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Z IPE > Differentials and Ix > Flashcards

Differentials and Ix Flashcards

1
Q

SOB differentials acute

A
  1. PE
    1. Pneumothorax
    2. Asthma/COPD
    3. Pneumonia
    4. Acute HF
    5. ACS
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2
Q

Ix for SOB

A

BOXES

Bloods:
	• FBC, U&E, CRP
	• D-Dimer to rule out PE
	• Blood culture if pyrexic
	• ABG

Orifice tests:
• Sputum

X-rays:
• CXR

ECG

Special:
• CTPA for PE

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3
Q

chest pain acute differentials

A

3Ps, 2As

1. ACS
2. PE
3. Aortic dissection
4. Pnuemothorax
5. Pneumonia
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4
Q

Chest pain ix

A

BOXES - Bloods - trop, FBC, WBC, CRP
CXR
ECG
CTPA (PE), CT angio (aortic dissection)

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5
Q

Abdo pain differential generalised

A

Generalised:

1. Peritonitis
2. AAA
3. Ischemic bowel
4. Medical causes (DKA, pneumonia, MI, Addisonian crisis)
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6
Q

RUQ abdo pain differentials

A

Hepatitis, cholecystitis

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7
Q

LUQ abdo pain differentials

A

LUQ:

1. Peptic ulcer
2. Pancreatitis
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8
Q

Abdo pain ix

A

BOXES

Bloods:
	• FBC, CRP, U&E
	• LFTs, amylase
	• INR
	• Glucose
	• VBG (lactate)

Orifice tests:
• Urine dip
• Urine beta HCG

Xrays:
• Erect CXR
• AXR if SBO

ECG

Special test:
• FAST scan for AAA
• USS/CT abdo

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9
Q

Red eye differentials

A 
Differentials:
	• Conjunctivitis
	• Corneal ulcer
	• Iritis
	• Episcleritis
	• Scleritis
	• Acute angle closure glaucoma
	• Age related macular degeneration
	• Diabetic Retinopathy
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10
Q

Sudden loss of vision painless differentials

A

Central retinal artery occlusion:
• Sudden painless loss of vision
• Cherry red spot on a pale retina

Central retinal vein occlusion:
• Causes - glaucoma, polycythemia, HTN
• Severe retinal hemorrhages on fundoscopy

Retinal detachment:
• Flashes of light
• Floaters
• Curtain being drawn, tunnel vision to central vision.

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11
Q

Goitre differentials

A

Non neoplasm:
Single nodule - colloid, cyst
Multinodular goitre

Neoplasm:
• Benign:
○ Adenoma
• Malignant:
○ Papillary adenocarcinoma - hx of irradiation
○ Follicular carcinoma - mets to bone and lungs
Medullary carcinoma - seen in MEN syndrome

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12
Q

Neck lump differentials

A

Reactive lymphadenopathy - hx of local infection

Lymphoma - rubbery + painless, night sweats

Thyroid swelling - moves up on swallowing

Thyroglossal cyst - midline. Moves upwards with protrusion of tongue

Branchial cyst - mobile cyst between SCM and pharynx

Cervical rib - adult females

Carotid aneurysm - pulsatile mass, doesnt move on swallow

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13
Q

Paeds wheeze differentials

A 
Wheeze:
	• Pneumonia
	• Asthma
	• Bronchiolitis
	• Bronchitis
	• Cystic Fibrosis
	• Inhalation of foreign body
	• Aspiration
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14
Q

Paeds acute cough differentials

A 
Acute Cough:
	• Upper airways:
		○ Rhinovirus
		○ Croup
		○ Allergy
	• Lower airways:
		○ Asthma
		○ Bronchitis, bronchiolitis
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15
Q

Paeds chronic cough differentials

A 
Chronic cough:
	• Upper airways:
		○ Infection - chronic sinusitis, tonsillitis
		○ GORD
	• Lower airways:
		○ Asthma
		○ Foreign body
		○ Bronchiectasis
		○ CF
	• Psychogenic cough
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16
Q

