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Differential diagnoses
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45
Medical
Graduate
04/22/2016

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Term
Knee Pain
Definition
V: Vasculitis
I: Septic arthritis
T: Hemarthrosis
A: RA, SLE, scleroderma, AS, reactive arthritis, rheumatic fever, and sarcoidosis
M: Gout, pseudogout, apatite-related arthropathy
I: Osteoarthritis
N: Metastasis, primary tumor of bone or cartilage, and paraneoplastic syndrome
Term
Carpal tunnel syndrome
Definition
T: Chronic repetitive use
A: RA
M: DM, hypothyroidism, acromegaly, gout, obesity
Idioapthic
C: Congenitally narrowed carpal tunnel
Other: Pregnancy
Term
Claudication
Definition
V: PVD (occlusive arterial disease), DVT
I: Thromboangitis obliterans, spinal stenosis (lumbar)
Term
Secondary hypercholesterolemia
Definition
M: Hypothyroidism, DM, cholestasis
I: Nephrotic syndrome, obesity (nonalcoholic steatohepatitis)
Term
Palpitations
Definition
V: Supraventricular tachycardia, rapid atrial fibrillation, ventricular tachycardia, torsades de pointe
M: Hypokalemia, hypomagnesium, fever, anemia, hyper/hypothryoidism, acromegaly
N: pheocromocytoma
S: Drug ingestion (sympathomimetic agents), acquired long QT (antidysrhythmics, antidepressants, antiemetics), drug withdrawal, anxiety, anorexia nervosa (electrolyte disturbance)
Congenital/genetic: Wolff-Parkinson-White syndrome, Jervell and Lange Neilsen syndrome, Romano-Ward syndrome
Term
Heart Failure
Definition
V: CHF, acute coronary syndrome, pulmonary embolism
I: Pneumonia
T: Pneumothorax
M: DKA
I: COPD/asthma, massive atelectasis
N: Large pleural effusion
Term
Chest pain
Definition
V: Aortic dissection, MI, PE, pulmonary infarction
I: Pericarditis, pneumonia, bronchiectasis, TB, empyema, subphrenic abscess, herpes zoster
T: Pneumothorax, fractured rib, chest wall injury
A: SLE (serositis)
M: DKA
I: Dressler syndrome, esophageal spasm, peptic ulcer disease, GERD
N: Malignant pericarditis
S: Cocaine ingestion (coronary vasospasm), other sympathomimetic ingestion, anxiety
C: Hiatal hernia
Term
Aortic stenosis
Definition
A: Rheumatic valvular disease
I: Degenerative valve calcification, hypertrophic cardiomyopathy
C: Congenital bicuspid valve
Term
Aortic regurgitation
Definition
V: Acute aortic dissection, dilatation of the aortic root (Marfan Syndrome)
I: Bacterial endocarditis, syphilis of the aorta
T: Chest trauma (Acute AR)
Term
Mitral stenosis
Definition
A: Rheumatic valvular disease
I: Idiopathic valvular degeneration
N: Left atrial myxoma
C: Congenital valvular lesion
Term
Mitral regurgitation
Definition
V: Ruptured chordae tendinae or papillary muscle (secondary to ischemia)
I: Bacterial endocarditis
A:Rheumatic valvular disease, RA
I: MVP
C: Dilation of the mitral ring
Term
Secondary hypertension
Definition
V:Renal vascular disease (fibromuscular dysplasia), coarctation of the aorta
M: Drugs, endocrine disease (Conn syndrome, Cushing syndrome, hyperthyroidism, congenital adrenal hyperplasia)
I: Sleep apnea, renal parenchymal disease
N: Pheochromocytoma
Term
Dyspnea
Definition
V: PE, CHF, acute coronary syndrome
I: Pneumonia
T: Pneumothorax, aspiration of foreign body
M: DKA
I: Exacerbation of COPD/asthma, massive atelectasis
N: large pleural effusion, significant ascites
S: Sympathomimetic ingestion, drug withdrawal syndrome, anxiety (diagnosis of exclusion)
Term
Cough
Definition
V: CHF, PE
I: Pneumonia, URTI (pharyngitis, laryngitis, tracheitis, tracheobronchitis), pertussis, TB
T: Inhalation injury, aspiration of foreign body
A: Sarcoidosis
I: Postnasal drip, GERD, aspiration pneumonitis, COPD/asthma, ACEI
Neoplasm
C: Anatomic abnormalities in the tracheobronchial tree or compressing the tracheobronchial tree, cystic fibrosis, alpha1-antitrypsin deficiency
Term
Hemoptysis
Definition
V: PE, pulmonary hypertension (mitral stenosis), ateriovenous malformation, vasculitis
I: TB, lung abscess, pneumonia, bronchitis
T: aspiration of foreign body
A: Goodpasture syndrome, Wegener granulomatosis
M: Coagulopathy
I: Bronchiectasis
N: Bronchogenic carcinoma
Term
Solitary lung nodule
