DDx/CBL/Disease profiles Flashcards
1
Q
Tachycardia + heart murmur
A
- Cardiovascular system, heart failure
(valvular disease, DCM, HCM, functional murmur congenital defect, arrhythmias) - Shock (not evident on exam)
- Systemic disease: Sepsis; Toxins; Anaemia (no evidence on further diagnostics: RBC count); Hyperthyroidism
- Physiological – Stress, fear, pain (but heart rate very high)
2
Q
Goitre
A
- Thyroid mass
- Mass unrelated to thyroid
3
Q
Unkempt/poor coat
A
- Diet
- Age-related change
- Lack of grooming - Lethargy – systemic disease; Oral disease - disinclination to groom; Osteoarthritis resulting in animals inability to groom (no evidence on clinical exam and doesn’t explain PP/weight loss)
- Endocrine disease: hyperthyroidism; hypothyroidism; DM
4
Q
Weight loss
A
- Liver disease
- Neoplasia
- Decreased nutrient intake
- Change in diet; Anorexia; Oral disease; Dysphagia
- Increased nutrient loss - Chronic blood loss (no evidence on diagnostics: RBC); Neoplasia; Parasites (receiving routine prophylaxis); PLE; PLN; Diabetes Mellitus; Regurgitation/vomiting; Maldigestion/Malabsorption
- Increased nutrient use - Endocrine - hyperthyroidism; Neoplasia; Physiological, cold, exercise, lactation, pregnancy; Fever
5
Q
Polyphagia
A
- Endocrine - DM; Hyperadrenocorticism; Hyperthyroidism; Insulinoma (glucose normal)
- Change in diet
- Concurrent drugs - glucocorticoids, benzodiazepines, progestogens
- Increased nutrient loss - EPI; Malabsorption
- Increased nutrient use - Neoplasia
- Physiological - Pregnancy; Lactation; Increased exercise; Cold environment
6
Q
Aggression
A
- Pain
- Behavioural
- Stress
7
Q
Anorexia
A
- Diet
- Oral disease
- Behavioural - stress
- Swallowing disorders
- Systemic disease
- Fever
- Pain
8
Q
PUPD
A
- Diet - Increased salt intake
- Drugs/toxins
- Renal disease - AKI; CKD; Pyelonephritis; Glomerulonephritis
- Liver disease
- Endocrine disease - Hyperadrenocorticism; Hypoadrenocorticism; Diabetes mellitus; Diabetes insipidus; Hyperthyroidism; Insulinoma
- Electrolyte disorder - Hypercalcaemia; Hypernatraemia; Hypokalaemia
- Infectious disease - Toxaemia e.g. pyometra
- Psychogenic polydipsia
- Dehydration – GIT disease
9
Q
Loose stools
A
- Diet
- Drugs/toxins
- Extra-gastrointestinal disease
- Infection
- Inflam/immune-mediated bowel disease
- Motility disorder
- Neoplasia
10
Q
Weight gain/distension of abdo
A
- Abdominal neoplasia
- Abdominal fluid - free fluid
- Increased body fat
- Endocrine disease - Hyperadrenocorticism, Hypothyroidism, Hypogonadism
- Overeating
- Increased organ size - Hepatomegaly; Renomegaly; Splenomegaly; Uterine enlargement
- Abdominal H+
11
Q
Pale mucous membranes
A
- Poor perfusion - shock
- Cardiogenic shock - Primary cardiac disease: cardiomyopathy, valvular insufficiency, myocarditis, myocardial infarction, congenital heart disease; Secondary cardiac disease: pericardial tamponade, electrolyte derangement.
