Differential Diagnoses Game! Flashcards

1
Q

DDx for Headache

A

Tension type headache
Migraine with/without aura
Medication overuse headache
Meningitis/Encephalitis
Space occupying lesion

Idiopathic Intracranial Hypertension
Cervicogenic
Cluster headache (uncommon - Males 20-40yrs)
Giant Cell Arteritis
Medication Side Effect: eg. calcium channel blocker

Subarachnoid haemorrhage
Trigeminal neuralgia
Haemorrhagic stroke
Venous Sinus Thrombosis
Malignant Hypertension
Acute glaucoma

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2
Q

Name Organic Causes of Psychosis

A

Brain space occupying lesion
Encephalitis
Neurosyphilis
Substance abuse/intoxication/withdrawal
Temporal Lobe epilepsy
Hypoglycaemia/hyperglycaemia
Hypothyroidism/Myxoedema, Thyrotoxicosis
CNS infection: Encephalitis/Meningitis
Space occupying lesion
Electrolyte abnormality
Metabolic abnormality
Sleep deprivation
HyperPTH
Cushing disease
Cerebrovascular disease
HIV infection
Neurosyphilis
Vitamin B deficiency
Creutzfeldt Jakob Disease
Heavy Metal Toxicity
Wilson Disease
SLE

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3
Q

Mental Health related Causes of Psychosis

A

Schizophreniform disorder (if <6mo)
Schizophrenia (if >6m)
Manic episode of bipolar affective disorder
Brief psychotic episode/disorder
Depression with psychotic features
Delusional disorder
Alcohol/Substance induced psychosis

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4
Q

DDx Syncope

A

Vasovagal
Situational (eg. micturition, coughing, post prandial)
Orthostatic
Tachy/brady arrhythmia or Long QT syndrome
Seizure
Psychogenic pseudoseizure
Alcohol intoxication
Subarachnoid haemorrhage
Carotid sinus massage
Aortic stenosis/HOCM

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5
Q

DDx Acute Red Eye

A

Conjunctivitis - bacterial, viral, allergic
Blepharitis
Foreign body
Corneal abrasion
Contact hypersensitivity
Subjunctival haemorrhage
Orbital cellulitis
HSV keratitis (painful)
Corneal ulcer (painful)
Scleritis/episcleritis
Acute uveitis/iritis
Acute glaucoma (fixed dilated pupil, blurry vision)

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6
Q

DDx Acute Visual Loss

A

Retinal detachment (flashing lights)
Optic Neuritis (painful)
Retinal Artery Occlusion (CV risk factors)
Retinal vein occlusion (CV risk factors)
Posterior vitreous detachment
Vitreous haemorrhage
Acute angle glaucoma (painful and blurring, fixed semi-dilated pupil)

Non-Orbital:
Amaurosis Fugax secondary to CVA
Giant cell arteritis
Migraine with or without headache
Papilloedmea (idiopathic intracranial hypertension)

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7
Q

Specific causes of mechanical back pain

A

Muscular tear or strain
Mechanical back pain
Pathological Fracture
Disc prolapse
Facet joint pain
Osteoporotic fracture

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8
Q

DDx Peripheral Neuropathy

A

Diabetes
Vitamin B12 deficiency
Vitamin B1 deficiency (usu. ETOH use or Bariatric Surgery)
Neurotoxic drugs (eg amiodarone, nitrofurantoin)
Immunological eg. Guillain-Barré syndrome
Vasculitis
Sarcoidosis
Leprosy
Heavy metal poisoning
Porphyria

Localised:
Nerve root compression/disease
Physical trauma
Compartment syndrome
Carpal/Tarsal tunnel syndrome

Asychronous pattern:
Mononeuritis multiplex

Mixed UMN/LMN: MS or ALS

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9
Q

DDx Shoulder Pain

A

Fracture/dislocation
Rotator cuff tear (Usu. Supraspinatus)
Labral tear
Gleno-humeral subluxation
Biceps tendinopathy

Tendinopathy/calcific tendonitis
Bursitis
Impingement
Degenerative tears
Adhesive capsulitis/frozen shoulder
Septic arthritis

Cervical pathology
OA
Rheumatological (PMR, RA)
Malignancy (rare)
Extrinsic (esp if normal ROM): PE, AMI, hepatobiliary

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10
Q

DDx Tremor

A

Physiological (50% autosomal dominant)
Benign essential (familial) - most common
Anxiety (
Hyperthyroidism
Toxicity (eg. alcohol, liver failure, uraemia)
Drugs (eg. lithium, narcotic withdrawal, drug-induced parkinsonism)
Parkinson’s Disease
Cerebellar Disease
Cerebral tumour
Alzheimer Dementia
Wilson Syndrome

Other: hypoglycaemia
Other involuntary movements: myoclonus, tic, chorea, dystonia, fasciculations

