matricaria recutita
Thymus vulgaris
What is the differential diagnosis for tracheal deviation?
Pneumothorax and atelectasis
Pneumothorax is a space occupying lesion, which pushes the trachea away (contralateral deviation) and causes decreased breath sounds and hyperresonance.
Atelectasis is lung collapse, which allows the trachea to fall towards the empty space (ipsilateral deviation) and has absent breath sounds.
What is the differential diagnosis for sensorineural hearing loss?
With sensorineural hearing loss, there is a defect in the conversion of sound into neural signals, such the air conduction is > bone conduction (Rinnie), and sound lateralizes to the unaffected side (Weber).
Congenital:
Intrauterine infections (TORCH diseases)
Teratogens
Perinatal hypoxia
Hyperbilirubinemia
Acquired:
Presbycusis
Meniere’s disease
CNS disease
Cranial nerve VII damage
Labyrinthitis*
Autoimmune disease of the inner ear
Infection (post meningitis, syphilis, mumps, CMV, HSV)
Neoplasms (acoustic neuroma)
Ototoxic drugs
What is the differential diagnosis for female infertility?
Ovulatory dysfunction:
Hypothalamic dysfunction
Hypopituitarism
Prolactinoma
Premature ovarian failure
Polycystic ovarian syndrome
Systemic disease (thyroid disease, Cushing’s syndrome, renal or hepatic failure)
Congenital (Turner’s syndrome, gonadal dysgenesis, gonadotropin deficiency)
Lifestyle factors (stress, poor nutrition, excessive exercise)
Outflow tract abnormalities:
Pelvic inflammatory disease
Adhesions
Tubal ligation
Congenital abnormalities
Endometriosis
Leiomyoma (fibroids)
Hostile or acidic cervical mucus
Antisperm antibodies
Structural defects
What is the homeopathic differential diagnosis for suicidal ideation?
Aurum (< cold)
Nat-sulph (< music)
Psorinum (< cold)
What is the botanical differential diagnosis for cholelithiasis?
Cholelithiasis:
Chelidonium majus
Mentha piperita
Cholelithiasis prevention:
Curcuma longa
Silybum marianum
What is the botanical differential diagnosis for benign prostatic hyperplasia?
Prunus africanum
Urtica dioica (root)
Serenoa repens
Hydrangea arborescens
“Cock PUSH”
What is the differential diagnosis for seizures?
Epilepsy, status epilepticus
Migraine variant
Syncope
Panic attack
Transient ischemic attack
Movement disorder
Narcolepsy
Cataplexy
Viral encephalitis
What is the botanical differential diagnosis for hay fever (allergic conjunctivitis, rhinitis or sinusitis)?
Euphrasia officinalis
Larrea tridentata
Sambucus nigra
What is the homeopathic differential diagnosis for fever without thirst?
Belladonna (< motion)
Gelsemium (> continued motion)
What is the botanical differential diagnosis for inflammatory bowel disease?
Aloe vera
Boswellia serrata
Glycyrrhiza glabra/ DGL
What is the differential diagnosis for elevated liver enzymes?
Drastically elevated AST and ALT (> 1000):
Acute viral hepatitis (most common)
Autoimmune hepatitis
Hepatic ischemia
Drugs and toxins
ALT > AST:
Chronic hepatitis
Fatty liver
ALT < AST:
Alcoholic liver disease
Cirrhosis
Elevated ALP and GGT:
Cholestasis
Increased AST and ALT indicate hepatocellular damage. ALLT is more specific for the liver, whereas AST can be elevated by multiple sources (especially muscle).
What is the botanical differential diagnosis for general infections?
Astragalus membranaceus
Baptisia tinctoria
Bryonia alba
Commiphora myrrha
Echinacea spp.
Eleutherococcus senticosus
Eucalyptus globulus
Eupatorium perfoliatum
Glycyrrhiza glabra
Hydrastis canadensis
Juniperus communis
Larrea tridentata
Ligusticum porteri
Ligustrum lucidum
Panax spp.
