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 6 Written by Leya Bedar Diagnosis: Giant cell arteritis (age, location of pain, jaw claudication, intense throbbing, visual disturbance) Other differentials: Trigeminal neuralgia (location of pain, worsens with certain actions but less likely due to visual disturbance) Migraine (intense throbbing pain, visual changes could be aura, but less likely due to location of…
Anxiety Anxiety is a feeling of worry or fear. It is common reaction to life events like taking an important exam or giving a speech to a crowd. But some people find it hard to control. When the feeling of anxiety is more constant and affects your daily life. This is when it starts to…
Neurological history 7 Written by Leya Bedar Diagnosis: Trigeminal neuralgia (location of pain, neuropathic pain, episodes of intense pain, sudden onset, triggers) Other differentials: Giant cell arteritis (age, location of pain, but less likely due to neuropathic pain, clear triggers and lack of jaw claudication and visual disturbances) Migraine (intense pain, but less likely due…
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…
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…
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)…
