Differential Diagnosis Flashcards
Weight Loss
M G3 E2 P3 I
Malignancy
Gastrointestinal
- Colon Cancer
- IBD
- Coeliac
Endocrinological
- Thyrotoxicosis
- T1DM
Psychological
- Anorexia/ Bulimia (menstrual cycle disturbance)
- Depression
- Stress
Infection
Fatigue
H E2 P2 R1 O3
Haematological
- Anaemia
Endocrine
- Hypothyroidism
- Diabetes
Psychological
- Depression
- Stress
Respiratory
- Sleep Apnoea
Others
- Infection
- Drugs
- Malignancy
Headache
P4 I4 E2 O3
Primary-
- Tension
- Cluster
- Migraine
- Trigeminal Neuralgia
Secondary (Intracranial)
- Meningitis
- Temporal Arteritis
- Subarachnoid Haemorrhage (any falls/ blood thinners)
- Raised ICP
Secondary (Extracranial)
- Glaucoma
- Sinusitis
Other
- Infections
- Pre- Eclampsia
- Drugs (PPI, Caffeine, Analgesia)
Vertigo
P4 C1 O3
Peripheral
- Benign Positional Vertigo
- Vestibular Neuritis
- Viral Labyrinthitis
- Menieres (Vertigo/ Tinnitus/ Hearing Loss)
Central
- Vertebrobasilar Insufficiency (caused by NEXK Extension, especially if Cervical Osteoarthritis)
Other
- NEUROMA (RULE THIS OUT)
- Cerebellar Stroke (ask about raised ICP signs and VISION/ BALANCE changes and say you would want to rule this out at the end)
- Neurological Causes- MS
Fits/ Falls/ Syncope
C3 N5 O3+2
Cardiovascular
- Postural Hypotension (Recent medication change)
- Arrhythmia (if during exercise/ with palpitation)
- Aortic Stenosis (if SOB on exertion)
Neurological
- Seizure
- Parkinsons
- TIA/ STROKE (Ask about Neurological Symptoms)
- Vasovagal (if Stimuli)/ Situational if Cough/ Micturition
- Haemorrhage
Other
- Structural Heart Disease
- Drugs/ Alcohol (POLYPHARMACY)
- Hypoglycaemia (if Diabetes and medication change)
Also Ruptured Ectopic/ AAA
Chest Pain
C4 R2 N3
Cardiac
- MI
- Angina
- Aortic Dissection
- Pericarditis
Respiratory
- Pulmonary Embolism
- Pneumothorax
Non Cardiorespiratory
- GORD
- Anxiety/ Panic Attacks
- MSK
Breathlessness
C2 R6 O4
Cardiac
- Myocardial Infarction
- Heart Failure
Respiratory
- LRTI/ Pneumonia
- Asthma
- COPD
- Pneumothorax
- Pulmonary Embolism
- Pulmonary Fibrosis
Other
- Anaemia
- DKA
- Pleural Effusion
- Bronchiectasis
Cough
R5 O4
Ask about Haemoptysis
Respiratory
- URTI/ LRTI/ Pneumonia
- Asthma
- COPD
- Lung Cancer
- Post nasal drip (if cough to clear throat)
Other
- GORD
- Smoking
- Cystic Fibrosis
- ACE Inhibitor
Abdominal Pain
Always ask about gynaecological symptoms if relevant
G7 U1 G2 O3
Gastrointestinal
- Appendicitis
- Gallstones
- Pancreatitis
- Peptic Ulcer
- Diverticulitis
- Bowel Obstruction
- IBD
Urological
- Renal COLIC (loin to groin and N+V)
Gynaecological
- Ectopic Pregnancy
- PID/ Endometriosis
Other
- Ruptured AAA
- DKA
- MI
Change in Bowel Habit
G5 E2 O2
Gastrointestinal
- Colon Cancer
- Gastroenteritis
- IBD
- IBS
- Coeliac
Endocrinological
- Thyrotoxicosis
- Hypothyroidism
Other
- Drugs
- Diet and Lifestyle Changes
Rectal Bleeding
On tissue or mixed with stool and what colour and any mucus
The 10 causes
AH DDI HAP HO
Anal Fissure
Haemorrhoids
Diverticular Haemorrhage
Distal Polyp or Malignancy (Weight Loss/ change in bowel habit)
IBD (Mucus)
Haemorhagic Gastroenteritis (if recent infecitve food intake)
Angiodysplasia if painless and subtle in elderly (abnormal blood vessel dilatation in the bowel)
Proximal Polyp (Weight loss and Anaemia)
Haemorrhagic Peptic Ulcer (Haematemesis/ NSAID/ ALcohol)