Rosmarinus officinalis
Salvia officinalis
Sambucus nigra
Scutellaria baicalensis
Thymus vulgaris
Withania somnifera
Zingiber officinale
What is the differential diagnosis for secondary amenorrhea?
Functional causes:
Pregnancy
Prolonged, intense exercise
Excessive dieting
Endocrine causes:
Hypothyroidism or hyperthyroidism
Hypothalamic dysfunction
Prolactinoma
Ovarian causes:
Menopause
Premature ovarian failure
Polycystic ovarian syndrome
Gonadal dysgenesis
Structural causes:
Atrophy
Imperforate hymen
Mullerian agenesis
What are the red flags for emergent abdominal pain?
Extremes of age
Unstable vital signs
Fever
Signs and symptoms of shock
Rapid onset severe pain
What is the differential diagnosis for emergent dyspnea?
Respiratory causes:
Bronchospasm
Pulmonary embolism
Pneumothorax
Infection (bronchitis, pneumonia)
Upper airway obstruction (aspiration, anaphylaxis)
Cardiac causes:
Acute MI
Congestive heart failure
Cardiac tamponade
What is the differential diagnosis for casts on urinalysis?
Hyaline casts:
Physiologic (concentrated urine, dehydration, fever, exercise)
Red blood cell casts:
Glomerular bleeding (glomerulonephritis, vasculitis)
White blood cell casts:
Infection (pyelonephritis)
Inflammation (interstitial nephritis)
Pigmented granular casts:
Acute tubular necrosis
Glomerulonephritis
Interstitial nephritis
What is the differential diagnosis for non-articular joint pain?
Localized:
Bursitis
Tendonitis
Capsulitis
Muscle sprain
Generalized:
Polymyalgia rheumatica
Fibromyalgia
Myofascial pain syndrome
What is the botanical differential diagnosis for uterine prolapse?
Chamaelirium luteum
Caulophyllum thalictroides
What is the differential diagnosis for otalgia?
Local causes:
Infection (AOE, AOM, herpes simplex/zoster, auricular cellulitis, mastoiditis)
Trauma (burns, hematoma, lacerations, traumatic perforation, barotrauma)
Obstruction (neoplasms, foreign body, cerumen impaction, cholesteatoma)
Referred pain (from CN V, IX, X):
Eustachian tube
TMJ syndrome
Trismus
Dental conditions
Tonsils (tonsillitis, tonsillar cancer)
Thyroiditis
Bell’s palsy (CN VII palsy)
What is the botanical differential diagnosis for diabetes?
Allium cepa/sativum
Panax spp.
Theobroma cacao
Linum usitatissimum
Momordica charantia
Gymnema sylvestre
“Ate Protein To Lower My Glucose”
What is the botanical differential diagnosis for headache?
Piscidia erythrina
Tanacetum parthenium
Vinca major/minor
What is the differential diagnosis for azotemia (elevated levels of urea and nitrogen)?
Prerenal causes:
Hypovolemia
Fluid losses (hemorrhage, gastrointestinal, urine)
Sepsis
Hepatorenal syndrome
Renal causes:
Renal failure
Glomerulonephritis
Renal tubular necrosis
Acute interstitial nephritis
Pyelonephritis
Renal artery obstruction (thrombosis, embolism, aortic dissection)
Postrenal causes:
Obstruction (stones, tumor, BPH)
Neurogenic
What is the differential diagnosis for diplopia (double vision)?
Monocular diplopia (persists when good eye covered):
Cataracts
Dislocated lens
Binocular diplopia (resolves with either eye covered):
Strabismus
Cranial nerve palsy (CN III, IV, VI)
Diabetes
Myasthenia gravis
Multiple sclerosis
What is the differential diagnosis for Kussmaul’s sign?
Kussmaul’s sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration. It can be seen in some forms of heart disease and is usually indicative of limited right ventricular filling due to right heart failure.
Constrictive pericarditis
Right ventricular myocardial infarction
Tricuspid stenosis
Cardiac tamponade
What is the differential diagnosis for headaches?
