Differentials Flashcards
Categories of causes of collapse
- Cardiac
- Resp
- Neuro
- Other
Cardiac causes of collapse
- Heart failure
- Arrhythmias
- Myocarditis
Resp causes of collapse
- Upper airway obstruction
- Respiratory failure
Neuro causes of collapse
- Birth asphyxia
- Cerebral oedema
- Coning of brainstem
- Head injury
Other causes of collapse
- Drug ingestion
- Severe trauma, e.g. falls, RTA, non-accidental
- Severe hypoxic-ischaemic insult, e.g. suffocation, drowning
Causes of acute fever
- Dehydration
- Otitis media
- Viral infection, e.g. non-specific viral infection, upper respiratory tract infection
- Post surgery
- Kawasaki’s disease
- Factitious
- Tonsillitis
- Post-immunisation
- Septic arthritis
- Pneumonia
- Serious blood infection
Causes of factitious acute fever
- Taking temperature after hot drink
- Deliberate manipulation of thermometer
- Excessive crying on exertion
- Overheating due to swaddling
Serious blood infections causing acute fever
- Meningococcal sepsis
- Streptococcal sepsis
- Toxic shock syndrome
- Malaria
Persistent fever
- HIV infection
- Collagen vascular disease
- Inflammatory bowel disease
- Infective endocarditis
- Occult abscess
- Osteomyelitis
- Infectious mononucleosis
- Tuberculosis
- Neoplastic disease
- Hepatitis
- Atypical pneumonia
- Urinary tract infection
Cough in infants
- Congenital malformation of airway
- Infections
- Gastro-oesophageal reflux
Infections causing cough in infants
- Bronchiolitis
- Pneumonia
- Upper respiratory tract infections
Cough in pre-school kids
- Asthma
- Passive smoking
- Infections
- Foreign body
- Cystic fibrosis
Infections causing cough in pre-school kids
- Acute bronchitis
- Upper respiratory tract infections
- Pneumonia
- Croup
Cough in school age to adolescent
- Post-nasal drip
- Cystic fibrosis
- Asthma
- Infections
- Cigarette smoking
- Psychogenic
Wheeze
- Aspiration of food or foreign body
- Cardiac failure
- Asthma
- Bronchopulmonary dysplasia
- Bronchiolitis
- Viral wheeze
Acute stridor
- Inhaled foreign body
- Tonsillar abscess (quinsy)
- Croup
- Anaphylaxis
- Epiglottitis
Chronic stridor
- Laryngeal abnormalities
- Vascular ring
- Upper airway obstruction
- Tracheal abnormality
Laryngeal abnormalities causing chronic stridor
- Papilloma
- Vocal cord palsies
- Laryngomalacia
Upper airway obstruction causing chronic stridor
- Severe micrognathia
- Pharyngeal cysts
Tracheal abnormality causing chronic stridor
- Tracheomalacia
- Subglottic stenosis
Causes of upper airway obstruction
- Croup
- Anaphylaxis with swelling
- Epiglottitis
- Foreign bodies
- Infection in upper airway
- Fire or burns from breathing in smoke
Categories of causes of cyanosis
- Alveolar hyperventilation
- Ventilation perfusion inequality
- Decreased affinity of oxygen to haem
- Impairment of oxygen diffusion right to left shunting
Categories of causes of alveolar hyperventilation
- CNS causes
- Hypothermia
CNS causes of alveolar hyperventilation
- Cerebral oedema
- Seizures
- Haemorrhage
- Infection
- Hypoxia-ischaemia
- Drugs
Categories of causes of VP inequality
- Cardiac
- Resp
Cardiac causes of VP inequality
- Decreased systemic perfusion decreased pulmonary blood flow
- Pulmonary atresia with intact septum
Causes of decreased systemic perfusion
- Sepsis
- Coarctation of the aorta
Causes of decreased pulmonary blood flow
- Tricuspid atresia
- Tetraology of fallot
- Critical pulmonary stenosis
Resp causes of VP inequality
- Tracheal compression
- Pneumonia
- Pleural effusion
- Bronchiolitis
- Respiratory muscle dysfunction
- Guillain-Barre
Causes of decreased affinity of oxygen to Hb
CO poisoning
Causes of impairment of oxygen diffusion
- Bronchopulmonary dysplasia
Diaphragmatic hernia
Causes of left to right shunting
- Congenital heart defects
- AV fistula - pulmonary or systemic
- Eisenmenger syndrome
Causes of innocent murmur
- Venous hum
- Pulmonary flow murmur
- Systolic ejection murmur
