Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

1PACES DIFFENTIALS > PACES Differentials & Causes > Flashcards

PACES Differentials & Causes Flashcards

1
Q

Differentials of Chest pain

A

Pleuritic:
 Infectious: Pneumonia
 Respiratory: Pneumothorax, Pleural effusion, Pulmonary Embolism
 Cardiac: Pericarditis, (Myocarditis)
Angina-like:
 Ischaemic: ACS
 Valvular: Aortic Stenosis, Aortic Regurgitation
 Structural: Aortic Dissection, Thoracic Aortic Aneurysm rupture
Non-cardiorespiratory:
 Muscular: Costochondritis
 GI: GORD
 Somatic: Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Differentials of Acute onset Dyspnoea

A

Cardiorespiratory:
 Cardiac: Pulmonary oedema,
 Resp: Asthma, Anaphylaxis, Pleural effusion, Pneumothorax, PE
 Infectious: Covid-19, Infective exacerbation of COPD, Pneumonia,

Systemic:
 Anaemic: Bleeding (inc. trauma)
 Neurological: MG, MS, GBS,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Differentials of Cough

A

 Infectious: typical or atypical pneumonia, tuberculosis, COVID-19, Influenza
 Inflammatory: Asthma, COPD, pulmonary fibrosis, bronchiectasis, interstitial lung disease, sarcoidosis
 Malignant: lung cancer, mesothelioma
 Iatrogenic: medication changes (ACEi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differentials of an acute Headache

A

Primary headaches…
 Tension
 Cluster
 Migraine

Secondary headaches…
 Neurological: Temporal arteritis, SAH, Meningitis,
Encephalitis
 ENT: Sinusitis, TMJ syndrome
 Iatrogenic: medication overuse
 Trauma: concussion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Differentials of delirium

A

 Endocrine & Biochemical causes: HypoNa, HyperNa, HyperCa, hypoglycaemia, hypothyroidism, DKA, HHS.
 Infectious: Sepsis, UTI, Pneumonia
 Neurological: intracranial bleeding, (hepatic) encephalopathy, concussion.
 Iatrogenic: medications, environmental change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Differentials of syncope

A

 Neurological: Vasovagal, Epilepsy, psychogenic seizures
 Cardiac: Arrhythmia (electrolyte), ACS, Aortic stenosis, HOCM
 Vascular: PE, Dissection, Aneurysm rupture, Subclavian steal syndrome
 Toxicological: overdose, alcohol, iatrogenic
 Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Differentials of acute limb weakness

A

 Vascular: Ischaemic stroke, haemorrhagic stroke, TIA,
 Neurological: Hemiplegic migraine, Hypoglycaemia, Todd’s Paresis, GBS
 Trauma: spinal disc injury
Note: in isolated limb findings consider – Acute limb Ischaemia, Peripheral nerve injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Differentials of chronic limb weakness

A

 Inflammatory: MS, Myasthenia Gravis
 Infectious: GBS, Tetanus, Botulism,
 Malignant: Space occupying lesion, Lambert Eaton
 Vascular: Stroke, SAH, subdural haematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differentials of dysphagia

A

 Luminal: foreign body
 Intramural: Oesophageal Cancer, Barrett’s oesophagus, Pharyngeal Pouch, Plummer-Vinson, GORD, Achalasia, Stricture
 Extra-mural: Lung cancer, Goitre, Head & Neck cancer.
 Neurological: Parkinson’s, MND, Stroke, MS, MG, CREST, Globus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Differentials of a breast lump

A

Benign:
 Areola: Duct Ectasia, Galactocele
 Parenchyma: Fibroadenoma, Fibrocystic change, breast cyst, Mastitis, Abscess
 Adipose: Lipoma, Fat necrosis
Malignant:
 Areola: Paget’s disease of the breast
 Parenchyma: Breast Cancer (IDC), Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Differentials of PR bleeding

A

 Colorectal: Cancer, IBD, Diverticular disease, angiodysplasia
 Anus: Haemorrhoids, rectal prolapse, Anal fissure, Anal fistula, peri-anal abscess
 Upper GI: Cancer, Peptic ulcers

+coagulaopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of (true) Bowel Obstruction

A

 Luminal: Faecal impaction, Gallstone Ileus
 Intramural: Colorectal Cancer, Strictures, Diverticulitis, Meckel’s diverticulum
 Extrinsic: Adhesions, Incarcerated Hernia, Volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of Pseudo-obstruction

