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AMC CLINICALS > Differentials > Flashcards

Differentials Flashcards

1
Q

Chronic constipation

A

C - hirschprung

T - post traumatic stricture; retroperitonela bleed secondary to SX

N -

Infl - ?

Infe - ?

E - hypothyroidism; hyperPTH; DM; hypoK

N - low fiber; high fat

Dr - codeine; Fe; aluminum; nitrates; Ca channel; anti-histamines; laxative abuse

De - fissue; PILES

PSYCH

old age; decreased exercise

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2
Q

H5 hearing loss in 10 month old

A

C - Maternal infections (congenital rubella syndrome: Sensorineural HL)

T -

N -

Infl -

Infe - middle ear effusions (transient, conductive HL), neonatal hyperbilirubinemia (cerebral damage)

E -

N -

D - Ototoxic drugs (aminoglycosides- gentamycin; chemo - cisplatin & carboplatin); temporary HL ( ASA, Quinine, loop diuretics- furosemide)

D -

P-

Perinatal jaundice

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3
Q

H6 hair loss

A

C - Down’s syndrome

T - post traumatic alopecia

N

Infl - atopic dermatitis, vitiligo

Infe - tinea capitis, syphilis

E - thyroid disease, androgenetic alopecia

N -

D - telogen effluvium

D - collagen vascular disease

P - stress, trichotillomania

Alopecia areata

Telofen effluvium - metabolic, hormonal, and medications

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4
Q

H7 feeling a lump in the throat

A

C -

T -

N - esophageal cancer,

Infe -

Infl -

E - goitre

N - GORD, visceral hypersensitivity, UES problems or esophageal dismotility, cricooharyngeal dysfunction,

D -

Deg-

P - globus pharyngeus

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5
Q

H22 headache

A

C - AVM

T - epidural hemorrhage/hematoma

N - brain tumor (pituitary adenoma, etc)

Infe - meningitis, encephalitis

Infl - SLE, temporal arteritis

E - pheochromocytoma

N -

Dr - alcohol withdrawal, recreational drugs

De - Fibromuscular dysplasia,

P -

Migraine, cluster, tension

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6
Q

H23 neck lump (anterior triangle)

A

C -

T -

N - lymphoma (hodgkin’s and non- hodgkin’s?), NPCA (post triangle),

Infe - lymph node enlargement,

Infl -

E - giotre,

N -

Dr -

De -

P -

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7
Q

H25 dysphagia

A

C -

T -

N - thyroid hyperplasia, esophageal neoplasm, gastric neoplasm

Infe -

Infl - myasthenia gravis

E - thyroid enlargement

N - GORD, benign peptic stricture

Dr -

De - achalasia, zenker’s,stroke

P -

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8
Q

H26 low back pain

A

C - gastroschisis?

T - fracture of the lumbar area

N - spinal metastasis, spinal cord neoplasm

Infe - osteomyelitis, septic arthritis, UTI

Inf - cellulitis

E -

N -

Dr -

De - spondylosis (osteoarthritis), intervertebral disc prolapse, arterial occlusive disease

P - fibromyalgia

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9
Q

Chronic cough

A

C - cystic fibrosis, a1 antitrypsin deficiency–>centrilobular emphysema

T - foreign body

N- carcinoma (lungs, larynx), vocal nodule

Infl- COPD, asthma, sarcoidosis

Infe- viral, bacterial, fungal, atypical, parasite (ascariasis, filiriasis), chronic bronchitis

E - thyroid enlargement

N- GORD

Dr - ACEI, smoking

De - voice abuse, chronic laryngitis

Psych

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10
Q

H27 knee pain

A

C - chondromalacia patellae

T - meniscal tears, fx,

N - bone neoplasia, mets,

Infe - septic arthritis,

Infl - SCFE, Osgood Schlatter disorder

E -

N - gout

Dr -

De - Perthe’s disease, osteoarthritis, patellofemoral syndrome, prepatellar bursitis, dvt, RA, juvenila arthritis,

