Presentations Flashcards
What are the causes of abdominal distension?
Intestinal obstruction Ascites Intestinal ischaemia Abdominal mass Pregnancy Obesity
Classify and differentiate the causes of an epigastric mass
Gastric: cancer
Pancreatic: abscess, cancer, pseudocyst
Hepatic: hepatomegaly
Classify and differentiate the causes of a LUQ mass
Splenic: splenomegaly
Gastric: cancer
Pancreatic: cancer, pseudocyst, abscess
Renal: hydronephrosis, RCC, PCKD
Classify and differentiate the causes of a RIF mass
GI: appendix mass/abscess, CRC, Crohn’s disease, hernia
Infection: TB
Renal: transplantation
Gynaecological: ovarian tumour, ovarian cyst
Classify and differentiate the causes of a suprapubic mass
Urological: urinary retention, bladder cancer
Gynaecological: pregnancy, fibroids
Classify and differentiate the causes of a LIF mass
Renal: transplantation
Gynaecological: ovarian cyst, ovarian tumour
GI: diverticular disease, CRC, constipation, hernia, Crohn’s disease
Classify and differentiate the causes of a L or R flank mass
Hydronephrosis
Renal cell carcinoma
Polycystic kidney disease
Classify and differentiate the causes of an umbilical mass
GI: hernia, gastric cancer, CRC, lymphoma
Vascular: AAA
Classify and differentiate the causes of RUQ pain
Biliary: gallstones, biliary colic, cholecystitis
Hepatic: hepatitis, HCC, liver abscesses
GI: CRC
Classify and differentiate the causes of epigastric pain
Gastric: PUD, gastritis, GORD, cancer, functional dyspepsia
Pancreatic: pancreatitis, cancer
Cardiac: atypical MI
Classify and differentiate the causes of LUQ pain
Splenic: abscess, splenomegaly, rupture, infarction
GI: CRC
Classify and differentiate the causes of L or R flank pain
Vascular: aortic dissection
Renal: urinary tract calculi, pyelonephritis, RCC, PCKD
Classify and differentiate the causes of lower abdominal pain
Urological: UTI, urinary retention, urinary tract calculi
Gynaecological: ovarian torsion, endometriosis, ectopic pregnancy, PID, ruptured ovarian cyst, ovarian tumour
GI: appendicitis, diverticular disease, UC, CD, CRC, constipation
Classify and differentiate the causes of central and diffuse abdominal pain
GI: intestinal obstruction, perforation, functional dyspepsia, IBS
Infection: gastroenteritis, infectious colitis
Vascular: intestinal ischaemia, AAA
Metabolic: DKA, Addisonian crisis, hypercalcaemia
Haematological: SCD
Inflammatory: vasculitides
Classify and differentiate the causes of raised aminotransferases
Liver failure Cirrhosis Viral hepatitis Alcoholic hepatitis AI hepatitis NASH Wilson's disease Sepsis syndromes
Classify and differentiate the causes of raised ALP
Marked elevation: extrahepatic biliary obstruction, intrahepatic cholestasis
Moderate elevation:
Hepatic - viral/alcoholic/AI hepatitis, NASH, amyloidosis, sarcoidosis, TB, liver abscesses, sepsis syndromes
Non-hepatic - pregnancy, osteomalacia, Paget’s disease of bone, hyperparathyroidism, thyrotoxicosis, DM, cancer
What causes raised GGT
Alcohol excess
Classify and differentiate the causes of raised bilirubin
Unconjugated:
- Overproduction - haemolytic anaemia, gallstones
- Impaired hepatic uptake - HF, drugs
- Impaired conjugation - Gilbert’s syndrome
- Neonatal jaundice
Conjugated:
- Hepatocellular dysfunction due to:
a. Infection - viral hepatitis, liver abscess
b. Hepatic - cirrhosis, NASH, alcoholic/AI hepatitis
c. Malignancy - HCC
d. Infiltration - amyloid, sarcoid, lymphoma