Causes of pathological murmur
- Aortic stenosis
- Coarctation of aorta
- Ventricular septal defect
- Pulmonary stenosis
- Atrial septal defect
Vomiting in newborn and infants
- Overfeeding
- Gastro-oesophageal reflux
- Systemic infection, e.g. meningitis, UTI
- Small bowel obstruction
- Constipation
- Pyloric stenosis
- Whooping cough
Vomiting in older kids and adolescents
- Gastroenteritis
- Toxic ingestion or medications
- Pregnancy
- Bulimia
- Raised ICP
- Migraine
Acute abdo pain
- Acute appendicitis
- Mesenteric adenitis
- Inflammatory bowel disease
- Intestinal obstruction
- Functional abdominal pain
- Renal calculi
- Constipation
- Lower lobe pneumonia
- Gastroenteritis
- Peptic ulcer
- Diabetes
- Henoch-Schonlein purpura
- Urinary tract infection
- Intussusception
- Colic
Acute constipation
- Hirschsprung’s
- Functional
Chronic constipation
- Bowel obstruction
- Fluid depletion
Causes of bowel obstruction
- Adhesions from previous surgery
- Congenital causes
Causes of conjugated hyperbilirubinaemia
- Hepatitis
- Choledocal cyst
- Cystic fibrosis leading to cholestasis
- Biliary atresia
Causes of unconjugated hyperbilirubinaemia
- Breast milk jaundice
- Rhesus incompatibility
- Hypothyroidism
- Physiological jaundice
- Bruising from traumatic delivery
- ABO incompatibility
- Infection
- Prematurity
Causes of physiological jaundice
- Low liver enzyme activity
- Breakdown of fetal Hb
Causes of acute diarrhoea
- Viral gastroenteritis
- Food poisioning
- Antibiotic induced
- Bacterial gastroenteritis
Causes of chronic diarrhoea
- Non-pathological overflow diarrhoea in constipation
- Malabsorption
- Inflammation
Causes of malabsorption
- Cystic fibrosis
- Coeliac disease
- Secondary lactose intolerance
- Parasitic infection, e.g. giardia lamblia
Causes of inflammation leading to chrnoic diarrhoea
- Cow’s milk proteins intolerance
- Crohn’s disease
- Ulcerative colitis
Categories of causes dehydration
- Decreased fluid intake
- Excess loss
Causes of decreased fluid intake
- Stomatitis
- Tonsillitis
Causes of excess loss of fluid
Acute surgical losses fluid loss from burns, sweat, stool, urine, vomiting
Causes of excessive sweating
- CF
- High fever
- Hot climate
- Excessive exercise
Excessive loss of fluid in poop
Gastroenteritis
Dehydration from urine
Diabetes
Causes of headache
- Hypertension
- Meningitis
- Haemorrhage
- Tumour
- Infection
- Raised ICP
- Tension headache
- Dental caries
- Migraine
Seizures
- Asphyxial injury
- Hypoglycaemia
- Epilepsy
- Febrile convulsions
- Head injury
- Hypoglycaemia
- Meningitis
- Drug ingestion
Coma
- Acute asphyxia event
- Shock
- Encephalitis
- Drug induced
- Raised ICP
- Head injury
- Meningitis
- Liver failure
- Cerebrovascular accident
- Renal failure
- Metabolic disorders
- Reye’s syndrome
- Convulsions
Acute asphyxia event leading to coma
- Birth asphyxia
- Near miss cot death
- Post cardiac arrest
Drugs leading to coma
- Accidental ingestion
- Overdose
Head injury leading to coma
- Subdural haematoma
- Extradural haematoma
- Diffuse axonal injury
- Non-accidental injury
Cerebrovascular causes of coma
- Vasculitic disorder
- Hypertension
- Thrombotic disorder
- Malformations
Metabolic disorders leading to coma
- Hypoglycaemia
- Diabetic ketoacidosis
- Inborn errors of metabolism
Weakness
- Central causes, e.g. cerebral palsy
- Nutritional deficiency
- Congenital heart disease
- Hypothyroidism
- Neuromuscular disorder
Categories of neuromuscular disorders
- Anterior horn cell
- Peripheral nerve
- Neuromuscular transmission
- Muscle disorders
disorders of anterior horn cell leading to weakness
spinal muscular atrophy poliomyelitis
disorders of peripheral nerve leading to weakness
hereditary motor sensory neuropathies acute post-infectious polyneuropathy, e.g. Guillan barre
Disorders of neuromuscualr transmission leadign to weakness
Myasthenia gravis
muscle disorders leading to weakness
