Murtagh Diagnoses Flashcards
angina + dyspnoea + blackouts
aortic stenosis
menstrual dysfunction + obesity + hirsutism
polycystic ovarian syndrome
dysmenorrhoea + heavy menstrual bleeding + dyspareunia (difficult/painful sexual intercourse) + abdominal/pelvic pain
endometriosis
abdominal pain + diarrhoea + fever
Crohn disease
ataxia + hearing loss + facial numbness
acoustic neuroma
fatigue + muscle weakness + cramps
Hypokalaemia
ECG: peaked T waves, ↓ QT, ↑ PR interval → arrhythmias
Hyperkalaemia
fever + rigors + hypotension
septicaemia
pale child + severe ‘colic’ + vomiting + inactivity/lethargy
acute intussusception
fatigue + palpitations + exertional dyspnoea
anaemia
(<2 years): lethargy + irritability + pallor
iron deficiency anaemia
fatigue + dizziness + exertional dyspnoea
cardiomyopathy
Fever of unknown origin + cardiac murmur + embolic phenomena
infective endocarditis
intense abdominal pain + pale and ‘shocked’ ± back pain
ruptured AAA
localised RIF pain + a/n/v + guarding
acute appendicitis
abdominal pain + malar flush + fever ± URTI
mesenteric adenitis
acute abdominal pain + left-sided radiation + fever
acute diverticulitis
amenorrhoea (65–80%) + lower abdominal pain (95+%) + abnormal vaginal bleeding (65–85%)
ectopic pregnancy
intense pain (loin) → groin + microscopic haematuria
ureteric colic
severe RUQ abdominal pain + vomiting + pain radiation
biliary colic
fever (often with rigor) + upper abdominal pain + jaundice
acute cholangitis
fatigue + weight loss + iron deficency + diarrhoea
coeliac disease
anorexia/nausea + faecal leaking + abdominal bloating
faecal impaction
abdominal cramps + flatulence + profuse diarrhoea
giardiasis
lethargy + abdominal pains + irritability (in child)
lead poisoning
aching bones + waddling gait + deafness
Paget disease
fever + drooling + stridor (child)
epiglottitis
URTI + brassy cough + inspiratory stridor
croup
drowsiness + tachypnoea + chest wall recession
pneumonia
‘flu’ + headache + dry cough
atypical pneumonia
(<12 months): drowsiness + cough + wheezing (associated with viral infection)
bronchiolitis
coughing + wheezing + chest wall recession
asthma or aspirated foreign body
fever + conjunctivitis + skin changes (cracked red lips, maculopapular rash, erythema of palms/soles,
desquamation of fingertips)
Kawasaki syndrome
malaise + cough + fever (± erythema nodosum)
sarcoidosis or TB (mantoux test to diferentiate them)
(history of travelling) + fever + chills + headache
malaria
fever + bradycardia + jaundice
yellow fever
fever + severe aching (especially headache) + rash
dengue fever
febrile illness + vomiting + stupor
Japanese B encephalitis
fever + pneumonia + myalgia
melioidosis
painful bite + paraesthesia + hydrophobia (pain with drinking)
rabies
‘stepladder’ fever + abdominal pain + relative bradycardia
typhoid (early)
fever + vomiting + abrupt onset ‘rice water’ diarrhoea
cholera
malaise + cough + weight loss ± fever/night sweats + haemoptysis
pulmonary TB
malaise + cough + weight loss (+ smoking)
lung carcinoma
(male child) snorting, blinking + oral noises (e.g. grunts) ± loud expletives
Tourette syndrome
fever + severe malaise + generalized lymphadenopathy
acute HIV
thirst + polyuria + weight loss
type 1 diabetes
polyuria + polydipsia + skin/orifice infections
diabetes mellitus
weakness + polyuria + polydipsia
diabetes insipidus
fatigue + polyarthritis + fever or skin lesions
SLE
finger discomfort + arthralgia + GORD (± skin tightness)
scleroderma
dry eyes + dry mouth + arthritis
Sjögren syndrome
arthralgia + weight loss + fever (± skin lesions)
polyarteritis nodosa
weakness + joint and muscle pain + violaceous facial rash + raised CK
dermatomyositis
malaise + painful shoulder girdle + morning stiffness (>50 years)
no raised CK
polymyalgia rheumatica
fatigue/malaise + headache + jaw claudication
temporal arteritis
urethritis + conjunctivitis ± iritis + arthritis
reactive arthritis
arthralgia (lower limbs) + rash (buttocks, legs) ± abdominal pain
Henoch–Schönlein purpura
recurrent oral and genital ulcers + uveitis + arthritis
Behçet syndrome