P -

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11
Q

H28 increasing abdominal pain

65 yo

A

C -

T - adhesions,

N - gastric cancer,

Inf - Appendicitis

Inf - crohns, ulcerative colitis

E -

N - GORD, peptic ulcer disease

Dr -

De - mesenteric ischemia,

P -

Cholesystitis

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12
Q

H29 hematemesis and melena

A

C -

T - ruptured AAA?,

N - gastric neoplasm with erosion, colin cancer (left),

Infe -

Infl -

E -

N - esophageal tear (Boerhave’s), PUD,

Dr -

De - diverticulitis

P -

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13
Q

H30 Neonatal jaundice

A

1st 24H of life:
ABO incompatibility
Rh isoimmunization
G6PD

> 24HOL

CONJUGATED:
biliary atresia

UNCONJUGATED:
breastmilk jaundice

Congenital hypothyroidism

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14
Q

H32 loud and disruptive behavior of 6 yo boy

A

C -

T -

N -

Infe - meningitis

Infl -

E -

N -

Dr -

De -

P - oppositional defiant disorder, ADHD, conduct disorder (after ruling out organic causes)

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15
Q

H33 shakes

A

C -

T -

N - cerebellar disease

Infe -

Infl -

E - hyperthyroidism

N -

Dr - alcohol withdrawal, drug abuse

De - parkinson’s disease

P - anxiety state

Benign essential tremor

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16
Q

H35 lethargy

50 female

A

H emochromatosis/ Hepatitis

Endo: hypothyroidism, DM, Addison’s

M alignancy: pituitary disorder

Infection: infective endocarditis

F atigue sx

A naemia / Atypical pneumonia

D epression/ drugs

S leep apnea

C oeliac disease

N - decreased intake, lack of iodine in diet

lithium and amiodarone –> hypothyroidism

De - RA, early dementia

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17
Q

H36 Syncope

A

C -

T - stroke

N - cerebral tumor

Infe - meningitis

Infl -

E -

N - hypoglycemia

Dr - anti- hypertensive drugs

De - postural hypotension, aortic stenosis, TIA, aFib, CHF

P -

Epilepsy

18
Q

H38 primary amenorrhea

18 yo

A

C - turner’s (hypergonadotropic hypogonadism), Mayer- Rokitansky-Hauser syndrome ( vaginal agenesis ), Imperforate hymen, Vaginal septum

T -

N - Anterior pituitary prolactinoma

Infe -

Infl -

E - ovarian failure (hypergonadotrpic hypogonadism- inc FSH and LH, low Es), Kallman syndrome (anosmia and pubertal delay), PCOS, thyroid disorder

N - malabsorption and poor nutrition, obesity

19
Q

Neck lumps

A

Lymphatic spread from (chest and lungs, abdomen, genitals.

Papillary carcinoma (thyroid)

Systemic lymphoid pathology (hodgkin)

20
Q

H44 Coma

A 
C - CNS
      C - Ruptured berry aneurysm
      T - head injury (don't move neck)
      N - brain tumor
      Inf - meninggoenceph

O -verdose
Opiates
Barbiturates
Iv

M - etabolic
DM coma
Hypothy (myxedema coma)
Addisonian crisis

A - lcohol
Overdose
Withdrawal
Hep failure

21
Q

H45 poor distance vision

A

Myopia

Astigmatism

If on pinhole, no improvement- macular degeneration, glaucoma, cataract

22
Q

Red eye

A

Conjunctivitis

Foreign body

Inflammation

Ulceration

Glaucoma

Subconjunctival hemorrhage

23
Q

H48 fever, maculopapular rash, lymphadenopathy

A

HIV infection

EBV

CMV

secondary syphillis

Toxoplasmosis

Rubella

HSV

Disseminated gonococcal infxn

Hep A, B, C, D, E

Inf mononucleosis

24
Q

H67 weakness and urinary symptoms

A

BPH

Drug induced (thiazides can cause hupoK)

Cancer

25
Q

H68 aches and pains

A

Polymyalgia rheumatica

Chronic fatigue syndrome

Fibromyalgia

Polymyositis

Carcinoma

26
Q

H72 dizziness (mid aged man)

A

C

T- subdural hematoma?