A

Pseudo Obstruction…
 Acute event: Post-operative, Recent cardiac ischaemia
 Endocrine: Hypothyroidism, Hypercalcaemia, hypomagnesaemia
 Neurological: Parkinson’s, MS
 Medications: Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of Ascites

A

Transudative “Failures”
 Cirrhosis, ALF
 Cardiac failure (inc. constrictive pericarditis)
 Nephrotic syndrome

Exudative
 Malignancy: Colorectal, pelvic,
 Infectious: tuberculosis
 Budd-Chiari syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of RUQ pain

A

Hepatic
 Hepatitis (viral, ischaemic, toxic)
 Perihepatitis (Fitz-Hugh Curtis syndrome)
 Abscess (including subphrenic)
Biliary
 Biliary colic
 Cholecystitis (acute, chronic)
 Cholangitis (ascending, primary sclerosing)
Referred:
 RLL pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of RIF pain

A

Gastrointestinal…
 Acute appendicitis
 IBD or IBS
 Mesenteric adenitis
 Bowel obstruction…
 Constipation
Gynaecological…
 Ovarian: torision, cyst rupture, haemmorhage
 Ectopic pregnancy
 Acute PID
 Endometriosis
 Mittelschmerz
Urological:
 Testicular Torsion
 Renal colic
 UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of LIF pain

A

Gastrointestinal…
 Diverticulitis
 IBD or IBS
 Bowel obstruction – including colorectal cancer..
 Constipation
Gynaecological…
 Ovarian: torision, cyst rupture, haemmorhage
 Ectopic pregnancy
 Acute PID
 Endometriosis
 Mittelschmerz
Urological:
 Testicular Torsion
 Renal colic
 UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Causes of epigastric pain

A

Cardiac:
 ACS
 Aortic Dissection
Pancreatic:
 Acute pancreatitis
 Chronic pancreatitis
Gastric:
 GORD
 Peptic Ulcer disease
 Mesenteric Ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of LUTS

A

Urological
 Urethra: Stricture, UTI
 Prostatic: BPE, Prostatitis, Prostate Cancer
 Bladder: Cancer, Detrusor muscle weakness
Non-urological
 Extrinsic compression: Pelvic mass compression e.g. colorectal cancer.
 Endocrine: Diabetes Mellitus, Diabetes Insipidus, Psychogenic Polydipsia
 Neurological: spinal cord injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Differentials of Scrotal swelling

A

Painful
 Infectious: Epididymo-orchitis
 Acute event: Testicular torsion, Torsion of the Hydatid of Morgagni
 Extra-testicular: Incarcerated inguinal hernia

Painless
 Benign: Hydrocele, varicocele, epididymal cyst, gumma
 Malignant: testicular seminomas and non-seminomas
 Extra-testicular: Inguinal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Differentials of Acute limb pain

A

 Arterial: Acute limb ischaemia, acute on chronic PAD,
 Venous: DVT, Lymph: lymphoedema
 MSK: Compartment syndrome, Trauma
 Infectious: osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Differentials of Chronic limb pain

A

 Arterial: PAD
 Venous: Chronic DVT, Post-thrombotic syndrome, venous insufficiency
 Neurological: lumbar stenosis, radiculopathy/sciatica
 Lymph: lymphoedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Differentials of a leg ulcer

A

 Venous: Venous insufficiency
 Arterial: PAD
 Neurological: Diabetes
 Environmental: Pressure ulcers
 GI: Pyoderma gangrenosum
 Malignant: Marjolin’s Ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of AR

