Red Flags Flashcards
1
Q
Vaginal disch
A
-flag symps- Recent change partner Blood stained disch Post coital bleed Lower abdo pain and fever Hx of intermenstrual bleeding Foul smelling - causes- Bacterial vaginosis Candidiasis DM TSS Chlamydia, gonorrhoea, trichomoniasis Cerival pathology PID Rectovaginal fistula
2
Q
Fever in kids
A
-flags under 5yo- Decr fluid intake and urine output Grunting Floppy, irritable Persis temp over 5d depsite antipyretic regularly. Incr RR, subcostal or intercostal recess Non blanching petechial rash Cool peripheries Incr smelly urine Bulging fontanelle Reduc interest in ext stim New onset seiz Complex birth -flags over 5- New onset headache or seiz New rash esp if non blanching New vomit Bloody diarr New abdo pain New jnt pain or swelling New back pain New limp New sore throat, otalgia, ear disch Photophobia, maybe with neck stiff New vaginal disch New testic swelling, maybe with erythema New dyuria, freq or haematuria Unexpl persis wl Persis neck, goin or axillary lumps Recent travel Persis night sweats over 6 wk New cough, SOB, expectorate, CP Persis fever over 1wk no clear cause -causes- Illness eg chickenpox, croup, URTI, otitis media or externa, tonsillitis. Less comm rash eg measles, slapped cheek, kawasaki. Acute resp eg bronchitis, whooping cough, pneum. Chronic resp eg TB. ENT eg quinsy, glandular fever, mastoiditis Dental infec Mesenteric adenitis Meningitis GI infec Pyloric stenosis Intussusception Malaria, dengue, lymes Appendicitis Testic or ovarian torsion UTI Haem malig Cellulitis -use centor criteria- Tonsillar exudate Cervical LN Fever No cough Score 3/4 of these means likely AB req
3
Q
Abdo pain
A
-flags- Possible preg Acute systemic unwell Dehyd Post trauma Guarding or rebound tenderness Distension Unexpl wl -causes- Constipat or obstruc Diverticulitis Appendicitis IBS Gallbladder Pancreatitis Malig UTI, Renal colic Ectopic preg, miscarriage, ovarian cyst, PID, endometriosis. AAA! DKA Coeliac Spleen rupture
4
Q
Wl or appettite loss
A
-flags- V rapid wl New dyspepsia over 55yo Dysphagia, vomit Persis low mood Alc dep Cog impair- MMSE Night sweats Resp symps, persis cough over 3wk, haemoptysis Bone pain PolyU and polyD, haematuria Change bowel habit over 6wk, rectal bleed Unexpl persis fever Recent travel Post menop, intermenstrual or post coital bleed -causes- Infec Metabolic eg hypothyr Malig GI eg gastritis, oesophagitis, IBD Psych eg dep, anx, alc or drug dep, ED Cog impair, dementia Malabs Malnutrit TB, HIV Haem malig DM Thyrotoxicosis Addisons AI Drug s/e eg GLP1 analogues
5
Q
SOB
A
-flags-
CP and other cardiac symps
Sudden onset and persis
Cyanosis, cant compl sentence, confus, agitat, leg swell
Stridor, wheeze, persis cough
Hx of long immobil, trauma, prev resp complics
Onset or worsening orthopnea
-causes-
Exacerbation LTC eg COPD, asthma, CF, HF
Airway trauma eg FB asp, excess sec, anaph, TE, pneumothorax, MI
Complic of ILD, asbestosis, CA, mets
Infec eg pneum, epiglottitis, meningitis
Anaem, liver or renal fail, DM
Psychogenic
Rare eg guillain barre, MG, MS, toxicity (CO, NSAID).