N- tumor (CPA)

infe-

Infl- BPPV, neuronitis, acute labyrinthitus, meniere, chronic petrositis

E-

N-

Dr-

Deg- stroke, TIA, MS

P-

Migraine

27
Q

H73 urinary frequency in a 60 yo man

A

C

T

N- Prostate CA, BPH

Infe- UTI

inlf-

Endo- maturity onset DM2

N-

Dr-

Deg-

P-

28
Q

H111 IDA in 55yo

A

C -

T

N - benign or malignant tumor of stomach or large bowel

Infe

Infl

E

N- Vit B12 def, peptic ulcer, reflux oesophagitis

Dr - NSAID, ASA

De

P

29
Q

H117 post partum hge

A

C

T - laceration if genital tract ( vagina, cervix, uterine rupture)

N -

Infe

Infl

E

N

Dr

Deg - uterine atony

P

Others: retained placental fragments, cotyledon, membranes

Coagulation disorder

30
Q

H133 intrauterine growth restriction

A

kidney disease –>oligohydramnios

Congenital anomaly

Pre eclampsia

Congenital infections (CMV and Toxoplasmosis)

Placental dysfunction

Lupus

APAS

31
Q

H134 delirium

A

C

T - brain injury, hypoxia

N

Infe - infection and sepsis

Infl

Endo - hypoglycemia or hyperglycemia, hyper/hypothyroidism

N

D - intoxicatio or withdrawal (sedatives, opiates, anesthetics, neuroleptanalgesics, alcohol)

Deg

P

Liver dse, anaemia, uremia, hypo/hypernatremia

32
Q

H135 chronic diarrhea mid age

A

C - CF,

T

N - ca

Infe - gastroenteritis

Infla- IBS, IBD

E - hyperthryroidism

N - lactose intolerance, gluten sensitivity (celiac dse)

Dr- laxative abuse, antibiotic induced (pseudomembranous colitis)

Deg- dumping syndrome, mesenteric ischaeimia

P

Travel- tropical sprue

33
Q

H144 nausea and vomiting in first trimester

A

Hyperemesis gravidarum

Multiple gestation

UTI

Molar pregnancy

Other less likely dd’s:
SBO
CEREBRAL tumor
Addison’s dse

34
Q

H149 delirium

A

C

T - stroke, peritonitis due to ruptured viscus (diverticulum)

N-

Infection/sepsis

Infl

E- hypothyroidism, hypogly

N- hypoxia (possible pulmo embo),hypotension, electrolyte abn

Dr- opioids, hypnotics?, bzd withdrawal, alcohol, narcotics

Deg- cardiac abn, pain, peritonitis (ruptured viscus– diverticulosis)

P

35
Q

Hypertension

A

T hyrotoxicosis

R enal artery stenosis (bruit)

A ortic coarctation (radiofemoral d)

C ushing’s

K idney (PCKD, Glomerulonephritis)

P heochromocytoma

A ldosteronism (Conn’s)

D rugs (OCP, NSAIDs, steroids, alcohol)

M arfan’s

36
Q

Intermittent fever (karen’s)

Pyrexia of unknown origin

A

Travel

Sexual hx

Lymphoma

Inf mono

Ebv

Tb

Malria

37
Q

Petechiae

A

ITP

HSP

MALIGNANCY

MENINGGOCOCCEMIA

38
Q

Postural hypotension

A

H ypovolaemia
(DHN, bleed, hypopit)

A ddison’s (adrenal gland failure)

N europathy (DM)

D rugs (vasodilators, antiHTN, TCA, diuretics, antipaychotics)

I diopathic orthostatic (geria)

39
Q

Skin change

A

Hemochromatosis

Addison’s disease

40
Q

Pain to one side of face

A

C

T rauma, mandibular fracture/dislocation

N

Infe- Acute sinusitis

Infl- trigeminal neuralgia, migraine, dental problem, temporal arteritis

E

N

Deg- TMJ dysfxn

Dr

P

AMC CLINICALS (3 decks)

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