Written by Leya Bedar
Depression (lethargy, weight loss, episodes of self-harm and thoughts of suicide, triggers, early-morning wakening, isolation)
Other differentials:
Hypothyroidism (lethargy, however less likely as no weight gain or systemic features)
Anxiety (due to stress but very unlikely as patient does not feel anxious)
Mark scheme for history taking can be found below
Neurological history 2 Written by Leya Bedar Diagnosis: Acute closed-angle glaucoma (eye pain, red eye, blurred vision, halos, age) Differential diagnosis: Orbital cellulitis (eye pain, red eye, vision affected, but ocular movements spared and would have been more relevant if recent cellulitis) Cluster headache (pain around the eye, but vision is affected and the pain…
Mental health history 4 Written by Leya Bedar Diagnosis: Anxiety – Panic Attack Disorder (episodic palpitations, SOB, dizziness, constant worrying, sources of stress) Other differentials: Hyperthyroidism (possible due to palpitations but less likely as lack of systemic features) Atrial fibrillation (possible due to tachycardia, SOB, dizziness but less likely due to features associated with anxiety)…
Neurological history 5 Written by Leya Bedar Diagnosis: Migraine with aura (throbbing intense pain, photophobia, bright zig zag patterns, possible family history) Differential diagnosis: Tension headache (intense pain worse with stress, location but less likely due to associated symptoms) Giant cell arteritis/ temporal arteritis (location of pain, throbbing, visual changes but as symptoms more suggestive…
Cardiovascular history 2 Written by Leya Bedar Diagnosis: Stable angina (due to cardiac nature of pain, onset with exertion, improvement with rest, cardiovascular risk factors, cardiac family history) Other differentials: Myocardial infarction (unlikely due to intermittent nature, lack of autonomic associated symptoms, likely more severe pain) Pulmonary embolism (due to shortness of breath and sudden…
Gastrointestinal history 2 Written by Leya Bedar Diagnosis: Biliary colic (due to intermittent colicky pain following meals exacerbated by eating junk food) Other differentials: Acute cholecystitis (systemic features would be present such as malaise and pyrexia) Ascending cholangitis (similar to acute cholecystitis but jaundice would also be present) Peptic ulcer disease (due to the pain…
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…