- Obstructive shock: tension pneumothorax, caval syndrome, emboli
- Hypovolaemic shock: Haemorrhage: trauma, ruptured neoplasia, GIT bleeding, bleeding disorders (primary hemostasis disorders, secondary haemostatic disease (coagulopathies)
- Dehydration - fluid loss: GIT disease, renal disease, 3rd spacing (ascites, pleural effusion)
- Distributive shock: Sepsis: acute abdomen- ruptured GIT; reproductive tract; urinary tract; Anaphylactic
12
Q
Anaemia
A
Regenerative
- Haemorrhage e.g. following trauma
- Haemolysis e.g. mycloplasma haemofelis infection, Feline Leukaemia Virus (FeLV), immune-mediated, toxin ingestion,
neonatal isoerythrolysis (no evidence on blood smear)
- Consumption e. g. flea infestation
Non regenerative - primary diseases of bone marrow, FeLV, iron deficiency renal disease (EPO)
13
Q
Tachycardia
A
- Non-cardiogenic - fear; pain; shock; anaemia; sepsis; pericardial disease; toxins; hypoxia
- Cardiogenic - HF - valvular disease, DCM, arrhythmias
14
Q
Heart murmur
A
- Anaemia
- Heart disease - e.g. ventricular septal defect, pulmonic stenosis, tetralogy of fallot, mitral + tricuspid valve dysplasia
- Innocent murmur - incidental
15
Q
Hypothermia
A
- Drugs
- Cardiac disease
- Hypothyroidism/hypoadrenocorticism
- Sepsis
- Environment
- Hypothalamic disorder
- Shock
16
Q
Inappetence
A
- Diet (no change)
- Oral disease
- Behavioural - stress
- Swallowing, prehending, masticating disorders - dysphasia
- Systemic disease
- Fever
- Pain
- Infection
- Secondary to other disease
- Anosmia (no sense of smell)
- Resp disease
- CVS
- Endocrine disease - ketoacidosis
- Pancreatic disease
- Renal disease
- Hepatic disease
- GIT disease
17
Q
Vomiting
A
- Dietary
- Drugs/toxins
- Endocrine disease
- Metabolic/systemic disease
- GIT disease
18
Q
Jaundice/icterus
A
- Pre-hepatic - Haemolytic anaemia; Internal haemorrhage; Severe myolysis
- Hepatic - Drugs/toxins; Intrahepatic cholestasis; Infection; Inflammation (cholangitis/cholangiohepatitis); Amyloidosis; Cirrhosis; Hepatic lipidosis; Neoplasia
- Post-hepatic - Bile duct obstruction; Pancreatitis or pancreatic neoplasia; Biliary duct neoplasia; Biliary rupture
19
Q
Enlarged liver
A
- Drugs
- Endocrine disease
- Inflam/infection
- Amyloidosis
- Cholestasis
- Cirrhosis
- Hepatic lipidosis
- Storage disease
- Neoplasia
- Venous congestion
20
Q
Muscle wasting
A
- Disuse atrophy
- Metabolic/endocrine/systemic disease
- Myopathies - generalised usually
- Neurogenic - marked
21
Q
Collapse
A
- CVS
- Neurogenic
- Respiratory
- MSK
- Metabolic - hypoglycaemia, hypoadrenocorticism, hypothyroidism
22
Q
LHS systolic heart murmur
A
- DCM
- Mitral valve degeneration
- Functional murmur
- Undiagnosed congenital heart defect e.g. subaortic stenosis/pul stenosis/VSD
23
Q
Reduced exercise tolerance
A
- Cardiovascular - Arrhythmias; CHF; Myocardial dysfunction; Obstruction to ventricular outflow
- Haemopoietic - Anaemia
- Metabolic/endocrine - Hypothyroidism, Hypoadrenocorticism, Hypoglycaemia, Hypokalaemic polymyopathy
- Respiratory - Upper respiratory: Laryngeal paralysis; Lower respiratory – parenchymal disease, Idiopathic pulmonary fibrosis, Pneumonia, Pulmonary oedema; Pleural space
- Pleural effusion
- Neuromuscular - Myasthenia gravis; Polymyositis; Polyarthritis; Peripheral polyneuropathy; Myopathy (congenital, metabolic, toxic); Spinal cord disease chronic intervertebral disc disease; Lumbosacral pain
24
Q
Tachypnoea
A
- Physiological - Exercise; Fear; High ambient temperature; Pain
