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TS PACES > Red flags > Flashcards

Red flags Flashcards

1
Q

Red flag symptoms for abdominal pain

A

Gastrointestinal
* Sudden onset
* Haematemsis
* Change in bowel habit (more loose stool) for >3 weeks
* Dysphagia
* New onset dyspepsia
* Persistent unexplained vomitting
* Any abdominal distension
* Not passing flatus or absolute constipation

Urological
* Haematuria
* Testicular pain +/- swelling
* Inability to pass urine

Other
* Fever
* Presyncopal
* SOB
* Unexplained weight loss
* New rash

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2
Q

Red flags symptoms for amenorrhoea

A
  • Older than 14 years and no signs of puberty
  • Visual field defects or lack of sense of smell
  • Virilisation
  • Excessive weight loss
  • Galactorrhoea
  • Presence of abdominal mass
  • No obvious cause
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3
Q

Red flag symptoms for arrhythmias

A
  • Persistent arrhythmias, increasing in frequency
  • Chest pain or dyspnoea
  • Pre-syncope
  • Syncope w/ or w/o palpitations
  • Exertional palpiatations
  • Unintentional weight loss
  • FHx of sudden death
  • Recreational drug use
  • Alcohol misuse
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4
Q

Red flag symptoms for back pain

A
  • Signs and symptoms suggestive of cauda equina or cord compression
  • Immunosuppression
  • Trauma
  • Hx of cancer
  • Nocturnal pain
  • Systemic upset - unintentional w/l, night sweats, fevers
  • Thoracic pain
  • Abnormal gait
  • History of steroid use
  • Age less than 20 or >55
  • History of osteoporosis
  • Associated light headedness
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5
Q

Red flag symptoms for blurred vision

A
  • Sudden onset
  • Loss of vision
  • Associated headache or weakness of arm, face or leg
  • Speech disturbance
  • Associated nause, vomiting or photophobia
  • Any history of sudden eye pain and or redness
  • Hx of trauma
  • Scalp tenderness or jaw claudication
  • New medications
  • Polyuria or polydipsia and or unintentional w/l
  • Problems w/ bright lights
  • Flashers or floaters
  • Recent COVID-19
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6
Q

Red flag symptoms for breathlessness

A
  • Associated chest pain or palpitations
  • Sudden onset with persistent symptoms
  • Visible physical signs (cyanosis, unable to speak in sentences, confusion, agitation)
  • Leg swelling
  • Noisy breathing (stridor, wheeze, persistent cough)
  • Hx of prolonged immobility, trauma or previous complications w/ breathing
  • Onset of or worsening orthopnoea
  • Haemoptysis
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7
Q

Red flag symptoms for chest pain

A
  • Exertional
  • Sudden onset
  • Dyspnoea
  • Haemoptysis
  • Significant unintentional weight loss
  • New onset dyspepsia if >55
  • Hx of leg swelling, long-haul flights or any recent periods of immobility
  • Cough for >3 weeks and/or fever
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8
Q

Red flag symptoms for constipation

A
  • Change in bowel habit for more than 6 weeks
  • Persistent rectal bleeding
  • W/l, night sweats, appetite loss
  • FHx of colorectal pathology
  • Pain
  • Vomiting
  • Abdominal bloating
  • New-onset confusion
  • Significant weight gain
  • Urinary urgency (women)
  • Tenesmus (feeling of incomplete emptying)
  • Inability to pass flatus
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9
Q

Red flag symptoms for persistent cough

A
  • Persistent cough for >3 weeks
  • Pleuritic chest pain
  • Dyspnoea
  • Haemoptysis
  • Persistent nocturnal cough
  • Wheeze
  • Recurrent chest infections
  • Coughing up phlegm every morning for more than 3 months of the year
  • Unintentional weight loss
  • History of night sweats
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10
Q

Red flag symptoms for diarrhoea

A
  • Symptoms >4 weeks
  • Bloody diarrhoea
  • Unintentional weight loss
  • Nocturnal diarrhoea
  • Reduced urine output
  • History of fever
  • History of foreign travel
  • History of eating out
  • Significant abdominal pain
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11
Q

Red flag symptoms for diplopia

A
  • Persistent headaches
  • Changes in pupillary size
  • Drooping of the eyelids
  • Ocular fatigue on excessive use
  • Loss of vision
  • Existing neurological symptoms, such as weakness of arm, face, or leg, or dysphasia
  • Excessive alcohol history
  • Protruding eyeballs
  • History of recent facial trauma
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12
Q

Red flag symptoms for dizziness

A
  • Headache
  • Ataxia
  • Loss of consciousness
  • Focal neurologic deficit
  • Hearing loss
  • Severe, continuous symptoms for >1 hour
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13
Q

Red flag symptoms for dyspepsia

A
  • Iron deficiency anaemia
  • Unintentional weight loss
  • Dysphagia
  • Persistent vomiting
  • Epigastric mass
  • Chronic GI bleeding
  • Over 55 years with unexplained and persistent dyspepsia
  • Low Hb, ferritin and/or mean corpuscular volume (MCV)
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14
Q

Red flag symptoms for epigastric pain

A
  • Abdominal mass
  • Central pulsatile mass with radiating pain
  • Rebound tenderness with rigid abdomen
  • Absent bowel sounds
  • Acute pain and vomiting
  • Ecchymosis of flanks or abdomen
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15
Q

Red flag symptoms for eye pain

A
  • Sudden onset
  • Visual loss
  • Photophobia
  • Fever
  • Recent trauma
  • Vomiting
  • Associated red eye
  • Contact lens wearer
  • History of malignancy
  • History of flashers or floaters
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16
Q

Red flag symptoms for facial pain

A
  • Systemic upset
  • Progressive pain, disability and distress
  • Focal neurological deficit
  • Weight loss
  • Facial swelling or rash
  • Vision disturbance
  • Hearing loss/tinnitus/vertigo
  • Unilateral nasal obstruction/discharge
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17
Q

Red flag symptoms for fever

A
  • Persistent fever for >3 weeks with no clear cause
  • Hx of foreign travel
  • Persistent cough, SOB, haemoptysis
  • New onset headache w/ or w/o focal neurological symptoms
  • New onset headache w/ photophobia, neck stiffness
  • New onset rashes
  • New onset facial swelling/pain
  • Persistent neck swelling/lymph glands for >6 weeks
  • Night sweats for >6 weeks
  • Unintentional weight loss
  • New onset abdominal pain
  • Bloody diarrhoea
  • New onset urinary symptoms
  • New onset testicular swelling
  • New onset significant back pain
  • New onset joint pain
  • Recent HIV exposure
  • New onset leg swelling
  • Any obvious skin redness or breakdown
  • Recent IVDU
  • Recent chemotherapy
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18
Q

Red flag symptoms for haematuria

A
  • Visible haematuria without urinary tract infection in patients aged 45 and over
  • Visible haematuria that persists or recurs after successful Tx of UTI
  • Non-visible haemarturia and either dysuria or raised WBC on blood test in pts aged 60 and over
  • Abdominal mass clinically or on imaging
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19
Q

Red flag symptoms for haemoptysis

A
  • Shortness of breath
  • Reduced/absent breath sounds
  • Malaise
  • Weight loss
  • Fatigue
  • Back pain
  • Calf pain/swelling
20
Q

Red flag symptoms for dysphagia

A

(Dysphagia is a red flag symptom requiring urgent endoscopy 2WW)

  • Drooling, inability to swallow saliva suggestive of complete obstruction - immediate referral may be needed
  • Rapidly progressive dysphagia w/o neurological findings may suggest oesophageal malignancy
  • Weight loss
  • Focal neurological deficit
  • Dysphagia and dyspepsia
  • Hoarse voice
21
Q

Red flag symptoms for headache

A
  • Onset of headaches >50 years
  • Thunderclap headache (SAH)
  • Neurological signs or symptoms
  • Meningism
  • Immunosuppression or malignancy
  • Red eye and haloes around lights - acute angle closure glaucoma
  • Worsenign symptoms
  • Symptoms of temporal arteritis
22
Q

Red flag symptoms for hip pain

A
  • Sudden onset
  • History of trauma
  • Any swelling
  • Any deformity
  • Inability to weight bear
  • Any lumps/bumps felt in groin
  • Night pain
  • Noticeable groin pulsations
  • Constipation or vomiting
  • Haematuria
  • Fever
  • Lower limb neurological symptoms - weakness, numbness or tingling
  • History of steroid use
  • Testicular swelling
  • Night sweats, unintentional weight loss, appetitie loss
  • Hx of malignancy
23
Q

Red flag symptoms for hoarse voice

A
  • Persistent hoarseness (>3 weeks)
  • Dysphagia
  • Odynophagia
  • Haemoptysis
  • Otalgia w/ normal otoscopy
  • Weight loss
  • Excessive alcohol intake
  • Smoking Hx
24
Q

Red flag symptoms for jaundice

A
  • Abdominal pain
  • Palpable gall bladder
  • Weight loss
  • Fever
  • Encephalopathy
  • Evidence of bleeding from GI tract
  • Coagulopathy
25
Q

Red flag symptoms for widespread joint pain

A
  • Night sweats
  • Appetite loss
  • Unintentional weight loss
  • Joint swelling/redness and heat
  • Early morning stiffness
  • Persistent fever of more than 3 weeks
  • Night pain
  • New onset headaches
  • Jaw claudication
  • Scalp tenderness
  • Significant lethargy
  • Hx of IBD
  • Hx of uveitis
26
Q

Red flag symptoms for loss of appetite

A
  • Significant unintentional weight loss
  • New-onset dyspepsia, age >55
  • Dysphagia
  • Symptoms raising suspicion of malignancy
  • Persistent low mood
  • Features suggesting alcohol dependence
  • Mini–Mental State Examination (MMSE) score, or equivalent, suggesting cognitive impairment
  • Genitourinary, gastrointestinal or respiratory symptoms
  • Loss of taste or smell contributing to the loss of appetite
27
Q

Loss of consiousness red flag symptoms

A
  • Preceding chest pain
  • Preceding dyspnoea
  • Preceding headaches
  • Preceding palpitations
  • Preceding abdominal pain
  • Associated weakness of arm, face or leg
  • Associated with exercise or posture
  • Blood loss
  • Evidence of GI bleeding
  • Associated tongue biting, urinary incontinence or prolonged limb jerking
  • New medication
  • Preceding lightheadedness
  • Known diabetic on an oral hypoglycaemic or insulin
28
Q

Red flag symptoms for muscle weakness

A
  • Persistent weakness (> 4 weeks)
  • Muscle wasting
  • Loss of power
  • Recurrent falls
  • Unusual paraesthesiae
  • Visual symptoms
  • Significant, unintentional weight loss
  • Night sweats
  • Loss of appetite
29
Q

Red flag symptoms for muscle pain

A
  • > 4 weeks duration
  • History of significant trauma
  • Early morning symptoms
  • Persistent fevers/systemic upset
  • Abnormal rashes
  • Associated weakness
  • Muscle wasting
  • Significant unintentional weight loss
  • Joint pains
  • Swelling or redness
  • Significant fatigue
  • New numbness or power loss in a limb
  • Loss of bowel or bladder control
30
Q

Red flag symptoms for neck pain

A
  • Significant preceding trauma or neck surgery
  • Systemic upset (unintentional weight loss, night sweats, fevers)
  • Severe pain
  • Nocturnal pain
  • Relatively young (<20 years) or old (>55 years)
  • Signs of spinal cord compression
  • Significant vertebral body tenderness
  • History of TB, HIV, cancer or inflammatory arthritis
  • Severe headache +/– fever +/– non-blanching rash
31
Q

Red flag symptoms for night sweats

A
  • Significant unintentional weight loss
  • Any symptoms warranting a two-week wait referral (see cancer risk assessment tools)
  • A history of foreign travel
  • Risk factors for HIV
  • Palpable lymph glands
  • Risk factors for TB
  • Recurrent bacterial infections requiring antibiotics
  • History of alcohol excess or recreational drug use
  • Signs of meningeal irritation (meningism), such as neck stiffness, photophobia, headache
  • Haemoptysis
  • Symptoms suggestive of COVID-19, such as cough, anosmia, dysgeusia
  • Persistent nose bleeds, bleeding gums or petechiae
32
Q

Red flag symptoms for numbness

A
  • Sudden or rapid onset
  • Confusion or loss of consciousness
  • Slurred speech
  • Change in vision
  • Saddle anaesthesia
  • Loss of bladder or bowel control
  • Difficulty walking
  • Numbness after a head, neck or back injury
33
Q

Red flag symptoms for oedema

A
  • Periorbital oedema in a child
  • Change in medication
  • Accompanying breathlessness
  • Pain, hyperpigmentation, absent leg pulse
  • Signs of sepsis
  • High blood pressure
34
Q

Red flag symptpms for palpitations

A
  • Chest pain
  • Acute dizziness or syncope
  • Shortness of breath
  • Hypotension
  • Focal neurological symptoms
35
Q

Red flag symptoms for persistent cough

A
  • Persistent cough for more than three weeks
  • Pleuritic chest pain
  • Dyspnoea
  • Haemoptysis
  • Persistent nocturnal cough
  • Wheeze
  • Recurrent chest infections
  • Coughing up phlegm every morning for more than three months of the year
  • Unintentional weight loss
  • History of night sweats
36
Q

Red flag symptoms for pharyngitis

A
  • Persistent sore throat for >6 weeks
  • Persistent cough, fever, loss of taste and loss of smell
  • Excessive drooling
  • Trismus
  • Unilateral facial swelling
  • Dysphagia
  • Dyspnoea
  • Immunosuppressant medication, such as carbimazole and monoclonal antibodies (MABs)
  • Persistent unilateral tonsillar enlargement
  • Neck stiffness
  • Photophobia
  • Non-blanching rash
37
Q

Red flag symptoms for rectal bleeding

A
  • Weight loss
  • Change in bowel habit, especially diarrhoea and/or increased frequency
  • Iron-deficiency anaemia
  • Abdominal mass
  • Rectal/anal mass
  • Faecal occult blood
38
Q

Respiratory tract infections red flag symptoms

A
  • Cough >3 weeks
  • Persistent cough in a smoker
  • Haemoptysis
  • Persistent hoarseness >3 weeks
  • Persistent sore throat
  • Persistent palpable neck lumps
  • Persistent unilateral enlarged tonsil
  • Difficulty completing sentences
  • Difficulty swallowing (particularly own saliva)
  • Shortness of breath
  • Pleuritic chest pain
  • Headache, photophobia and neck stiffness
  • Non-blanching rash
  • Nasal flaring/grunting in babies
  • Recession of intercostal muscles in young children
39
Q

Skin rash red flag symptoms

A
  • Rash covering more than 90% of a person’s body surface area
  • Punched-out lesions in a person with eczema
  • Fever
  • An unwell patient (adult or child)
  • Diarrhoea
  • Nausea and vomiting
  • Headache
  • Photophobia
  • Non-blanching rash
  • Arthralgia and muscle pains
  • Pharyngitis
  • Blisters and bullae
  • Scalded skin appearance
  • Skin lesions
40
Q

Swollen calf red flag symptoms

A
  • Recent immobility or surgery
  • 3cm discrepancy compared to the other calf
  • Unilateral swelling
  • Calf pain/tightness/redness
41
Q

Tingling red flag symptoms

A
  • Onset after trauma, surgery or systemic infection
  • Multiple areas involved or progressive symptoms
  • Additional behavioural or memory changes, or dizziness/headaches
  • Fever or other systemic upset
  • Disturbances of autonomous nervous system or objective muscular weakness
  • Patient is at high risk because of age, existing chronic conditions or lifestyle factors
42
Q

Tinnitus red flag symptoms

A
  • Sudden and pulsatile tinnitus
  • Significant neurological signs/symptoms
  • Severe vertigo
  • Sudden unexplained hearing loss
  • Developing after head injury
  • Severe functional or psychological distress
43
Q

Tired all the time red flag symptoms

A
  • Significant unexplained weight loss
  • Lymphadenopathy with features of malignancy or infection such as HIV
  • Other features of malignancy - haemoptysis, dysphagia, rectal bleeding, altered bowel habit, breast lump, postmenopausal bleeding (also see NICE guidance on suspected cancer2)
  • Muscle or joint pain suggestive of inflammatory joint or connective tissue disease
  • Localising or focal neurological signs
  • Suicidal ideation
44
Q

Tremor red flag symptoms

A
  • Sudden onset
  • Progressive
  • Stepwise (suggestive of stroke or MS)
  • Neurological deficits
  • Age under 50 years in the absence of family history of essential tremor
45
Q

Urinary retention red flag symptoms

A
  • Pain
  • Painless acute retention
  • Haematuria or clots
  • History of prolonged bladder outflow obstruction
46
Q

Vomiting red flags

A
  • Severe abdominal pain – consider GI obstruction, acute pancreatitis or cholecystitis. If guarding, peritonism and absent or scanty bowel sounds are found, think acute abdomen.
  • Rectal bleeding – consider GI inflammation or malignancy
  • Haematemesis – peptic ulcer, Mallory-Weiss tear, oesophageal varices, malignancy
  • Acute or focal neurological symptoms – CNS infection, tumour, stroke. Beware the patient with vomiting and unexplained headache
  • Chest pain or other features of acute coronary syndrome. Ischaemic gastroparesis should be considered in older patients with known atherosclerotic disease
  • Anorexia or weight loss may indicate cancer. Also consider psychiatric causes
  • Shock, volume depletion or life-threatening illness – consider adrenal insufficiency, which is a medical emergency, with nausea, vomiting, volume depletion and low sodium
47
Q

Unintentinal weight gain red flag symptoms

A
  • Rapid onset
  • Recurrent hypoglycaemia
  • Headache
  • Uncontrollable hunger
  • Shortness of breath
  • Abdominal pain
  • Hair or skin change
  • Constipation or cold intolerance
  • Menstrual disturbance
  • Mood disturbance

TS PACES (3 decks)

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