Muscular dystrophies metabolic myopathies congenital myopathies myotonic disorders
muscular dystrophies leading to weakness
duchennes beckers
Inflammatory myopathies leading to weakness
Benign acute myositis polymyositis/dermatomyositis
categories of causes of floppy infant
Central spinal cord anterior horn cell muscle neuromuscular junction peripherla nerve metabolic myopathies
central causes of floppy infant
• Drug effects, e.g. benzodiazepines • Hypoxic-ischaemic encephalopathy Intracranial haemorrhage
spinal cord causes of floppy infant
Birth trauma syringomelia
Anterior horn cell causes of floppy infant
Spinal muscular atrophy
muscle causes of floppy infant
• Muscular dystrophies Congenital myopathies
neuromuscular junction causes of floppy infant
• Myasthenia gravis Infantile botulism
peripherla nerve causes of floppy infant
• Hereditary motor and sensory neuropathies Inborn errors of metabolism
metabolic myopathies causes of floppy infant
Carnitine deficiency
haematuria
• Henoch-Schonlein purpura • Alport’s syndrome • Post-streptococcal glomerulonephritis • IgA nephropathy • Renal stones • Thin basement membrane disease • Kidney tumours • Urinary tract infection • Sickle cell disease • Trauma Polycystic kidneys
acute macular rash
Rubella roseola
acute vesicular rash
chicken pox hand foot mouth
Acute papular rash
allergic reaction
Acute maculopapular rash
Measles fifth disease scarlat fever
Acute purpuric rash
Hsp meningococcal sepsis idiopathic thrombocytopenic purpura
acute wheals
Urticaria
chronic rash
• Seborrhoeic dermatitis • Eczema • Contact dermatitis Psoriasis
Types of anppy rash
• Psoriatic nappy rash • Candida • Seborrhoeic dermatitis Ammoniacal dermatitis
crying baby
• Normal response to hunger and discomfort • Infections, e.g. urinary tract, middle ear, meningeal • Pain from unrecognised fracture • Oesophagitis • Torsion of testis • Preterm infants that have spent several weeks in hospital • Chronic neurological disorder, e.g. cerebral palsy • Teething Colic
Feeding problems
• Traumatic birth injuries that lead to neurological disorders, e.g. cerebral palsy • Cleft lip and/or palate • Autism • Neck and head abnormalities • Premature birth • Low birth weight • Respiratory problems • Heart disease • GI disorders • Medications that decrease appetite Non-medical causes, e.g. baby stressed or scared, isn’t receiving enough attention, doesn’t like tastes, smell, and/or texture of some foods
leg pain and limp
• Transient synovitis • Growing pains • Trauma • Osteomyelitis • Perthes disease • Slipped capital femoral epiphysis • Neoplastic disease Septic arthritis
categories of developmental delay
Neurocutaneous syndromes cns malformation endocrine metabolic disorders neurodegenerative disorders chromosomal abnormalities pre-natal injury post-natal injury idiopathic
Neurocutanoeus syndromes causing developmental delay
• Neurofibromatosis • Tuberous sclerosis Sturge-Weber
cns malformations causing developmental delay
• Neural tube defects Hydrocephalus
endocrine and metabolic disorders causing developmental delay
• Phenylketonuria Congenital hypothyroidism
neurodegenerative disorders causing developmental delay
Leucomalacia
Chromosomal abnormalities causing developmental delay
• Fragile X Down syndrome
pre-natal injury causing developmental delay
Intrauterine infections (TORCH)
peri-natal injury causing developmental delay
• Asphyxia Birth trauma
post-natal injury causing developmental delay
• Meningitis • Non-accidental injury Neglect
Idiopathic causing developmental delay
• Autism Various dysmorphic syndromes
categories of growth failure
Steady growth below centiles fall off in growth
causes of steady growth below centiles
• Constitutional (familial) short stature • Maturational delay • Turner’s syndrome • IUGR Skeletal dysplasia
causes of fall off in growth across centiles
• Chronic illness • Growth hormone deficiency • Cushing’s disease • Acquired hypothyroidism Psychosocial