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Phase 2 ICE > Differentials > Flashcards

Differentials Flashcards

1
Q

Differentials for LOC

A

SYNCOPAL: CROC
1. CARDIAC (arrhythmias, structural cardiac pathology causing outflow obstruction - e.g. aortic stenosis, hypertrophic obstructive cardiomyopathy)

  1. REFLEX (vasovagal, carotid sinus hypersensitivity, situation syncope - e.g. micturition)
  2. ORTHOSTATIC (dehydration, drugs - e.g. antihypertensives/sympathomimetics, autonomic instability, baroreceptor dysfunction in hypertensive patients
  3. CEREBROVASCULAR (vertebrobasilar insufficiency, subclavian steal, aortic dissection)

NON-SYNCOPAL

  1. Intoxication (alcohol/sedatives)
  2. Head trauma
  3. Metabolic
  4. Non-epileptic seizure (psychologically driven)
  5. Epileptic seizure
  6. Narcolepsy
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2
Q

Differentials for Headache

A

SINISTER CAUSES: VIVID

  1. VASCULAR: Subarachnoid haemorrhage; sub-dural/extra-dural haematoma, cerebral venous sinus thrombosis, cerebellar infarct
  2. INFECTION: Meningitis, encephalitis
  3. VISION THREATENING: Acute glaucoma, temporal arteritis, pituitary apoplexy, posterior leucoencephalopathy, cavernous sinus thrombosis
  4. INTRACRANIAL PRESSURE (raised): SOL (e.g. tumour, abscess, cyst); cerebral edema (trauma, altitude); hydrocephalus; malignant hypertension
  5. DISSECTION: carotid dissection

NON-SINISTER: tension headache, migraine, sinusitis, medication overuse headache, TMJ syndrome, trigeminal neuralgia, cluster headache

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3
Q

Differentials for Chest pain

A

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4
Q

Differentials for Dyspnoea

A

ACUTE: Acute asthma, pulmonary oedema, pneumothorax, PE, anaphylaxis, foreign body causing obstruction

INTERMEDIATE: exacerbation of COPD, cardiac failure, asthma, respiratory infection, pleural effusion, metabolic acidosis

CHRONIC: COPD, interstitial lung disease, pleural effusion, anaemia, carcinoma

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5
Q

Differentials for Oedema

A

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6
Q

Differentials for GI bleeding

A

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7
Q

Differentials for weakness

A 
SUDDEN ONSET (seconds-minutes): trauma, vascular insult (stroke, TIA, SAH)
SUBACUTE ONSET (hours-days): GBS (progressive autoimmune demyelination), venous thrombosis (progressive blockage of a vein), subdural haematoma (progressive enlargement of the haematoma)
CHRONIC ONSET (weeks-months): slow growing tumour, motor neuron disease (progressive degeneration of motor neurons)
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8
Q

Differentials for Falls

A

a

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9
Q

Differentials for Delirium

A

a

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10
Q

Differentials for Dementia

A

a

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11
Q

Differentials for Vertigo

A

PERIPHERAL: Labyrinthitis, Meniere’s disease, BPPV, acoustic neuroma, vestibular neuronitis
CENTRAL: lesion to brainstem/cerebellum (therefore TIA may cause vertigo)

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12
Q

Differentials for RUQ pain

A

a

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13
Q

Differentials for RIF pain

A

a

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14
Q

Differentials for LIF pain

A

a

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15
Q

Differentials for Flank pain

A

a

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16
Q

Differentials for confusion

A

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17
Q

Differentials for stroke

A

She Hikes Mountains Every Autumn Til December

Seizure
Hypoglycaemia
Migraine with aura
Encephalopathy (Wernicke's/hypertensive)
CNS Abscess
CNS Tumour
Drug toxicity
Psychogenic
18
Q

Differentials for haemoptysis

A

Bronchitis
Bronchial carcinoma
Bronchiectasis
Pneumonia

19
Q

Signs of Horner’s syndrome and cause

A

Ptosis, miosis, anhydrosis, exopthalmos - due to interruption of sympathetic chain in neck/brainstem - commonly due to apical lung tumour interrupting sympathetic chain

20
Q

Respiratory causes of raised JVP

A

Cor pulmonale, elevated intrathroacic pressures (acute asthma, tension pneumothorax), SVC obstruction

21
Q

Causes of clubbing

A

RESP: carcinoma of bronchus, chronic suppurative lung disease (e.g. CF, empyema, bronchiectasis, lung abscess, fibrosing alveolitis)
CARDIAC: cyanotic heart disease, infective endocarditis
GI: liver cirrhoses, irritable bowel disease
IDIOPATHIC, FAMILIAL

22
Q

dDx anosmia

A

URTI (commonest), smoking and increasing age, ethmoid tumours, basal skull fracture, Kallman’s syndrome (hypogonadotrophic hypogonadism).

23
Q

UML vs. LMN signs

A

UMN: increased tone, increased reflexes, clonus (sometimes), upgoing plantar (babinki reflex). Extensors disproportionately weaker than flexors in the upper limb, and vice versa in the lower limb.

LMN: decreased tone, decreased reflexes, wasting, fasiculations (sometimes)

Phase 2 ICE (7 decks)

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