A

 Acute: Aortic dissection, IE
 Chronic: Syphilis (Luetic disease), CTDs inc. Marfan’s, Rheumatic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Causes of MS (cardio)
 Infectious: Rheumatic fever/rheumatic heart disease  Age related calcification  Congenital valve defects
26
Causes of MR
Causes:  Infectious: Infective endocarditis, rheumatic fever & heart disease  Structural defect: papillary muscle rupture, mitral valve prolapse
27
Causes of MVP (cardio)
• Primary/idiopathic • Rheum: Marfan’s, Ehlers Danlos, osteogenesis imperfecta, • Endocrine: turner’s, Fragile X • Cardiac: WPW, PDA, ASD, Cardiomyopathies • Renal: ADPKD
28
Causes of TR
 Infectious: Infective Endocarditis (IVDU), Rheumatic fever & heart disease  Congenital: Ebstein’s anomaly
29
Causes of a third heart sound? By what mechanism?
 Physiological (<30)  Heart failure  Dilated cardiomyopathy Caused by Rapid ventricular filling (RVF - 3 letters)
30
Causes of a forth heart sound? By what mechanism?
 Hypertension  HOCM (4 letters)  End stage heart failure (gallop) Caused by atrial contraction against a stiff ventricle (CASV - 4 letters)
31
Cardiac causes of Clubbing
 Atrial Myxoma  Bacterial endocarditis  Congenital cyanotic heart disease
32
Respiratory causes of Clubbing
 Infection: Empyema  Inflammation: Bronchiectasis & Interstitial lung disease (classically IPF)  Malignant: Lung cancers (non-SCC classically) & Mesothelioma
33
Gastro causes of Clubbing
 Hepatocellular Carcinoma  Cirrhosis  Crohn’s & UC  Coeliac
34
Causes of Asterixis
 Hepatic: Acute liver failure  Respiratory: Type 2 respiratory failure  Medications: Phenytoin, Benzodiazepines & Barbiturates
35
Causes of Coarse crepitations
 Pneumonia  Severe pulmonary Oedema  COPD  Bronchiectasis
36
Causes of Fine crepitations
 Interstitial Lung Disease  Early Pulmonary oedema
37
Causes of Wheeze
Polyphonic  Asthma  COPD  Aspiration  Congestive heart failure (“cardiac wheeze”) Monophonic  Foreign body  Bronchial carcinoma  Goitre
38
Causes of Barrel chest
 COPD  Alpha-1 antitrypsin deficiency  Acromegaly  Chest deformity: pectus carinatum
39
Causes of Dupytren's contracture
 Alcoholic Liver disease  Peyronie’s disease  Idiopathic/Familial
40
Causes of Splenomegaly
"Hinfectious”:  Viral: Glandular fever  Bacterial: Salmonella, Brucellosis  Parasitic: Malaria, schistosomiasis Hepatic:  Portal hypertension  Primary Sclerosing Cholangitis  Wilson’s disease Haemolytic (any severe haemolysis will do):  G6PD deficiency  Sickle Cell splenic sequestration  Thalassaemia Haematological:  Myelofibrosis  Chronic Myeloid Leukaemia  Felty’s Syndrome
41
Causes of Hepatomegaly
Regular...  Jaundiced: Hepatitis, Cholangitis, Biliary tract obstruction  Not jaundiced: Heart failure, Budd-Chiari, Amyloidosis Irregular...  HCC, Mets, (macro) Cirrhosis, Liver Abscess,
42
Causes of Nephromegaly
 Malignant: Kidney Cancer (in adults RCC, in children Nephroblastoma), Lymphoma  Cystic: Polycystic kidney disease  Obstruction: Hydronephrosis
43
Causes of Gynaecomastia
 Hepatic: Chronic liver disease  Endocrine: Klinefelter’s, puberty, testicular tumours,  Drug related: Spironolactone, Digoxin, Marijuana
44
Causes of Proximal Myopathy
NERD  Neuromuscular: Myasthenia gravis, LEMS  Endocrine: Hypothyroidism, hyperthyroidism, Cushing’s syndrome, Acromegaly  Rheumatological: Dermatomyositis, polymyositis  Dystrophic: Becker’s  Drugs: Steroids, Statins, Alcohol
45
Causes of peripheral sensory Neuropathy
 Metabolic: Diabetes, Hypothyroidism, Alcohol, Dietary B12 def., Pernicious Anaemia*  Neuromuscular: GBS, Chronic inflammatory demyelinating polyneuropathy (CIDP)  Drug related: Isoniazid, Nitrous Oxide gas abuse
46
Causes of tremor
Resting tremor  Essential tremor  Neurodegenerative causes: Parkinson’s, Parkinson’s plus syndromes  Metabolic: Hyperthyroidism, Alcohol withdrawal  Iatrogenic: Salbutamol Intention tremor:  Cerebellar dysfunction e.g. acute alcohol abuse Both: Dystonic tremor (tug of war)