Oesophageal Varices (Liver Disease/ Alcohol)
Haematemesis
The 5 causes
OMP +2
Oesophageal Varices
Mallory weiss
Peptic Ulcer Disease
Oesophageal carcinoma
Gastric Cancer
Dysphagia
S O3 N2 M2 C2
Swallowing Difficulty- Globus/ Odynophagia
Not an Oropharyngeal Cause- if they report food sticking to the lower throat-
- Stricture
- Oesophagitis (UGIE)
- Motility Issue/ Pharyngeal Pouch
Neurological
- Bulbar Palsy
- Parkinson’s
Muscle Weakness
- Myasthenia Gravis
- Myositis
Cancer- Oropharyngeal Cancer or Pharyngeal Pouch if No neurological/ neuromuscular cause
Scrotal Swelling
I OP UTO
Inflammation VISIBLE
- Cellulitis/ Fournier’s Gangrene
Oedema
- Consider causes of Oedema such as HF/ Hypoalbuminaemia/ Nephrotic Syndrome- ask about swelling elsewhere
Painful
- Torsion
- Epidydimo Orchitis
- HERNIA
Unable to Feel above Swelling-
- Varicocele
- Inguinal Hernia
Transillumination
- Hydrocele
Other
- Tumour (Weight Loss)
- Spermatocoele
Frequency/ Dysuria/ Nocturia
U4 O2
Urological
- UTI
- Urethritis (if pus in urine)
- Pyelonephritis (Loin Pain/ Fever)
- BPH
Other
- Drugs
- Pregnancy
Haematuria
U6 O4
Urological
- Bladder Transitional cell Cancer- Painless Haematuria and AMINE Exposure (Involved with PAINT)
- Renal Cell Cancer (Mass and Flank Pain)
- Urethral Trauma (Catheter)
- UTI
- Urethritis (if Purulent)
- Calculi (Loin to Groin pain)
Other-
- Prostate Cancer/ BPH
- Haematological (Bleeding Disorder/ Anticoagulants)
Polyuria
E2 U1 O3
Endocrine
- Diabetes MELLITUS
- Diabetes INSIPIDUS (if NO fatigue and weight loss etc.)
Urological
- CKD (ask about Pruritus, Dyspnoea, Fatigue, Weakness)
Other
- UTI
- Drugs (Diuretics, Lithium)
- Psychogenic
Incontinence
S1 U2 O3 M T O
Stress
- Incompetent Sphincter (if multiple pregnancies, post-menopause, pelvic floor trauma)
Urge
- Detrusor Instability
- SPINAL PATHOLOGY (MS/ SCC)
Overflow
- Prostatic Hypertrophy
- Stone or TUMOR
- SPINAL PATHOLOGY
Mixed
True Incontinence (CONTINOUS LEAKAGE OF URINE)
- Theres a FISTULA
Other
- Pscyhogenic
Retention
U5 N2 D
Urological
- Prostate Hypertrophy
- Stricture (if trauma/ Catheterisation)
- Bladder obstruction (Stone or tumour)
- UTI
- Constipation
Neurological
- MS
- SCC
Drugs (anticholinergics/ TCA)
Pelvic Pain (Gynaecology)
G5 U1 G3
Gynaecology
- PID/ Salpingitis (dyspareunia and dysmenorrhoea)
- Ectopic Pregnancy
- Ovarian Cyst Rupture/ Torsion (Fever and Vomiting)
- Endometriosis (deep dyspareunia and menstrual disturbance)
- Mittelschmirz
Urological
- Pyelonephritis
Gastrointestinal
- Appendicitis
- Diverticulitis
- IBS/ IBD
PV Bleeding (Gynaecology)
M6 I7 P4 P4
Menorrhagia
- Dysfunctional Uterine Bleeding
- Endometriosis
- Fibroids
- PID
- Endometrial Cancer
- IUD
Intermenstrual Bleeding
- Pregnancy
- PID
- Endometrial Cancer
- IUD
- Ectropion
- Polyps
- IUD
Post-Coital Bleeding
- Cervical Trauma
- Cervical Polyps
- Cervical Cancer
- PID
Post-Menopausal Bleeding
- Endometrial Cancer
- Atrophic Vaginitis is the MOST COMMON
- Oestrogen WITHDRAWAL
- Cervical Cancer
Secondary Amenorrhoea
G3 E5 D2
Gynaecology
- Pregnancy
- PCOS
- Menopause/ Premature Ovarian Failure
Endocrinology
- Hypothalamic Amenorrhoea (Anxiety, Stress, Athletes)
- Cushing’s
- Hyperprolactinaemia
- Hyper/hypothyroidism
- Pituitary Failure
Drugs
- Drug causes (Hormonal therapy, Antipsychotics)
Subfertility