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11
Q

DDx Urinary Symptoms - general

A

General:
UTI (acute/chronic)
Urethral stricture
STI
Bladder calculi
Interstitial cystitis
OAB
Neurological condition
Diabetes
Iatrogenic
Constipation

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12
Q

DDx Lower Urinary Symptoms - male

A

General:
UTI (acute/chronic)
Urethral stricture
STI
Bladder calculi
Interstitial cystitis
OAB
Neurological condition
Diabetes
Iatrogenic
Constipation

Male:
BPH
Prostate or Bladder Ca
Phimosis
Prostatitis (acute/chronic)

Female:
Vaginal prolapse
Vaginal atrophy

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13
Q

DDx Vertigo

A

BPPV
Vestibular neuritis
Meniere’s Disease
Labyrinthitis
CVA, Vertebrobasilar insufficiency
MS
Space occupying lesion/tumour
Cholesteatoma
Acoustic neuroma/vestibular schwannoma
Ramsay-Hunt syndrome
Psychogenic
Perilymphatic fistula

Non-Vertiginous: syncope, light-headedness
Frusemide induced ototoxicity

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14
Q

DDx Child with a Limp

A

Transient Synovitis
Septic arthritis
Fracture/MSK
NAI
Malignancy
Vasculitis: HSP
Referred pain

DDH
Toddler’s Fracture

Perthes Disease

SUFE
JIA
Osgood Schlatter Disease

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15
Q

DDx Heel Pain

A

Plantar Fasciitis
Calcaneal Fat Pat Atrophy
Achilles Tendinopathy
Retrocalcaneal Bursitis
Calcaneal stress fracture
Calcaneal apophyisis (usu. Children)

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16
Q

DDx Fever in a Returned Traveller

A

Fever Alone:
Malaria
Typhoid
Dengue Fever
Hepatitis A
Chikungunya
Rickettsial infection

Fever + Diarrhoea
As above PLUS
Traveller’s Diarrhoea
Cholera
Dysentry

Fever + Respiratory
Malaria
Pnuemonia (typical or atypical)
Influenza
Pulmonary tuberculosis
Viral respiratory (eg. Rhinovirus)

Fever + STI risks
Hepatitis
Syphilis
HIV
Gonorrhoea/Chlamydia

Non-Vaccinated
Measles
Rubella

Onset >2 weeks after travel
Malaria
EBV
CMV
Toxoplasmosis
Acute HIV
Acute Shistosomiasis
Brucellosis
TB
Q fever
Malaria
Acute Hepatitis

17
Q

DDx Uncontrolled Hypertension

A

Phaeochromocytoma
Conn’s Disease
OSA
Renal Artery Stenosis
Renal disease (eg. nephritis)
Hyperthyroidism
Cushings
Cardiomyopathy
Drug side effect (steroids, NSAIDs)
Non-compliance with medications
White coat syndrome
Alcohol/Elicit substance use

18
Q

DDx Acute Cough

A

Bronchiolitis
Croup
Tonsillitis/pharyngitis
Post viral cough
Inhaled foreign body
Whooping cough
Asthma

Rhinitis/sinusitis (allergic vs. non allergic)
Occupational asthma
Atypical pneumonia
TB
Psychogenic

Heart Failure

19
Q

DDx Elevated Lipids

A

Primary hyperlipidaemia

Familial hypercholesterolaemia
Metabolic syndrome
Hypothyroidism
Nephrotic syndrome/CKD
T2DM
Cholestasis/obstructive liver disease

Drugs: thiazide diuretics, beta blockers, oral oestrogens, atypical antipsychotics, antiretroviral drugs for HIV

20
Q

DDx Epigastric Pain

A

Gastrooesophageal Reflux Disease
Peptic Ulcer Disease
Hiatus hernia
Eosinophilic oesophagitis
MSK (costochondritis)
Gastroenteritis

Pericarditis
Aortic Dissection
PE
AMI/Angina

GI: hepatitis, pancreatitis, cholecystitis

21
Q

DDx Pelvic Pain

A

Ectopic Pregnancy
PID
STI: chlamydia, gonorrhoea
Large fibroids
Uterine adhesions
Ovarian torsion/cyst rupture

Urinary retention
Cystitis
Renal Stones
Incarcerated hernias
Lymphadenopathy
Malignant mass

Appendicitis
Crohn Disease

22
Q

DDx Fatigue/Tiredness

A

Depression/Stress/Generalised Anxiety
Diabetes
Sleep deprivation
Iron deficiency anaemia
Hypothyroidism
Fibromyalgia
Chronic Fatigue Syndrome
Coeliac Disease
Cancer

Vitamin B12 deficiency
Pregnancy
Substance abuse

23
Q

DDx Back Pain

A

Muscular
Osteomyelitis/epidural abscess
Metastatic Disease
Acute spinal fracture
Osteoporosis
Atypical AMI presentation
GORD
Ankylosing spondylitis (other rheum arthritis)

