Paeds DDx Flashcards
ACUTE SHORTNESS OF BREATH (DYSPNOEA) 5
Asthma Viral-induced wheeze Pneumonia CCF Psychogenic Foreign body Epiglottitis Anaphylaxis
CHEST PAIN
Idiopathic
Psychogenic (anxiety or stress) Costochondritis
Direct trauma to the chest
Pulmonary (pneumonia, asthma, pleurisy)
Cough
URTI (e.g. viral URTI, croup) LRTI (e.g. pneumonia, bronchitis) Asthma
Allergy (dust or pollen inhalation) Psychogenic (Habit cough)
Haemoptysis 4
Pneumonia Coagulopathy CF Vigorous cough Foreign body (FB) (mostly <4 years of age)
Palpitations
Sinus tachycardia (fever, exercise)
Anxiety
Anaemia
Arrhythmia (such as ectopic beats, SVT) Drugs (e.g. bronchodilators, use of stimulants)
ACUTE ABDOMINAL PAIN
GE Psychogenic (e.g. anxiety, school phobia) Constipation Appendicitis Mesenteric adenitis (MA) Migraine
RECURRENT ABDOMINAL PAIN
Functional (psychogenic, e.g. school phobia) IBS
Food intolerance/allergy
Abdominal migraine (cyclic vomiting syndrome) Parasites (Giardia)
Inflammatory bowel diseases (IBDs) (CD, ulcerative colitis)
ABDOMINAL DISTENSION
Physiological in toddlers (usually mild) Malabsorption (coeliac disease, Giardia) Intestinal obstruction Constipation Abdominal mass (e.g. hepatic or renal)
CONSTIPATION
Chronic habitual constipation Prolonged febrile illness Increased output (e.g. polyuria, vomiting) Neurodisability (CP, myotonica dystrophica) IBS
DIARRHOEA
Acute infective enteritis, GE (viral and bacterial) Antibiotic induced
Postinfectious secondary lactose/protein intolerance Toddler’s diarrhoea
Overflow in constipation
Coeliac disease (CD)
IBD
IBS
GASTROINTESTINAL BLEEDING (RECTAL BLEEDING)
Any cause of haematemesis Bacterial colitis
Anal fissure Thrombocytopenia
HSP
Colitis (e.g. ulcerative colitis) Meckel’s diverticulum
Peptic ulcer
Intussusception
VOMITING
Gastroenteritis Systemic infection (e.g. pneumonia, UTI) Medications (e.g. chemotherapy) GO reflux Migraine Appendicitis Meningitis
VOMITING BLOOD (HAEMATEMESIS)
Drugs
Gastritis
Mallory–Weiss tear (MWT) Oesophagitis (GO reflux) Swallowed blood (e.g. epistaxis)
CRYING, EXCESSIVE IN INFANTS
Colic (evening colic)
Discomfort (too warm or too cold, nappy rash) Gastro-oesophageal (GO) reflux
Infection (e.g. otitis media [OM])
Milk and food allergy/intolerance
FAILURE TO THRIVE AND WEIGHT LOSS
Psychosocial (e.g. emotional deprivation) Eating disorder (e.g. anorexia nervosa) Chronic infection (e.g. HIV, parasitic) Malnutrition and under-nutrition (from poverty) Malabsorption (e.g. coeliac disease)
WEIGHT GAIN, EXCESSIVE (OBESITY)
Simple obesity
Polycystic ovary syndrome (PCOS)
Endocrine (e.g. Cushing’s syndrome [CS])
Genetic syndromes (e.g. Turner’s syndrome)
Drugs (e.g. steroids, pizotifen, anticonvulsants, antidepressants)
STRIDOR
Laryngotracheobronchitis (croup) Laryngomalacia
Angioneurotic oedema Spasmodic croup
Bacterial tracheitis
DEAFNESS/IMPAIRED HEARING