e. Genetic - Wilson’s disease, haemochromatosis
f. Drugs - Obstruction - gallstones, pancreatic Ca, PBC, PSC, drugs
Classify and differentiate the causes of abnormal lung function tests (obstructive picture)
Asthma
COPD
Classify and differentiate the causes of abnormal lung function tests (restrictive picture)
Intrinsic: pulmonary fibrosis
Extrinsic:
Neuromuscular - GBS, MND
Obesity
Classify and differentiate the causes of metabolic acidosis
Normal anion gap: loss of bicarbonate - diarrhoea
High anion gap:
- Decreased renal acid excretion - CKD
- Increased acid production - lactic acidosis, ketoacidosis, aspirin OD
Classify and differentiate the causes of respiratory acidosis
Central depression:
1. Drugs - opiate OD, alcohol
Neuromuscular: MND, GBS, myasthenia gravis
Respiratory: COPD, asthma
Classify and differentiate the causes of metabolic alkalosis
GI H+ loss: n+v
Renal H+ loss: primary hyperaldosteronism
Intracellular H+ shift: hypokalaemia
Classify and differentiate the causes of respiratory alkalosis
Central stimulation: anxiety, pain, fever, pregnancy, stroke, cancer, aspirin OD
Respiratory: PE, asthma, COPD, pneumonia, HF
Classify and differentiate the causes of monoarthritis
Degenerative: osteoarthritis
Inflammatory: rheumatoid arthritis, seronegatic arthritides (UC, CD, ankylosing spondylitis, psoriatic arthritis, reactive arthritis), vasculitides, SLE, sarcoidosis, Behcet’s disease
Infection: septic arthritis
Metabolic: crystal arthropathy - gout/pseudgout
Traumatic injury
Classify and differentiate the causes of oligoarthritis
Infection: infective endocarditis
Inflammatory: seronegative arthritides (reactive arthritis, UC, CD, AS, psoriatic arthritis), rheumatoid arthritis, vasculitides, SLE, sarcoidosis, Behcet’s disease, Sjogren’s syndrome
Degenerative: osteoarthritis
Classify and differentiate the causes of polyarthritis
Degenerative: osteoarthritis
Inflammatory: rheumatoid arthritis, seronegative arthritides, vasculitides, SLE, sarcoidosis, Behcet’s disease, Sjogren’s syndrome
Infection:
Viral - infectious mononucleosis, HIV
Post-infective - rheumatic fever
Metabolic: gout, pseudogout, haemochromatosis
Haematological: SCD
Cancer
Classify and differentiate the causes of ascites
Exudative: infection, pancreatitis, cancer
Transudative: Hepatic - cirrhosis Cardiac - HF, constrictive pericarditis Renal - CKD, nephrotic syndrome Ovarian - tumours
Haemorrhagic: cancer, trauma, acute pancreatitis
Classify and differentiate the causes of back pain
Malignancy: multiple myeloma, metastases, lymphoma, leukaemia, CNS tumours
Mechanical: osteoarthritis, osteoporosis, spine fracture, trauma
Infection: osteomyelitis
Inflammatory: ankylosing spondylitis, psoriatic spondylitis, reactive arthritis, enteropathic arthritis (UC, CD)
Classify and differentiate the causes of bradycardia
Physiological: fitness, sleep
CV: IHD, cardiomyopathy, myocarditis, heart block, congenital heart disease
CNS: raised ICP
Endocrine: hypothyroidism
Electrolyte disturbance: hyperK, hypoK
Drugs
Hypothermia
Anorexia nervosa
Classify and differentiate the causes of breast lump
Benign: physiological, fibroadenoma, cysts, mastitis, abscess, benign ductal disease (ectasia, papilloma), lipoma
Malignant: breast cancer
Classify and differentiate the causes of breast pain
Cyclical: physiological, contraceptives, HRT
