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Differentials Flashcards

1
Q

confusion/memory loss

A

vascular dementia
Alzheimer’s disease
Normal pressure hydrocephalus

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2
Q

loss of vision

A 
retinal artery occlusion
retinal vein occlusion
acute angle-closure glaucoma
Retinal detachment
temporal arteritis
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3
Q

depressed mood

A

Normal bereavement
Adjustment disorder with depressed mood
Major depressive disorder
Substance-induced mood disorder

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4
Q

psychosis

A 
schizophrenia
schizoid or schizotypal personality disorder
Schizophreniform disorder
Substance-induced psychosis
Depression with psychotic features
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5
Q

dizziness

A

Menier’s disease
Vestibular neuritis
Benign positional vertigo
Orthostatic hypotension due to dehydration

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6
Q

Loss of consciousness

A 
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Hypoglycemia
Vasovagal syncope
Stroke
PE
Cardiac arrhythmia
Severe aortic stenosis
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7
Q

numbness/weakness

A 
TIA
Hypoglycemia
Seizure
Stroke
Facial nerve palsy
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8
Q

bilateral loss of strength

A 
Guillain-Barre 
MS
Polymyositis
Myasthenia gravis
Peripheral neuropathy
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9
Q

double vision

A

Myasthenia gravis
Horner’s syndome
MS

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10
Q

tingling/numbness of thumb

A

Carpal tunnel syndrome secondary to hypothyroidism Median nerve compression in forearm/arm
Radiculopathy of nerve roots
De Quervain’s tenosynovitis

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11
Q

fatigue

A

Depression
Adjustment disorder
Hypothyroidism
Anemia

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12
Q

fatigue/insomnia after bad event

A

PTSD
Depression
Generalized anxiety disorder
Psychotic or delusional disorder

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13
Q

constipation

A

…

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14
Q

fatigue + weight gain + depression

A

hypothyroidism
depression
diabetes

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15
Q

fatigue + daytime sleepiness

A

OSA
hypothyroidism
narcolepsy

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16
Q

Diabetes-like presentation

A

Diabetes mellitus
Diabetes insipidus
Atypical depression
Primary polydipsia

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17
Q

fatigue after starting night job

A

shift work sleep disorder
sleep apnea
anemia

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18
Q

Night sweats

A 
TB
acute HIV infection
Lymphoma
Leukemia
Hyperthyroidism
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19
Q

hyperthyroidism presentation

A

Hyperthyroidism
Pheochromocytoma
Carcinoid syndrome

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20
Q

insomnia

A

Stress-induced insomnia
Caffeine-induced insomnia
Insomnia related to major depressive disorder

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21
Q

sore throat

A 
Infectious mononucleosis
Hepatitis
Viral or bacterial pharyngitis
Acute HIV infection
Secondary syphilis
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22
Q

sore throat in injection drug user

A 
HIV
Infectious mononucleosis
Hepatitis
Viral pharyngitis
Streptococcal tonsilitis
Secondary syphilis
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23
Q

fever + sore throat

A

Bacterial or viral pharyngitis
Mycoplasma pneumonia
Acute HIV infection
Infectious mononucleosis

