Differential Diagnoses: General Approach

Question 1

VITAMINS C

Answer 1

V: Vascular
I: Infections
T: Traumatic
A: Autoimmune/Allergic
M: Metabolic/Medications
I: Idiopathic/Iatrogenic
N: Neoplastic
S: Substance abuse/ pSychiatric
C: Congenital

Question 2

At the door, what to think and write, ALWAYS?

Answer 2

1. RED FLAGS/Safety:
   - Constitutional symptoms!!
   - Allergies
   - What is the worst that this could be?
   - Should the patient be admitted?
   - Reporting to entities?
   - I/C to specialties
   - How does it impact your life
2. DDx
3. Fife the patient
4. If pediatric:
   - BINDE
   - HEADSSS
5. If psychiatric:
   - MOAPS
   - CAGE
6. If women:
   - MGOS
   - PBGOS: Pregnant

Question 3

What to ask always to female patients?

Answer 3

MGOS
M - Menopausal symptoms, and HRT. LMP
G - Gyn history. Previous abdominal or pelvic surgeries
O - Obstetric: how many pregnancies. Route of delivery.
S - Sexual: repeated infections/ dryness / dyspareunia

Question 4

What to ask always to adolescents?

Answer 4

HEADSSS
H - Home
E - Education
A - Activity
D - Diet
S - Suicide
S - Sexual history
S - SAD

Question 5

What approach to take with psych patients?

Answer 5

MOAPS
M: Ask one and the other if positive
- Depression: Mood and Interest questions. If one +, MSIGECAPS.
- Mania
O:
-Organic: Endogenous (hypothyroidism and exogenous (MAD)
A
-Anxiety: Are you a worrywart? If yes, ANDICREST
P
- Psychosis: Have you ever seen or heard things that others don’t? If yes, continue with other questions.
S
- Suicide
- Substance abuse: If alcohol +, CAGE

Question 6

FIFE your patient!

Answer 6

F - Feelings: How are you feeling?
I - Ideas: Do you have any idea what might be causing the problem?
F - Function: How is this affecting your life?
E - Expectations: What were you hoping we can do for you today.