MBChB Year 3 > Core Clinical Problems > Flashcards

Core Clinical Problems Flashcards

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1
Q

Abdominal distension/ Weight gain (9)

A
  • Abdominal/pelvic mass (tumour/ abscess)
  • Ascites
  • Hepatosplenomegaly
  • Polycystic kidneys
  • Pregnancy
  • Obesity
  • Hypothyroidism
  • Cushing’s
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2
Q

Abdominal/ loin/ pelvic pain (20)

A
  • cholecystitis/ biliary colic, pancreatitis, appendicitis, diverticulitis
  • perforated peptic ulcer
  • large and small bowel obstruction
  • colitis/ Crohn’s disease
  • leaking aortic aneurysm
  • mesenteric ischaemia
  • pelvic inflammatory disease
  • endometriosis
    accident to ovarian cyst
  • UTI
  • Urinary calculi
  • ectopic pregnancy
  • placental abruption
  • renal tract infection
  • renal stone (hypercalcaemia)
  • renal tumour
  • congenital pelvi-uretric obstruction
  • MSK
  • indigestion/ heartburn/ reflux/ oesophagitis
  • upper abdominal pain (peptic ulcer, somatisation, child abuse, drug reaction)
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3
Q

Abnormal/ irregular vaginal bleeding (8)

A
  • Menstrual: fibroids, PID, Endometriosis, Dysfunctional uterine bleeding
  • post-menopausal: atrophic vaginitis, malignancy, HRT, polyps
  • irregular: polyps, breakthrough, cervical cancer
  • Endocrine: hypo/hyperthyroidism, PCOS, hyperprolactinaemia, menopause
  • Sexual abuse
  • In pregnancy: miscarriage, ectopic pregnancy, antepartum haemorrhage, cancer, polyps
  • Post partum haemorrhage: trauma, atonic uterus, retained products, infection
  • Somatisation
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4
Q

Abnormal/ unsteady gait (4)

A
  • limb deformity
  • cerebral/ cerebellar mets
  • muscular dystrophy
  • cerebral palsy
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5
Q

Abnormal blood test result (3)

A
  • anaemia: low folate/ B12, haemolysis, bleeding, pregnancy, erythropoietin deficiency
  • hyperlipidaemia
  • blood gases
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6
Q

Altered Mood (6)

A
  • depression
  • bipolar affective disorder
  • abuse
  • frontal lobe mets
  • drug reaction
  • substance misuse
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7
Q

Anxiety (7)

A
  • phobia
  • GAD
  • panic disorder
  • separation anxiety
  • OCD
  • drug effects
  • substance misuse
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8
Q

Arrested Intellectual Development (6)

A
  • congenital disorders (downs syndrome/ fragile X)
  • Cerebral palsy
  • congenital hypothyroidism
  • epilepsy
  • sensory deficits
  • behavioural disorders
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9
Q

Back and Neck Pain (4)

A
  • MSK
  • nerve root compression
  • spinal cord injury
  • spondyloarthritis
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10
Q

Behavioural Problems (5)

A
  • personality traits/ disorders
  • gender/ sexual orientation
  • disordered impulse control
  • ADHD
  • Conduct disorders
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11
Q

Blocked Nose (9)

A
  • common cold
  • hayfever
  • acute/chronic rhinosinusitis
  • nasal polyps
  • septal deviation
  • adenoid hypertrophy
  • abscess
  • neoplasia
  • drug reaction
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12
Q

Breast Lump (4)

A
  • benign: fibroadenoma, cyst
  • malignant
  • pregnancy changes
  • gynaecomastia
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13
Q

Bruising (5)

A
  • Haematological causes: thrombocytopenia, purpura, leukaemia, haemophilia, von willebrand disease
  • liver disease
  • senile purpura
  • infection (meningitis)
  • trauma (child abuse)
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14
Q

Chest Pain (7)

A
  • cardiac: MI, angina, pericarditis
  • respiratory: PE, pneumonia, pleurisy, pleural effusion, lung cancer
  • GI: oesophagitis, peptic ulcer
  • muscular
  • trauma: fractured rib
  • somatisation
  • anxiety disorder
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15
Q