genital pruritus + soreness + white wrinkled plaques
lichen sclerosus
genital pruritus + soreness + white wrinkled plaques
lichen sclerosus
bruising + oral bleeding + epistaxis
ITP
menorrhagia + bruising + increased bleeding
1. incisions 2. dental 3. mucosal
Von Willebrand disease
spontaneous haemarthrosis + muscle bleeds + delayed bleeding
haemophilia A
facial rash + intellectual disability + seizures
tuberous sclerosis
haematuria + dysmorphic RBCs/casts + hypertension
acute nephritic syndrome
proteinuria + generalised oedema + hypoalbuminaemia
nephrotic syndrome
1–2 WEEKS AFTER THE INFECTION
discoloured urine + peri-orbital oedema + oliguria
poststreptococcal glomerulonephritis
1-2 DAYS AFTER INFECTION
discoloured urine + peri-orbital oedema + oliguria
IgA Nephropathy
malaise (extreme) + a/n/v + confusion (± oliguria)
AKI
fatigue + a/n/v + sallow skin
chronic kidney failure
severe abdominal pain + abnormal illness behaviour + ‘red’ urine
acute intermittent porphyria
loin pain + haematuria + palpable loin mass
kidney carcinoma
malaise + night sweats + painless lymphadenopathy
Non-Hodgkin’s lymphoma
fever + myalgia/headache + non-productive cough
atypical pneumonia
malaise + fever + cough (± erythema nodosa
TB or sarcoidosis
arthralgia + Raynaud phenomenon + GORD (± skin changes)
systemic sclerosis
fatigue + headache + jaw claudication
temporal arteritis
weakness + back pain + weight loss
multiple myeloma
lethargy + physical/mental slowing + constipation
hypothyroidism
tiredness + husky voice + cold intolerance
myxoedema
anxiety + weight loss + weakness
thyrotoxicosis
nasal problems + fitting problems (e.g. rings, shoes) + sweating
acromegaly
amenorrhoea + loss of axillary and pubic hair + breast atrophy
hypopituitarism (female)
↓ libido + impotence + loss of body hair
hypopituitarism (male)
fatigue + a/n/v + abdominal pain (± skin discolouration)
Addison disease
fatigue + a/n/v + abdominal pain (± skin discolouration)
Infection/trauma present
Addisonian crisis
plethoric moon face + thin extremities + muscle weakness
Cushing syndrome
episodic headache/hypertension + sweating + tachycardia
phaeochromocytoma
weakness + constipation + polyuria
hypercalcaemia
cramps + confusion + tetany
hypocalcaemia
haematuria + abdominal mass + malaise
tumour doesn’t cross the midline
constitutional symptoms UNCOMMON
mass fixed and immobile
calcifications uncommon
AGE 3-4 years old
nephroblastoma (Wilms tumour)
fever + malaise (extreme) + a/n/v (± anaemia)
tumour doesn’t cross the midline
Constitutional symptoms COMMON
mass can be displaced during physical examination
calcifications common
AGE < 2 years old
neuroblastoma
(<3 months, usually male): weakness + weight loss + vomiting (severe, intermittent)
pyloric stenosis
(neonate): vomiting (after first feeds) + drooling + abdominal distension
oesophageal or duodenal
atresia
severe pain + nausea and vomiting + relative lack of abdominal signs
acute pancreatitis
painful swallowing + referred ear pain + hoarseness
pharyngeal cancer
fatigue + progressive dysphagia + weight loss
oesophageal cancer
Associated with alcoholism and chronic pancreatitis
jaundice + constitutional symptoms (malaise, anorexia, weight loss) + epigastric pain (radiating to
back)
pancreatic cancer
abdominal discomfort + anorexia + abdominal bloating/distension
ovarian cancer
blood in stools + abdominal discomfort + change in bowel habit
colon cancer
malaise + pallor + bone pain
acute lymphoblastic leukaemia (ALL)
L for umeraL/femoraL/radiaL
malaise + pallor + oral problems
acute myeloid leukaemia (AML)
M for Mouth
fatigue + fever/night sweats + abdominal fullness (splenomegaly)
chronic myeloid leukaemia (CML)
fatigue + fever/night sweats + weight loss + lymphadenopathy
chronic lymphoblastic leukaemia (CLL)
malaise + night sweats + pruritus
Hodgkin’s lymphoma
malaise + fever/night sweats + lymphadenopathy
non-Hodgkin’s lymphoma
weakness + unexplained back pain + susceptibility to infection
multiple myeloma
fever + vomiting + headache
meningitis
drowsiness + fever + purpuric rash
meningococcal infection
