Gastrointestinal history 8

 Musculoskeletal history 5 Written by Leya Bedar Diagnosis: Psoriatic arthritis (stiffness, dactylitis, nail lesions, history of psoriasis) Differential diagnosis: Rheumatoid arthritis (morning stiffness, swelling, joint pain, age) Osteoarthritis (could be early osteoarthritis – could be Heberdens nodes at DIPs, stiffness, swelling, joint pain) Mark scheme for history taking can be found below    

 Respiratory history 4 Written by Leya Bedar Diagnosis: COPD (progressive cough, SOB, age, family history of pulmonary disease, smoking history) Other differentials: Congestive heart failure (cough and exertional features and cardiovascular risk factors, but less likely due to no orthopnoea or paroxysmal nocturnal dyspnoea and much more gradual onset) Bronchiectasis (due to productive cough, SOB,…

 Cardiovascular history 3 Written by Olivia Nwosu Diagnosis: Myocardial infarction (due to cardiac nature of pain, intense, autonomic features, family history of cardiovascular disease, T2DM, cardiovascular risk factors) Other differentials: Unstable angina (due to cardiac features, but pain usually goes away) Oesophageal spasm (due to chest pain and previous heartburn, unlikely as factors point to…

 Respiratory history 2 Written by Leya Bedar Diagnosis: Asthma (episodic cough, SOB, wheeze, atopy, family history of atopy, recently got a pet – common trigger) Other differentials: Bronchiectasis (cough producing mucus, less likely due to atopic features and no identifiable risk factors) Interstitial lung disease (possible due to non-productive cough and link to triggers but…

 Gastrointestinal history 3 Written by Leya Bedar Diagnosis: Irritable bowel syndrome (flatulence, generalised abdominal pain, fluctuating between diarrhoea and constipation, link to anxiety) Other differentials: Inflammatory bowel disease – Crohn’s disease/ Ulcerative colitis (possible due to change in bowel habit but less likely due to lack of extra-gastrointestinal manifestations and no blood or mucus in…

Osteoarthritis We have cartilage between our joints to cushion the joints. Over time, this cartilage breaks down and wears away. As a result, the bones begin to rub against each other, causing swelling and pain in that joint. Rheumatoid arthritis The body needs a way of protecting itself. We call this the immune system. The…