Definition
V: Infarct, vascular lesion
I: TB (granuloma), histoplasmosis, aspergilloma, abscess, consolidation
T: Hematoma
I: Fluid filled cyst, artifact
N: Bronchial carcinoma (squamous cell carcinoma, adenocarcinoma, small cell carcinoma, large cell carcinoma), metastatic disease, and benign neoplasm (bronchial adenoma, hamartoma)
Term
Pneumothorax
Definition
I: Abscess, pneumonia, TB
T: Punctured by fractured rib, penetrating injury (stab wound, gunshot wound), mechanical ventilation, barotrauma
I: Spontaneous pneumothrorax, COPD/asthma (bleb rupture), central line insertion, thoracentesis, ascent in plane
Neoplasm
C: Rupture of subpleural bleb, cystic fibrosis
Term
Dysphagia
Definition
T: Ingestion of caustic substance
A: Collagen vascular disease (scleroderma)
M: Iron-deficiency anemia (Plummer-Vinson syndrome)
I: Benign esophageal stricture, achalasia, neurogenic disorders (stroke, Parkinson disease, bulbar palsy, Guillain-barré syndrome, ALS)
N: Esophageal, pharyngeal, mediastinal (lung, lymphoma)
C: Pharyngeal pouch
Term
Hematemesis
Definition
V: esophageal varices, angiodysplasia, aortoenteric fistula
T: Mallory-Weiss tear, nose bleed (swallowed blood)
M: Coagulopathy
I: Esophagitis, gastritis, peptic ulcer disease
Substance abuse and psychiatric
Term
Diarrhea
Definition
V: Ischemic colitis
I: Bacterial, parasitic or viral gastroenteritis, pseudomembranous colitis
A: celiac disease, Whipple disease
M: Drug reactions, carcinoid syndrome, hyperthyroidism
I: IBD, IBS, malabsorption, runner's diarrhea
C: cystic fibrosis, lactose intolerance
Term
RLQ pain
Definition
I: PID/ tubo-ovarian abscess, psoas abscess
T: Musculoskeletal injury
I: Appendicitis, mesenteric adenitis, ascending diverticulitis, incarcerated hernia Crohn disease, ruptured ectopic pregnancy, ovarian torsion, renal colic
Term
Jaundice
Definition
I: Viral hepatitis
T: Resorption of a large hematoma
A: Autoimmune hepatitis
M: Hemolysis
I: Biliary obstruction (Stone/Stricture)
N: Obstructing biliary lesion
S: alcoholic or toxic hepatitis
C: Gilbert syndrome
Term
RUQ pain
Definition
V: Right-sided heart failure (congestive hepatomegaly)
I: Acute pyelonephritis, right-sided pneumonia, viral hepatitis
T: MSK injury
A: Autoimmune hepatitis
I: Acute cholescystitis, duodenal ulcer/PUD
Term
Epigastric pain
Definition
V: Leaking or ruptured AAA, myocardial infarction, aortic dissection, right-sided heart failure (congestive hepatomegaly)
I: Viral hepatitis, pneumonia
T: MSK injury
A: Autoimmune hepatitis
I: Perforated viscus, acute cholecystitis, pancreatitis (e.g. biliary stones), duodenal ulcer/PUD
S: Alcoholic pancreatitis, alcoholic/toxic hepatitis
Term
LLQ pain
Definition
V: Leaking/ruptured AAA, aortic dissection
I: PID/tubo-ovarian abscess
T: MSK injury
I: Sigmoid diverticulitis, incarcerated hernia, perforated viscus, Crohn disease, ulcerative colitis, ruptured ectopic pregnancy, ovarian torsion, and renal colic
Term
Lower GI bleed
Definition
V: esophageal varices, aortoenteric fistula, angiodysplasia, ischemic colitis
I: Invasive diarrhea (eg enteroinvasive E. coli)
T: Mallory-Weiss tear, anorectal trauma, anal fissures
M: Coagulopathy
I: Diverticular disease, IBD, proctitis
Neoplasm
Term
Constipation
Definition
V: Stroke (atonic colon)
T: Spinal cord injury (atonic colon), anal fissure
M: Hypothyroidism, hypercalcemia, drugs (chronic laxative use), diet
I: IBS, fecal impaction, bowel obstruction (adhesions), rectal stricture
N: Bowel tumor
C: Hirschsprung disease
Term
Steaorrhea
Definition
I: Giardia lambia, postinfectious malabsorption (villous sloughing)
A: Celiac disease, Whipple disease
I: Chronic pancreatitis, biliary obstruction
C: Cystic fibrosis
Term
Painless hematuria
Definition
I: UTI
A: Wegener granulomatosis, Goodpasture syndrome
M: Sickle cell anemia, coagulopathy, drugs
I: Glomerulonephritis, stones (bladder, renal)
N: Bladder or kidney tumor
Term
Flank pain and hematuria
Definition
V: ruptured/leaking AAA
I: UTI
M: Coagulopathy, sickle cell crisis
I: renal colic, hemorrhagic cystitis, incarcerated/strangulated hernia, appendicitis, diverticulitis
Term
UTI
Definition