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24
Q

SOB + cough + wheezing

A 
Asthma
GERD
Bronchitis
Pneumonitis
Foreign body
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25
SOB + productive cough for 3 months over last two years
Chronic bronchitis Bronchiectasis Lung cancer TB
26
Nonproductive cough following sore throat and runny nose a couple weeks ago
``` atypical pneumonia reactive airway disease URI-associated cough postnasal drip GERD ```
27
cough for 6 months with hemoptysis, dyspnea, weakness, weight loss
``` lung cancer TB lung abscess COPD vasculitis (GPA) ILD ```
28
dyspnea + sputum production for three days in COPDer
``` COPD exacerbation (bronchitis) Lung cancer Pneumonia URI CHF ```
29
SOB + cough + unprotected sex
``` TB Pneumonia Bronchitis Asthma Acute HIV infection ```
30
Cough worse when laying down + improved when propping up on pillows
``` CHF Cardiac valvular disease GERD Pulmonary Fibrosis COPD Postnasal drip ```
31
dyspnea of 6 hrs duration + cough with sputum production
pulmonary edema CHF mitral valve stenosis pneumonia
32
pneumonia clinical features
``` Cough Increased sputum production SOB Pleuritic chest pain Fever Chills Weakness ```
33
CHF clinical features
``` paroxysmal nocturnal dyspnea orthopnea dyspnea on exertion fatigue and weight gain cough exercise intolerance increasing abdominal girth lower extremity edema shortness of breath when bending forward. ```
34
MI features
dyspnea diaphoresis nausea history of HTN, HLD, smokin
35
MI differential
``` MI GERD angina costochondritis aortic dissection pericarditis PE Pneumothorax ```
36
chest pain in SCD patient
``` acute chest syndrome PE pneumonitis MI pneumothorax aortic dissection ```
37
GERD differential
GERD esophagitis peptic ulcer disease esophageal spasm
38
stable angina differential
stable angina esophageal spasm esophagitis
39
pericarditis differential
``` pericarditis aortic dissection MI costochondritis GERD esophageal spasm ```
40
PE differential
``` PE Pneumonia Costochondritis MI CHF Aortic dissection ```
41
PE features
``` acute onset SOB pleuritic hcest pain tachycardia hypotension tachypnea mild fever ```
42
aortic dissection differential
``` Aortic dissection MI Pericarditis Esophageal rupture Esophageal spasm GERD Pancreatitis ```
43
palpitations and diaphoresis in diabetic patient
``` Hypoglycemia Cardiac arrhythmia Angina Hyperthyroidism Panic atack Pheochromocytoma ```
44
panic attack differential
``` Panic attack GAD Acute stress disorder Specific phobia Hyerthyroidism ```
45
palpitations during speeches
Social phobia Avoidant personality disorder Generalized anxiety disorder Panic attack
46
young woman with episodic palpitations accompanied by lightheadedness and sharp chest pain
MVP cardiac arrhythmia panic attack pheochromocytoma
47
weight loss + tremor + tachy
``` Hyperthyroidism Cancer HIV infection Dieting drugs Anorexia nervosa ```
48
weight gain after quitting smoking (and otherwise)
``` Smoking cessation Drug side effect Hypothyroidism Cushing's syndrome PCOS DM Atypical depression ```
49
Insulinoma presentation
``` Tremor Palpitations Anxiety Hunger Proximal muscle eeakness Easy bruising ```
50
Dysphagia differential
``` Esophageal cancer Achalasia Esophagitis Systemic sclerosis Esophageal stricture ALS ```
51
Plummer-Vinson syndrome presentation
Dysphagia Odynophagia Fatigue Pika
52
dysphagia + odynophagia
``` Esophagitis Systemic sclerosis GERD Esophageal stricture Zenker's diverticulum ```
53
Hodgkin's presentation
``` night sweats fever weight loss loss of appetite early satiety ```
54
sudden onset of colicky right-sided flank pain radiating to testicles
Nephrolithiasis Renal cell carcinoma Pyelonephritis Appendicitis
55
nephrolithiasis presentation
``` colicky pain flank pain pain radiating to testicles nausea vomiting hematuria CVA tenderness ```