Intracranial pressure causes:
Hypertensive encephalopathy
Brain tumor
Preeclampsia, eclampsia
Vascular causes:
Migraine
Temporal arteritis
Cerebrovascular accident
Pituitary apoplexy
Hematoma
Subarachnoid hemorrhage
Musculoskeletal causes:
Tension type
Temporomandibular joint syndrome
Infectious causes:
Meningitis
Brain abscess
Other causes:
Cluster headaches
Trigeminal neuralgia
Acute angle-closure glaucoma
Medication overuse or withdrawal
Red flags of serious headaches include sudden onset of severe pain, accompanying symptoms (impaired mental status, fever, seizures, focal neurological deficits) and new headaches beginning > 50 yo.
What is the differential diagnosis for acute diarrhea?
Diarrhea is the production of >200g of feces per day along with a change in stool consistency. Acute onset diarrhea is usually infectious and self-limiting. The causes of acute diarrhea can be inflammatory (which present with small volume, high frequency, often bloody diarrhea, with urgency, fecal WBC and RBC, and possible fever) or non-inflammatory (which present with high volume, watery diarrhea that is negative for fecal WBC). The most common cause of pediatric diarrhea is rotavirus infection.
Inflammatory causes:
Invasive bacteria (Salmonella, Campylobacter, C. difficile, E. coli, Shigella, Yersinia)
Protozoal (E. histolytica, amoebiasis)
Drugs (NSAIDs)
Inflammatory bowel disease
Non-inflammatory causes:
Non-invasive bacteria (S. aureus, B. cereus, C. perfringens, V. cholera)
Protozoal (Giardia)
Viral (Rotavirus, Norwalk virus, CMV)
Drugs (antacids, antibiotics, laxatives, Colchicine)
Sugars (lactose, sorbitol, mannitol)
What is the botanical differential diagnosis for amenorrhea?
Angelica sinensis
Chamaelirium luteum
Caulophyllum thalictroides
Verbena officinalis
Vitex agnus-castus
What is the differential diagnosis for tremors?
Intention tumors:
Benign essential tremor
Hypoglycemia
Brainstem lesion
Cerebellar lesion (MS, stroke, trauma)
Wilson’s disease
Sedative or alcohol withdrawal
Thyrotoxicosis
Pheochromocytoma
Anticonvulsant use
Resting tremors:
Parkinson’s disease
Wilson’s disease
Lewy body disease
Mercury poisoning
What is the differential diagnosis for hematuria?
Pre-renal causes:
Hematologic (coagulopathy, sickle cell disease, thromboembolism)
Leukemia
Neoplasms
Drugs (anticoagulants)
Renal causes:
Trauma
Infarct
Obstruction (renal colic, urolithiasis)
Neoplasms (renal cell carcinoma, bladder cancer, prostate cancer, Wilms tumor)
Inflammation (pyelonephritis, glomerulonephritis, interstitial nephritis)
Connective tissue disorders (Wegner’s, Goodpasture’s disease, SLE, Churg-Strauss, Henoch-Schonlein purpura, polyarteritis nodosa)
Hereditary (polycystic kidneys, Alport’s syndrome, arteriovenous malformation)
Post-renal causes:
Obstruction (nephrolithiasis, polyps, tumor, urethral stricture)
Inflammation (prostatitis, cystitis, urethritis)
Pseudohematuria:
Vaginal bleeding
Dyes (beets, rhodamine B)
Hemoglobin (hemolytic anemia)
Myoglobin (rhabdomyolysis)
Drugs (rifampin, phenazopyridine, pyridium, phenytoin)
Porphyria
Laxatives (phenolphthalein)
Gross painless hematuria is bladder cancer until proven otherwise.
What is the homeopathic differential diagnosis for diarrhea?
Arsenicum (< cold)
Gelsemium (from fright, > continued motion)
Podophyllum (< heat, morning)
Sulphur (< heat, morning)
Veratrum (< cold, motion)
What is the differential diagnosis for hematemesis?
