Written by Leya Bedar
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 pain, jaw claudication)
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 1 Written by Leya Bedar Diagnosis: Appendicitis (due to generalised pain to right iliac fossa and progression from dull to sharp suggesting peritonitis, along with exacerbating and relieving factors, anorexia, fever, and nausea) Other differentials: Ruptured ectopic pregnancy (possible cause of peritonitis but very unlikely as patient has never had sex) Ovarian torsion…
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 3 Written by Olivia Nwosu Diagnosis: Myocardial infarction (due to cardiac nature of pain, intense, autonomic features, family history of cardiovascular disease, T2DM, cardiovascular risk factors) Other differentials: Unstable angina (due to cardiac features, but pain usually goes away) Oesophageal spasm (due to chest pain and previous heartburn, unlikely as factors point to…
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