G6 O2/ 2
Gynaecology
- PCOS
- Fallopian Tube Damage (PID/ Surgery)
- Endometriosis (Menstrual Disturbance)
- Cervical Barrier (Mucus/ Polyp/ Inflammation)- STI/ Surgery
- Hyperprolactinaemia (antipsychotics, prolactinoma)
- Hypothalamic Disturbance (Anxiety, Anorexia, Stress, Exercise)
Other
- Hypogonadotrophic hypogonadism (Pituitary disease)
- Hypergonadotrophic Hypogonadism (Premature Ovarian Failure (female), Klinefelters (male) or gonadal damage (both)
- Erectile Dysfunction
- Timing
Abdominal Pain (Obstetrics)
O7 G3
Obstetrics
- Ectopic
- Miscarriage
- Placental Abruption
- Pre Eclampsia
- Acute Fatty Liver Disease
- Braxton Hicks (Infrequent Irregular Contractions)
- Labour (painful regular)
Gynaecology
- Fibroids
- PID
- Ovarian Torsion
PV Bleeding (Obstetrics)
E3 L4 O2
Early
- Implantation (if 6-12 days after conception)
- Ectopic (usually 4-12 weeks gestation)
- Miscarriage
Late
- Labour
- Placental Abruption
- Placenta Praevia (sudden bleeding >28 weeks)
- Vasa Praevia
Other
- Cervical Pathology (Polyps/ Cancer/ Ectropion)
- PID
Lower Back Pain
O6 R1
Orthopaedics
- Muscular (Acute and ONLY paraspinal muscles are affected
- Lumbar Spondylosis (progressive stiffening/ related to sitting/ standing in one space)
- Lumbar Disc Prolapse (Sciatica and pain when coughing/ lifting)
- Discitis (Fever and IVDU)
- Spinal Fracture
- Cauda Equina
- Osteoporosis
Rheumatology
- Ankylosing Spondylitis
-
Joint pain/ stiffness/ swelling
R7 O3
Rheumatological
- Rheumatoid Arthritis
- Psoriatic Arthritis
- Gout
- Pseudogout
- SLE
- Enteropathic Arthritis
- Transient Synovitis
Orthopaedics
- Fracture
- Osteoarthritis
- Septic Arthritis
Anxiety
P6 O4
Psychiatry
- Generalised Anxiety Disorder
- Depression
- Panic Disorder
- Phobia
- OCD
- PTSD
Other
- ACS
- Hyperthyroidism
- Arrhythmia
- Phaeochromocytoma
Psychosis
P8 O5
Psychiatry
- Schizophrenia
- Delusional Disorder (only disorder)
- Dementia with Lewy Bodies
- Schizoaffective Disorder (Both Schizophrenia and Bipolar Disorder)
- Psychotic Depression
- Puerperal Psychosis
- Delirium
- Bipolar Disorder
Other
- Drugs (Recreational Drugs, Steroids, Levodopa, Antimalarials)
- Space Occupying Lesion
- Temporal Lobe Epilepsy
- Alcohol
- SLE
Low Mood
P5 O2
Psychiatry
- Depression
- Bipolar Disorder
- Adjustment Disorder
- Psychotic Depression
- Postnatal Depression
Other
- Hypothyroidism
- Drug Reactions
Memory Loss
D5 P2
Dementia
- Alzheimer’s
- Vascular Dementia
- Lewy Body Dementia
- Fronto-Temporal Dementia
- Creutzfeldt Jakob Disease
Psychiatric
- Positive Depression Screen
- Delirium (fluctuating, reduced consciousness, infection)
Eating Disorder
2
Anorexia (BMI<17.5, Amenorrhoea, Developmental delay, Poor Sleep)
Bulimia (BMI>17.5, Binge Eating)
Paediatric Failure to Thrive
G7 N4 O3
Gastrointestinal
- Coeliac Disease
- Protein Intolerance (Cows Milk)
- Carbohydrate (Lactose) Intolerance
- Pyloric Stenosis
- GORD/ Oesophagitis
- Cystic Fibrosis
- IBD
Non-Gastrointestinal
- Not enough FOOD (most obvious)
- Nutritional neglect
- Emotional Neglect (poor interaction)
- Eating Disorder
Other
- Malignancy
- Chronic Infection/ Illnesses
- Toxins
Paediatric Weight Increase
E3 N2 O2
Endocrine
- Hypothyroidism
- Cushing’s
- PCOS
Non Endocrine
- Obesity
- Familial
Other
- Steroid
- Genetic Syndromes (Turner’s Syndrome, Prader Willi)
