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Emergency Medicine > Differential Diagnosis > Flashcards

Differential Diagnosis Flashcards

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0
Q

Causes of Afib (at least 10)

A
  1. PE
  2. Ischemia

3,Resp Dz - COPD

  1. Atrial enlargement
  2. TSH
  3. ETOH
  4. Sepsis
  5. HTN Cardiomyopathy
  6. Valvular dz
  7. CHF
  8. SSS
  9. Myocardial contusion
  10. Cardiac surgery
  11. Catecholamine excess
  12. Accessory pathyway - WPW
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1
Q

Sick Neonate ddx (at least 9)

A

Sepsis, Sepsis, Sepsis

T-Trauma (nonaccidental and accidental)

H-Heart disease/hypovolemia/hypoxia E-Endocrine (congenital adrenal hyperplasia, thyrotoxicosis)

M-Metabolic (electrolyte imbalance)

I-Inborn errors of metabolism: Metabolic emergencies

S-Sepsis (meningitis, pneumonia, urinary tract infection)

F-Formula mishaps (under- or overdilution) I-Intestinal catastrophes (volvulus, malrotation, intussusception, necrotizing enterocolitis) T-Toxins/poisons

S-Seizures

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2
Q

ddx microcytic anemia

A
  1. Fe Def anemia
  2. Thalasemia
  3. Anemia of Chronic dz
  4. Lead poisoning
  5. Sideroblastic anemia
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3
Q

Syncope ddx (at least 10)

A

R/O seizure

Neurologic:

  • Seizure
  • Stroke
  • Vasovagal
  • Situational syncope
  • Orthostatic HypoTN
  • Carotid sinus sensitivity
  • Autonomic neuropathy

Cardiac:

  • Tachy or brady arrhythmia
  • AoStenosis
  • MI
  • HOCM
  • Cardiac Tamponade
  • Atrial myoma
  • Aortic dissection

Pulmonary

  • PE
  • Hypoxia
  • Hypercapnia

Non-cardiac:

  • hypovolemia
  • Drugs (ccb, bb, vasodilators, diuretics)
  • Autoimmune insuff (DM, AI, spinal cord lesion),
  • Hypoglycemia - Narcolepsy - Vertigo
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5
Q

DDX Abdominal pain in peds (at least 10)

A
  1. Pyloric Stenosis 2. Malrotation 3. Mid gut volvulous (commonly rotates around SMA causing ischemia) 4. Appendicitis 5. Intusseception 6. Duodenal Atresia 7. Mesenteria adenitis 8. Constipation 9. Referred pain from pneumonia, UTI, Renal colic (RLL can mimic appy) 10. Gastroenteritis 11. PUD 12. DKA 13. Henoch-Schnlein purpura 14, Testicular Torsion (Check cremaster reflex) 15. Renal colic
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6
Q

DDX Normocytic anemia (at least 3)

A
  1. Anemia chronic disease 2. Hemolytic anemia 3. Acute hemorrage 4. Myelodysplasia 5. Infiltration (leukemia, myeloma, mets, infection) 6. Aplasia 7. Liver Dz 8. Uremia 9. Hyper/Hypothyroid 10. Treated nutritional def
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6
Q

DDX Macrocytic anemia (at least 3)

A
  1. Folate or B12 def 2. Reticulocytosis 3. ETOH 4. Liver Dz 5. Myelodysplasia 6. Drugs
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7
Q

DDX isolated elevated PT/INR

A
  1. Factor 7 def (inherited) 2. Warfarin 3. Vit K def 4. Liver disease 5. Factor 7 inhibitor
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8
Q

DDX isolated elevated PTT (3)

A
  1. Heparin 2. Hemophilias 3. vWF
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9
Q

DDX elevation PT/INR and PTT (4)

A
  1. Deficencies of prothrombin, fibrinogen, Factors V and X 2. Heparin + warfarin 3. DIC * 4. Liver Dx
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11
Q

DDX agitated Delirium (at least 10)

A

DIMS DRUGS 1. Sympathemimometics/Stimulants: - Cocaine, amphetamines, methamphetamines - PCP, ketamine 2. Anticholinergics - Serotonin Syndrome - Sedative withdrawl syndrome INFECTION 3. Viral or bacterial meningitis, encephalitis METABOLIC/Endocrine 4. Hyponatremia, Hypercalemia 5. Hypoglycemia 6. Hypoxia 7. Uremia 8. Hyperammonia 9. Thyrotoxicosis STRUCTURAL 10. Trauma 11. Stroke 12. Hemorrhage 13. Mass

