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Flashcards in Differentials and Ix Deck (33)
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1

SOB differentials acute

1. PE
2. Pneumothorax
3. Asthma/COPD
4. Pneumonia
5. Acute HF
6. ACS

2

Ix for SOB

BOXES

Bloods:
• FBC, U&E, CRP
• D-Dimer to rule out PE
• Blood culture if pyrexic
• ABG

Orifice tests:
• Sputum

X-rays:
• CXR

ECG

Special:
• CTPA for PE

3

chest pain acute differentials

3Ps, 2As
1. ACS
2. PE
3. Aortic dissection
4. Pnuemothorax
5. Pneumonia

4

Chest pain ix

BOXES - Bloods - trop, FBC, WBC, CRP
CXR
ECG
CTPA (PE), CT angio (aortic dissection)

5

Abdo pain differential generalised

Generalised:
1. Peritonitis
2. AAA
3. Ischemic bowel
4. Medical causes (DKA, pneumonia, MI, Addisonian crisis)

6

RUQ abdo pain differentials

Hepatitis, cholecystitis

7

LUQ abdo pain differentials

LUQ:
1. Peptic ulcer
2. Pancreatitis

8

Abdo pain ix

BOXES

Bloods:
• FBC, CRP, U&E
• LFTs, amylase
• INR
• Glucose
• VBG (lactate)

Orifice tests:
• Urine dip
• Urine beta HCG

Xrays:
• Erect CXR
• AXR if SBO

ECG

Special test:
• FAST scan for AAA
• USS/CT abdo

9

Red eye differentials

Differentials:
• Conjunctivitis
• Corneal ulcer
• Iritis
• Episcleritis
• Scleritis
• Acute angle closure glaucoma
• Age related macular degeneration
• Diabetic Retinopathy

10

Sudden loss of vision painless differentials

Central retinal artery occlusion:
• Sudden painless loss of vision
• Cherry red spot on a pale retina

Central retinal vein occlusion:
• Causes - glaucoma, polycythemia, HTN
• Severe retinal hemorrhages on fundoscopy

Retinal detachment:
• Flashes of light
• Floaters
• Curtain being drawn, tunnel vision to central vision.

11

Goitre differentials

Non neoplasm:
Single nodule - colloid, cyst
Multinodular goitre

Neoplasm:
• Benign:
○ Adenoma
• Malignant:
○ Papillary adenocarcinoma - hx of irradiation
○ Follicular carcinoma - mets to bone and lungs
Medullary carcinoma - seen in MEN syndrome

12

Neck lump differentials

Reactive lymphadenopathy - hx of local infection

Lymphoma - rubbery + painless, night sweats

Thyroid swelling - moves up on swallowing

Thyroglossal cyst - midline. Moves upwards with protrusion of tongue

Branchial cyst - mobile cyst between SCM and pharynx

Cervical rib - adult females

Carotid aneurysm - pulsatile mass, doesnt move on swallow

13

Paeds wheeze differentials

Wheeze:
• Pneumonia
• Asthma
• Bronchiolitis
• Bronchitis
• Cystic Fibrosis
• Inhalation of foreign body
• Aspiration

14

Paeds acute cough differentials

Acute Cough:
• Upper airways:
○ Rhinovirus
○ Croup
○ Allergy
• Lower airways:
○ Asthma
○ Bronchitis, bronchiolitis

15

Paeds chronic cough differentials

Chronic cough:
• Upper airways:
○ Infection - chronic sinusitis, tonsillitis
○ GORD
• Lower airways:
○ Asthma
○ Foreign body
○ Bronchiectasis
○ CF
• Psychogenic cough

16

Paeds stridor differentials

Stridor:
• Nose and nasopharynx:
○ Inflammation eg rhinitis and sinusitis
• Mouth:
○ Tonsillar hypertrophy
○ Foreign body
• Larynx:
○ GORD
○ Epiglottitis
○ Abscess
○ Foreign body
• Trachea:
○ Tracheomalacia
○ Tracheitis

17

Syncope differentials

Syncope differentials:
• Epilepsy
• Narcolepsy
• Dizziness without LOC
• TIA/Stroke
Hypoglycaemia

18

Neural causes of syncope

• Neural causes:
○ Vasovagal (most common):
§ Severe pain, fear, blood phobia
§ Orthostatic stress eg prolonged standing or in hot places
○ Situational eg micturition, Cough, sneeze
Carotid sinus hypersensitivity - while shaving, tight collar

19

Postural hypotension causes of syncope

Postural hypotension:
○ Autonomic failure - postprandial, medication, MSA, parkinsons, diabetic neuropathy
Hypovolemia - haemorrhage, addisons, dehydration

20

Cardiac arrhythmia causes of syncope

○ Long QT
○ Drug induced arrhythmia
AV conduction disease

21

Structural cardiopulmonary causes of syncope

○ Aortic stenosis
○ ACS
○ Pericardial tamponade
HOCM

22

Tremor differentials and classification

Classifying tremors:
• Rest - PD (pill rolling, bradykinesia)
• Intention - Cerebellar disease
• Tremor on movement - Essential tremor, thyrotoxicosis, anxiety, drugs (beta agonists)

23

Acute cough <3wks differentials normal and abnormal cxr

• Normal CXR :
○ bacterial / viral RTI
○ Inhaled foreign body
○ Irritation from fumes
• Abnormal CXR:
○ Pneumonia
○ Inhaled foreign body
Extrinsic allergic Alveolitis

24

Chronic cough >8 wks differentials normal and abnormal cxr

• Normal CXR:
○ GORD
○ Asthma
○ ACEi - bradykinin
• Abnormal CXR:
○ TB
○ Lung cancer
○ ILD
Bronchiectasis

25

Miosis differentials

pinpoint pupils - Differentials:
• Opioids
• Horners
Pilocarpine

26

Mydriasis differentials

Mydriasis (blown out pupils) differentials:
• 3rd nerve palsy
• Phaeochromocytoma
• Holmes-Adie pupil - damage to PS innervation of eye by infection
• Topical mydriatics - atropine
• Cocaine and amphetamines

27

Massive splenomegaly causes

CML,CLL
Malaria
Myelofibrosis
Young - EBV, Haemolytic anaemia

28

Acute recurrent headaches differentials

migraine, cluster, sinusitis, trigeminal neuralgia

29

Chronic headache differentials

Increased ICP eg SOL
Tension headache
Analgesia rebound

30

Single episode headaches differentials

Meningitis
encephalitis
Subarach hemorrhage
Sinusitis