Cold Extremities

A
  • Reynaud’s disease
  • microvascular disease (diabetes)
  • peripheral vascular disease
  • connective tissue disorders
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16
Q

Collapse (11)

A

Anaphylaxis

Cardiovascular:
Vasovagal;
Stokes Adams;
Postural hypotension;
Myocardial infarction;
Arrhythmias;
Neurologic:
Epilepsy;
Cerebrovascular disease/accident;
Motor neurone disease;
Spinal cord compression

Middle ear disease;

Metabolic:
Hypoglycaemia;
Hypocalcaemia;
Inborn errors of metabolism;

Musculoskeletal:
Osteoarthritis;

Infection;

Anaemia;

Alcohol;

Pregnancy:

Placental abruption,
Eclampsia

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17
Q

Confusion

A 
Acute:
Encephalopathy;
Sepsis,
Post operative,
Drug related,
Delirium,
Alcohol withdrawal,
Myocardial infarction,
Impaired vision / hearing;
Sinusitis,
Viral/atypical upper respiratory tract infection,
Inhaled foreign body,

Chronic:
Alzheimer’s,
Multi-infarct dementia,
Vascular dementia,
Brain tumour,
Lewy body dementia,
Alcohol induced dementia,
Huntingdon’s chorea,
Creutzfeldt Jakob disease;

Treatable dementias:
Hypothyroidism,
Vitamin B12 deficiency,
Depression,
Anxiety,
Hyperparathyroidism,
Syphilis,
Drug toxicity,
Hypoglycaemia,
Hypoxia (acute/chronic)
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18
Q

Constipation (9)

A

Diverticular disease;

Irritable bowel syndrome;

Polyps;

Colo-rectal cancer;

Coeliac disease;

Bowel obstruction;

Somatisation;

Hypothyroidism;

Drug reaction

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19
Q

Cough

A 
Respiratory causes:
Viral/atypical upper respiratory tract infection;
Inhaled foreign body;
Asthma;
Bronchiectasis;
Bronchitis;
Bronchial carcinoma;
COPD;
Pneumonia;
Interstitial lung disease;

Non respiratory causes:
Gastro-oesophageal reflux;
Drug reaction;
Sinusitis

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20
Q

Deafness (11)

A

Infection (Bacterial, Viral or Fungal)

Trauma;

Neoplasia;

Iatrogenic (Surgical or Drug induced);

Metabolic;

Vascular;

Otosclerosis;

Ménière’s;

Earwax;

Congenital;

Presbyacusis

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21
Q

Deliberate Self Harm (6)

A

Depression

Post natal depression

Schizophrenia;

Alcohol/drug misuse;

Bipolar disorder;

Personality disorders

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22
Q

Diarrhoea (11)

A

Gastroenteritis

Parasitic infection

Irritable bowel syndrome

Crohn’s disease;

Ulcerative colitis;

Polyps;

Colo-rectal cancer;

Coeliac disease;

Bowel obstruction;

Somatisation;

Drug reaction

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23
Q

Difficulty in Swallowing (7)

A

Oesophageal cancer Oesophagitis;

Benign oesophageal stricture;

Barrett’s oesophagus;

Motor neurone disease;

Primary motility disorder;

Mediastinal mass;

Multinodular goitre

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24
Q

Dizziness

A

Syncope;

Anaemia;

Hypovolaemic shock;

Dysrhythmias;

Aortic stenosis;

Postural hypotension;

Vertebrobasilar insufficiency;

Brain stem vascular disease;

Infection;

Anxiety;

Epilepsy;

Disseminated sclerosis;

Autonomic neuropathy;

Peripheral neuropathy;

Tumour;

Benign Positional Paroxysmal Vertigo;

Vestibular Neuronitis;

Labyrinthitis;

Ménière’s Disease;

Addison’s Disease;

Hypoglycaemia;

