Differential Diagnoses Game! Flashcards
DDx for Headache
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
Name Organic Causes of Psychosis
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
Mental Health related Causes of Psychosis
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
DDx Syncope
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
DDx Acute Red Eye
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)
DDx Acute Visual Loss
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)
Specific causes of mechanical back pain
Muscular tear or strain
Mechanical back pain
Pathological Fracture
Disc prolapse
Facet joint pain
Osteoporotic fracture
DDx Peripheral Neuropathy
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
DDx Shoulder Pain
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
DDx Tremor
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
DDx Urinary Symptoms - general
General:
UTI (acute/chronic)
Urethral stricture
STI
Bladder calculi
Interstitial cystitis
OAB
Neurological condition
Diabetes
Iatrogenic
Constipation
DDx Lower Urinary Symptoms - male
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
DDx Vertigo
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
DDx Child with a Limp
Transient Synovitis
Septic arthritis
Fracture/MSK
NAI
Malignancy
Vasculitis: HSP
Referred pain
DDH
Toddler’s Fracture
Perthes Disease
SUFE
JIA
Osgood Schlatter Disease
DDx Heel Pain
Plantar Fasciitis
Calcaneal Fat Pat Atrophy
Achilles Tendinopathy
Retrocalcaneal Bursitis
Calcaneal stress fracture
Calcaneal apophyisis (usu. Children)
DDx Fever in a Returned Traveller
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
DDx Uncontrolled Hypertension
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
DDx Acute Cough
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
DDx Elevated Lipids
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
DDx Epigastric Pain
Gastrooesophageal Reflux Disease
Peptic Ulcer Disease
Hiatus hernia
Eosinophilic oesophagitis
MSK (costochondritis)
Gastroenteritis
Pericarditis
Aortic Dissection
PE
AMI/Angina
GI: hepatitis, pancreatitis, cholecystitis
DDx Pelvic Pain
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
DDx Fatigue/Tiredness
Depression/Stress/Generalised Anxiety
Diabetes
Sleep deprivation
Iron deficiency anaemia
Hypothyroidism
Fibromyalgia
Chronic Fatigue Syndrome
Coeliac Disease
Cancer
Vitamin B12 deficiency
Pregnancy
Substance abuse
DDx Back Pain
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
DDx RUQ Abdominal Pain
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
DDx Testicular Swelling
Hydrocele
Varicocele
Epididymo-orchitis
Inguinal Hernia
Testicular Torsion
Testicular Cancer
Idiopathic scrotal oedema
Post-traumatic
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
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
DDx Palpitations
Premature ectopic beats
Atrial fibrillation
Paroxysmal SVTs
WPW or Brugada Syndrome
Phaeochromocytoma
Hyperthyroidism
Anaemia
Electrolyte disorder
Sepsis
Anxiety/Stress
Drugs: caffeine, amphetamines
DDx Wrist Pain
De Quervain’s Tenosynovitis
Carpal Tunnel Syndrome
Arthropathy (Osteo/RA/gout/psoriatic)
Scaphoid Fracture
Distal radial/ulnar fracture
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,
DDx Knee Pain
Osteoarthritis
Reactive, psoriatic, gouty arthritis,
Traumatic: fracture, ligamental, meniscal
Bursitis
Septic Arthritis
Patellofemoral syndrome, Iliotibial Band Syndrome
Malignancy
DDx Hip Pain
OA
Greater trochanteric pain syndrome
Septic arthritis
NOF fracture
Referred lumbar back pain
Iliopsoas bursitis
Merlagia Paraesthetica
Femoroacetabular impingement
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
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
DDx Early Pregnancy Bleeding
Ectopic Pregnancy
Non-viable pregnancy
Threatened Miscarriage
Molar pregnancy
Implantation bleeding
Cervical: trauma, ectopion, polyp, malignancy, infection
DDx Antepartum Haemorrhage
Placenta praevia
Vasa praevia
Placental abruption
Show
Cervical: trauma, cervicitis, polyp, ectropion, carcinoma, insufficiency
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