56
pancreatitis presentation differential
``` pancreatic cancer cholangiocarcinoma acute viral hepatitis acute alcoholic hepatitis Chronic pancreatitis Abdominal aortic aneurysm Peptic ulcer disease ```
57
acute pancreatitis differential
``` Acute pancreatitis Peptic ulcer disease Cholecystitis Gastritis Abdominal aortic aneurysm Mesenteric ischemia Alcoholic hepatitis ```
58
cholecystitis differential
``` Acute cholecystitis Choledocholithiasis Hepatitis Ascending cholangitis Peptic ulcer disease ```
59
burning epigastric pain after meal differential
``` Peptic ulcer disease Gastritis Cholecystitis Chronic pancreatitis Mesenteric ischemia ```
60
Severe LUQ abdominal pain
``` Splenic rupture Kidney stone Rib fracture Pneumonia Perforated peptic ulcer Splenic infarct ```
61
intestinal obstruction differential
``` Small bowel obstruction Small bowel or colon cancer Volvulus Gastroenteritis Food poisoning Ileus Hernia ```
62
Dark bowel movement/bloody bowel movement
``` mesenteric ischemia/infarction Diverticulitis PUD Gastroenteritis acute pancreatitis cholecystitis ```
63
severe RLQ pain in young woman
``` ovarian torsion appendicitis nephrolithiasis ectopic pregnancy ruptured ovarian cyst pelvic inflammatory disease Bowel infection or perforation ```
64
diverticulitis differential
``` Diverticulitis Crohn's disease Ulcerative colitis Gastroenteritis Abscess ```
65
young male with severe RLQ abdominal pain
``` Acute appendicitis Gastroenteritis Crohn's disease Nephrolithiasis Perforation ```
66
IBS differential
``` Irritable bowel syndrome Inflammatory bowel disease Crohn's disease Celiac disease Chronic pancreatitis ```
67
pelvic inflammatory disease differential
``` Pelvic inflammatory disease Endometriosis Dysmenorrhea Vaginitis Cystitis Spontaneous abortion ```
68
constipation differential
``` Low-fiber diet Depression Substance abuse (heroin) Irritable bowel syndrome Hypothyroidism ```
69
infectious diarrhea differential
Infectious diarrhea | Food poisoning
70
Traveler's diarrhea differential
``` Traveler's diarrhea Giardiasis Amebiasis Food poisoning Hepatitis A ```
71
coffee-ground emesis + epigastric pain
Bleeding peptic ulcer Gastritis Gastric cancer Esophageal varices
72
blood in stool differential
``` colorectal cancer anal fissure hemorrhoids diverticulosis ischemic bowel disease angiodysplasia IBD ```
73
painless hematuria differential
``` Bladder cancer Renal cell carcinoma Nephrolithiasis Acute glomerulonephritis Prostate cancer Coagulation disorder Polycystic kidney disease ```
74
BPH differential
BPH Prostate cancer UTI Bladder stones
75
dysuria + discharge + unprotected sex
Urethritis Cystitis Prostatitis
76
pyelo differential
Acute pyelonephritis Nephrolithiasis Lower UTI (cystitis, urethritis) Renal cell carcinoma
77
urinary leakage differential
Stress incontinence Mixed incontinence Urge incontinence Overflow incontinence
78
pregnancy differential
pregnancy anovulatory cycle Hyperprolactinemia
79
PCOS/amenorrhea differential
PCOS Thyroid disease Hyperprolactinemia Pregnancy
80
menopause differential
Menopause Pregnancy Pituitary tumor Thyroid disease
81
Sheehan's syndrome presentation
``` amenorrhea cold intolerance coarse hair weight loss fatigue ```
82
amenorrhea in young woman differential
Anorexia nervosa Pregnancy Hyperthyroidism Anxiety-induced amenorrhea
83
vaginal bleeding history
- pre vs. post menopausal - status - duration - amount - menstrual history and relation to last menstrual period - associated discharge - pelvic or abdominal pain - urinary symptoms - trauma - medications (especially blood thinners, contraceptives) - history of easy bleeding or bruising - history of abnormal pap smears
84
differential for prolonged, excessive, irregular bleeding
- dysfunctional uterine bleeding - coagulation disorder - cervical cancer - molar pregnancy