OME (glue ears) Infection (e.g. following meningitis) Trauma (including acoustic trauma) Drugs (ototoxic drugs) Genetic CMV Acoustic neuroma
DIZZINESS AND VERTIGO
Benign paroxysmal vertigo of childhood (BPVC) Acute middle ear disease/eustachian tube dysfunction Vestibular neuritis
Labyrinthitis
Migraine
EARACHE (OTALGIA)
Infective OM Infective otitis externa Referred pain (toothache, tonsillopharyngitis) Trauma (including foreign body) Barotitis media (e.g. flying)
ACUTE AND TRANSIENT LOSS OF VISION
Migraine
Uveitis
Infection (e.g. trachoma, meningitis, keratitis) Thromboembolic phenomenon
Raised intracranial pressure (ICP) (tumour,
pseudotumour cerebri)
BLOOD IN URINE (HAEMATURIA)
IgA nephropathy
Poststreptococcal glomerulonephritis (PSGN) HSP
UTI
Coagulopathies (e.g. thrombocytopenia)
Renal stones
Vascular (e.g. renal vein thrombosis, SCA) Haemolytic uraemic syndrome (HUS)
Systemic lupus erythematosus (SLE)
Idiopathic haematuria
Tumour (e.g. nephroblastoma, bladder hamartoma)
POLYURIA (EXCESSIVE URINATION)
T1DM
Psychogenic polydipsia (compulsive fluid drinking)
Renal tubular acidosis
DI, cranial
Metabolic polyuria (potassium deficiency, hypercalcaemia)
VAGINAL DISCHARGE
Physiological VD
Non-specific vulvovaginitis STD
Foreign body (FB)
Child abuse
ACUTE CONFUSIONAL STATE
Migraine
Side effect of medication (e.g. antihistamine) Encephalitis/encephalopathy
Non-convulsive status epilepticus (NCSE)
Psychosis
Concussion
Drug ingestion
DEVELOPMENTAL DISABILITY
Chromosomal (trisomy-21, fragile X syndrome) Idiopathic (cause unidentified)
Cerebral palsy (CP)
Autism spectrum disorder Traumatic brain injury
HEADACHE
Common viral infections Migraine Tension headache Brain lesions (e.g. tumour, haemorrhage) Sinusitis Medication overuse
NEUROMUSCULAR WEAKNESS
Spinal muscular atrophy (SMA)
Peripheral nerve (e.g. Guillain–Barré syndrome) Neuromuscular junction (e.g. myasthenia gravis) Muscular dystrophy (e.g. DMD)
Congenital myopathy
Dermatomyositis
SEIZURE
Febrile seizure
Epilepsy (generalised and focal) Metabolic (e.g. hypoglycaemia) Infection (encephalitis)
Non-epileptic seizures (pseudo-seizure)
DELAYED PUBERTY
Constitutional
Functional hypo-gonadotropic hypogonadism (FHH) Structural hypo-gonadotropic hypogonadism (SHH) Intensive physical exercise
Gonadal failure (Turner’s, Noonan’s syndromes)
Central nervous system (CNS) tumour (craniopharyngioma) Prader-Willi syndrome
Hyperprolactinaemia
Klinefelters
ARTHRALGIA (PAINFUL JOINT)
Acute viral infection
Trauma
Referred pain (knee arthralgia referred from hip) Pre-arthritic (e.g. JIA)
Malignancy (e.g. leukaemia)
SCA
Vasculitis (e.g. Henoch–Schönlein purpura)
Child abuse
Avascular necrosis (e.g. slipped capital femoral epiphysis) Brucellosis
Fabry’s disease
Inflammatory bowel disease (Crohn’s disease, colitis)
ARTHRITIS (SWOLLEN JOINTS)
Post-infectious arthritis (reactive, synovitis) JIA
Transient synovitis (TS)
Vasculitis (e.g. Henoch–Schönlein disease) Septic arthritis (SA)
