Differentials fun Flashcards
(33 cards)
Differentials for Chest pain
MI
Angina
Aortic dissection
Pericarditiis
PE
Pneumothorax
GORD
Anxiety and panic attacks
MSK
Chest pain - MI
Crushing central chest pain
Radiates to neck and left (or right) arm
Associated nausea/vomiting/SoB/clammy
Cardiovascular risk factors - DM, HTN, Smoking, Drinking, FH, etc.
Chest pain - Angina
Cardiac type chest pain
Exacerbated by exercise
Relieved by rest and GTN
Chest pain - Aortic dissection
Tearing chest pain
Sudden onset
Radiates to back
Pain in other sites - legs, arms, neck, head
Chest pain - Pericarditis
Pleuritic chest pain
Relieved by sitting forwards
Radiate to trapezius ridge at neck and shoulder
Chest pain - Pulmonary embolism
Pleuritic chest pain
haemoptesis
SoB
Risk factors - stasis, recent surgery, immobility, previous VTE.
Chest pain - pneumothorax
Sudden onset
Pleuritic
May be SoB
Rick factors - Marfan’s, COPD, asthma
Chest pain - GORD
“Burning”
Related to meals
Changes with by lying and straining
“Water Brash”
Chest pain - Anxiety and panic attack
Tight chest
Associated with SoB, sweating, dizziness, palpitations, sense of doom.
Anxious personality/ GAD
Recurrent episodes and triggers
Chest pain - MSK
Sharp chest pain
Exacerbated by movements and inspiration
Well localised
Exacerbated by pressure
Differentials for Breathlessness
MI
CHF
Pneumonia
Asthma
COPD
Pneumothorax
PE
Pulmonary fibrosis
Also: anaemia, Anxiety, pleural effusion, DKA, lobar collapse, Aortic stenosis, bronchiectasis,
Breathlessness - MI
Acute onset
Woken up by SoB
Nausea and vomiting
May have crushing central chest pain
CV risk factors
Breathlessness - Congestive heart failure
SoB, orthopnoea, PND
Pink and frothy sputum
peripheral oedema
Cardiac history
Breathlessness - Pneumonia, LRTI
Acute SoB
Cough and sputum
Systemic - fever
Breathlessness - Asthma
Intermittant wheeze
Diurnal variation
Nocturnal cough
Exacerbated by exercise, pet allergens etc.
Breathlessness - COPD
Chronic SoB
Significant smoking history
Chronic sputum production
Breathlessness - Pneumothorax
Sudden onset pleuritic chest pain
Risk factors - Marfan’s, COPD, asthma
Breathlessness - Pulmonary embolism
Pleuritic chest pain
Haemoptesis
Risk factors - stasis, surgery, previous VTE etc.
Breathlessness - Pulmonary fibrosis
Progressive long term SoB
Dry cough
Differentials for Headache
Primary - Tension, cluster, migraine, trigeminal neuralgia
Secondary - Meningitis, giant cell (temporal) arteritis, Subarachnoid heamorrahage, increased ICP, Venois sinus heamorrhage.
Others - encephalitis, intercranial haemorrhage, tumour, subdural and extradural haematoma.
Headache - Tension
Bilateral tight band
Recurrent
Occurs later in the day
Associated with stress
Tender neck and scalp muscles
Headache - Cluster
Short attacks centered around one eye
Last 30 mins - 3 hours
Occurs for 1 - 3 months
1-2 attacks a day
Associated lacrimations and flushing
Headache - migraine
Unilateral and pulsating - CN V distribution
Last hours to days
May have aura (usually visual)
Photophobia
Promdrome
Headache - Trigeminal neuralgia
Stabbing pain in CN V
Face screws up in pain
Triggers - Shaving,
