Written by Leya Bedar
Depression (lethargy, weight loss due to lack of appetite, thoughts of self-harm and suicide, hopelessness, worthlessness, early-morning wakening, stress)
Other differentials:
Hypothyroidism (lethargy, loss of appetite 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…
Musculoskeletal history 2 Written by Leya Bedar Diagnosis: 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…
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)…
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…
Cardiovascular history 5 Written by Leya Bedar Diagnosis: Anaemia (age, menorrhagia, SOB, lethargy, palpitations, pallor, dizziness) Other differentials: Anxiety (episodic shortness of breath and palpitations but less likely due to other physical manifestations and lack of anxiousness) Thyroid disease (SOB, lethargy, palpitations, but less likely due to menorrhagia in history and lack of other physical…
