Ddx's for station 5/2's Flashcards
Blackout / collapse
- Cardiac (AS, arrhythmias, HOCM)
- Vasovagal syncope
- BPPV
- Epilepsy / NEAD
- POTS
- Situational (micturition)
- Postural hypotension
- Subclavian steal syndrome
- Vertebrobasilar insufficiency (head extension in cervical OA)
- Carotid sinus hypersensitivity (head-turning, shaving)
Shortness of breath
- ILD (mention CTD screen!)
- Pulmonary HTN
- COPD / Bronchiectasis
- Infection
- Heart failure
- Asthma
- Acute: PE / PTX
- Malignancy
Acute confusion
- Infection
- Delirium
- Alcohol withdrawal
- Subdural haematoma
- Wernicke’s encephalopathy
- Dementia / Parkinsonism
- TIA / stroke
- Hypoglycaemia
- Depression / anxiety / psychosis
- Drug / alcohol intox
- Thyroid disease
- Charles Bonnet Syndrome / visual impairment
Acute back pain
- Osteoporosis / fracture (this is common - steroid use, rule out secondary causes. organise DEXA)
- Cauda equina / cord compression
- Malignancy - mets / myeloma / lymphoma
- Haematoma - warfarin use / injury?
- Ankylosing spondylitis
- Vascular claudication
- Sciatica / spinal stenosis
- Myelopathy
- AAA
- Shingles
- RA / PMR
Falls
- Mechanical (footwear / visual impairment)
- Polypharmacy
- Cardio: arrhythmias / orthostatic / bradycardia / valvular disease
- Neuro: Parkinson’s (don’t forget!), stroke, peripheral neuropathy
- Incontinence
- Infection
- Hypoglycaemia
- Arthritis / disuse atrophy / myopathy
- BPPV
- Environmental
- Cognitive impairment
- Alcohol withdrawal / intoxication
Abdominal pain
- Infection (gastroenteritis, pyelonephritis, UTI)
- IBD
- Pregnancy (ectopic) - do test!
- PID
- Perforated viscus
- Pancreatitis
- Ischaemic bowel (vasculopathy, hx of AF)
- AAA
- SBO
- Malignancy
- Cholangitis
- Biliary colic
- Dyspepsia
Headache
Primary headaches:
* Migraine, cluster headache, paroxysmal hemicranias, tension headache
Secondary headaches:
* ICH
* CVST
* GCA
* Hypertension
* Head/neck trauma, cervical radiculopathy, torticollis
* Medication overuse headache
* Trigeminal neuralgia / post-herpetic
* Infection
* Pre-eclampsia
* SOL
Haematemesis / malaena
- NSAID use (ask about concomitant RA / CTDs)
- Mallory-Weiss tear
- Malignancy
- Decompensated liver disease (variceal)
Nausea / vomiting
- Interaction between meds (clarithromycin for recent CAP, takes digoxin)
- Abx-related GI upset
- Malignancy
- Pregnancy
- Infection
Chest pain
- Cardio: ACS, dissection, myo/pericarditis, PE, valve disease, cardiomyopathy
- Acute resp: pneumothorax, pneumonia, PE
- Infection (shingles)
- Pericardial effusion (CTD, SLE)
- MSK / costochondritis / rib fractures
- Acute sickle cell chest crisis
Seizure
- Alcohol withdrawal / drug intoxication
- Epilepsy - any reason to lower the seizure threshold? Meds compliance? Drug interactions
- Hypoxia
- Hypoglycaemia / uraemia / hepatic encephalopathy
- Trauma (ICH, SDH)
- SOL
- Stroke / TIA
- Infection
- Seizure mimics: syncope, NEAD, dystonia, rigors, arrhythmias
Palpitations
- Hyperthyroidism
- Arrhythmia: SVT, WPW, heart block, AF, ventricular ectopy
- Sinus tachycardia: anxiety, pain, caffeine, PE
- Phaeochromocytoma
Weakness / paralysis
- TIA / stroke - ASK ABOUT DRIVING!
- Todd’s paresis
- Myopathies
Acute / chronic kidney disease
- Dialysis complications: fever and pain in fistula arm (NB assess for ischaemia in distal limb), SBP in PD, tunnelled line infection
- Renal anaemia
- Secondary hyperparathyroidism
Fever / PUO
Infective
- IE / subacute IE
- Dressler’s syndrome
- Soft tissue infection translocation
- TB
- Intra-abdominal abscess
- Discitis
- Osteomyelitis
- Neutropaenic sepsis
- Throat / sinus infection - look in the throat, feel the LN’s
- Don’t forget risk factors (HIV, IVDU) and travel history, unwell contacts at home
Inflammatory:
- Vasculitis
- SLE
- RA
- IBD
- Reactive arthritis
- PMR / GCA
- Still’s disease
Neoplastic:
- Lymphoma / leukaemia
- Metastases
Miscellaneous:
- DVT
- Hepatitis
- Sarcoid
- Drug fever