Hematemesis is passage of dark brown, partially digested blood by mouth. It usually presents with coffee-grounds consistency, and may be accompanied by melema, hematochezia and symptoms of blood loss including shock, dizziness and dyspnea.
Upper gastrointestinal causes:
Oral laceration
Pharyngeal lesion
Esophageal varices or laceration
Gastric causes:
Bleeding gastric ulcer
Bleeding duodenal ulcer
Stress ulcer
Gastric laceration
Non-gastrointestinal causes:
Aspirin or NSAID use
Caustic toxic ingestion
What is the differential diagnosis for chronic dyspnea?
Cardiac causes:
Valvular disease
Decreased cardiac output (CHF)
Respiratory causes:
Upper airway obstruction (tumor)
Airway disease (asthma, COPD)
Parenchymal lung disease (interstitial disease, fibrosis, bronchiectasis, sarcoidosis)
Pulmonary vascular disease (pulmonary hypertension, vasculitis)
Pleural disease (effusion, mesothelioma)
Gastrointestinal causes:
Gastroesophageal reflux disease
Hematologic causes:
Severe anemia
Neuromuscular causes:
Amyotrophic lateral sclerosis
Myasthenia gravis
What is the differential diagnosis for sore throat?
Streptococcal or viral pharyngitis
Infectious mononucleosis
Tonsillitis
Peritonsillar abscess
Leukemia
Hodgkin’s disease
What is the homeopathic differential diagnosis for hypertension?
Belladonna (< heat, motion, lying down)
Glonoine (< heat, especially around the head)
What is the differential diagnosis for restrictive lung disease?
Pneumonia
Acute respiratory distress syndrome
Interstitial lung disease
Pulmonary fibrosis
Scleroderma
Pulmonary edema
Effusion
Neuromuscular disease (myasthenia gravis, poliomyelitis)
Chest wall disease (scoliosis)
What is the differential diagnosis for loss of vision?
Transient vision loss:
Transient ischemic attack
Migraine with aura
Acute vision loss:
Trauma/foreign body
Cerebrovascular accident
Occipital infarction
Retinal artery or vein occlusion
Retinal detachment
Uveitis
Optic neuritis
Chronic vision loss:
Cataracts
Corneal dystrophy
Corneal ulcer
Macular degeneration
Glaucoma
Diabetic retinopathy
Compressive optic neuropathy (intracranial mass, pituitary tumor, orbital mass)
Pituitary adenoma
Nutritional deficiency
What is the differential diagnosis for constipation?
Constipation is defined as infrequent bowel movements (typically less three times per week), often with difficulty or straining during defecation. The most common cause is inadequate fiber or fluid intake.
Obstructive causes:
Colorectal cancer
Stricture
Extrinsic compression
Rectocele
Metabolic causes:
Diabetes
Thyroid dysfunction
Hypercalcemia, hypokalemia
Neurological causes:
Parkinson’s disease
Multiple sclerosis
Stroke
Collagen vascular disease:
Scleroderma
Dermatomyositis
Iatrogenic causes:
Narcotics
Antidepressants
Calcium channel blockers
What is the differential diagnosis for syncope?
Syncope is a sudden, transient loss of consciousness and postural tone secondary to abrupt drops in cerebral perfusion.
Cardiac causes:
Acute coronary syndrome
Ventricular arrhythmia
Acute atrial fibrillation
Tachycardia
Heart block
Myocardial infarction
Aortic dissection
Congestive heart failure
Valvular disease (aortic or mitral stenosis)
Outflow obstruction (pulmonary embolism, cardiac tamponade, tension pneumothorax, pulmonary hypertension)
Neurologic causes:
Vasovagal
Orthostatic hypotension
Epilepsy, seizure
Dysfunctional brainstem
Cerebrovascular disorders
Metabolic causes:
Hypoglycemia
Addison’s disease
Hypoxemia
Alcohol intoxication
Psychogenic causes:
Anxiety
What is the differential diagnosis for lower GI bleeds?