- Upper airway disease
- Lung parenchymal disease
- Restrictive disorders - Diaphragmatic hernia; Thoracic neoplasia; Pleural effusion; Pneumothorax
- Systemic disorders - Anaemia; Metabolic acidosis – compensatory; Central neurological disease; Acute respiratory distress syndrome
25
Panting
- Physiological - fear, pain, exercise, ambient temperature
- Pathological - upper respiratory; lower respiratory - bronchial disease; parenchymal disease: infection, trauma, toxins, oedema (CHF common cause)
26
Cough
- Infection
- Inflammation e.g. asthma
- Irritants
- Pulmonary neoplasia
- Pulmonary haemorrhage
- Pulmonary oedema (CHF common cause)
- Miscellaneous - pulmonary fibrosis inhaled foreign body (acute); laryngeal paralysis (often worse on exercise); left atrial enlargement
27
Harsh lung sounds throughout lung fields
- Pulmonary exudate
- Pulmonary haemorrhage
- Pulmonary fibrosis
- Pulmonary oedema
- Bronchoconstriction
28
Pulse deficits
- Tachyarrhythmias - cardiac disease
29
Perivulvar erythema and clear vulval discharge
Urogenital
- Urinary Incontinence/UTI
- Genital tract disease - likely licking causing erythema
- Entire bitch - uterine changes - mucometra
30
Lame hind limb + worse w/ exercise
- Fracture distal femur/patella/prox tibia/fibula
- Tibial tuberosity avulsion
- Cranial cruciate ligament rupture
- Caudal cruciate ligament rupture
- Long digital extensor tendon avulsion
- Meniscal tear
- Patellar ligament avulsion/tear
- Patellar luxation
- Degenerative joint disease
- Inflammatory joint disease
- Haemarthrosis
- Neoplasia – synovial sarcoma
31
Difficulty rising
- Muscle weakness
- Pain
- Joint instability
32
Effusion + pain of stifle
- Trauma
- DJD
- Neoplasia
- Inflammatory joint disease - Infectious: Bacterial (septic), Lyme’s disease; non-infectious: immune-mediated polyarthropathy, SLE (Systemic lupus erythematosus), Rheumatoid
33
Ataxia
- Peripheral nerve disease
Abnormal mentation, CN affected, proprioceptive, intention tremor, hypermetria
- Forebrain disease
- Cerebellar disease
- Brain stem disease
- Spinal cord disease
- Peripheral nerve disease
34
Head tilt/nystagmus
Vestibular disease
- Central vs peripheral
- Peripheral - drugs/toxins; idiopathic vestibular disease; immune-mediated /infectious; otitis interna; neoplasia; metabolic
- Hypothyroidism
35
Peripheral disease (neuro)
- Alert mentation
- Head tilt/ataxia e.g. circling towards side of lesion
- Nystagmus - horizontal or rotational fast phase away from lesion
- Positional strabismus (eye drop)
- Normal conscious proprioception
- Cranial n VII deficit - Horner's syndrome (miosis, ptosis - eyelid drooping, enophthalmos, sinking eyes into socket)
36
Central disease
- Abnormal/depressed mentation
- Head tilt to side of lesion but can be paradoxical
- Nystagmus - horizontal, rotatory, vertical or positional
- Proprioceptive deficits
- Ipsilateral hemiparesis/quadriparesis
- Hopping + placing deficits
37
Neck pain - neurological
- Steroid-responsive meningitis - arteritis
- Granulomatous meningoencephalomyelitis
- Intervertebral disc disease
- Chiari like malformation/syringomyelia
- Cervical spondylomyelopathy
- Atlanto-axial instability
- Vertebral fracture
- Vertebral neoplasia
- Discospondylitis
- Facet joint pain (djd)
- Intracranial lesion (stretched meninges)
- Spinal cord haemorrhage
38
Neck pain - non-neurological
- Infection/inflammation in soft tissue
- Otitis media
- Soft tissue neoplasia
- Temperomandibluar joint pain