I: UTI, STI, vaginitis
T: Passage of stone
I: Urethral syndrome
Term
Testicular pain
Definition
V: Hemorrhage into testicular tumor
I: epididymitis, orchitis, cellulitis or fasciitis (Fournier gangrene)
T: Acute injury
I: Incarcerated/strangulated inguinal hernia, torsion of testicular appendages
N: Testicular tumor
C: Testicular torsion (bell-clapper deformity)
Term
Urinary hesitancy
Definition
I: UTI
T: Posttraumatic urethral stricture
I: Bladder calculi
N: Prostatic enlargement (BPH or malignancy), bladder tumor
C: urethral stricture
Term
Penile ulcer
Definition
I: Syphilis, herpes, chancroid, granuloma inguinale, lymphogranuloma venerum
T: Repetitive trauma
A: Behçet disease
N: Malignancy
Term
Headache
Definition
V: Migraine, subarachnoid hemorrhage, temporal arteritis
I: Cerebral abscess, meningitis, sinusitis
T: Head injury, concussion, intracranial hemorrhage (subdural hematoma, epidural hematoma)
I: Post-lumbar puncture headache
N: Brain tumor
S: Carbon monoxide posioning
Other: tension headache, cluster headache, acute angle closure glaucoma, occipital neuralgia
Term
Seizure
Definition
V: Intracranial hemorrhage
I: Meningitis, encephalitis
T: Head Injury, post-brain injury seizure
M: Hypoglycemia, hypocalcemia, hyponatremia, hypoxia
I: Nonadherence with antiseizure medication regimen, drug interactions
N: Brain tumor
S: Drug withdrawl, sympathomimetic agents, serotonin syndrome, neuroleptic malignant syndrome, pseudoseizure
Other: Epilepsy, eclampsia
Term
Facial droop
Definition
V: Stroke, intracranial hemorrhage
I: Acute otitis media, otitis externa, parotitis, herpes zoster oticus, Lyme disease
T: Mandible fracture, blunt injury to face, laceration
I: Bell palsy, post-facial surgery condition
N: Brain tumor, facial neuroma, acoustic neuroma, parotid tumor, cholesteatoma
Term
Altered LOC
Definition
V: Stroke (ischemic or hemorrhagic)
I: Cerebral abscess, encphalitis, meningitis, sepsis
T: Traumatic brain injury, intracranial hemorrhage, hypotension
M: Hypoglycemia, hypoxia, electrolyte disturbance
I: Prescription medications
N: Brain tumor
S: Accidental toxic exposure, drug withdrawl, use of street drugs, malingering, mental illness
Other: Postictal state
Term
Stroke
Definition
V: Ischemic stroke (embolism or thrombosis), hemorrhagic stroke, transient ischemic attack, arterial dissection, vasculitis
T: Traumatic intacranial hemorrhage
M: Todd's paralysis (postseizure), hypoglycemia
Term
Neuropathic pain
Definition
V: Poststroke pain
I: Epidural abscess, discitis, apical lung pneumonial, postherpetic neuralgia, HIV neuropathy
T: Posttraumatic spinal cord injury, spinal fracture, dislocation, or ligamentous injury with spinal cord or nerve compression
M: Diabetes, nutritional deficiency
I: Postsurgical pain, postradiation myelopathy
N: Primary or spinal cord tumor, metastatic cancer with spinal cord or nerve involvement or compression
S: Alcohol neuropathy, diethyltoluamide (DEET)
Term
Spinal injury
Definition
V: Vertebral artery dissection
T: Cervical spine fracture, dislocation or ligamentous injury; muscle strain
I: Pressure sores caused by spine board immobilization
Term
Cauda equina syndrome
Definition
V: Spinal cord infarction, aortic dissection
I: Epidural abscess, discitis
T: Spinal fracture, dislocation, ligamentous injury with spinal cord compression or cauda equina syndrome
N: Primary or metastatic neoplasm with erosion or compression of spinal cord or cauda equina, spinal cord tumor
Term
Head injury
Definition
Scalp contusion
Scalp laceration
Skull fracture
Epidural hematoma
Subdural hemorrhage
Subarachnoid hemorrhage
Term
Knee pain
Definition
V: Vasculitis
I: Septic arthritis
T: Hemarthosis
A: RA, SLE, Scleroderma, AS, reactive arthritis, rheumatic fever, sarcoidosis
M: Gout, pseudogout, apatite-related arthopathy
I: Osteoarthritis
N: Metastasis, primary tumor of bone or cartilage, and paraneoplastic syndrome
Term
Carpal tunnel syndrome
Definition
T: Chronic repetitive use syndrome
A: RA
M: DM, hypothyroidism, acromegaly, gout, obesity
Idiopathic
C: Congenitally narrowed carpal tunnel
Other: Pregnancy
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