Neurological history 5

 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    

 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)…

 Gastrointestinal history 2 Written by Leya Bedar Diagnosis: Biliary colic (due to intermittent colicky pain following meals exacerbated by eating junk food) Other differentials: Acute cholecystitis (systemic features would be present such as malaise and pyrexia) Ascending cholangitis (similar to acute cholecystitis but jaundice would also be present) Peptic ulcer disease (due to the pain…

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…

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…

 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