- Thoracic pain
- Proximal humerus/scapula injury
39
Tetraparesis R > L
- Atlanto-axial instability
- Cervical spondylomyelopathy
- Discospondylitis
- Fibrocartilaginous embolism
- Fracture
- Steroid responsive meningitis – arteritis
- Granulomatous meningoencephalomyelitis
- Intervertebral disc disease
- Neoplasia
- Subarachnoid cysts
- Spinal cord haemorrhage
- Chiari like malformation/syringomyelia
40
Lesion located to C1 - C5
- Neck pain
- Horner's syndrome
- Proprioceptive deficits x 4
- Normal or inc myotatic reflexes x 4
- Tetraparesis/plegia
- Inc limb tone x 4
- Upper motor neurone bladder
41
Lesion located to C6 - T2 (Brachial plexus, LMN signs forelimbs)
- Absent cutaneous trunci (panniculus) reflex
- Neck pain
- Decreased thoracic limb tone/withdrawal reflex
- Decreased thoracic limb myotatic reflexes
- Proprioceptive deficits x 4
- Tetraparesis/plegia forelimbs
- Normal or increased hind limb myotatic reflexes
- Increased hind limb muscle tone
- Upper motor neuron bladder
42
Lesion located to T3 - L3
- Absent cutaneous trunci near level of lesion
- Paraparesis/plegia
- Back pain
- Proprioceptive deficits in hind limbs
- Normal or increased hind limb myotatic reflexes
- Increased hind limb muscle tone
- Upper motor neuron bladder
43
Lesion located to L4 - S3 (lumbosacral plexus, LMN signs, hind limbs)
- Decreased anal tone/reflex
- Lower motor neuron bladder
- Decreased hind limb myotatic reflexes
- Decreased hind limb muscle tone/ withdrawal reflex
- Lumbosacral pain
- Paraparesis/plegia
- Hind limb proprioceptive deficits
- Limp tail
44
Pruritus
- Parasites - fleas, sarcoptes scabiei, cheyletiella, demodex, trombiculiasis
- Allergy - Atopy, contact allergy, food allergy, flea allergy
- Primary or secondary pyoderma
- Fungal - dermatophytosis, malassezia (not seen on cytology)
- Immune-mediated - drug reactions, systemic/discoid lupus erythematous,
pemphigus
- Neoplasia - mast cell tumour, neoplasia with secondary pyoderma
- Solar dermatitis
- Zinc deficiency
- Behavioural
- Immune-mediated - no vesicles, ulcerations
- Drug eruption
45
Papular, crusting rash
- Sarcoptes scabiei
- Dermatophytosis
- Miliary dermatitis e.g. flea allergy
- Primary superficial pyoderma
- Secondary pyoderma to atopy, food allergy, contact allergy; parasites - fleas, demodex
- Pemphigus foliaceous
- Systemic lupus erythematous
- Drug reactions
46
Alopecia
- Self-trauma 2y to pruritus
- Demodecosis
- Dermatophytosis
- Bacterial folliculitis
- Endocrine disease - hypothyroidism, hyperadrenocorticism
- Idiopathic cyclic flank alopecia
- Telogen defluvium caused by stress – anaesthesia, pregnancy, shock
- Alopecia x (breed predilection, non pruritic)
47
Erythema/papules
- Infection - pyoderma, demodicosis, dermatophytosis, Sarcoptes, trombiculosis
- Allergy
- Autoimmune disease
- Early neoplasia
48
Otitis externa
- Allergy - atopy, food, contact
- Parasites
- Dermatophytes
- Bacterial
- Endocrine - hypothyroidism
- FB
- Glandular abnormalities
- Autoimmune disease
49
Lameness (cat)
- Fracture
- Cat bite abscess
- Soft tissue injury e.g. from fall
- Neoplasia
- Joint infection
- Damage claw/ foot injury
- Migrating foreign body
- Osteomyeltitis
- Nutritional osteopathy
- Neuropathy
50
Pyrexia
- Bacterial infection - localised or generalised/multifocal
- Viral infection (much less likely cause than bacterial infection)
- Protozoal infection
- Stress
- Heatstroke
- Increased muscular activity- Seizures; Tetany; Exercise
