Ddx Flashcards
Cardiac causes of breathlessness
- Acute pulmonary oedema
- Cardiac arrhythmia
- Cardiac tamponade
- Chronic heart failure
- Silent MI
- SVC syndrome
Pulmonary causes for breathlessness
- Asthma
- Bronchiectasis
- COPD
- COVID-19
- ILD
- Lung/ lobar collapse
- Pleural effusion
- Pneumonia
- PTX/ tension PTX
- Pulmonary elmbolism
- Lung or pleural cancer
Shortness of breath
- Foreign body aspiration
- Acute epiglottitis (child)
- Acute asthma exacerbation, COPD
- Pulmonary embolism
- Pneumothorax
- Panic attack
Life-threatening vomiting
Sudden, severe pain (abdomen, chest)
Blood
* ↑ ICP
* Meningitis
* DKA
* MI
* Bowel obstruction
* Acute abdomen
Causes of airway compromise
- Inhaled foreign body
- Blood, vomit, secretions in airway
- Soft tissue swelling (edema)
- Local mass effect- tumours
- Lanryngospasm (asthma, GORD, intubation)
- Depressed level of consciousness
Petechial rash
- Meningococcus
- Acute leukaemia
- Vasculitis
- Thrombocytopaenia
- Dengue
- Severe vitamin deficiency- B12, folate
- Drugs- carbamazepine, valproate
Signs of focal neurological deficits
- Contralateral hemiparesis
- Sensory loss
- Cranial nerve palsy
- Slurred/ disorganised speech
- Impaired co-ordination
Signs of hypercalcaemia
Moans- depression
Groans- abdo pain
Stones- nephrocalcinosis
Bones- fracture
Headache emergencies
- Intracranial hemorrhage (SAH)
- Meningitis, Encephalitis (abscess)
- ↑ ICP (SOL- space occupying lesion)
- Hypertensive crisis
- Temporal arteritis
- Acute glaucoma
- Trauma
Headache Red Flags
SNOOP
* Systemic symptoms (fever, weight loss)- infection, malignancy
* Neurological- confusion, altered consciousness, focal neuro signs, neck stiffness (meningitis)
* Onset- sudden, ‘thunderclap’ (SAH!!), new-onset (in preggo- preeclampsia)
* Older- > 50 yo (giant cell arteritis)
* Positional/ papilledema- ICP issues (mass, cerebral spinal fluid leak); laying down worse, early morning nausea
Life-threatening limb pain
- Acute limb ischaemia
- Compartment syndrome
- DVT
- Necrotising fasciitis
- Septic arthritis, osteomyelitis
- Rhabdomyolysis
- MI (arm radiation)
- Gangrene
Back pain- serious causes
- Cord compression (e.g. metastatic)
- Cauda equina syndrome
- Malignant metastasis
- Myeloma
- Infection (e.g. discitis)
- Fracture
- Aortic aneurysm rupture
Causes of loss of consciousness
- Hypovolaemia
- Hypoglycaemia
- Seizures
- Cardiac arrhythmia
- SAH
- Encephalitis
- Sepsis
Life-threatening rash
- Meningococcal septicaemia
- Necrotising fasciitis
- Toxic epidermal necrolysis (TEN)
- Stevens-Johnson syndrome (SJS)
- Urticaria (anaphylaxis)
- Staphylococcal scalded skin syndrome
Life-threatening vaginal bleeding
- Massive bleed
- Ectopic pregnancy
- Ovarian cyst rupture
- Miscarriage
- Maternal sepsis- endometritis due to POC
Life-threatening hypotension
- Hypovolaemic/ haemorrhagic shock
- Septic shock
- Cardiogenic shock
- Anaphylactic shock
- Neurogenic shock
- Trauma
Causes of DIC
- Septicaemia
- Disseminated malignancy
- Incompatible blood transfusion reaction
- Obstetric emergencies
- Liver failure
- Severe trauma/ burns
Life-threatening abdominal pain
- Perforation
- Bowel infarction/ ischaemia
- Bowel obstruction
- Acute pancreatitis, cholangitis
- Appendicitis
- Leaking AAA
- Strangulation hernia
- Testicular or ovarian torsion
- Ruptured ectopic pregnancy
- Referred pain (MI, arotic dissection)
- Toxic megacolon
- Peritonitis
- DKA
Reduced GCS causes
- Trauma- head injury, spinal cord injury
- Neurological- stroke, seizures, meningitis, encephalitis, brain abscess, brain tumors
- Increased ICP- hydrocephalus, subdural haematoma
- Metabolic and endocrine- hypoglycaemia, hyperglycaemia, hypoxia, hypercapnia, hypo and hypernatraemia
- Hepatic encephalopathy, kidney uraemic encephalopathy, myxedema comma, thyroid storm
- Toxic- drugs, poison, alcohol
- Infection and sepsis
- CV- hypotension, cardiac arrest
- Respiratory- PE
- Hypo and hyperthermia
- Shock
Causes of falls
- CVS- MI, dysrrhythmia
- Infection- sepsis, shock
- Neuro- CVA, seizure, ataxia
- Metabolic- hypoglycaemia, hypoxia, excess alcohol
- MSK- deconditioning, arthritis, inadequate mobility aids
- Syncope
- Mechanical fall
- Postural hypotension
- Vertigo
- Polypharmacy
- Visual impairment
- Dehydration
Causes of delirium
Emergencies
* Hypoxia, hypercarbia
* MI
* CVA, intracranial bleed, meningitis, encephalitis
* Anticholinergic medication
Common
* Pain
* Sepsis
* Hypoglycaemia, hyponatraemia
* Drug toxicity (post-GA, NMS, serotonin syndrome, opioids, benzo, lithium)
* HF
* Head injury
* Alcohol withdrawal or intoxication
* Post-ictal
* Urinary retention, constipation
Life-threatening chest pain
- ACS
- Thoracic aortic aneurysm (aortic dissection)
- Tension PTX (pneumothorax)
- Cardiac tamponade
- PE (pulmonary embolism)
- Esophageal rupture
Back pain red flags
- Pain/ paresthesia/ weakness radiating to both legs
- Saddle anesthesia
- Bladder or bowel dysfunction
- Fever
- HIV/ steroid use/ immunocompromised
- Direct trauma
- History of cancer
- Age > 50 yo
- Persistent pain at rest and at night
Abdominal pain red flags
- Sudden, severe pain
- Vomiting
- High fever
- Bloody stools
- Unexplained weight loss