Drug reaction

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25
Ear Ache (2)
- otitis media/externa | - refered pain
26
Falls and Immobility (13)
Drugs (e.g. sedatives, antidepressants, antihypertensives); Syncope; Postural hypotension; Arrhythmias; Myocardial infarction; Cerebrovascular disease; Parkinsons disease; Epilepsy; Dementia; Peripheral neuropathy; Arthritis; Depression; Alcohol
27
Fever
``` With rash: Meningitis; Viral exanthenam; Toxic shock syndrome; Drug hypersensitivity; ``` ``` Without rash: Meningitis Upper/lower respiratory tract infection; Sepsis; UTI; Malaria; Cellulitis; Neutropenic infection ``` Pyrexia of unknown origin (PUO) Febrile convulsions
28
Foal Neurological Deficit (6)
Stroke; Multiple sclerosis; Nerve root compression; Facial palsy; Trauma Migraine
29
Generalised Weakness (10)
Guillain-Barre syndrome; Myasthenia gravis; Myopathy; Cord pathology; Chronic fatigue syndrome; Anaemia; Post viral syndrome; Myalgic enecephalomyelitis; Depression; Diabetes
30
Haematemesis (5)
Mallory-Weiss tear; Oesophageal varices; Peptic ulceration; Malignancy (e.g. gastric) Drug effects
31
Haematuria (6)
Malignancy (kidney, bladder, prostate); Infection (kidney, bladder, prostate); Stones; Trauma; Glomerulonephritis; Polycystic disease
32
Haemoptysis (6)
Infection (e.g. tuberculosis); Pulmonary embolism; Malignancy; Pulmonary hypertension (e.g. following mitral stenosis); Bronchiectasis; Laryngeal cancer
33
Hair Problems
``` Hair loss: Male pattern balding, Hypothyroidism, Alopecia, Drug-induced ``` ``` Hirsutism: Cushing’s syndrome, Menopause, Poly cystic ovarian syndrome (PCOS) Menopause, Drug-induced ```
34
Headache (12)
Tension headache; Migraine; Cluster headache; Intra-cranial haemorrhage; Brain tumour; Pituitary tumour; Extra cranial causes (nasal, ear, teeth); Meningitis; Facial pain; Temporal arteritis; Trigeminal neuralgia; Drug reaction
35
Hoarseness (7)
Laryngeal malignancy; Vocal abuse; Recurrent laryngeal nerve damage: Bronchial carcinoma, Thyroid cancer/infiltrating cancer; Laryngeal inflammation; Hypothyroidism
36
Faecal Incontinence (4)
Pelvic floor trauma, e.g. Childbirth; Fistula eg: malignancy post radiotherapy Overflow incontinence Cauda equina syndrome
37
Female Infertility (3)
Anovulatory, Poly cystic ovarian snydrome (PCOS) Tubal (Pelvic inflammatory disease/Endometriosis)
38
Itching (13)
Lichen simplex; Urticaria; Pruritis ani Pruritis vulvae; Allergy; Iron deficiency; Liver disease; Renal failure; Malignancy; Thyroid dysfunction; Polycythaemia; Diabetes (type 2); Scabies; Obstetric Cholestasis
39
Jaundice (9)
Hepatitis; Liver disease; Gall stones; Billiary tract pathology; Pancreatic cancer; Cirrhosis; Drug induced; Newborn; Haemolysis
40
Joint pain/ swelling (12)
Arthritis (osteo/rheumatoid); Psoriatic arthropathy; Crystal arthritis (Gout); Seronegative spondylo-arthritis; Shoulder impingement; Tendonitis; Infection; Trauma; Haemophilia Synovitis; Rheumatic fever; Juvenile arthritis; Reactive arthritis
41
Leg pain/ ankle swelling
Peripheral vascular disease; Sciatica; Deep vein thombosis (DVT); Varicose veins; Neuropathy; Lymphoedema; Joint trauma; Ankle swelling: - Cardiac failure, - Acute glomerulonephritis; - Acute/chronic renal failure; - Hepatic failure; - Hypoalbuminaemia; - Pelvic mass; - Venous insufficiency
42
Loss of Vision