6
Q
Bone pain
A
-flags- Hx of malig Wl Night sweats Low appet Night pain Proggresive or persis Recent trauma Symmetrical jnt swell Thoracic pain -causes- Fracture Primary bone CA eg osteosarcoma, mets Vit D defic osteomalacia Mutip myeloma Pagets OP, OA, RA HyperCa Bone TB Psychosomatic Iatrogenic eg isphosphonates
7
Q
Neck pain
A
-flags- Trauma or surg Systemic ill eg wl, night sweat, fever Sev pain Nocturnal pain SC comp signs???? Sig Verteb body tenderness Hx TB, HIV, CA, RA -causes- Whiplash Cervical spondylosis/degen Verteb disc prolapse RA or seroneg arthropathies Malig TB, meningitis Cervical rib Neck A distension or aneur Verteb frac
8
Q
Back pain
A
-flags- Thoracic pain V yng or old Loss bowel or bladder control Weak or numb limbs Foot drop or gait disturb High fever Saddle anaeshesia Hx carcinoma Struc deformity -causes- SC comp! Cauda equina synd Tumour Infec Lumbar disc herniation Periph neuropathy Prim or met carcinoma Fracture Mechanical Rheumatoid, vascular, visceral
9
Q
Fever in adult
A
Persis fever over 3 wk no clear cause Travel Persis cough, SOB, expectorate, haemoptysis New headache Photophobia, neck stiff New rash esp non blanch petechial New facial swelling or pain Persis neck swell/LN swell over 6wk. Night sweat over 6wk Uninten wl New abdo pain Bloody diarr New dysuria, haematuria New vag disch with lower abdo pain New testic swell New sig lower back pain New jnt swell HIV expos Skin breakdown eg ulcer Indwelling device IV drug use Chemo recent Preg in last wk, and birth compics. -causes- Infec eg tonsillitis, gland fever, bronchitis, whooping, penum. TB ENT infec eg sinusitis, parotitis, otitis Dental infec Cerebral abcess, meningitis Malaria, lymes GI infec UTI PID Orchitis Infective endocarditis Malig Malig hyperthermia Diverticulitis Empyema
10
Q
Diarrhoea
A
-flags- Over 4wk in adult, 2 wk in kids Wl Nocturnal or continuous Blood or mucous Pale offensive Dehyd Travel In kids, if assoc fail to thrive or malnutr then consider CF, coeliac, chronic infec eg UTI. -causes- IBS IBD Malig C diff Diverticular dis Malabs Chronic infec DM Post surg Drug s/e eg NSAID Alc or laxative abuse Food intol Imm defic Mesenteric isch Radiation enteritis Autonomic neurop
11
Q
TATT
A
-flags- Dysphagia Mood Bleeding Sig unexpl wl Alt bowel habit Lymphadenop with malig feats Breast or other lump Post menop bleed Localising neuro signs Suicidal ideation -causes- Iron defic anaem, comm due to menstruation Malig Psych Socila/lifestyle stressors Sys illness
12
Q
Weight gain
A
-flags- Rapid onset Recurr hypoglycaemia Headache Uncontrollable hunger SOB Abdo pain Hair and skin change Constipation or cold intol Menstrual disturb Mood disturb -causes- Lifestyle- diet, exercise, alc Cushings Insulinoma Hypothyr PCOS Preg Genetic eg prader willi Drug s/e Organ fail MH eg dep
13
Q
Night sweats
A
-flags- Sig uninten wl HIV RFs Travel Enlarged LN TB RFs Recurr bact infec Hx of alc or drug excess Meningism- neck stiff, photophobia, headache Haemoptysis -causes- Infec Malig Complex infec eg TB, HIV Dryg s/e Anx Menop
14
Q
Pelvic pain acute
A
-flags- Pelvic mass Preg Vaginal bleed and pain if post menop Testic mass/torsion Shoulder radiation -causes- Miscarriage Ectopic preg Rupture corpus luteal cyst If preg then premat labour, placental abruption, uterine rupt. Ovulation Dysmenorrhoea PID Rupt or torsion of ovarian cyst Degen fibroid changes Pelvic tum or pevlic V thrombosis Diverticulitis Appendicitis Prostatitis Orchitis Bowel obstruc Adhesions Strangulated hernia Urolithiasis MSK Neurogenic- herpes, syphillis, N impinge eg tum MS Pelvic floor musc dysfunc
15
Q
Groin swelling
A
-flags- V pain Systemic ill Irreducible and tender Hx of CA Prev surg Pulsatile Groin node with new trunk/limb/pelvic symps. -causes- Ing hernia Femoral hernia- high rsik strang Lymphadenop Vasc pathol eg femoral A aneur Undesc testis Psoas abcess