Non-cyclical: breast cancer, benign ductal disease (ectasia, papilloma), mastitis, abscess, pregnancy, HRT
Extra-mammary: chest wall pain, spinal disorders
Classify and differentiate the causes of calf swelling/pain
Unilateral: DVT, acute/chronic limb ischaemia, cellulitis, erysipelas, compartment syndrome, trauma, lymphoedema
Bilateral: hypoalbuminaemia, lymphoedema, varicose veins, acute/chronic limb ischaemia, HF
Classify and differentiate the causes of cerebellar signs (e.g. ataxia, dysdiadochokinesia)
Vascular: stroke, TIA
Infection: meningitis, encephalitis, TB
Inflammatory: sarcoidosis, MS, GBS, Coeliac disease
Toxic: chemotherapy, alcohol abuse
Metabolic: vit B12/thiamine deficiency
Endocrine: hypothyroidism
Malignancy: CNS tumours, metastases, paraneoplastic syndromes
Degenerative: Wilson’s disease
Classify and differentiate the causes of chest pain
CV: IHD, pericarditis, cardiomyopathy, aortic dissection
Respiratory: pulmonary HTN, sarcoidosis, pneumothorax, lung cancer, asthma, COPD, PE, pneumonia
GI: pancreatitis, GORD, PUD, gastritis
MSK: vasculitides, trauma
Neuro: radiculopathy, varicella zoster
Psychiatric: panic disorder, depressive disorder
Classify and differentiate the causes of an abnormal APTT
Haematological: haemophilia, VWD, antiphospholipid syndrome
Drugs
Vit K deficiency
Liver Failure
DIC
Classify and differentiate the causes of an abnormal PT and INR
Drugs
Vit K deficiency
Liver failure
DIC
Classify and differentiate the causes of clubbing
CV: congenital heart disease, infective endocarditis
Respiratory: lung cancer, bronchiectasis, idiopathic pulmonary fibrosis, TB
GI: IBD, cirrhosis, lymphoma, Coeliac disease
Classify and differentiate the causes of acute confusion
Vascular: stroke, TIA
Infection: meningitis, encephalitis, pneumonia, UTI
Metabolic: liver failure, CKD, hyperCa, hypoNa, hypoxia (respiratory failure), vit B12 deficiency
Endocrine: hypoglycaemia, hypothryoidism, thyrotoxicosis, adrenal insufficiency
Neuro: post-ictal
Neoplastic: CNS tumours
Drugs: alcohol abuse, drug abuse, opiate OD
Psychiatric disorders
Trauma: head injury, SDH, SAH
Classify and differentiate the causes of constipation
GI: obstruction (diverticular disease, hernia, CRC, UC, CD), anal fissure, rectal prolapse, IBS
Endocrine: DM, hypothyroidism, hypercalcaemia
Neuro: Parkinson’s disease, MS, spinal cord injury
Drugs
Psychiatric: anorexia nervosa
Diet: low fibre + fluids
Post-operative
Immobility
Classify and differentiate the causes of cough
Infection: pneumonia, TB, URTI
Respiratory: asthma, COPD, bronchiectasis, lung cancer
CV: HF
GI: GORD
Drugs: ACE inhibitors
Classify and differentiate the causes of central cyanosis
Infection
Respiratory: asthma, pneumothorax, right to left pulmonary shunt (COPD, PE)
Cardiac: right to left cardiac shunt (congenital HD), HF
Haematological: SCD, thalassaemia
Classify and differentiate the causes of peripheral cyanosis
Arterial thrombosis
Sepsis syndromes
Raynaud’s phenomena
Classify and differentiate the causes of decreased consciousness
Vascular: SDH, SAH, EDH, stroke
Infection: meningitis, encephalitis
Trauma: head injury
Hypoxia: cardiac arrest, type 1/2 respiratory failure
Metabolic: hypoglycaemia, liver failure, CKD, hyperNa, hypoNa, hyperK, hypoK, hyperCa
Neuro: raised ICP, epilepsy
Malignancy: SOL
Drugs: alcohol
Classify and differentiate the causes of diarrhoea