Common causes:
Diverticulosis
Ischemia
Angiodysplasia
Infection
Anorectal (hemorrhoids, fissures, ulcers)
Uncommon causes:
Post-polypectomy
Radiation colitis
Irritable bowel disease
Upper GI bleed
What is the differential diagnosis for abnormal uterine bleeding?
Gynecological causes:
Cervical cancer
Endometrial hyperplasia or carcinoma
Leiomyoma (fibroids)
Adenomyosis
Pelvic inflammatory disease
Copper IUD
Infection (endometritis*, cervicitis, vaginitis, STI)
Obstetric causes:
Miscarriage
Ectopic pregnancy
Placenta previa
Endocrine causes:
Polycystic ovarian syndrome
Hyper or hypothyroidism
Adrenal insufficiency
Insulin resistance
Prolactinoma
Estrogen producing tumor
Weight loss
Hematological causes:
Coagulopathy (von Willebrand’s disease)
Platelet abnormalities (immune thrombocytopenic purpura)
Hematologic malignancy (leukemia, lymphoma)
Renal causes:
Impaired estrogen excretion
Hepatic causes:
Decreased coagulation factors
Impaired estrogen metabolism
Drug causes:
Anticoagulants
Danazol
OCP, HRT
Spironolactone
Steroids
Neuroleptics
What is the differential diagnosis for dysphagia?
Dysphagia is difficult swallowing.
Mechanical dysfunction (symptoms primarily with solids):
Eosinophilic esophagitis
Stricture
Schatzki ring/esophageal web
Zenker’s diverticulum
Extrinsic compression (thyromegaly, tumor)
Mobility dysfunction (symptoms with solids and liquids):
Diffuse esophageal spasm
Achalasia
Scleroderma
Neurological dysfunction* (cortical, bulbar, peripheral)
Muscular dysfunction (muscular dystrophy, myasthenia gravis, polymyositis)
What is the differential diagnosis for dyspareunia?
Introital pain:
Inadequate lubrication
Rigid or intact hymen
Bartolin’s or Skene’s gland infection, abscess*
Lichen sclerosus
Vulvovaginitis (atrophic, chemical, infectious)
Herpes simplex
Midvaginal pain:
Urethritis
Short vagina
Trigonitis
Vaginal atrophy
Congenital abnormality of the vagina
Deep pain:
Endometriosis
Endometritis
Cervicitis
Adenomyosis
Leiomyoma (fibroids)
Pelvic inflammatory disease
Hydrosalpinx
Tubo-ovarian abscess
Uterine retroversion
Ovarian cyst
What is the differential diagnosis for claudication?
Vascular causes:
Atherosclerotic disease
Vasculitis (Buerger’s disease, Takayasu’s arteritis)
Diabetic neuropathy
Venous disease (deep vein thrombosis, varicose veins)
Neurologic causes:
Neuro Spinal disease (spinal stenosis)
Reflex sympathetic dystrophy
Musculoskeletal causes:
Osteoarthritis
Rheumatoid arthritis
Connective tissue disease
What is the differential diagnosis for jaundice with conjugated (direct) hyperbilirubinemia?
Serum bilirubin is a maker of RBC metabolism and hepatic excretion. Unconjugated bilirubin is a breakdown product of hemoglobin destruction, which travels to the liver where it becomes conjugated before being excreted.Thus, elevation of conjugated bilirubin in the serum is indicative of a pathology downstream of the liver.
Impaired hepatic secretion:
Hepatic disease (hepatitis,, cirrhosis)
Metabolic disease (Wilson’s disease, hemochromatosis)
Drug-induced cholestasis (OCP, chlorpromazine)
Primary biliary cirrhosis
Primary sclerosing cholangitis
Sepsis
Extrahepatic, intraductal biliary obstruction:
Gallstone
Biliary stricture
Parasites
Malignancy (cholangiocarcinoma)
Sclerosing cholangitis
Extrahepatic, extratraductal biliary obstruction:
Malignancy (pan occlusion, pancreatic cancer)
Inflammation (pancreatitis)
What is the botanical differential diagnosis for hypertension?
