Mental health history 2 Written by Leya Bedar Diagnosis: 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…
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…
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
Gastrointestinal history 5 Written by Leya Bedar Diagnosis: Peptic ulcer disease (nature of pain, epigastric, worse after eating but delayed onset, exacerbated by spicy food, NSAID use, smoking history) Other differentials: Gastric cancer (weight loss, abdominal pain, haematemesis) Pancreatitis (abdominal pain, delayed onset after eating, weight loss) Mark scheme for history taking can be found…
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…
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…
Respiratory history 4 Written by Leya Bedar Diagnosis: COPD (progressive cough, SOB, age, family history of pulmonary disease, smoking history) Other differentials: Congestive heart failure (cough and exertional features and cardiovascular risk factors, but less likely due to no orthopnoea or paroxysmal nocturnal dyspnoea and much more gradual onset) Bronchiectasis (due to productive cough, SOB,…
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)…
