Written by Leya Bedar
Osteoarthritis (pain, gradual onset, worse with use, improves with rest, stiffness, age, history of heavy use of joint)
Differential diagnosis:
Crystalline arthropathies (ie, gout and pseudogout) (joint pain, stiffness, swelling)
Inflammatory arthritis (eg, rheumatoid arthritis) (joint pain, stiffness, swelling)
Mark scheme for history taking can be found below
Musculoskeletal history 1 Written by Leya Bedar Diagnosis: Rheumatoid arthritis (morning stiffness >1hr, features of inflammation, improves with ibuprofen and with use, quicker onset, age, autoimmune history) Other differentials: Osteoarthritis (stiffness, joint pain, swelling) Repetitive strain injury (pain, stiffness, throbbing, occupation) Mark scheme for history taking can be found below
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…
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…
Gastrointestinal history 8 Written by Leya Bedar Diagnosis: Inflammatory bowel disease (diarrhoea, location of pain, fatigue, weight loss, blood in stools, extra-gastrointestinal manifestations) Other differentials: Chronic pancreatitis (possible due to weight loss, fatigue, abdominal pain but less likely due to location of pain, no other suggestive symptoms) Coeliac disease (possible due to abdominal pain and…
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…
Respiratory history 5 Written by Leya Bedar Diagnosis: Lung cancer (haemoptysis, cough, constitutional symptoms, family history of lung cancer, smoking history) Other differentials: Tuberculosis (ethnic, haemoptysis, constitutional symptoms but lack of travel history, infectious contacts, night sweats, make less likely) COPD (cough, SOB and smoking history but less likely due to haemoptysis and constitutional symptoms)…
