Differentials for Pathologies Flashcards
Epidural Hematoma
Top 5
Did you hit your head in the temporal region?
Do you have focal pain/a headache in the temporal region?
Have you been vomiting?
Did your symptoms happen within the past few hours (suddenly)?
Did you lose consciousness?
Subdural Hematoma
Top 5
Did you fall or hit your head at all?
Do you have a headache that just keeps getting worse?
Did you lose consciousness?
Did you take any antiplatelets/anti-clotting medications (Asprin + heparin)?
Do you have any difficulty speaking or seeing?
Subarachnoid Hemorrhage
Top 5
Located at bifurcations
45% younger than 55 y/o
Can affect children the elderly & alcoholics
Are you experiencing a THUNDER CLAP headache?
Did the symptoms come on suddenly? (min-hours-days)
Do you have nuchal rigitidy? (up and down head movement)
Do you have a past/family history of brain aneurysms?
Check/ask about photophobia?
Projectile vomiting?
Intraparenchymal/Intracerebral Hemorrhage
Top 5
anterior portion of the temporal lobes & the posterior portion of the frontal lobes
older men (68)
Do you have a headache in a sepcific spot?
Did you fall or hit your head recently?
Does you have a history of hypertension or AVM?
Were you straining yourself?
Are you on any anticoagulant/antiplatlet medications (heprin +aspirin)
Basal Skull Fracture
Top 5
Was there a high energy M.O.I involved?
Are you losing consciousness/did you?
Do I see racoon eyes?
Do I see/feel any skull deformeties?
Do I see any blood/csf coming from the nose or ears?
Hydrocephalus
Top 5
Are you diagnosed with Hydrocephalus?
Do you have a shunt?
Do I see a pee rash - maculopapular rash?
Do you have a headache/migraine that hurts more when you stand?
Do you need to go to the bathroom a lot?
Do I see any open wounds or infections?
Meningitis
Top 5
Check/ask about the photophobia (bright light sensitivity)
Check/ask about the presence of a stiff neck and/or nuchal rigidity.
Ask the patient if they’ve had any recent injuries/open wounds – assess the area.
Were you vaccinated against meningitis as a child?
Do you have a rash? (Red/Purple blotches)
Alzheimer’s Disease
Top 5
Everyday tasks become increasingly difficult such as driving, paying bills, cooking
They may ask or repeat the same phrase over and over.
They may get lost easily
find simple tasks confusing
Parkinson’s Disease
Top 5
Do you have Parkinson’s Disease?
Do you take any parkinson medications like dopamine?
Do you have tremors - maybe have them hold something?
Do you have difficulty with balance?
Have you noticed any of your normal movements slowing down like walking or putting clothes on?
Multiple Sclerosis
Top 5
Do they have a diagnosis of multiple sclerosis or autoimmune disorders?
Has there been a recent onset of muscle weakness or inability to function normally?
Are you having vision problems (blurred, double, painful)?
Are you experiencing global burning/shooting pain sensations?
Are you having trouble concentrating recently?
Huntington’s Chorea
Top 5
Have you been diagnosed with huntington’s?
Does your family have a hx of HDC?
Do you often have uncontrolled movements like jerks/twitch/full reflex?
Do you have trouble walking? Are you felling at all?
Look for dystonia (stuck in twitch posture)
Myasthenia Gravis
Top 5
Have you been diagnosed with MG?
Have you had any muscle weakness recently?
I’m looking for ptosis - drooping of the eye(s)
I’m looking for dysarthria - imparied speech
Do you have difficulty swallowing or breathing?
Epilepsy - Absence
Top 5
Do they have a diagnosis of absent seizures?
Do I notice lip smacking/eye fluttering?
How long does it last? - 5-30sec
Do you lose conciousness? -no just zone out
How often does this occur? - 15-100x
Epilepsy - Tonic Clonic
Top 5
Do you have a diagnosis?
Do I see incontinence?
Did you have a post-ictal phase - 5min to several hours of confusion?
Did you have an aura - few sec long?
Did you lose consciousness?
Do they experience tonic (frozen) phase of 5-15sec and clonic phase of 30sec (the twitching)?
Arteriovenous Malformation (AVM)
Top 5
Do you have a diagnosis?
Do you experience sudden and severe headaches?
Have you ever had a seizure or lost consciousness before?
Do you have numbness or tingling in certain areas of your body?
Do you have a cardiac hx meaning have you ever had surgeries on your heart before?