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Y6 PACES > Histories differentials > Flashcards

Histories differentials Flashcards

1
Q

Weight loss

A

ENDO: T1DM, diabetes insipidus, hyperthyrod, addison’s

GI: Chron’s, UC, coeliac, malnutrition

Infectious: TB, IV

CANCER (anywhere)

DEPRESION

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2
Q

weight gain

A

Pregnancy

Endo: Hypothyroid, Cushing’s, PCOS

Steroid tx

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3
Q

what questions can you ask for Cushing’s

A

stretch marks
easy bruising
weakness in hips or shoulders
difficulty getting up from chair

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4
Q

what questions for PCOS

A

hirsutism (unusual hair growth on body)
oligo/amenorrhoea
acne
oily hair

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5
Q

what questions for hypothyroidism

A 
always cold? 
tired
constipated 
menorrhagic 
appetite loss, weight gain

neck swelling / neck lump?

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6
Q

differentials for chest pain

A

CARDIAC – RESP – GASTRO – MSK

Cardiac: ACD, stable angina, aortic diss, pericarditis

Resp: PE, pneumonia, pneumothorax

GI: peptic ulcer, pancreatitis

MSK: costochondritis

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7
Q

presentation of ACD

A

central crushing pain
radiates to arm jaw neck epig
sweating pallor nausea
lasts >20 mins

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8
Q

presentation of aortic diss

A 
tearing pain (retrosternal/intrascap) 
collapse, dizziness, weakness, parasthesia
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9
Q

presentation of pericarditis

A

central pleuritic pain

RELIEVED SITTING FORWARD

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10
Q

which types of chest pain are relieved by sitting forqard

A

pancreatitis

pericarditis

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11
Q

causes of pleuritic pain

A

pericarditis
PE
pneumothorax

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12
Q

assoc sx to ask about with cardiac pain

A

nausea vomitng sweating
dizziness collapse
fever? pericarditis

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13
Q

assoc sx to ask if resp related chest pain

A

SOB cough haemoptysis

leg swelling / leg pain (PE)

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14
Q

assoc sx for GORD related pain

A 
associated with eating 
worse lying down 
post prandial 
regurgitation / heartburn 
anaemia sx (peptic ulcer)
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15
Q

diiffs for palpitations

A

Cardiac (AF, SVT)
Endo (hypethyroidism, phaeo, hypoglyucaemia)
Drugs, alcohol, caffeine, anxiety

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16
Q

causess of acute SOB

A

Cardiac: MI, angina, pulm oedema, aortic diss, arrythmia, acute pericarditis
Resp: PE, pneumothorax, COPD IE, Asthma, ANAPHLAXIS
Endo: DKA

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17
Q

causes of chronic SOB

A

Cardiac: HF
Resp: COPD, bronchiectasis, interstitial lung disease, malignancy
Anaemia

18
Q

Respiratory sx to ask about

A 
SOB (+ orthopnoea + PND)
Cough 
Sputum 
Blood 
Chest pain, pleuresis
19
Q

red flag respiratory sx

A

FLAWS
haemoptysis
hoarseness
dysphagia

20
Q

RF to ask about in resp hx

A 
smoking 
asbestos exposure / occupation 
animals 
dusts 
hx of atopy if suspecting asthha
21
Q

diffs haemoptysis

A

RESP:

  • PE
  • pneumonia
  • TB
  • lung cancer

Rheum:

  • Wegener
  • SLE
22
Q

headache differentials

A 
RED FLAGS: 
Vascular: SAH, Subdural, extradural 
Infection: meningitis, encephalitis 
Vision threatening: Temporal arteritis, acute glaucoma 
SOL (raised ICP)

Benign: migraine, cluster, tension, medication overuse
Trigeminal neuralgia

23
Q

how does SAH present

A

sudden onset back of head
worse headache ever
meningism

24
Q

sx of meningism

A

neck stiffnness
photophobia
N/V

25
Q

sx SDH

A

gradual onset confusion and headache

alcoholic or elderly

26
Q

sx extradural haemorrhage

A

head trauma.: LOC > resume consciousness > rapid deterioration

27
Q

sx meningitis

A 
gradual onset 
headache, neck stiffness, photophobia 
malaise, fever, RASH 
N/V
irrtability 
seizures, focal neuro deficit, confusion

TRAVEL HX
OTHER UNWELL PEOPLPE

28
Q

triigem neuralgia sx

A

facial pain

triggers (wind, vinration, brushing hair)

29
Q

GCA sx

A 
gradual headache 
vision blurring 
drop in visual acuity 
scalp tendenes
jaw pain
30
Q

differentials for neck lump

A

Midline:

  • thyroid (graves, Hashimoto, toxic multinod etc – benign: thyroglossal cyst, thyroid nodule)
  • non thyroid: lipoma, dermoid cyst, ABSCESS

MUMPS

LYMPHOMA

31
Q

how do you categorise causes of dysphagia

A

neuro

GI

32
Q

neuro cause of dysphagia

A 
stroke
PD 
myasthenia 
MS
MND
33
Q

GI causes of dysphagia

A

achalasa
CREST
oesophageal cancer
peptic stricture from GORD

34
Q

what can you ask to characterise the dysphagia

A

WORSE WITH SOLID OR LIQUID?

  • worse with solid = mechanical obstruction e.g. stricture
  • worse with liquid = motlity disorder (achalasia or neuromusc)
35
Q

differentials for constipaton

A 
GI: IBD, colorectal CA, adhesions
Pt not pushing: haemorrhoid,anal fissure
Drugs: opiates, iron tablets, CCB 
Metabolic: Hypothyroid, hypercalcaema 
Neuro: DM, spinal colrd compression, MS
36
Q

DIarrhoea differentials

A

GI: coeliac, IBD, lactose intolerance, ingection

Hyperthyroidism

37
Q

questions to ask about stool

A 
Characterise stool: colour, consistency, quantity 
Bloody, mucoid
Foul smelling, floating
Pale, greasy 
Nocturnal diarrhoea
Urgency 
Incontinence, 
Tenesmus

Constant or variaable’

Assoc: FLAWS, FLATUS
Top to bottom: N/V, dysphagia, abdo pain,

38
Q

Infecrtive urinary s x

A

FUND (storage)

Freq
urgency
Noct
Dysuria

39
Q

voiding urinary sx

A

Hesitancy (difficulty in starting to urinate)
Intermittent stream (start - stop)
Poor stream (weak)
Terminal dribbling

40
Q

other sx for urinary hx

A

pain in abdo
lumps in abdo
blood in urine, urine colour (clear or cloudy)
discharge from pens, rashes, spots on genital

41
Q

differentials for fatigue

A

Anxiety / obstructve sleep appnoea / environmental /depression or prychosocial – HOW HAVE YOU BEEN SLEEPING? WHAT DOES YOUR PARTNER SAY?

Endo: hypothyroid, DM, addisons

Haem: anaemia

Malignancy screen

Y6 PACES (7 decks)

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