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YEAR 3 Manchester Medicine > Differentials fun > Flashcards

Differentials fun Flashcards

1
Q

Differentials for Chest pain

A

MI

Angina

Aortic dissection

Pericarditiis

PE
Pneumothorax

GORD

Anxiety and panic attacks

MSK

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2
Q

Chest pain - MI

A

Crushing central chest pain

Radiates to neck and left (or right) arm

Associated nausea/vomiting/SoB/clammy

Cardiovascular risk factors - DM, HTN, Smoking, Drinking, FH, etc.

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3
Q

Chest pain - Angina

A

Cardiac type chest pain

Exacerbated by exercise

Relieved by rest and GTN

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4
Q

Chest pain - Aortic dissection

A

Tearing chest pain

Sudden onset

Radiates to back

Pain in other sites - legs, arms, neck, head

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5
Q

Chest pain - Pericarditis

A

Pleuritic chest pain

Relieved by sitting forwards

Radiate to trapezius ridge at neck and shoulder

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6
Q

Chest pain - Pulmonary embolism

A

Pleuritic chest pain

haemoptesis

SoB

Risk factors - stasis, recent surgery, immobility, previous VTE.

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7
Q

Chest pain - pneumothorax

A

Sudden onset

Pleuritic

May be SoB

Rick factors - Marfan’s, COPD, asthma

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8
Q

Chest pain - GORD

A

“Burning”

Related to meals

Changes with by lying and straining

“Water Brash”

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9
Q

Chest pain - Anxiety and panic attack

A

Tight chest

Associated with SoB, sweating, dizziness, palpitations, sense of doom.

Anxious personality/ GAD

Recurrent episodes and triggers

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10
Q

Chest pain - MSK

A

Sharp chest pain

Exacerbated by movements and inspiration

Well localised

Exacerbated by pressure

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11
Q

Differentials for Breathlessness

A

MI

CHF
Pneumonia

Asthma

COPD

Pneumothorax
PE
Pulmonary fibrosis

Also: anaemia, Anxiety, pleural effusion, DKA, lobar collapse, Aortic stenosis, bronchiectasis,

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12
Q

Breathlessness - MI

A

Acute onset

Woken up by SoB

Nausea and vomiting

May have crushing central chest pain

CV risk factors

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13
Q

Breathlessness - Congestive heart failure

A

SoB, orthopnoea, PND

Pink and frothy sputum

peripheral oedema

Cardiac history

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14
Q

Breathlessness - Pneumonia, LRTI

A

Acute SoB

Cough and sputum

Systemic - fever

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15
Q

Breathlessness - Asthma

A

Intermittant wheeze

Diurnal variation

Nocturnal cough

Exacerbated by exercise, pet allergens etc.

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16
Q

Breathlessness - COPD

A

Chronic SoB

Significant smoking history

Chronic sputum production

17
Q

Breathlessness - Pneumothorax

A

Sudden onset pleuritic chest pain

Risk factors - Marfan’s, COPD, asthma

18
Q

Breathlessness - Pulmonary embolism

A

Pleuritic chest pain

Haemoptesis

Risk factors - stasis, surgery, previous VTE etc.

19
Q

Breathlessness - Pulmonary fibrosis

A

Progressive long term SoB

Dry cough

20
Q

Differentials for Headache

A

Primary - Tension, cluster, migraine, trigeminal neuralgia

Secondary - Meningitis, giant cell (temporal) arteritis, Subarachnoid heamorrahage, increased ICP, Venois sinus heamorrhage.

Others - encephalitis, intercranial haemorrhage, tumour, subdural and extradural haematoma.

21
Q

Headache - Tension

A

Bilateral tight band

Recurrent

Occurs later in the day

Associated with stress

Tender neck and scalp muscles

22
Q

Headache - Cluster

A

Short attacks centered around one eye

Last 30 mins - 3 hours

Occurs for 1 - 3 months

1-2 attacks a day

Associated lacrimations and flushing

23
Q

Headache - migraine

A

Unilateral and pulsating - CN V distribution

Last hours to days

May have aura (usually visual)

Photophobia

Promdrome

24
Q

Headache - Trigeminal neuralgia

A

Stabbing pain in CN V

Face screws up in pain

Triggers - Shaving,

25
Q

Headache - Meningitis

A

Photophobia

Neck stiffness

Systemic - fever, non blanching rash

Focal neurological deficit (20%)

26
Q

Headache - Giant cell (temporal) arthirits

A

Unilateral throbbing

Scalp tenderness

Jaw claudication

> 55 years

Visual problems - spontaneous blindness

27
Q

Headache - subarachnoids haemorhage

A

First and Worst

Thunderclap

Meningism

28
Q

Headache - raised ICP

A

Worse in morning

Worse when bending down

Vomiting

Lower GCS

Visual disturbances

Focal neurological deicit and seizures

Signs: papilloedema, CN VI pulsy, Ipsilateral mydriasis, Chushings response ( raised BP, decreased HR), Cheyne-strokes respiration.

29
Q

Headache - Acute closed-angle glaucoma

A

Pain localised to one eye

Swollen red eye

Visual bluring and halos

Cloudy cornea

Pupil mid dilated and irregular

30
Q

Differential for cough

A

Pneumonia/ UTRI/ LRTI

Asthma

Postnasal drip

COPD
PE
Lung tumour

31
Q

Cough - pneumonia/ UTRI/LRTI

A

Acute cough and sputum

May have SoB

Systemic - fever

32
Q

Cough - Asthma

A

Nocurnal cough

Intermittant wheeze

Diurnal variation

Exacerbating factors - exercise, pets, allergens

33
Q

Differentials for haemoptesis

A

Bronchitis

TB

Lung absses pneumonia

Primary and metastatic lung cancer

Anticoagulation

PE and cuagulopathy

Mitral vavle stenosis

Left ventricular failure

YEAR 3 Manchester Medicine (34 decks)

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