GI: gastroenteritis, infectious colitis, IBD, Coeliac disease, pancreatic insufficiency (due to CF), CRC, gastric Ca, diverticular disease, overflow diarrhoea
Endocrine: thyrotoxicosis, DM
Drugs
Classify and differentiate the causes of diplopia
Monocular: cataracts, macular degeneration
Binocular: Wernicke’s encephalopathy, CN palsies, migraine, Grave’s disease, Miller Fisher syndrome, myasthenia gravis
Classify and differentiate the causes of dizziness/blackouts/LoC
Vasovagal syncope
CV: tachy/bradycardia, outflow obstruction (AS, cardiomyopathy, PE), hypotension, IHD, aortic dissection
Neuro: epilepsy, stroke, TIA
Metabolic: hypoglycaemia
Classify and differentiate the causes of dysarthria
Cerebellar: MS, stroke, CNS tumours
Bulbar/pseudobulbar: MND, MS
Extrapyramidal: Parkinson’s
Drugs: alcohol
Classify and differentiate the causes of dyspepsia
Oesophageal: GORD, cancer
Gastroduodenal: functional dyspepsia, PUD, gastritis, gastric cancer, hiatus hernia
Biliary: gallstones, cholecystitis
Drugs: alcohol
Psychiatric: anxiety disorder, depressive disorder
Classify and differentiate the causes of dysphagia
Intraluminal: foreign body
Intramural: achalasia, GORD, pharyngeal cancer, oesophageal cancer, gastric cancer, scleroderma, radiotherapy
Extramural: retrosternal goitre, lung cancer, lymphadenopathy, aortic aneurysm
Neuromuscular: stroke, GBS, MND, myasthenia gravis
Classify and differentiate the causes of dyspnoea
Acute: pneumothorax, PE, acute HF, anaphylaxis, foreign body, panic disorder
Subacute: asthma, COPD, pneumonia, PE, HF, lung cancer, metabolic acidosis
Chronic: MND, COPD, bronchiectasis, CF, idiopathic pulmonary fibrosis, lung cancer, pulmonary HTN, chronic HF
Classify and differentiate the causes of dysuria
Urinary tract: urinary tract calculi, bladder cancer, UTI
Vaginal: candidiasis, BV
Prostatic: BPH, epididymitis, orchitis
Classify and differentiate the causes of PR interval changes
Heart block
Wolff-Parkinson-White syndrome
Classify and differentiate the causes of QRS segment changes
Ventricular tachycardia Ventricular fibrillation Supraventricular tachycardia Wolff-Parkinson-White syndrome Cardiomyopathy Hypothermia
Classify and differentiate the causes of ST segment changes
ST elevation: IHD, pericarditis, raised ICP, pacemaker
ST depression: IHD, SVT, hypoK, pacemaker
Classify and differentiate the causes of QT interval changes
Short QT: hyperCa
Prolonged QT: IHD, hypoK, hypoCa, hypothermia
Classify and differentiate the causes of P wave changes
Atrial fibrillation
Atrial flutter
Classify and differentiate the causes of T wave changes
IHD Cardiomyopathy PE Raised ICP Hyper/hypoK
Classify and differentiate the causes of bilateral facial nerve palsy
AI: GBS, myasthenia gravis
Infection: HIV
Sarcoidosis
MND
Classify and differentiate the causes of unilateral facial nerve palsy
Infection: TB, otitis media, varicella zoster
Inflammation: sarcoidosis, lymphoma
Idiopathic: Bell’s palsy
Trauma
Vascular: stroke
Classify and differentiate the causes of fatigue
Infection Cancer Anaemia Obesity Drugs
Endocrine: hypothyroidism, adrenal insufficiency, DM
Cardiac: HF
Renal: CKD
Hepatic: liver failure
Psychiatric: depressive disorder
Classify and differentiate the causes of GI bleeding
Upper GI:
Swallowed blood - haemoptysis, epistaxis
Oesophageal - GORD, varices, M-W tear, cancer
Gastric - PUD, gastritis, cancer
Bleeding disorders - thrombocytopenia, haemophilia
Drugs
Lower GI:
Intestinal - GE, infectious colitis, diverticular disease, UC, intestinal ischaemia, CRC
Anal - haemorrhoids
Classify and differentiate the causes of goitre
Hypothyroidism
Grave’s disease
Thyroid nodule
Thyroid cancer
Classify and differentiate the causes of groin swelling
Scrotal: hydrocoele, varicocoele
Femoral: hernia, saphena varix
Inguinal: hernia, lymph nodes
Skin: lipoma, epidermoid/pilar (sebaceous) cysts
Classify and differentiate the causes of gynaecomastia
Physiological: puberty
Malignancy: testicular cancer
Endocrine: thyrotoxicosis, hypogonadism
Hepatic: cirrhosis
Renal: CKD
Drugs
Classify and differentiate the causes of haematuria
Bladder: cancer
Kidney: UTI, stones, glomerulonephritis, PCKD, RCC
Urethra: urethritis
Prostate: BPH, cancer
Haematological: haemophilia, thrombocytopenia, SCD
Trauma
Drugs
Classify and differentiate the causes of haemoptysis
Respiratory: lung cancer, TB, pneumonia, abscess, COPD, bronchiectasis, vasculitides, trauma
CV: PE, pulmonary HTN, HF
Coagulopathy: thrombocytopenia
Classify and differentiate the causes of headache
Acute: trauma, meningitis, encephalitis, acute closed-angle glaucoma, HTN, SAH, SDH, EDH
Chronic/recurrent:
Neuro - tension, migraine, cluster, raised ICP
Inflammatory - GCA
Psychiatric - depressive disorder, anxiety disorder
Drugs
Classify and differentiate the causes of hemiparesis
Vascular: SDH, EDH, stroke
Neuro: epilepsy, MS, CNS tumours, migraine
Infection: cerebral abscess
Classify and differentiate the causes of hepatomegaly
Hepatic: hepatitis, cirrhosis, liver abscess, liver cyst
Biliary: PBC, PSC
Cardiac: constrictive pericarditis, HF
Malignancy: metastases, HCC
Infiltration: amyloidosis, sarcoidosis, haemochromatosis
Classify and differentiate the causes of hypercalcaemia
Sarcoidosis
Primary hyperparathyroidism
Cancer
Multiple myeloma
Classify and differentiate the causes of hyperkalaemia
Increased release: metabolic acidosis, DM
Reduced excretion:
Renal - CKD
Endocrine - adrenal insufficiency
Drugs
Classify and differentiate the causes of hypernatraemia
Decreased water intake: acute confusion, dementia
Non-renal water loss: diarrhoea, fever, burns injury
Renal water loss: hypercalcaemia, diabetes insipidus
Sodium excess: primary hyperaldosteronism
Classify and differentiate the causes of hypoalbuminaemia
Reduced synthesis: liver failure, malnutrition
Increased losses: nephrotic syndrome, protein-losing enteropathy (Coeliac disease, IBD), burns injury, bullous skin lesion
Classify and differentiate the causes of hypocalcaemia
Low PTH: thyroidectomy
High PTH: vit D deficiency, metastases, acute pancreatitis, drugs
Classify and differentiate the causes of hypoglycaemia
Adrenal insufficiency
Malnutrition
Hypoglycaemic drugs
Classify and differentiate the causes of hypokalaemia
Renal losses: diuretics
GI: nausea and vomiting, diarrhoea
Endocrine: Cushing’s syndrome, primary hyperaldosteronism
Classify and differentiate the causes of hyponatraemia
Hypovolaemic:
GI losses - diarrhoea, n+v, intestinal obstruction
Renal losses - CKD, adrenal insufficiency, drugs
Burns injury
Euvolaemic:
Endocrine - hypothyroidism, adrenal insufficiency
SIADH - pneumonia, lung cancer, CNS tumours, head injury, drugs
Hypervolaemic:
Cardiac - HF
Hepatic - cirrhosis
Renal - nephrotic syndrome, CKD
Classify and differentiate the causes of hypotension
Volume depletion: haemorrhage, diarrhoea, diabetes insipidus, DM, AKI, burns
Infection: sepsis