Paeds stridor differentials

A 
Stridor:
	• Nose and nasopharynx:
		○ Inflammation eg rhinitis and sinusitis
	• Mouth:
		○ Tonsillar hypertrophy
		○ Foreign body
	• Larynx:
		○ GORD
		○ Epiglottitis
		○ Abscess
		○ Foreign body
	• Trachea:
		○ Tracheomalacia
		○ Tracheitis
17
Q

Syncope differentials

A 
Syncope differentials:
	• Epilepsy
	• Narcolepsy
	• Dizziness without LOC
	• TIA/Stroke
Hypoglycaemia
18
Q

Neural causes of syncope

A

• Neural causes:
○ Vasovagal (most common):
§ Severe pain, fear, blood phobia
§ Orthostatic stress eg prolonged standing or in hot places
○ Situational eg micturition, Cough, sneeze
Carotid sinus hypersensitivity - while shaving, tight collar

19
Q

Postural hypotension causes of syncope

A

Postural hypotension:
○ Autonomic failure - postprandial, medication, MSA, parkinsons, diabetic neuropathy
Hypovolemia - haemorrhage, addisons, dehydration

20
Q

Cardiac arrhythmia causes of syncope

A

○ Long QT
○ Drug induced arrhythmia
AV conduction disease

21
Q

Structural cardiopulmonary causes of syncope

A

○ Aortic stenosis
○ ACS
○ Pericardial tamponade
HOCM

22
Q

Tremor differentials and classification

A

Classifying tremors:
• Rest - PD (pill rolling, bradykinesia)
• Intention - Cerebellar disease
• Tremor on movement - Essential tremor, thyrotoxicosis, anxiety, drugs (beta agonists)

23
Q

Acute cough <3wks differentials normal and abnormal cxr

A 
• Normal CXR :
		○ bacterial / viral RTI
		○ Inhaled foreign body
		○ Irritation from fumes
	• Abnormal CXR:
		○ Pneumonia
		○ Inhaled foreign body
Extrinsic allergic Alveolitis
24
Q

Chronic cough >8 wks differentials normal and abnormal cxr

A 
• Normal CXR:
		○ GORD
		○ Asthma
		○ ACEi - bradykinin
	• Abnormal CXR:
		○ TB
		○ Lung cancer
		○ ILD
Bronchiectasis
25
Q

Miosis differentials

A

pinpoint pupils - Differentials:
• Opioids
• Horners
Pilocarpine

26
Q

Mydriasis differentials

A

Mydriasis (blown out pupils) differentials:
• 3rd nerve palsy
• Phaeochromocytoma
• Holmes-Adie pupil - damage to PS innervation of eye by infection
• Topical mydriatics - atropine
• Cocaine and amphetamines

27
Q

Massive splenomegaly causes

A

CML,CLL
Malaria
Myelofibrosis
Young - EBV, Haemolytic anaemia

28
Q

Acute recurrent headaches differentials

A

migraine, cluster, sinusitis, trigeminal neuralgia

29
Q

Chronic headache differentials

A

Increased ICP eg SOL
Tension headache
Analgesia rebound

30
Q

Single episode headaches differentials

A

Meningitis
encephalitis
Subarach hemorrhage
Sinusitis

31
Q

Sensory neuropathies causes

A 
• Diabetes
	• Alcohol
	• RA
	• Drugs
	• Malignancy
B12 deficiency
32
Q

Motor neuropathy causes

A

• Guillan Barre
• Motor neurone disease
• Charcot-marie-tooth disease
Lead toxicity

33
Q

Muscle myopathy causes

A

Inherited:
• Duchenne’s
• Becker’s

Acquired:
• Cushings
• Hyperthyroidism
• Drugs - statin, steroids

Z IPE (15 decks)

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