Differentials Flashcards
Chronic constipation
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
H5 hearing loss in 10 month old
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
H6 hair loss
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
H7 feeling a lump in the throat
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
H22 headache
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
H23 neck lump (anterior triangle)
C -
T -
N - lymphoma (hodgkin’s and non- hodgkin’s?), NPCA (post triangle),
Infe - lymph node enlargement,
Infl -
E - giotre,
N -
Dr -
De -
P -
H25 dysphagia
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 -
H26 low back pain
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
Chronic cough
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
H27 knee pain
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 -
H28 increasing abdominal pain
65 yo
C -
T - adhesions,
N - gastric cancer,
Inf - Appendicitis
Inf - crohns, ulcerative colitis
E -
N - GORD, peptic ulcer disease
Dr -
De - mesenteric ischemia,
P -
Cholesystitis
H29 hematemesis and melena
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 -
H30 Neonatal jaundice
1st 24H of life:
ABO incompatibility
Rh isoimmunization
G6PD
> 24HOL
CONJUGATED:
biliary atresia
UNCONJUGATED:
breastmilk jaundice
Congenital hypothyroidism
H32 loud and disruptive behavior of 6 yo boy
C -
T -
N -
Infe - meningitis
Infl -
E -
N -
Dr -
De -
P - oppositional defiant disorder, ADHD, conduct disorder (after ruling out organic causes)
H33 shakes
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
H35 lethargy
50 female
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
H36 Syncope
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
H38 primary amenorrhea
18 yo
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
Neck lumps
Lymphatic spread from (chest and lungs, abdomen, genitals.
Papillary carcinoma (thyroid)
Systemic lymphoid pathology (hodgkin)
H44 Coma
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
H45 poor distance vision
Myopia
Astigmatism
If on pinhole, no improvement- macular degeneration, glaucoma, cataract
Red eye
Conjunctivitis
Foreign body
Inflammation
Ulceration
Glaucoma
Subconjunctival hemorrhage
H48 fever, maculopapular rash, lymphadenopathy
HIV infection
EBV
CMV
secondary syphillis
Toxoplasmosis
Rubella
HSV
Disseminated gonococcal infxn
Hep A, B, C, D, E
Inf mononucleosis
H67 weakness and urinary symptoms
BPH
Drug induced (thiazides can cause hupoK)
Cancer
H68 aches and pains
Polymyalgia rheumatica
Chronic fatigue syndrome
Fibromyalgia
Polymyositis
Carcinoma
H72 dizziness (mid aged man)
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
H73 urinary frequency in a 60 yo man
C
T
N- Prostate CA, BPH
Infe- UTI
inlf-
Endo- maturity onset DM2
N-
Dr-
Deg-
P-
H111 IDA in 55yo
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
H117 post partum hge
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
H133 intrauterine growth restriction
kidney disease –>oligohydramnios
Congenital anomaly
Pre eclampsia
Congenital infections (CMV and Toxoplasmosis)
Placental dysfunction
Lupus
APAS
H134 delirium
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
H135 chronic diarrhea mid age
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
H144 nausea and vomiting in first trimester
Hyperemesis gravidarum
Multiple gestation
UTI
Molar pregnancy
Other less likely dd’s:
SBO
CEREBRAL tumor
Addison’s dse
H149 delirium
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
Hypertension
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
Intermittent fever (karen’s)
Pyrexia of unknown origin
Travel
Sexual hx
Lymphoma
Inf mono
Ebv
Tb
Malria
Petechiae
ITP
HSP
MALIGNANCY
MENINGGOCOCCEMIA
Postural hypotension
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)
Skin change
Hemochromatosis
Addison’s disease
Pain to one side of face
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