85
vaginal bleeding in post-menopause differential
``` endometrial cancer cervical cancer atrophic endometrium endometrial hyperplasia endometrial polyp ```
86
postcoital bleeding differential
cervical cancer endometrial cancer cervical polyp cervicitis
87
vaginal bleeding in pregnant patient differential
spontaneous abortion ectopic pregnancy molar pregnancy
88
left lower abdominal pain in female differential
ectopic pregnancy ruptured ovarian cyst ovarian torsion PID
89
grayish-white, foul-smelling vaginal discharge differential
Bacterial vaginosis Candidal vaginitis Trichomonal vaginitis Cervicitis (chlamydia, gonorrhea)
90
painful intercourse differential
Atrophic vaginitis Endometriosis Cervicitis Domestic violence
91
dyspareunia + dysmenorrhea differential
``` Endometriosis Cervicitis Vaginismus Vulvodynia PID domestic violence ```
92
Domestic violence differential
Domestic violence Osteogenesis Imperfecta Substance abuse
93
Rape differential
Rape | Domestic violence
94
Lupus differential
SLE RA Psoriatic arthritis Parvovirus B19 infection
95
young person with joint pain
RA SLE Disseminated gonorrhea Arthritis associated with IBD
96
changes associated with pregnancy
polyuria breast tenderness nausea/morning sickness constipation
97
murphy's sign
ask pt to breathe out -- place the hand below the costal margin on the right side at the mid-clavicular line (the approximate location of the gallbladder) -- tell patient to breathe in -- positive if pt stops breathing in and whinces (gallbladder comes in contact with examiner's fingers)
98
Mcburney's point
have patient lay supine -- place hand one-third of the distance from the anterior superior iliac spine to the umbilicus (navel) --
99
ROS frame
``` Head to Toe Constitutional HEENT CV PULM GI GU MSK DERM Neuro Psych Endocrine ```
100
constitutional ROS
weight loss night sweats fatigue/malaise sleeping appetite fever
101
HEENT ROS
``` Vision changes HA Double vision Runny nose Nose bleeds sinus pain Ear pain sore throat odynophagia ```
102
CV ROS
``` chest pain PND orthopnea edema palpitations faintness LOS ```
103
Pulm ROS
``` cough sputum wheeze hemoptysis SOB Exercise intolerance ```
104
GI ROS
``` abdominal pain weight loss dysphagia indigestion bloating/cramping anorexia N - V diarrhea/constipation obstipation hematemesis BRBPR melena ```
105
GU ROS
``` incontinence dysuria hematuria nocturia polyuria Genital -- discharge pain with urination, menstruation use of pads/tampons duration LMP contraception ```
106
MSK ROS
pain, stiffness, joint swelling, ROM, crepitus, arthritis
107
Neuro ROS
``` sight, smell, hearing, taste seizures faints HA numbness/paresthesias weakness speech problems ```
108
psych ROS
``` depression sleep anxiety concentrating energy personality ```
109
inability to use leg
Hip fracture Hip dislocation Pelvic fracture
110
fever + joint pain
Septic arthritis Gout Pseudogout Lyme arthritis
111
right foot pain related to overuse
stress fracture plantar fasciitis foot sprain or strain
112
plantar fasciitis differential
plantar fasciitis | heel fracture
113
pain in both legs induced by walking and relieved by rest differential
peripheral vascular disease Lumbar spinal stenosis Osteoarthritis
114
DVT differential
DVT baker's cyst rupture cellulitis Superficial venous thrombosis
115
shoulder dislocation differential
shoulder dislocation fracture of the humerus rotator cuff injury
116
crampy muscle pain + fatigue + dark urine
rhabdomyolysis due to statins polymyositis Inclusion body myositis
117
low back pain differential
``` Disc herniation Lumbar muscle strain vertebral compression fracture Lumbar spinal stenosis Peripheral vascular disease ```
118
fever + lethargy in infant differential
neonatal sepsis meningitis pneumonia
119
gastroenteritis in kid differential