“Muscular”
- Spondylolisthesis
- Muscular tear or strain
- Mechanical back pain
- Pathological Fracture
- Disc prolapse
- Facet joint pain
- Osteoporotic fracture

24
Q

DDx RUQ Abdominal Pain

A

Cholecystitis
Choledocolithiasis
Ascending Cholangitis
Cholangiocarcinoma

Hepatitis (eg. infectious)
Primary Biliary Sclerosis
Primary Sclerosing Cholangitis

Pancreatitis

Peptic Ulcer Disease
GORD

Less Likely: Cardiac, MSK, Oesophageal, Renal Colic

25
DDx Testicular Swelling
Hydrocele Varicocele Epididymo-orchitis Inguinal Hernia Testicular Torsion Testicular Cancer Idiopathic scrotal oedema Post-traumatic
26
DDx Amenorrhoea
Hypothalamic dysfunction (high exercise, eating disorder, low BMI, stress, medical illness) Primary - Constitutional delay of puberty - Congenital absence of uterus or vagina - Imperforate hymen - Chromosomal abnormalities (Eg. Kallman , Turner) Secondary Pregnancy/ectopic Hypothyroidism Hyperprolactinaemia PCOS Uterine Adhesions CAH Cushings Menopause Primary ovarian insufficiency
27
DDx Floppy Baby (Hypotonia)
Down Syndrome Prader-Willi Syndrome Trisomy 13 Trisomy 18 Muscular Dystrophy Hypotonic cerebral palsy Congenital hypothyroidism Hypoglycaemia Inborn errors of metabolism
28
DDx Palpitations
Premature ectopic beats Atrial fibrillation Paroxysmal SVTs WPW or Brugada Syndrome Phaeochromocytoma Hyperthyroidism Anaemia Electrolyte disorder Sepsis Anxiety/Stress Drugs: caffeine, amphetamines
29
DDx Wrist Pain
De Quervain's Tenosynovitis Carpal Tunnel Syndrome Arthropathy (Osteo/RA/gout/psoriatic) Scaphoid Fracture Distal radial/ulnar fracture
30
DDx Nausea/Vomiting
CNS - head injury, CVA, mass lesion, migraine, seizure disorder, vestibular GI - Functional disorders, obstruction, appendicitis/pancreatitis/etc Infectious - gastroenteritis, UTI, pneumonia, viral Medication/Toxin - antibiotics, chemotherapies, alcohol overdose, opiates, arsenic Metabolic - DKA, paraneoplastic syndrome, pregnancy, uraemia Other - Pain, psych, AMI, acute glacoma,
31
DDx Knee Pain
Osteoarthritis Reactive, psoriatic, gouty arthritis, Traumatic: fracture, ligamental, meniscal Bursitis Septic Arthritis Patellofemoral syndrome, Iliotibial Band Syndrome Malignancy
32
DDx Hip Pain
OA Greater trochanteric pain syndrome Septic arthritis NOF fracture Referred lumbar back pain Iliopsoas bursitis Merlagia Paraesthetica Femoroacetabular impingement
33
DDx Ankle Pain
Posterior: Achilles tendonopathy, Superficial calcaneal bursa Medial: Tibialis posterior or flexor hallucis longus tendinopathy Anterior: Tibialis anterior tendinopathy Ankle sprain (Anterior talofibular ligament is the most often sprained) Arthropathies: gout, reactive, osteoarthritis, septic arthritis Claudication Peripheral oedema
34
DDx Shortness of Breath
Acute viral illness Pneumonia Pulmonary Oedema Interstitial Lung Disease Asthma/COPD Lung malignancy Ischaemic Heart Disease Pulmonary Embolism Congestive Cardiac Failure Pneumothorax Hyperthyroidism Anaemia Acidosis (eg. DKA) Obesity Anxiety/Panic
35
DDx Early Pregnancy Bleeding
Ectopic Pregnancy Non-viable pregnancy Threatened Miscarriage Molar pregnancy Implantation bleeding Cervical: trauma, ectopion, polyp, malignancy, infection
36
DDx Antepartum Haemorrhage
Placenta praevia Vasa praevia Placental abruption Show Cervical: trauma, cervicitis, polyp, ectropion, carcinoma, insufficiency
37
DDx abdominal pain - paediatrics
Sudden onset: testicular/ovarian torsion, intussusception, volulvus, perforated viscus, incarcerated hernia Bloody diarrhoea: gastroenteritis, Meckel's diverticulum, IBD Bilious vomiting: volvulus, obstruction Polyuria/polydipsia/weight loss: DKA Episodic/colicky: constipation, gastroenteritis, intussusception, mesenteric adenitis, ovarian torsion Increasing severity + localisation: appendicitis Vomiting/diarrhoea: gastroenteritis Cough/fever: pneumonia Dysuria/frequency/fever: UTI, pyelonephritis