Differentials Flashcards
Differentials
Melanoma types
Superficial Spreading Melanoma
Lentigo Maligna
Acral Lentiginous Melanoma
Nodular Melanoma
Differentials
Headache DDx
Meningitis SAH / Intracranial Haemorrhage Tumour GCA Migraine Cluster Tension Medication-overuse Head injury Sinusitis Raised ICP Trigeminal Neuralgia
Differentials
Syncope DDx
Vasomotor (postural, vasovagal, drug) Arrhythmias (VT, SVT, brady/heart block) Neurological (Seizure, CVD) Metabolic (low BGL) Psychological (anxiety)
Differentials
Hepatomegaly DDx
Nodular - NASH / CLD -> Cirrhosis - Malignancy (secondary > primary) Tender - RHF (pulsatile) - Infection CTD - Connective Tissue Disorder
Differentials
Hepatosplenomegaly or Splenomegaly DDx
CLD + Portal HTN Haem Malignancies & Disorders - RC - WC - LL (A,C, Lymph) & ML (A,C, MDS) Infection - HAV, HBV, HVC, EBV, CMV CTD
Differentials
Enlarged Kidney DDx
PCKD Hydronephrosis Diabetes Bilateral RCC Pyelonephritis
Differentials
ID History
Country of Origin Housing Immunisations Contacts Travels Occupation Animals Drugs Sexual Hx
Differentials
Peripheral Neuropathy DDx
Diabetes Alcohol Nutritional (eg B12 deficiency) Guillain-Barre Toxic (eg amiodarone) Heriditary Endocrine Recurring (10% of G-B) Amyloid Pb (lead) Idiopathic Sarcoid Thyroid
Differentials
Diarrhoea DDx
Exudative Secretory Osmotic Malabsorptive Increased motility
Differentials
Haemoptysis DDx
Resp - Lung Carcinoma - Pneumonia - TB - Bronchiectasis - Abscess - PE - Trauma CV - CCF Haem - Coagulopathy
Differentials
Haemoptysis Ix
Bedside - Vitals x5, ECG Bloods - FBE, CRP, UEC, LFT, COAGs Sputum sample - MCS Radiology - CXR, CT, Biopsy or bronchoscopy Others - VATS - video assisted thoracoscopy + biopsy
Differentials
CXR Interpretation
Name, date, orientation, rotation, penetration/quatlity A – Airways B – Bones C – Cardiac silhouette D – Diaphragm E – Equal volume F – Fine detail G – Gastric bubble H – Hilum I – Iatrogenic
Differentials
CXR upper lobe opacification DDx
-Right upper lobe bronchopneumonia (klebsiella , mycoplasma, viral ) - Pulmonary tuberculosis - Pancoast tumor - Lung abscess
Differentials
Chest Pain DDx
Cardio - Angina & ACS - Pericarditis - Myocarditis - Arrhythmia Resp - Pneumothorax - PE GI - GORD - Gastritis - PUD MSk - Tietze's syndrome
Differentials
Chest Pain Ix
Bedside - Vitals x5, ECG Bloods - FBE, UEC, LFT, Trops, CK-MB Radiology - CXR, CT, Angiogram
Differentials
Murmur characteristics
Location
Character
Radiation
Manoeuvres
Differentials
ECG Interpretation
Introduction - Confirm patient name & age - ECG date Rate Rhythm - Sinus? Axis - Deviated? P wave - Shape & size P-R interval - Prolonged or short (WPW)? QRS complex - Width - Height - Pathological Q wave (> 1 sm sq wide, > 2mm deep; MI) ST segment - Elevation (acute MI, pericarditis) - Depression (ischaemia, digoxin) T wave - Inverted in I,II & V4-V6 (ischaemia, infarction, BBB, ventricular hypertrophy) - Peaked (hyperkalaemia) - Flattened (hypokalaemia) U waves - In hypokalaemia
Differentials
STEMI Mx
Short term - MONAS - PCI or thrombolysis - Cardiac monitoring Long term - Lifestyle mods - BB, ACEi, Statin, aspirin / antiplatelet
Differentials
CCF CXR Signs
Alveolar oedema
Kerley B lines (interlobular septal lines) Cardiomegaly
Distended upper lobe vessels
Bilateral pleural effusions
Differentials
Exacerbation CCF Mx
- Acute – Transfer to ED,
LMNOPP
