Written by Olivia Nwosu
Tuberculosis (constitutional symptoms, recent travel history)
Other differentials:
Lung cancer (This is the main differential, but the travel history and low amount of cigarettes make this less likely)
Sarcoidosis (can produce a cough and systemic features but less likely due to no SOB and other body systems not affected)
Mark scheme for history taking can be found below
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
Cardiovascular history 4 Written by Leya Bedar Diagnosis: Pericarditis (features of infection, pleuritic chest pain, improves when leaning forward, recent viral illness) Other differentials: Pulmonary embolism (shortness of breath, sudden onset, pleuritic chest pain, but less likely due to features of infection) Oesophagitis (features of infection but unlikely as no link to swallowing/eating and no…
Neurological history 4 Written by Leya Bedar Diagnosis: Meningitis (typical symptoms, infectious contacts) Differential diagnosis: Tension headache associated with a viral illness (possible due to features of infection, but less likely due to location of pain, photophobia) Migraine with aura (generalised headache with photophobia and family history, but less likely due to infectious symptoms and…
Mental health history 3 Written by Leya Bedar Diagnosis: 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…
Respiratory history 3 Written by Leya Bedar Diagnosis: Pulmonary embolism (pleuritic chest pain, SOB, cough, recent surgery, signs of DVT, recent long journey) Other differentials: Acute coronary syndrome e.g. stable angina (possible due to chest pain but unlikely due to cough, pleuritic chest pain and lack of cardiovascular risk factors, past medical history and family…
Musculoskeletal history 4 Written by Leya Bedar Diagnosis: Septic arthritis (local and systemic inflammatory features, recent knee surgery) Differential diagnosis: Haematoma post-operation (recent knee surgery but does not explain local and systemic inflammatory features) Problem with prosthesis placement (same as above) Mark scheme for history taking can be found below