Acute: - Ischaemic optic neuropathy (arteritic/ non-arteritc), - Retinal artery occlusion, - Retinal vein occlusion, - Retinal detachment, - Retrobulbar neuritis, - Amaurosis fugax, - Vitreous haemorrhage; Chronic: - Macular degeneration, - Glaucoma, - Cataract, - Diabetic maculopathy, - Refractive error (myopia), - Malignancy; Congenital
43
Lump in Groin (8)
Inguinal hernia; Femoral hernia; Hydrocele of cord; Maldescended testis; Femoral aneurysm; Lymphadenopathy; Lipoma; Sebaceous cyst
44
Lump in Neck
Thyroid; - Congenital; - Inflammatory; - Neoplastic; Lymph Node
45
Muscle Pain (4)
Injury Polymyalgia Rheumatica Fibromyalgia Drug Induced (statins
46
Noisy Breathing (wheeze/ stridor) (5)
Asthma; Chronic obstructive pulmonary disease (COPD); Bronchial carcinoma; Bronchiolitis; Heart failure
47
Numbness and Tingling (13)
Carpal tunnel syndrome; Generalised peripheral neuropathy; Multiple sclerosis; Stroke; Transient ischaemic attacks; Epilepsy; Migraine; Drugs; Anxiety/Panic; Hyperventilation; Disc prolapse, Degeneration of vertebra, Sciatica
48
Painful or uncomfortable mouth (5)
Dental problems; Mouth abscess; Cancer of mouth; Parotid gland blockage; Candida
49
Palpitations (12)
Stress; Exercise; Panic attacks; Thyrotoxicosis; Arrhythmias; Valvular heart disease; Alcohol; Tobacco; Caffeine; Fever; Anaemia; Drugs
50
Paraplegia (11)
Spinal injuries; Malignancy causing spinal cord compression; Acute disc prolapse; Neurofibroma/meningioma; Epidural abscess; Post infectious transverse myelitis; Congenital disorders e.g. spina bifida; Guillian-Barre syndrome; Multiple sclerosis; Motor neurone disease; Spinal cord infarction
51
Psychosis (7)
Schizophrenia; Psychotic depression; Mania; Delirium; Dementia; Puerperal Psychosis; Drug reactions
52
Birth - large for date
``` Wrong dates; Multiple pregnancy; Diabetes; Polyhydramnios; Fibroids; ```
53
Birth - small for date
Intrauterine growth restriction; | Prematurity
54
Raised Blood Pressure
Primary (essential) hypertension; Secondary hypertension - Renal artery stenosis - Coarcatation of aorta - Phaeochromocytoma Hypertension in pregnancy (pre-eclampsia, eclampsia); ‘White coat syndrome’
55
Rash
Without fever: - Eczema/dermatitis; - Urticaria; - Drug reactions; - Psoriasis; - Lichen planus; - Infections; - Contact dermatitis. With fever: - Meningitis; - Viral exanthenam; - Toxic shock syndrome; - Drug hypersensitivity;
56
Rectal bleeding
Colorectal cancer;Colorectal polyps; Crohn’s disease; Ulcerative colitis; Proctitis; Diverticular disease; Anal fissure; Haemorrhoids; Enteritis
57
Recurrent Infections
HIV Cystic Fibrosis Congenital immunological defects
58
Red/ painful eye (11)
Acute/chronic conjunctivitis; Corneal abrasion/ulcer; Blepharitis; Dry eyes; Glaucoma; Acute angle glaucoma; Anterior uveitis; Scleritis; Iritis Foreign body: - Mode of injury (high/low velocity, thermal, chemical); - Type of material (dust, metal, glass, chemical); - Site (e.g. conjunctival, corneal, intraocular); Superficial ocular foreign body
59
Sexually Transmitted Infection (genital discharge)
Hepatitis (B and C); HIV; Chlamydia; Syphilis; Gonorrhoea; Candida; Trichomonas; Cervical cancer
60
Shortness of Breath