gastroenteritis food poisoning volvulus intussusception
120
infant spitting up milk
pyloric stenosis GERD gastroenteritis
121
hirschprung's differential
Hirschprung's Low-fiber diet anal stenosis hypothyroidism
122
bloody stools + abdominal pain in infant
``` intussusception appendicitis Meckel's diverticulum volvulus gastroenteritis ```
123
kid with abdominal pain worse at school
somatoform disorder malingering IBS
124
persistent crying differential
colic formula allergy GERD
125
pink eye differential
Bacterial conjunctivitis Viral conjunctivitis Keratitis
126
short kid + lack of sexual development differential
Constitutional short stature Growth hormone deficiency Hypothyroidism
127
ADHD differential
``` ADHD Oppositional defiant disorder Conduct disorder Adjustment disorder Substance abuse Age-appropriate behavior ```
128
orders for headache workup
ESR CT-head MRI-brain
129
temporal arteritis orders
ESR CRP Temporal artery biopsy
130
sinusitis differential
Sinusitis Migraine Tension headache Meningitis
131
subarachnoid hemorrhage differential
SAH Migraine Meningitis Intracranial hemorrhage
132
meningitis differential
meningitis migraine SAH Encephalitis
133
SAH orders
Noncontrast CT-head LP-CSF analysis CBC
134
meningitis orders
CT-head MRI-brain LP-CSF
135
pseudotumor orders
urine hCG CT-head LP--opening pressure + CSF
136
dementia orders
``` CBC VDRL - RPR B12 TSH MRI-brain CT-head LP-CSF ```
137
hypoglycemic episode orders
Glucose CBC Troponin ECG
138
subdural hematoma orders
CT-head CBC LP-CSF
139
pysch disorders orders
TSH | Urine toxicology
140
BPV order
Dix-hallpike maneuver
141
orthostatic hypotension order
orthostatic vital signs | BMP
142
Menier's disease order
audiogram | electronystagmography
143
other disorder that can cause positional dizziness
vertebrobasilar insufficiency
144
seizure workup
``` BMP Blood glucose Utox EEG CT-head ECG ```
145
syncope orders
``` ECG Holter monitoring CT-head BMP-glucose Echocardiography ```
146
TIA-stroke orders
``` CT-head Fasting lipid panel ECG MRI_brain Doppler US-carotid Echocardiography EEG ```
147
GBS-MS orders
``` LP-CSF MRI-brain,spine nerve conduction studies Edrophonium test (MG) serum B12 ```
148
carpal tunnel syndrome orders
TSH | Nerve conduction studies
149
colon cancer orders
Colonoscopy rectal exam CBC (CT abdomen-pelvis)
150
OSA orders
Nocturnal pulse oximetry Polysomnography TSH
151
DM2 orders
``` Glucose tolerance test HbA1c UA CBC BMP ```
152
TB orders
``` Quantiferon gold CBC CXR Sputum grain stain, acid-fast stain HIV antibody ```
153
pheochromoctyoma orders
24-hour urinary catecholamines | TSH
154
carcinoid syndrome order
5-HIAA
155
mono-sore throat orders
Monospot test Throat culture HIV antibody test Anti-EBV antibodies
156
orders for fever + sore throat
Rapid streptococcal antigen Throat swab for culture Monospot test Cold agglutinin titer for mycoplasma
157
MI orders
troponin x3 CXR Echo d-dimer
158
acute chest syndrome orders
CBC with reticulocyte count and peripheral smear
159
GERD-esopaghitis-PUD workup
ECG | Upper endoscopy
160
stable angina workups
``` Exercise stress test Cardiac catheterization ECG Troponins CXR ```
161
PE order
CTA-chest with IV contrast | Doppler U/S legs
162
pancreatitis orders
amylase, lipase
163
what to order for weight loss + fine tremor + tachycardia
TSH + Utox + BMP
164
what to order for Cushing's
24-hour urine free cortisol
165
Hodgkin's orders
CBC with differential Lymph node biopsy Thyroid US
166
pregnancy orders
Urine hCG Pelvic exam Pelvic US
167
nephrolithiasis orders
KUB Renal US CT--abdomen
168
hepatitis orders
viral hepatitis serologies
169
PID-endometriosis orders
``` Pelvic exam US-pelvis Urine hCG CBC UA-Urine culture ```
170
constipation orders
rectal exam TSH Electrolytes U toxicology
171
pseudomembranous colitis order
stool for c diff toxin