Autonomic failure: Parkinson’s, DM, GBS
Anti-hypertensive drugs
Classify and differentiate the causes of hypoxia (type 1 respiratory failure)
Asthma COPD PE Pneumothorax Pneumonia Idiopathic pulmonary fibrosis ARDS
Classify and differentiate the causes of hypoxia (type 2 respiratory failure)
Respiratory: asthma, COPD, obstructive sleep apnoea
Central depression: resp centre depression, opiate OD
Neuromuscular: GBS, MND, myasthenia gravis
Classify and differentiate the causes of jaundice
Pre-hepatic:
Congenital haemolysis - SCD, thalassaemia
Acquired haemolysis - malaria
Hepatic: AI/viral hepatitis, liver abscess, sepsis, cirrhosis, mets, Wilson’s disease, haemochromatosis, alcohol abuse
Obstructive: pancreatic cancer, PBC, PSC, gallstones
Classify and differentiate the causes of nausea and vomiting
GI: GORD, PUD, gastritis, cholecystitis, pancreatitis, GE, infectious colitis, appendicitis, intestinal obstruction, peritonitis
Endocrine: DKA, Addisonian crisis, hyperCa
Neuro: raised ICP, meningitis, migraine, head injury
Ophthalmological: acute closed-angle glaucoma
Pregnancy
Drugs: alcohol abuse, drug abuse, paracetamol OD
Classify and differentiate the causes of neck swelling
Anterior triangle:
Moves with swallow - thyroglossal cysts, thyroid nodule, goitre
Fixed with swallow - salivary gland tumour, lymphadenopathy, lymphoma
Posterior triangle: lymphadenopahty, lymphoma
Classify and differentiate the causes of night sweats
Infection: infective endocarditis, osteomyelitis, TB, HIV
Endocrine: thyrotoxicosis, phaeochromocytoma, menopause, carcinoid syndrome
Malignancy: lymphoma, cancer
Classify and differentiate the causes of nipple discharge
Milky: late pregnancy, puberty, duct ectasia, prolactinoma
Purulent: breast abscess
Serous: early pregnancy, breast cancer
Blood-stained: mastitis, breast cancer
Classify and differentiate the causes of oedema (ankle/pitting)
Cardiac: HF
Hepatic: cirrhosis, liver failure
Renal: nephrotic syndrome, CKD
Endocrine: hypothyroidism
Lymphoedema
Drugs
Classify and differentiate the causes of palpitations
Anaemia
Fever
Pregnancy
Cardiac: SCT, CT, AF, flutter, permanent pacing, MS, MR, AS, AR, TR, cardiomyopathy
Endocrine: phaeochromacytoma, hypoglycaemia, thyrotoxicosis
Psychiatric: panic disorder, anxiety disorder, depressive disorder,
Drugs: alcohol excess, drug abuse
Classify and differentiate the causes of pancytopenia
AI: SLE
Hypersplenism: splenomegaly
Aplastic anaemia: infection, chemotherapy, hormone therapy, radiotherapy
Megaloblastic anaemia
Marrow infiltration: myelofibrosis, metastases, lymphoma, leukaemia, multiple myeloma
Sepsis
Classify and differentiate the causes of papilloedema
Raised ICP
Optic nerve: optic neuritis (MS), infiltration (sarcoidosis, lymphoma, CNS tumours
Globe: glaucoma, posterior uveitis
Vascular: malignant HTN
Classify and differentiate the causes of peripheral neuropathy
Endocrine: DM, hypothyroidism
Infection: varicella zoster, HIV
Inflammation: vasculitides
AI: GBS, rheumatoid arthritis
Renal: CKD
Malignancy: multiple myeloma
Nutritional: vitamin B12 deficiency
Drugs: alcohol excess
Classify and differentiate the causes of petechiae and purpura
Infection: meningococcal septicaemia (from meningitis, IE, sepsis)
Inflammation: vasculitides, SLE, rheumatoid arthritis
Haematological: clotting abnormalities
Drugs
Amyloidosis
Classify and differentiate the causes of pleural effusion?