47
Causes of Trendelenburg gait
Neuromuscular  Bilateral = Proximal myopathy at the hip  Superior gluteal nerve injury  L5 radiculopathy  Lesion to G. medius & minimus Skeletal  DDH  SUFE  Perthes disease
48
Causes of Foot drop
LMN  Common peroneal nerve palsy.... o Trauma o Plaster cast compression o Posture (sitting cross-legged) o Diabetic neuropathy o Leprosy  L5 Radiculopathy.... o Lumbar disc prolapse o Spinal stenosis o Impingement due to a mass UMN  Stroke  Multiple sclerosis  Cerebral palsy
49
Causes of Carpal tunnel
 Idiopathic  Occupational: repetitive movement/vibration  Endocrine: Obesity, DM, Hypothyroidism, Acromegaly  Rheumatological: RhA  Pregnancy
50
Causes of Tracheal deviation
 Towards: Lobar collapse, pneumonectomy, pulmonary fibrosis  Away: Tension pneumothorax, Large pleural effusion, Mediastinal mass
51
Causes of a displaced apex beat
 Cardiac: Dilated cardiomyopathy, MR, Dextrocardia  Respiratory: Tension pneumothorax, Lung collapse
52
Causes of Syncope
 Neurological: Vasovagal, Epilepsy, psychogenic seizures  Cardiac: Arrhythmia (electrolyte), Postural hypotension, ACS, Aortic stenosis, HOCM, PE,  Vascular: Dissection, Aneurysm rupture, Subclavian steal syndrome  Toxicological: overdose, alcohol, iatrogenic  Trauma
53
Causes of stridor
Acute:  Intraluminal: foreign body  Intramural: Anaphylaxis, Epiglottitis, Croup  Extramural: Ludwig’s Angina, Abscess Chronic:  Intramural: Laryngomalacia, Vocal cord paralysis  Extrinsic compression: malignancy
54
Causes of pulmonary fibrosis
Upper  Infectious: TB  Inflammatory: Ankylosing Spondylitis, Sarcoidosis,  Environmental: Radiation, Silicosis, Coal Worker’s lung Basal  Idiopathic  Inflammatory: Rheumatoid  Environmental: Asbestosis  Iatrogenic: Methotrexate, Amiodarone
55
Causes of pleural effusion
Transudative  Failures: cardiac, cirrhosis  Hypoalbuminaemia: nephrotic syndrome  Meig’s Syndrome (benign ovarian tumour, ascites, pleural effusion) Exudative  Infectious: Tuberculosis, pneumonia  Inflammatory: pancreatitis, rheumatoid,  Malignancy: Lung cancer, mesothelioma,
56
How is a pleural effusion determined to be an exudate or transudate?
1. protein level <25 is transudate, >35 is exudate 2. if in middle apply Light's criteria:  Fluid/Serum Protein > 0.5  Fluid/Serum LDH >0.6  Fluid LDH >2/3 of normal upper limit ...if any apply - exudate.
57
Chronic causes of Dyspnoea
Respiratory:  Infectious: Tuberculosis  Inflammatory: COPD, interstitial lung disease, bronchiectasis, sarcoidosis  Malignant: lung cancer, mesothelioma Non-respiratory  Cardiac: Heart failure, AS, AR  Anaemic: Any bleeding  Neurological: MND
58
Differentials of chronic headache
Idiopathic raised ICP Malignancy Malignant hypertension
59
Causes of Bronchiectasis?
Congenital: Cystic fibrosis (ΔF508), Primary ciliary dyskinesias inc. Kartagener’s syndrome Acquired: post- TB, pneumonia
60
Differentials of a systollic murmur
Left sided: Aortic Stenosis Aortic Sclerosis Mitral regurgitation Right sided: Tricuspid regurgitation
61
Causes of Cirrhosis
Acquired:  Alcohol & NAFLD  Infectious: HBV, HCV, HIV  Malignant: HCC, metastatic liver disease  Auto-immune: PBC, PSC  Drug related (e.g. paracetamol) Inherited:  Metabolic: Wilson’s, Haemochromatosis, Alpha-1-antitrypsin deficiency
62
Causes of acute liver failure
Ischaemic: hypovolvaemic shock, distributive shock. Toxicological: Paracetamol, Aspirin (Reye’s Syndrome) Viral: HAV, acute HBV
63
Features of an UMN lesion
Weakness Hypertonia (rigidity) Spasticity Hyperreflexia Babinski present
64
Features of a LMN lesion
Weakness Hypotonia Flaccid paralysis Hyporeflexia Wasting Fasciculations

1PACES DIFFENTIALS (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions