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Flashcards in Red Flags Deck (35)
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1

Vaginal disch

-flag symps-
Recent change partner
Blood stained disch
Post coital bleed
Lower abdo pain and fever
Hx of intermenstrual bleeding
Foul smelling
- causes-
Bacterial vaginosis
Candidiasis
DM
TSS
Chlamydia, gonorrhoea, trichomoniasis
Cerival pathology
PID
Rectovaginal fistula

2

Fever in kids

-flags under 5yo-
Decr fluid intake and urine output
Grunting
Floppy, irritable
Persis temp over 5d depsite antipyretic regularly.
Incr RR, subcostal or intercostal recess
Non blanching petechial rash
Cool peripheries
Incr smelly urine
Bulging fontanelle
Reduc interest in ext stim
New onset seiz
Complex birth
-flags over 5-
New onset headache or seiz
New rash esp if non blanching
New vomit
Bloody diarr
New abdo pain
New jnt pain or swelling
New back pain
New limp
New sore throat, otalgia, ear disch
Photophobia, maybe with neck stiff
New vaginal disch
New testic swelling, maybe with erythema
New dyuria, freq or haematuria
Unexpl persis wl
Persis neck, goin or axillary lumps
Recent travel
Persis night sweats over 6 wk
New cough, SOB, expectorate, CP
Persis fever over 1wk no clear cause
-causes-
Illness eg chickenpox, croup, URTI, otitis media or externa, tonsillitis.
Less comm rash eg measles, slapped cheek, kawasaki.
Acute resp eg bronchitis, whooping cough, pneum.
Chronic resp eg TB.
ENT eg quinsy, glandular fever, mastoiditis
Dental infec
Mesenteric adenitis
Meningitis
GI infec
Pyloric stenosis
Intussusception
Malaria, dengue, lymes
Appendicitis
Testic or ovarian torsion
UTI
Haem malig
Cellulitis
-use centor criteria-
Tonsillar exudate
Cervical LN
Fever
No cough
Score 3/4 of these means likely AB req

3

Abdo pain

-flags-
Possible preg
Acute systemic unwell
Dehyd
Post trauma
Guarding or rebound tenderness
Distension
Unexpl wl
-causes-
Constipat or obstruc
Diverticulitis
Appendicitis
IBS
Gallbladder
Pancreatitis
Malig
UTI, Renal colic
Ectopic preg, miscarriage, ovarian cyst, PID, endometriosis.
AAA!
DKA
Coeliac
Spleen rupture

4

Wl or appettite loss

-flags-
V rapid wl
New dyspepsia over 55yo
Dysphagia, vomit
Persis low mood
Alc dep
Cog impair- MMSE
Night sweats
Resp symps, persis cough over 3wk, haemoptysis
Bone pain
PolyU and polyD, haematuria
Change bowel habit over 6wk, rectal bleed
Unexpl persis fever
Recent travel
Post menop, intermenstrual or post coital bleed
-causes-
Infec
Metabolic eg hypothyr
Malig
GI eg gastritis, oesophagitis, IBD
Psych eg dep, anx, alc or drug dep, ED
Cog impair, dementia
Malabs
Malnutrit
TB, HIV
Haem malig
DM
Thyrotoxicosis
Addisons
AI
Drug s/e eg GLP1 analogues

5

SOB

-flags-
CP and other cardiac symps
Sudden onset and persis
Cyanosis, cant compl sentence, confus, agitat, leg swell
Stridor, wheeze, persis cough
Hx of long immobil, trauma, prev resp complics
Onset or worsening orthopnea
-causes-
Exacerbation LTC eg COPD, asthma, CF, HF
Airway trauma eg FB asp, excess sec, anaph, TE, pneumothorax, MI
Complic of ILD, asbestosis, CA, mets
Infec eg pneum, epiglottitis, meningitis
Anaem, liver or renal fail, DM
Psychogenic
Rare eg guillain barre, MG, MS, toxicity (CO, NSAID).

6

Bone pain

-flags-
Hx of malig
Wl
Night sweats
Low appet
Night pain
Proggresive or persis
Recent trauma
Symmetrical jnt swell
Thoracic pain
-causes-
Fracture
Primary bone CA eg osteosarcoma, mets
Vit D defic osteomalacia
Mutip myeloma
Pagets
OP, OA, RA
HyperCa
Bone TB
Psychosomatic
Iatrogenic eg isphosphonates

7

Neck pain

-flags-
Trauma or surg
Systemic ill eg wl, night sweat, fever
Sev pain
Nocturnal pain
SC comp signs????
Sig Verteb body tenderness
Hx TB, HIV, CA, RA
-causes-
Whiplash
Cervical spondylosis/degen
Verteb disc prolapse
RA or seroneg arthropathies
Malig
TB, meningitis
Cervical rib
Neck A distension or aneur
Verteb frac

8

Back pain

-flags-
Thoracic pain
V yng or old
Loss bowel or bladder control
Weak or numb limbs
Foot drop or gait disturb
High fever
Saddle anaeshesia
Hx carcinoma
Struc deformity
-causes-
SC comp!
Cauda equina synd
Tumour
Infec
Lumbar disc herniation
Periph neuropathy
Prim or met carcinoma
Fracture
Mechanical
Rheumatoid, vascular, visceral

9

Fever in adult

Persis fever over 3 wk no clear cause
Travel
Persis cough, SOB, expectorate, haemoptysis
New headache
Photophobia, neck stiff
New rash esp non blanch petechial
New facial swelling or pain
Persis neck swell/LN swell over 6wk.
Night sweat over 6wk
Uninten wl
New abdo pain
Bloody diarr
New dysuria, haematuria
New vag disch with lower abdo pain
New testic swell
New sig lower back pain
New jnt swell
HIV expos
Skin breakdown eg ulcer
Indwelling device
IV drug use
Chemo recent
Preg in last wk, and birth compics.
-causes-
Infec eg tonsillitis, gland fever, bronchitis, whooping, penum.
TB
ENT infec eg sinusitis, parotitis, otitis
Dental infec
Cerebral abcess, meningitis
Malaria, lymes
GI infec
UTI
PID
Orchitis
Infective endocarditis
Malig
Malig hyperthermia
Diverticulitis
Empyema

10

Diarrhoea

-flags-
Over 4wk in adult, 2 wk in kids
Wl
Nocturnal or continuous
Blood or mucous
Pale offensive
Dehyd
Travel
In kids, if assoc fail to thrive or malnutr then consider CF, coeliac, chronic infec eg UTI.
-causes-
IBS
IBD
Malig
C diff
Diverticular dis
Malabs
Chronic infec
DM
Post surg
Drug s/e eg NSAID
Alc or laxative abuse
Food intol
Imm defic
Mesenteric isch
Radiation enteritis
Autonomic neurop

11

TATT

-flags-
Dysphagia
Mood
Bleeding
Sig unexpl wl
Alt bowel habit
Lymphadenop with malig feats
Breast or other lump
Post menop bleed
Localising neuro signs
Suicidal ideation
-causes-
Iron defic anaem, comm due to menstruation
Malig
Psych
Socila/lifestyle stressors
Sys illness

12

Weight gain

-flags-
Rapid onset
Recurr hypoglycaemia
Headache
Uncontrollable hunger
SOB
Abdo pain
Hair and skin change
Constipation or cold intol
Menstrual disturb
Mood disturb
-causes-
Lifestyle- diet, exercise, alc
Cushings
Insulinoma
Hypothyr
PCOS
Preg
Genetic eg prader willi
Drug s/e
Organ fail
MH eg dep

13

Night sweats

-flags-
Sig uninten wl
HIV RFs
Travel
Enlarged LN
TB RFs
Recurr bact infec
Hx of alc or drug excess
Meningism- neck stiff, photophobia, headache
Haemoptysis
-causes-
Infec
Malig
Complex infec eg TB, HIV
Dryg s/e
Anx
Menop

14

Pelvic pain acute

-flags-
Pelvic mass
Preg
Vaginal bleed and pain if post menop
Testic mass/torsion
Shoulder radiation
-causes-
Miscarriage
Ectopic preg
Rupture corpus luteal cyst
If preg then premat labour, placental abruption, uterine rupt.
Ovulation
Dysmenorrhoea
PID
Rupt or torsion of ovarian cyst
Degen fibroid changes
Pelvic tum or pevlic V thrombosis
Diverticulitis
Appendicitis
Prostatitis
Orchitis
Bowel obstruc
Adhesions
Strangulated hernia
Urolithiasis
MSK
Neurogenic- herpes, syphillis, N impinge eg tum
MS
Pelvic floor musc dysfunc

15

Groin swelling

-flags-
V pain
Systemic ill
Irreducible and tender
Hx of CA
Prev surg
Pulsatile
Groin node with new trunk/limb/pelvic symps.
-causes-
Ing hernia
Femoral hernia- high rsik strang
Lymphadenop
Vasc pathol eg femoral A aneur
Undesc testis
Psoas abcess

16

Cervical lymphadenopathy

-flags-
Persis over 6 wk
Firm hard
Over 2cm
Rapid increasing
Sig uninten wl, night sweats, appet loss
HIV or hep expos
Travel and fever since
Breast lumps or bronchogenic CA symps
Gen lymphadenop
-causes-
URTI
Infectious mononucleosis
HIV, hep, syphillis, dengue, TB
Mets
Lymphoma, acute leuk
SLE

17

Parasthesia

-flags-
Post trauma, surg, or sys infec
Multip areas or progressive symps
Behav or mem changes
Fever and systemic upset
Alt ANS func or musc weakness
Age, chronic conds, lifestyle
-causes-
Mechanical press temporary
Chronic N comp eg CTS
Progressing arthritis, fibromyalgia, vert collapse, disc herniat, cervical rib.
Electrolyte disturb eg hyperventil, dehyd, alt Ca
Drug s/e eg BDZ, SSRI withdraw
Chemo
Metal pois
MS, MND
Brain or SC comp eg abcess, trauma, tum, mets
Sensory epil or psychosomatic
DM polyneuropathy
Hypothyr
Frostbite
AI
Malnutr and vit defic
Infec eg herpes simplex, HIV, VZ, lymes, guillain barre, bells.
Limb isch, thrombosis, periph vasc dis
TIA or migraine.

18

Facial pain

-flags-
Systemic illn
Progressive pain, disabil, distress
Focal neuro deficit
Wl
Facial swell or rash
Vis disturb
Hear loss, tinnitus, vertigo
Unilat nasal obstruc or disch
-causes-
Sinus dis
Dental caries, abcess, cyst
Salivary gl eg stones, mumps, parotitis
Tempromandib disorder
Neoplasia eg nasoP or brainstem
Trigeminal neuralgia, or glossoP neuralgia
Giant cell arteritis
Migraine
Cluster headache
Carotid artery dissection

19

Chest pain

-flags-
Exertional
Sudd onset
Dyspnoea
Haemoptysis
Sig uninten wl
New dyspepsia if over 55
Leg swell, flights, immobil
-causes-
ACS
HVD
PE
Pneum
Lung CA
Pneumothorax
Dissecting thoracic AA
Costochondritis
Anx

20

Diplopia

-flags-
Persis headache
Pupil size change
Ptosis
Ocular fatigue
Loss vis
Neuro symps eg weakness, dysphasia
Alc hx
Eyeball protrusion
Facial trauma
-causes-
Refrac error
MG
Horners (apical lung tum, dissecting carotid A)
IC tum, abcess, haemorr
Orbital floor frac
Thyrotox
CN 3,4,6 palsy
Opiates
Alc intox
Temporal arteritis
MS

21

Arrhythmia

-flags-
Palpitat with CP or SOB or on exertion
Pre syncope
Syncope
Uninten wl
Fam hx sudd death
Drug use
Alc abuse
-causes-
Caffeine
Anx
Alc withdraw
TCA, domperidone
Amphetamine abuse
AF, VF, SVT, HB
Cardiomyopathy
Long QT synd
WPW
Electrolyte disturb
Phaeochromo

22

Vomiting

-flags-
Sev abdo pain eg obstruc, pancreatitis, cholecyctitis
Guarding sugg peritonitis
Absent or scanty bowel sounds
Rectal bleed- GI inflamm and malig
Haematemesis- peptic ulcer, mallory weiss tear, oes varices, malig
Acute or focal neuro symps- CNS infec, tum, stroke. Esp if headache.
CP- isch gastroparesis
Anorexia or wl- CA, psych causes
Shock, vol deplet, life threat illness- adrenal insuff if low Na too.
-causes-
Gastroeneteritis, us viral
ADR
Motion sickness
Preg
Vestibular disorder
ACS
Endoc eg DKA, hypoglycaemia, hyperCa, thyr prob.
GI eg biliary colic, cholecystitis, pancreatitis, hep, gastritis, peptic ulcer, food pois, obstruc.
Malig eg ovarian, renal, stomach, smallc ell lung, liver mets.
Neuro eg migraine, CNS infec, tum, stroke, vestib N lesion, parkinsons.
Psych- ED, drug OD
Renal- nephrolithiasis, renal fail, pyelonephritis
Other- alc, cannabis, chemo, radiotherapy.

23

Amenorrhoea

-flags-
Over 14 and no signs of puberty
Vis field defect or lack sense smell
Virilisation
Excess wl
Galactorrhoea
Abdo mass
-cause-
Preg
Menop
Medicat
Life- exercise, stress
Turners, kallman, sheehan synds
Pvarian or adrenal malig
Imperforate hymen
Cushings
PCOS
Hypothyr

24

Delerium

-flags-
Alt conciousness
Over 65
Head trauma
Neuro signs
Sev headache
Delerium tremens
Vom
-causes-
HIDEMAP-
Hypoxia, infec, drugs, endoc eg DM, metab eg Ca, alc, psychosis.
Infec
Drug s/e, or toxic from non prescribed drugs
Vasc dis
Metab
Epil post ictal
Vit B defic
Endoc
Neopasia
Urin reten
Constip

25

Dysphagia

-flags-
Steady prog in eld with solids first indics CA
Solid and liq sugg motil or neuro
Liquid fine but solid bad sugg stricture
Wl
Pain on swallow likely malig
Hx reflux or dyspepsia
Lymphadenop
Choking, drooling
Musc wasting, CN symps
CREST synd signs- calcinosis, raynauds, oes dysfunc, sclerodactyly, telangiectasia.
-causes-
Oesophagitis maybe with stricture
Oes, gastric, pharyng CA
FB
Stroke
Achalasia
Syringomyelia
MG, MND, MS, myopathy, parkinsons
Pahryngeal pouch
Ext comp
CREST, scleroderma.

26

Blurred vis

-flags-
Sudd change
Eye pain
Vis field defect
HIV, imm comprom
Pre exist systemic disorder
-causes-
Refrac error
Age macular degen
Cataracts
DM retinopathy
Glaucoma
Optic neutitis
Systemic dis eg HTN, DM, myeloma, HIV

27

Headache

-flags-
Onset over 50
Thunderclap subarach
Neurological S+S
Meningism
Imm supp, malig
Red eye and haloes around lights- acute angle closure glaucoma
Worsening symps
Temporal arteritis symps
-causes-
IC malig
Haemorr
Idiopathic IC HTN
Infec eg encephalitis, meningitis
Giant cell arteritis
Analgesia overuse
CO pois

28

LOC

-flags-
CP, palpit, SOB
Syncope on exertion
Fam hx gardiac probs
Preceding headache
Limb jerk, tongue bite, urin incontin
Using hyoplgycaemics
-causes-
Epil
Orthostatic hypot
Hypog
Vasovagal syncope
Arrhyth
HVD
Cardiomyop
Dehyd
Hyperventil synd
Pseudoseiz
Iatrogenic

29

Jaundice

-flags-
Abdo pain
Palpab gall bladder
Wl
Fever
Encephalop
GI bleed
Coagulaopathy
-causes-
Malig eg panc head carcinoma, cholangiocarcinoma.
Prim sclerosing cholangitis
Prim biliary cirrhosis
Biliary stricture
Haemolytic anaemia
Haemochromotosis, gilberts
ALD
Drug indeuced hyperbilirubinaemia

30

Dizziness

-flags-
Faint
Hear loss
Headache
Vertigo
CP
Behav change
-causes-
Post hypot
BPPV
Menieres
Labyrinthitis, vestibular neuronitis
Ototox
Mid ear dis, labyrinth fail
MI or arrhyth
Epil
Head inj
Brain tum or mets.