Exudative: Infection - pneumonia, TB Inflammation - SLE, sarcoidosis, vasculitides Malignancy - lung cancer, mesothelioma Trauma GI - pancreatitis
Transudative: Cardiac - HF, constrictive pericarditis Hepatic - liver failure Renal - nephrotic syndrome, peritoneal dialysis Endocrine - hypothyroidism Hypoalbuminaemia
Classify and differentiate the causes of polydipsia
Endocrine: primary hypoaldosteronism, diabetes insipidus, DM
Drugs: diuretics
Psychogenic polydipsia
Classify and differentiate the causes of polyuria
Endocrine: diabetes insipidus, DM
Drugs
Psychogenic polydipsia
Classify and differentiate the causes of postural hypotension
Volume depletion: hypotension, sepsis, diabetes insipidus, adrenal insufficiency
Autonomic: Parkinson’s disease, diabetic neuropathy
Drugs
Classify and differentiate the causes of proximal muscle weakness (myopathy)
Endocrine: thyrotoxicosis, hypothyroidism, osteomalacia, Cushing’s syndrome
Infection: HIV, influenza
Inflammation: vasculitides, idiopathic inflammatory myopathies (polymyositis, dermatomyositis)
Drugs: alcohol excess
Classify and differentiate the causes of raised CRP
Infection
Inflammation
Malignancy
Classify and differentiate the causes of raised ESR
Infection Inflammation AI Malignancy Renal: CKD, nephrotic syndrome Haematological: anaemia Obesity
Classify and differentiate the causes of raised JVP
Non-pulsatile: superior vena cava obstruction
Pulsatile:
Cardiac - RHF, TR, constrictive pericarditis
Resp - COPD, cor pulmonale
Abdo - ascites, pregnancy
Classify and differentiate the causes of seizure
Vascular: stroke, SAH
Infection: brain abscess, TB, HIV, meningitis, encephalitis
Inflammation: MS, vasculitides, SLE, sarcoidosis
Trauma: head injury
Metabolic: hypoxia, hypoglycaemia, hyperK, hypoK, hyperNa, hypoNa
Drugs: alcohol
Malignancy: brain mets, CNS tumours
Neuro: epilepsy
Degenerative: Alzheimer’s dementia
Endocrine: thyrotoxicosis
Classify and differentiate the causes of sensory disturbance
Neuropathy:
Mono - carpal tunnel syndrome
Spine - radiculopathy
Poly - DM, alcohol, vit B12/folate def, HIV, vasculitides
Spinal cord: CNS tumours, MS
Brainstem/thalamic: stroke, TIA, CNS tumours, brain abscess
Drugs: chemo, HRT, biological agents
Epilepsy
Migraine
Classify and differentiate the causes of spastic paraparesis
Vascular: spinal cord infarction due to stroke
Infection: TB, AIDS myelopathy, epidural abscess
Inflammation: MS, sarcoidosis, paraneoplastic syndromes
Malignancy: CNS tumours
Hereditary: MND
Trauma
Classify and differentiate the causes of splenomegaly
Massive:
Malignancy - CML, myelofibrosis, lymphoma
Infection - HIV
Moderate:
Haematological - haemolytic anaemia, thalassaemia, SCD, hereditary spherocytosis
Hepatic - cirrhosis
Infection - IE, infectious mononucleosis, TB, malaria, HIV
Inflammation - SLE, RA
Trauma
Malignancy - lymphoma, multiple myeloma, metastases
Classify and differentiate the causes of sweating
Endocrine: diabetic autonomic neuropathy, thyrotoxicosis, hypoglycaemia, menopause, phaeochromocytoma, carcinoid syndrome
Infection: TB, HIV
Malignancy: lymphoma
Psychiatric: panic disorder, drug abuse
Alcohol withdrawal
Classify and differentiate the causes of tachycardia
Sinus:
Physiological - exercise, pain, fever, pregnancy
CV - MI, HF, constrictive pericarditis, hypotension, sepsis
Resp - PE, asthma, COPD
Endocrine - thyrotoxicosis, phaeochromocytoma
Psychiatric - generalised anxiety disorder, panic disorder
Drugs
Supraventricular:
Atrioventricular - WPW syndrome
Atrial - AF/flutter
Ventricular: IHD, cardiomyopathy, hyperK, hypoK
Classify and differentiate the causes of testicular pain and swelling
Epididymitis + orchitis Testicular torsion Strangulated inguinal hernia Testicular cancer Varicocoele Hydrocoele Trauma
Classify and differentiate the causes of thrombocytopenia
Increased splenic sequestration: hypersplenism
Reduced platelet production:
Pregnancy
Drugs: alcohol abuse, chemo, HRT, biological agents
Malignancy: multiple myeloma, myelofibrosis, lymphoma, leukaemia
Vitamin B12/folate deficiency
Increased platelet destruction:
AI - ITP, SLE, RA, antiphospholipid syndrome
Infection - EBV (infectious mononucleosis), HCV, HIV, malaria
Liver failure
DIC
Drugs
Classify and differentiate the causes of thyrotoxicosis
Graves’ disease
Thyroid nodules
Thyroiditis
Drugs
Classify and differentiate the causes of tinnitus
Auditory: sensorineural hearing loss (presbycusis, otosclerosis), drugs
Vascular: stroke
Neuro: MS
Classify and differentiate the causes of tremor
Essential
Parkinson’s disease
Cerebellar: stroke, infection, MS, vasculitides, CNS tumours
Endocrine: hypoglycaemia, thyrotoxicosis, phaeochromocytoma
Psychiatric: generalised anxiety disorder
Drugs: alcohol withdrawal, opiate withdrawal, antidepressants
Classify and differentiate the causes of urinary frequency
Infection: UTI, urethritis
Bladder: diabetic autonomic neuropathy, urinary tract calculi, bladder cancer, stress incontinence
Prostate: BPH, cancer
Pregnancy
Drugs: diuretics
Classify and differentiate the causes of urinary incontinence
Stress: childbirth, transurethral resection of the prostate (TURP)
Urge: SC compression, SCI, bladder cancer, bladder outflow obstruction (retention), stroke, MS
Overflow: bladder outflow obstruction (retention)
Classify and differentiate the causes of urinary retention
Outflow obstruction:
Intraluminal - UT calculi
Intramural - urethral stricture
Extramural - BPH, constipation, pregnancy
Infection: UTI, urethritis, genital herpes (HSV)
Neurological impairment: SCI, diabetic autonomic neuropathy, MS, CNS tumours, metastases
Trauma
Post-operative
Drugs
Classify and differentiate the causes of urinary urgency
Infection: UTI, urethritis
Bladder: cancer, stress incontinence, UT calculi
Prostate: BPH, prostate cancer
Pregnancy
Classify and differentiate the causes of visual field defect
Stroke TIA CNS tumours MS Trauma
Classify and differentiate the causes of weight loss
GI: PUD, gastritis, UC, CD, Coeliac disease
Infection
Cancer
Endocrine: thyrotoxicosis, DM, adrenal insufficiency
Cardiac: HF
Resp: bronchiectasis, idiopathic pulmonary fibrosis, CF
Renal: CKD
Rheumatological: RA, GCA
Neuro: stroke, dementia, Parkinson’s disease, MND
Psychiatric: depressive disorder, anorexia nervosa, bipolar affective disorder
Drugs: alcohol abuse, drug abuse
Classify and differentiate the causes of wheeze
Anaphylaxis
Resp: asthma, COPD, bronchiectasis, lung cancer
Cardiac: HF
Foreign body
