Differential Diagnosis

Question 1

Chest Pain DDx

Answer 1

MPAPP - Life Threatening
- Myocardial Infarction
- Pericarditis
- Aortic Disection
- Pulmonary Embolis
- Pneumothorax
- Esophageal Rupture
CVS - Heart Failure, Aortic Stenosis, Arythmia, HOCM (If Young)
Respi - Pneumonia, Lung CA, Pleuritis
GI - GORD/PUD, Pancreatitis, Biliary Colic
MSK and Psychogenic - Costochondritis, Shingles, Stress

Question 2

Palpitations DDx

Answer 2

CVS - IHD, CHF, Valvular Dx, Pericarditis
Respiratory - PE, COPD
Hyperthyroid
Hypoglycemia
Anxiety D/o
Phenochromocytoma
Stimulants, Drugs
Anemia
Menopause (>50y/o)

Question 3

Problem w/ Nerves DDx

Answer 3

Psychological - Anxiety Dx, Panic Dx, OCD, PTSD, GAD, MDD
Menopause (>50y/o Female)
Cardiac - Arythmia, IHD, CHF
Hyperthyroid
Phenochromocytoma
Hypoglycemia
Stimulants
Respiratory - COPD, PE

Question 4

Syncope DDx

Answer 4

CVS
- IHD/MI
- Arythmias
- Aortic Stenosis
- HOCM
- Bradycardia
- Pericarditis
Neuro
- Stroke,
- SAH
- Menigitis
- Head Trauma (ICH)
- Seizures
- Brain Tumors
Vasovagal and Reflex Syncope
Hypoglycemia (Insulin Over, Skipped) and Electrolytes, Heat Exhaustion
Alcohol, Drugs, Medications
Psychogenic - Panic Attack
Pulmonary Embolism
Seizure - Non-provoked, Alcohol, Temazepam withdrawal

Question 5

Falls DDx - RF Falls in Elderly

Answer 5

Diabetic Retinopathy
Sensory Neuropathy
OA in Knee
Other RF of Falls
- Vision and Hearing Problems
- Home Problems
- Urinary Problems
- Weakness in the Muscles, Deformities
- Balance Problems
- Postural Hypotension
Autonomic Neuropathy
Hypoglycemia
Neuro – TIA, Stroke, ICH, Seizure
CVS – IHD/ACS, Arrythmia
Medications
– Drowsy – Painkillers, Sleeping Pills
– Low BP – BP medications

Question 6

Dizziness (Giddiness) DDx

Answer 6

Ear – BPPV, Vestibular Neuritis, Labyrinthitis, Meniere Dx, Acoustic Neuroma
Brain - Head injury, ICH, Vestibular Migraine, MS, Stroke, PICA, Brain CA
CVS – Arrythmia, ACS, AS
Psych – Panic Attack
Medication – Postural Hypotension
Alcohol, Drugs
Balance – Cerebellar Degeneration

Question 7

Geriatric Screening Qs

Answer 7

Mood
Memory
Support - Diet, Prepares food,
Daily Activities your self?
Fractures/ Recurrent Falls

Question 8

Nervousness with - Normal TSH, Inc. T4, T3 DDx

Answer 8

Pituitary Adenoma*
Amiodarone Induced Thyrotoxicosis*
Thyroid Adenoma, Multi Nodular Goiter, Thyroiditis
Psychological Dx
Pheochromocytoma
Hypoglycemia
Stimulants
Respiratory - COPD, PE

Question 9

Cause of Hypoglycemia

Answer 9

Insulin - Change in dose, Too much Dose
Medications
Fever, Infections
Stress
Change in Diet/ Skipped meals
Streneous Activities

Question 10

RF for Falls

Answer 10

Vision impairment and Balance disorder, (Eyes and Ears)
Muscle weakness, Gait Problem, Inappropriate Footwear
Home environment,
Neuropathy, Urinary Incontinence
Sedating Drugs (Benzodiazepine)
Anti-HTN Drugs (Thiazides (Fav of AMC), Clonidine) (And others)
Orthostatic Hypotension

Question 11

PMHx - Inc. Fall Risk

Answer 11

DM - DM Retinopathy, Sensory Neuropathy, DM Neuropathy, Hyperglycemia
HTN - HTN Retinopathy, PVD and Pain in the Legs, TIA, Stroke
Polymyalgia Rheumatica - Hip pain and Weakness

Question 12

Bradycardia DDx

Answer 12

Long QT Syndrome, Sinus Bradycardia, Heart Block, Medications, Sick sinus Sx, ACS

Question 13

Seizure DDx

Answer 13

Head Injury
Meningitis
Brain Tumor
Drugs
Alcohol
Brain Trauma
Electrolyte Imbalance
Hypoglycemia

Question 14

Diabete Syncope DDx

Answer 14

Hypoglycemia,
DKA
Stroke
MI
Arrythmia
Vasovagal Syncope
Autonomic Neuropathy
(Insert other Syncope DDx)