Cardiac failure; COPD; Pneumonia; Asthma; Pulmonary embolism; Pleural effusion; Pneumothorax; Pulmonary fibrosis; Lung cancer; Anaemia; Metabolic Acidosis (ARF/DKA); Respiratory distress: - Neonatal (Respiratory distress syndrome); - Adult; Congenital pneumonia; Pneumothorax; With stridor: - Croup; - Foreign body; - Whooping cough
61
Sick Child
Meningitis; Encephalitis; Septicaemia; Pneumonia; Neonatal collapse; Convulsions; Allergy/anaphylaxis; Head injury; Diabetic Ketoacidosis; Child abuse
62
Skin Lumps (12)
Basal cell carcinoma; Squamous cell carcinoma; Bowens disease; Actinic keratosis; Melanoma; Atypical naevi; Basal cell papilloma; Dermatofibroma; Keratoacanthoma; Port wine stains; Strawberry naevi; Mongolian blue spot
63
Sleep Problems (6)
Disorders of initiating and maintaining sleep (DIMS); Disorders of excessive somnolence (DOES); Daytime sleepiness (hypersomnia); Depression; Anxiety disorders; Drug reactions
64
Sore Throat (4)
Tonsillitis; Glandular fever; Peritonsilar abscess; Laryngopharyngeal reflux
65
Squint (9)
Long sightedness (hypermetropia); Poor vision in one eye; Cataract; Retinal/optic nerve; Developmental problems; Neurological disease (Nerve Palsy); Thyroid eye disease; Myasthenia gravis; Raised intracranial pressure
66
Sudden Death (5)
SIDS; Acute MI; Pulmonary embolism; Stroke; Arrhythmias (including inherited cardiac arrhythmias)
67
Swelling in Scrotum (7)
Testicular cancer; Hydrocele; Epididymal cyst; Varicocele; Testicular torsion; Epididymo-orchitis; Inguinal hernia
68
Thirst (6)
Diabetes mellitus; Diabetes insipidus; Hypercalcaemia; Renal failure; Psychogenic; Drug reactions
69
Tinnitus (5)
Sensorineural hearing loss; Vestibular Schwannoma; Other Cerebellopontine angle tumours; Vascular causes, e.g. carotid artery stenosis; Drugs
70
Tiredness
Somnolence: - Sleep apnoea, - Narcolepsy Fatigue: - Chronic fatigue syndrome; - Anaemia; - Chronic fatigue syndrome; - Post viral syndrome; - Myalgic enecephalomyelitis; - Depression; - Diabetes
71
Trauma
Accidental: - Burns; - Fractures; - Lacerations; - Contusions Non accidental: - Domestic violence; - abuse (physical / sexual); - Deliberate self harm; - Alcohol misuse - Shock
72
Tremor (8)
Parkinsons disease; Anxiety; Hyperthyroidism; Drugs; Inherited; Alcohol; Cerebellar disorders; Psychological
73
Unconscious Patient (15)
Cardiac (e.g. dysrhythmia, shock); Infection (e.g. meningitis, encephalitis); Hypoxia; Hypercarbia; Drugs; Neurological disease: Stroke; subarachnoid haemorrhage; Cerebral tumour; Epilepsy (post ictal); Eclampsia (post ictal); Trauma (head injury); Metabolic disorders (hypoglycaemia, hypothyroidism); Poisoning (carbon monoxide); Hypothermia
74
Urinary Symptoms (5)
Prostatic hypertrophy; Infection; Renal tract malignancy; Unstable bladder; Incontinence: - Stress; - Urge; - Overflow; - Fistulae; - Child abuse; - Constipation
75
Vomiting (13)
Bowel obstruction; Peptic ulcer; Gastric ulcer; Gastroenteritis; Raised intracranial pressure; Hyperemesis; Drugs; Liver disease; Post operative; Migraine; Diabetic Ketoacidosis; Addisons; Renal Failure;
76
Weight loss/ loss of appetite (4)
Mechanisms of weight loss: - Insufficient protein/energy intake (e. g. change in appetite, eating disorders/anorexia); - Impaired digestion/absorption (e.g. short gut syndrome); - Increased catabolism (e. g. sepsis, malignancy, diabetes, hyperthyroidism); Depression; Chronic disease (e.g. renal failure); Dysphagia
MBChB Year 3
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