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12
Q

DDX Fever in returning traveller

A
  1. Malaria 2. Typhoid 3. Dengue Fever 4. Meningitis 5. Rickettsial disease 6. Mononuecleosis (CMV, EBV) – 7. Yellow Fever 8. Lassa Fever 9. Japanese encephalitis 10. Cysteriosis 11. Viral hemorragic fevers 12. Common infections (pnuemonia, UTI, gastroenteritis) 13. Hepatitis A,B,C 14. HIV 15. STIs- do GU exam
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13
Q

Ddx of Vertigo (8)

A

Cerebellar stroke Vertebrobasilar a. Insufficiency Vertebral artery dissection Multiple sclerosis BPPV Vestibular neuritis Labyrinthitis Ménière’s disease

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14
Q

Ddx acute painful vision loss (5)

A

Acute angle closure glaucoma Optic neuritis Trauma Uveitis Temporal arteritis Keratitis

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15
Q

Ddx painful red eye (6)

A

Acute angle closure glaucoma Keratitis ( UV or ulceration) Epi scleritis Uveitis Scleritis Enopthalmitis Conjunctivitis Orbital cellulitis

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16
Q

Ddx acute painless vision loss (8)

A

Central retinal artery occlusion Central retinal vein occlusion Retinal detachment Temporal arteritis Amaurosis fugax (TIA) Vitreous hemorrage Macular degeneration Optic neuritis (MS) Papilledema Opthalmic migraine

16
Q

DDX of hypertensive emergencies with ‘toxicologic’ characteritics

A
  • MAOI toxicity - Drug/Sympathomimetic OD - Anti-cholinergic - Methylxanthine toxicity Non-toxicologic causes - Environmental hyperthermia - Febrile illness - Pheochromocytoma - Carcinoid syndrome - Thyroid Storm - Meningitis - Hypertensive Emergency
17
Q

DDX pin point pupils (5)

A
  1. Cholinergic syndrome (organophosphates) 2. Opiate OD 3. Central pontine stroke (hemorrage) 4. Neurosyphilis apparently.. 5. Pilocarpine drops..
19
Q

DDX of Hyperkalemia (10)

A
  • Pseudohyperkalemia (due to hemolysis) Decreased excretion - Renal failure - Renal secretory defects (interstitial nephritis, sickle cell) - Hypoaldosteronism: hyporeninism (type IV RTA) - Adrenal insuff - Drugs (spironolactone, Acei, NSAIDS) K shift out of cells - Burns - Rhabdomyalysis - Hemolysis - Severe infection - Metabolic acidosis - Insulin deficiency - Hyperkalemic periodic paralysis - Drugs (digitalis toxicity, beta-adrenergic antagonists, suxx) Iatrogenic
20
Q

DDX Bitemporal hemianopsia (3)

A

Pituitary tumor Craniopharyngioma Meningioma Aneurysm of circle of willis Metastatic carcinoma

21
Q

DDX Dyspnea (10)

A

CV - MI - CHF - Tamponade Pulmonary - PTX - Asthma - COPD - Pneumonia - PE - Aspiration - Anaphylaxis Anemia Acidosis

22
Q

DDX Hemoptysis (8)

A

Malignancy Bronchiectasis Lung abcess Pulmonary AVM CHF Alveolar hemorrhage syndrome Infection - Bacterial - Viral - TB - Fungal Inflammation - SLE - Goodpastures syndrome - Wegeners Granulomatosis

22
Q

DDX intraocular HTN (>20mmHg) (3)

A

Glucoma Suprachoroidal hemorrage Retrobulbar space occupying tumor

23
Q

DDX Drug induced Hyperthermia? (5)

A
  1. Malignant hyperthermia 2. NMS 3. Psychostimulants (cocaine, amphetamines,MDMA) 4. Anticholinergic toxicity 5. Serotonin syndrome 6. Salicyclate poisoning 7. Withdrawal syndromes (last 2 are more fever than hyperthermia)
24
Q

DDX Severe Headache (10)

A

SAH/ICH Sub-dural hemorrage Temporal arteritis Meningitis Migraine Acute angle glucoma Cerebral venous thrombosis CO poisoning Preeclampsia Brain Tumor/ Increased ICP Idiopathic intracranial HTN Pseudotumor cerebri

25
Q

DDX rash on palms/soles (6)

A
  1. Syphilis (secondary) 2. Erythema multiforme/SJS (Drug rxn) 3. Hand, foot, mouth dz (Coksakie virus) 4. Rocky Mountain spotted fever 5. Kawasaki’s 6. Atypical Measles 7. Toxic Shock syndrome 8. Meningococcemia may cause petichiae on the palms and soles. 9. Bacterial endocarditis with it’s Janeway lesions and Osler’s nodes. 10. Scabies 11. Tinea mannum 12. Atopic dermatitis
26
Q

