Murtagh's triads Flashcards
dry eyes + dry mouth + arthritis =
Sjogren syndrome
Arthralgia + weight loss + fever (+/- skin lesions) =
polyarteritis nodosa
malaise + painful shoulder girdle + morning stiffness (>50 years) =
polymyalgia rheumatica
fatigue + headache + jaw claudication =
temporal arteritis
Malaise + URIs (e.g. rhinitis, sinusitis) + LRTs (e.g. wheeze, cough) =
Wegener granulomatosis
Asthma + rhinitis + vasculitis + hypereosinophilia =
Churg-Strauss vasculitis
Fatigue + psychiatric symptoms + myoclonus
CJD
Tiredness + husky voice + cold intolerance
Hypothyroidism (myxoedema)
Anxiety + weight loss + weakness
Thyrotoxicosis
Nasal problems + fitting problems (eg rings, shoes) + sweating
Acromegaly
Weakness + polyuria + polydipsia
Diabetes insipidus
Female: amenorrhoea + loss of axillary and pubic hair + breast atrophy
Male: reduced libido + impotence + loss of body hair
Hypopituitarism
Fatigue + anorexia, nausea, vomiting + abdominal pain (+/- skin discolouration)
Addison disease
Plethoric moon face + thin extremities + muscle weakness
Cushing syndrome
Weakness + constipation + polyuria
Hypercalcaemia
Cramps + confusion + tetany
Hypocalcaemia
Discoloured urine + peri-orbital oedema + oliguria
post-streptococcal glomerulonephritis
Proteinuria + generalised oedema + waxy pallor
Nephrotic syndrome
Dysuria + fever + perineal pain
Acute prostatitis
Poor urine flow + straining to void + frequency
Bladder outlet obstruction
Unilateral sensorineural deafness + tinnitus + unsteady gait (+/- facial palsy)
Acoustic neuroma
Acute vertigo + nausea + vomiting
Vestibular neuronitis
Acute vertigo + nausea + vomiting + hearing loss +/- tinnitus
acute labyrinthitis
Vertigo + vomiting + tinnitus + sensorineural deafness
Meniere syndrome
Malaise + cough + weight loss
lung cancer
Haematuria + loin pain + palpable kidney mass
kidney cell cancer
haematuria + abdominal mass + malaise
Wilms tumour
Abdominal discomfort + anorexia + abdominal bloating/distension
ovarian cancer
Blood in stools + abdominal discomfort + change in bowel habit
Colon cancer
Jaundice + anorexia + abdominal discomfort/pain
pancreatic cancer
Malaise + pallor + bone pain
ALL
Malaise + pallor + oral problems
AML
Fatigue + fever/night sweats + abdominal fullness (splenomegaly)
CML
Fatigue + weight loss + fever/night sweats + lymphadenopathy
CLL
Malaise + fever/night sweats + pruritis
Hodgkin lymphoma
Malaise + fever/night sweats + lymphadenopathy
non-Hodgkin lymphoma
Weakness + unexplained back pain + susceptibility to infection
Multiple myeloma
Severe abdominal pain + abnormal illness behaviour + “red” urine
Acute intermittent porphyria
Child:
Arthralgia (lower limbs) + rash (buttocks, legs) +/- abdominal pain
Henoch-Schonlein purpura
Child:
Respiratory symptoms + vomiting + mental changes +/- seizure/coma
Reye syndrome
Child
Pallor + drowsiness + fever
Meningitis
Child
Pallor + abdominal pain (severe, intermittent) + inactivity
intussusception
Child
Malaise + fever + polyarthritis (flitting) +/- rash +/- chorea
Acute rheumatic fever
Child <12 months
drowsiness + cough + wheeze
bronchiolitis
Baby <3 months
Weakness + weight loss + vomiting (projectile)
pyloric stenosis
Neonate Vomiting (after first feeds) + drooling + abdominal distension
oesophageal or duodenal atresia
Child
Malaise + pallor + bone pain
Acute lymphoblastic leukaemia
Child
Malaise + pallor + oral problems(gingival hypertrophy, bleeding, ulceration)
Acute myeloid leukaemia
Child
Abdominal pain + pallor + anorexia/nausea/vomiting
acute appendicitis
Child
Abdominal pain + malar flush + fever +/- URTI
mesenteric adenitits
Child (during gastro epidemic)
Malaise (extreme) + diarrhoea + severe abdominal pain
Haemolytic uraemic syndrome
Child
Drowsiness + tachypnoea + chest wall recession
pneumonia
Child
Drowsiness + fever + purpuric rash
meningococcal infection
Child Lethargy (extreme) + drooling saliva + stridor
Acute epiglottitis
Child
URTI + barking cough + stridor
croup
Child
Cough + wheeze + chest wall recession
asthma or inhaled FB
Child
Fever + conjunctivitis + skin changes (cracked red lips, maculopapular rash, erythema of palms/soles, desquamation fingertips)
Kawasaki disease
Child
Large ears + long narrow face + large genitals
Fragile X
Child Small extremities (hands, feet, genitals) + narrow forehead + eating disorder
Prader-Willi syndrome
Child
“Elfin” face + low set ears + cardiac murmur
Williams syndrome
Female
Short + webbed neck + pigmented naevi +/- cardiac disorder
Turner syndrome
Child
Short + webbed neck + facial disproportion (broad forehead, ptosis, low-set ears) +/- cardiac disorder
Noonan syndrome
Child
Malaise + abdominal pain (vague) + abnormal behaviour
lead poisoning
<2 years
Lethargy + irritability + pallor
iron deficiency anaemia or thalassaemia major
Child
Fever + malaise (extreme) + a/n/v +/- anaemia
neuroblastoma
child
headache + a/n/v + ataxia
medulloblastoma
Older children: male
snorting, blinking etc. + oral noises (grunts, hisses) +/- loud expletives
Tourette syndrome
Older children
Irritability + disorders of appetite + abdominal pain (vague)
Substance abuse
Older children
Mid to low back pain/discomfort + inability to touch toes + kyphosis
Scheuermann disorder
Older children Knee pain (after activity) + tender knee 'lump' + pain on kneeling
Osgood-Schlatter disorder
Adolescent
Limp + knee pain + hip pain
Slipped capital femoral epiphysis
Patch of complete hair loss + clean scalp + exclamation mark hairs
alopecia areata
Stressful event + 2-3 months gap to diffuse hair loss + ‘white bulbs’
teflogen effluvium (increased shedding of hairs in the telogen phase)
Fair females <5 + thin wispy hair + easy loss with pulling
loose anagen syndrome (improves with age)
Angina + dyspnoea + blackout or lightheadedness
aortic stenosis
Severe seizures (peak age 3-5) + mental retardation + characteristic EEG
Lennox-Gastaut syndrome (myoclonic epilepsy of infancy)
Retro-orbital headache + rhinorrhoea + lacrimation
cluster headache
Drowsiness + vomiting + seizure
raised intracranial pressure
Occipital headache + vomiting + neck stiffness
SAH
Headache + visual disturbance + nausea (obese female)
idipathic intracranial hypertension
Fever (+/- rigors) + upper abdominal pain + jaundice
acute cholangitis (Charcot triad)
Jaundice + constitutional symptoms (malaise, anorexia, weight loss) + epigastric pain (radiating to back)
pancreatic cancer