Written by Leya Bedar
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 below
Neurological history 3 Written by Leya Bedar Diagnosis: Cluster headache (pain around eye, autonomic symptoms, periods of remission) Differential diagnosis: Temporal arteritis (pain around eye, but no visual disturbances, jaw claudication, or other suggestive features) Migraine with aura (intense headaches, but less likely due to autonomic features, triggers associated with cluster headache as well as…
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…
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…
Gastrointestinal history 3 Written by Leya Bedar Diagnosis: Irritable bowel syndrome (flatulence, generalised abdominal pain, fluctuating between diarrhoea and constipation, link to anxiety) Other differentials: Inflammatory bowel disease – Crohn’s disease/ Ulcerative colitis (possible due to change in bowel habit but less likely due to lack of extra-gastrointestinal manifestations and no blood or mucus in…