DDX penile ulcer (at least 4)

A

Syphilis Herpes Simplex Chancroid Lymphogranuloma venereum Bechet’s syndrome Neoplasm Lichen Planus

27
Q

DDx of ‘Fever and Altered LOC’ - state 6 categories and at least 3 in each

A

Infection - Sepsis - Meningitis - Encephalitis - Abcess - Tetanus - Typhoid - Malaria Drug/Toxin - Psychostimulants(cocaine, amphetamines, MDMA) - Malignant hyperthermia - NMS - Anti-cholinergic syndrome - Serotonin syndrome - Salicyclate toxicity - Withdrawal syndromes Neurologic - Hypothalamic stroke - Status Epilepticus - Cerebral hemorrage Environmental - High temperature or humidity Endocrine - Thyroid storm - Pheochromocytoma - DKA Oncologic - Lymphoma - Leukemia

28
Q

DDX Altered LOC

A

A — Alcohol/Acidosis E — Endocrine Epilepsy Electrolytes (Na, K, Ca) I — Infection (Meningitis, Sepsis)/Insulin O — Oxygen, Opiates, Overdose U — Uremia T — Trauma/Toxins/Temperature I — Insulin/Infection P — Poisoning/Psychosis S —Stroke/Seizure/Space occupying lesions Or DIMS Or Diffuse/Metabolic processes vs. Focal/ structural

29
Q

What are 7 causes of mesenteric ischemia? (there are 4 main categories)

A
  1. Arterial mesenteric embolus (usu cardiac in origin) 2. Arterial mesenteric thrombus - 2ndary to atherosclerotic dz. 3. Venous mesenteric thrombus (least common) usu SMV - Thrombotic d/o (Factor V leiden, protein c/s, AT III) - Hypercoagulable state - Sickle cell crisis - Polycythemia 4. Non-occlusive - Hypovolemia/Shock - Pancreatitis - Sepsis - Drugs causing vasoconstriction
31
Q

Ddx Vesiculobullous Rash (name 5, there are 10)

A
  1. Herpes 2. Varicella 3. Dyshidrotic eczema 4. EM Major 5. SJS/TEN 6. SSSS 7. TSS 8. P. vulgaris 9. Meningococcemia/gonococcemia 10. Nec Fasc
32
Q

DDX Rash and joint pain (name 5, there are 9)

A
  1. HSP 2. R. Fever 3. Lyme Disease 4. Reactive arthritis/Reiter’s 5. Transient synovitis 6. Drug Reactions – including SJS/TEN 7. Rheumatic illnesses (SLE, IBD, Psoriatic, JIA, Ank spond…) 8. Dermatomyositis 9. Septic joint + sepsis
33
Q

DDX for strawberry tongue (3)

A
  1. Kawasaki 2. Scarlet fever 3. TSS/STSS
34
Q

DDX of Delirium (iwatchdeath approach)

A
  1. Infectious: Sepsis, encephalitis, meningitis, syphilis, central nervous system abscess 2. Withdrawal: Alcohol, barbiturates, sedative-hypnotics 3. Acute metabolic: Acidosis, electrolyte disturbance, hepatic or renal failure, other metabolic disturbances (↑ or ↓ glucose,magnesium, calcium) 4. Trauma Head trauma, burns 5. CNS disease: Hemorrhage, stroke, vasculitis, seizures, tumor 6. Hypoxia: Acute hypoxia, chronic lung disease, hypotension 7. Deficiencies: Vitamin B12, hypovitaminosis, niacin, thiamine 8. Environmental: Hypothermia, hyperthermia, Endocrinopathies (diabetes, adrenal, thyroid) 9. Acute vascular: Hypertensive emergency, subarachnoid hemorrhage, sagittal vein thrombosis 10. Toxins or drugs Medications, street drugs, alcohol, pesticides,industrial poisons (e.g., carbon monoxide, cyanide,solvents) 11. Heavy metals Lead, mercury
35
Q

DDX cerebral ring enhancing lesion (8)

A

D - demyelinating disease (incomplete ring) R - radiation necrosis or resolving haematoma M - metastasis A - abscess G - glioblastoma multiforme I - infarct (subacute phase) C - contusion L - lymphoma

36
Q

DDX of asterixis (3)

A
  1. Hepatic encephalopathy 2. Hypercarbia 3. Uremic encephalopathy
37
Q

Ddx for Petechiae and Purpura (5)

A
38
Q
A

Emergency Medicine (39 decks)

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