172
lactose interolerance order
hydrogen breath test
173
bladder cancer order
cystoscopy | CT--abdomen-pelvis
174
painless hematuria other oder
Genitourinary exam
175
BPH-prostate cancer orders
``` PSA US-prostate Rectal exam CBC prostate biopsy ```
176
STD-dysuria orders
UA-urine culture Chlamydia and gonorrhea PCR Gram stain and culture of discharge
177
pyelo orders
UA, urine culture and sensitivity Blood cultures US-renal CT-abdomen
178
incontinence orders
UA-culture Urodynamic testing IVP Cystourethroscopy
179
impotence differential
Drug-related ED ED caused by HTN ED caused by DM Psychogenic ED
180
impotence orders
GU exam Glucose CBC Testosterone level
181
PCOS orders
LH-FSH, TSH, prolactin
182
molar pregnancy order
pelvic US
183
endometrial cancer orders
endometrial biopsy-curretage | US pelvics
184
cervical cancer order
Colposcopy
185
spontaneous abortion-ectopic pregnancy-molar pregnancy
``` Urine hCG quantitative serum hCG US-abdomen-pelvis Pelvic exam CBC ```
186
vaginal discharge orders
Pelvic exam Wet mount, KOH prep vaginal fluid pH Cervical cultures
187
order for rape
forensic exam | pelvic exam
188
SLE orders
ANA, anti-dsDNA, ESR, C4, C4
189
parvovirus B19 infection
antibody titers for parvovirus B19
190
gout-psuedogout orders
knee arthroentesis and synovial fluid analysis | uric acid
191
PVD order
ankle-brachial index | angiography
192
back pain orders
XR-L-spine | MRI-L-spine
193
infant with constipation orders
``` Anorectal manometry Rectal exam Stool exam and culture TSH electrolytes ```
194
conjunctivitis orders
Discharge cultures | Slit lamp exam
195
delayed growth orders
``` GH stimulation test IGF-1, IGFBP-3 TSH XR-hand Sweat chloride testing ```
196
cholecystitis clinical features
``` after eating fatty food colicky nausea vomiting fever on exam ```
197
choledocholothiaisis presentation
jaundice
198
endometrial cancer
``` abdominal-pelvic pain abdominal distention bloating early satiety change in bowel-bladder function ```
199
retinal artery occlusion presentation
sudden painless, monocular vision loss or degradation
200
lung cancer presentation
dyspnea persistent cough wheezing hemoptysis
201
schizophrenia features
hearing voices which are often critical or abusive (auditory hallucinations) articulating strange beliefs (delusions) disorganized speech and thought (thought disorder) disorganized social behavior social withdrawal and loss of will (negative symptoms) flattened affect
202
GERD features
- burning behind sternum - burning worse after meals or in recling position - eased by antacids - hoarseness - throat clearing - chronic cough
203
asthma features
cough chest tightness wheezing dyspnea
204
OSA features
``` insomnia snoring awakenings excessive daytime sleepiness decreased concentration and memory morning HA ```
205
Infectious mononucleosis | features
``` fever pharyngitis fatigue HA abdominal pain nausea vomiting ```
206
PCOS
``` infertility hirsutism acne amenorrhea obesity hair loss ```
207
AAA features
smoking back pain hematuria
208
colon cancer presentation
``` rectal bleeding change in bowel habit fatigue weight loss generalized or localized abdominal pain ```
209
meniere's disease presentation
``` hearing loss tinnitus fullness vertigo hearing loss ```
210
meningitis presentation in infant
``` neck pain HA fevers poor cry poor feeding altered behavior altered muscle tone signs of respiratory distress seizure oliguria ```
211
sepsis in child
``` fever hypothermia tachypnea abdominal pain with vomiting or diarrhea lethargy, which may be profound altered mental status ```
212
Neonatal Jaundice differential
crigjler-najjar breast milk jaundice hemolytic disease of newborn
213
diarrhea in a child
intussusception gastroenteritits functional diarrhea lactase deficiency

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