occipital headache + vomiting + altered consciousness + neck stiffness
subarachnoid haemorrhage
retro-orbital headache + rhinorrhoea + lacrimation
cluster headache
headache + vomiting + visual aura
migraine with aura
drowsiness + vomiting + seizure
raised intracranial pressure
headache + a/n/v + ataxia
medulloblastoma
mental dysfunction + vomiting + (waking/early morning) headache
late presentation
cerebral tumour
obese young patient + headache + visual obscurations + nausea
idiopathic intracranial
hypertension
fatigue + psychiatric symptoms + myoclonus
Creutzfeldt–Jakob disease
malaise + headache + undulant fever
brucellosis
fever + headache + prostration
Q fever
abrupt fever + headache + conjunctivitis
Farmer with skin lesion in contact with water contaminated with animal urine (igs, cattle, rodents, dogs)
leptospirosis
indrawn eye + small pupil + ptosis (± anhydrosis)
pancostal tumor (Horner syndrome)
malaise + URTs (e.g. rhinitis, sinusitis) + LRTs (e.g. wheeze, cough)
granulomatosis with polyangiitis
asthma + rhinitis + vasculitis + hypereosinophilia
Churg−Strauss vasculitis
failure to thrive + chronic cough (recurrent chest infections) + loose bowel actions
cystic fibrosis
light-brown skin patches + skin tumours + axillary freckles
neurofibromatosis (Von Recklinghausen
disorder)
male child + gait disorder + bulky calves
Duchenne’s muscular dystrophy
chorea + abnormal behaviour + dementia + family history
Huntington’s disease
pallor + jaundice + hepatosplenomegaly
thalassaemia major
Cardiac defects, duodenal atresia
typical facies + hypotonia + single palmar crease
Down syndrome
characteristic facies + intellectual disability + large testes
Fragile X syndrome
neonatal hypotonia + failure to thrive + obesity (later)
Prader–Willi syndrome
tall stature + dislocated lens and myopia + aortic root dilatation
Marfan syndrome
short stature + webbed neck + facies
Turner syndrome
facies + short stature + pulmonary stenosis
Noonan syndrome
male Turner
abnormal facies + growth retardation + microcephaly + history of alcohol intake during pregnancy
fetal alcohol spectrum disorder
delayed communication skills + poor socialisation + repetitive/obsessive behaviour/restriction of
interests
autism spectrum disorder
acute diarrhoea + colicky abdominal pain ± vomiting
gastroenteritis
(young adult) diarrhoea ± blood and mucus + abdominal cramps
inflammatory bowel disease
(UC/Crohn)
(young adult) diarrhoea ± blood and mucus + abdominal cramps + constitutional symptoms ± eyes/joints
Crohn’s disease
pale bulky offensive stools, difficult to flush, weight loss
malabsorption
fatigue + weight loss + iron deficiency
gluten
coeliac disease
failure to thrive (child) + recurrent chest infections
cystic fibrosis
altered bowel habit: diarrhoea ± constipation ± rectal bleeding ± abdominal discomfort
colorectal carcinoma
diarrhoea (fluid/incontinent) + constipation + abdominal discomfort + anorexia/nausea
faecal impaction
profuse watery diarrhoea + abdominal cramps and increasing distension (on antibiotics)
pseudomembranous colitis (Girotra’s triad)
variable diarrhoea/constipation + abdominal discomfort + mucus PR + flatulence
irritable bowel syndrome
unilateral) tinnitus + hearing loss + unsteady gait
acoustic neuroma
acute vertigo + nausea + vomiting
vestibular neuronitis
acute vertigo + nausea + vomiting + hearing loss ± tinnitus
acute labyrinthitis
vertigo + vomiting + tinnitus + sensorineural deafness
Ménière’s syndrome
(adolescent): limp + knee pain + hip pain
slipped capital femoral epiphysis
knee pain (after activity) + tender knee ‘lump’ + pain on kneeling
Osgood–Schlatter disorder
mid to low back pain/discomfort + inability to touch toes + kyphosis
Scheuermann disorder
dysuria + fever + perineal pain
acute prostatitis
poor urine flow + straining to void + frequency
bladder outlet obstruction
patch of complete hair loss + clean scalp + exclamation-mark hairs
alopecia areata
stressful event + 2–3 month gap to diffuse hair loss + ‘white bulbs’
telogen effluvium
fair females under 5 + thin wispy hair + easy loss with pulling
loose anagen syndrome