Adrenergics:
Rauwolfia serpentina
Circulatory stimulants:
Allium cepa/sativum
Theobroma cacao
Camellia sinensis
Inotropics:
Crataegus oxycantha
Vasodilators:
Coleus forskohlii
Ganoderma lucidum
Tilia europaea
Veratrum alba/viride
Vinca minor/major
Viscum flavescens
What is the botanical differential diagnosis for varicose veins and hemorrhoids?
Centella asiatica
Hamamelis virginiana
Aesculus hippocastanum
Geranium maculatum
Vaccinium myrtillus
“Curse My Hemorrhoids And Giant Veins”
What is the botanical differential diagnosis for dermatitis?
Calendula officinalis
Quercus alba
Symphytum officinale
What is the differential diagnosis for emergent coma?
Primary CNS disease:
Epilepsy
Diffuse trauma or ischemia
Compression (tumor, hematoma)
Brainstem infarct or hemorrhage
Metabolic causes:
Acid or base disorders
Hypo- or hyperglycemia
Endocrine disorders
Electrolyte disturbances
Hypoxia
Lactate
Toxic causes:
Alcohol
Infection, sepsis
Rapid or abrupt onset suggests CNS hemorrhage, ischemic or cardiac causes. Gradual progression suggests CNS lesion, toxic or metabolic causes.
What is the botanical differential diagnosis for threatened miscarriage and premature labor?
Uterine tonics
Angelica sinensis
Chamaelirium luteum
Caulophyllum thalictroides
Mitchella repens
Spasmolytics:
Cimicifuga racemosa
Dioscorea villosa
Viburnum opulus
What is the differential diagnosis for emergent headache?
Meningitis
Increased intracranial pressure
Temporal arteritis
Subarachnoid hemorrhage
Red flags of serious headaches include sudden onset of severe pain, accompanying symptoms (impaired mental status, fever, seizures, focal neurological deficits) and new headaches beginning > 50 yo.
What is the differential diagnosis for GI bleeds?
Common causes:
Ulcers
Esophageal varices
Mallory-Weiss tears
Erosive esophagitis
Erosive gastritis
Uncommon causes:
Tumors
Arteriovenous malformation
Gastric antral vascular gastropathy
Portal hypertensive gastropathy
What is the botanical differential diagnosis for wet cough?
Stimulating expectorants:
Asclepias tuberosa
Aspidosperma quebracho
Lobelia inflata
Sanguinaria canadensis
Mixed expectorants
Inula helenium
Anticatarrals
Solidago odora
What is the differential diagnosis for infective diarrhea?
Watery diarrhea with minimal abdominal pain and no fever:
Staphylococcus aureus
Clostridium perfringens
Vibrio cholera
Enterotoxigenic E. coli
Watery diarrhea with moderate abdominal pain and variable fever:
E. coli
Giardia
Bloody diarrhea with severe abdominal pain and mild fever:
Hemorrhagic E. coli
Clostridium difficile
Bloody diarrhea with severe abdominal pain and high fever:
Salmonella
Campylobacter
Shigella
Enterovasive E. coli
Entamoeba histolytica
What is the botanical differential diagnosis for symptoms of menopause?
Humulus lupulus
Angelica sinensis
Linum usitatissimum
Trifolium pratense
Salvia officinalis
Medicago sativa
“HALTS Menopause”
What is the botanical differential diagnosis for hypoadrenocorticism (adrenal fatigue)?
Eleutherococcus senticosus
Glycyrrhiza glabra
What is the botanical differential diagnosis for urinary tract infections?
Antimicrobials
Arctostaphylos uva ursi
Barosma betulina
Berberis aquifolium/vulgaris
Juniperus communis
Glycyrrhiza glabra
Antiadhesions
Vaccinium macrocarpon
Alteratives:
Equisetum arvense
Galium aparine
Diuretics:
Hydrangea arborescens
Urtica dioica (leaf)
Solidago odora
Taraxacum officinle (leaf)
Anodynes:
Salix alba
Demulcent:
Ulmus rubra
