Differentials and Ix Flashcards
(33 cards)
SOB differentials acute
- PE
- Pneumothorax
- Asthma/COPD
- Pneumonia
- Acute HF
- ACS
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
chest pain acute differentials
3Ps, 2As
1. ACS 2. PE 3. Aortic dissection 4. Pnuemothorax 5. Pneumonia
Chest pain ix
BOXES - Bloods - trop, FBC, WBC, CRP
CXR
ECG
CTPA (PE), CT angio (aortic dissection)
Abdo pain differential generalised
Generalised:
1. Peritonitis 2. AAA 3. Ischemic bowel 4. Medical causes (DKA, pneumonia, MI, Addisonian crisis)
RUQ abdo pain differentials
Hepatitis, cholecystitis
LUQ abdo pain differentials
LUQ:
1. Peptic ulcer 2. Pancreatitis
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
Red eye differentials
Differentials: • Conjunctivitis • Corneal ulcer • Iritis • Episcleritis • Scleritis • Acute angle closure glaucoma • Age related macular degeneration • Diabetic Retinopathy
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.
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
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
Paeds wheeze differentials
Wheeze: • Pneumonia • Asthma • Bronchiolitis • Bronchitis • Cystic Fibrosis • Inhalation of foreign body • Aspiration
Paeds acute cough differentials
Acute Cough: • Upper airways: ○ Rhinovirus ○ Croup ○ Allergy • Lower airways: ○ Asthma ○ Bronchitis, bronchiolitis
Paeds chronic cough differentials
Chronic cough: • Upper airways: ○ Infection - chronic sinusitis, tonsillitis ○ GORD • Lower airways: ○ Asthma ○ Foreign body ○ Bronchiectasis ○ CF • Psychogenic cough
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
Syncope differentials
Syncope differentials: • Epilepsy • Narcolepsy • Dizziness without LOC • TIA/Stroke Hypoglycaemia
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
Postural hypotension causes of syncope
Postural hypotension:
○ Autonomic failure - postprandial, medication, MSA, parkinsons, diabetic neuropathy
Hypovolemia - haemorrhage, addisons, dehydration
Cardiac arrhythmia causes of syncope
○ Long QT
○ Drug induced arrhythmia
AV conduction disease
Structural cardiopulmonary causes of syncope
○ Aortic stenosis
○ ACS
○ Pericardial tamponade
HOCM
Tremor differentials and classification
Classifying tremors:
• Rest - PD (pill rolling, bradykinesia)
• Intention - Cerebellar disease
• Tremor on movement - Essential tremor, thyrotoxicosis, anxiety, drugs (beta agonists)
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
Chronic cough >8 wks differentials normal and abnormal cxr
• Normal CXR: ○ GORD ○ Asthma ○ ACEi - bradykinin • Abnormal CXR: ○ TB ○ Lung cancer ○ ILD Bronchiectasis
