APPROACH TO A PATIENT WITH VISUAL DISTURBANCE

APPROACH TO A PATIENT WITH VISUAL DISTURBANCE

Youtube linkhttps://youtu.be/j3LaPmp6B-M

Acute Onset Visual Disturbance

• Acute closed angle glaucoma

• Central retinal artery/vein occlusion

• Retinal detachment

• Anterior uveitis

• Vitreous haemorrhage

• Endophthalmitis

• Giant cell arteritis

• optic neuropathy

• Leber's hereditary optic neuropathy

• Amaurosis fugax

Chronic Onset Visual Disturbance

• Open angle glaucoma

• Cataracts

• Retinitis Pigmentosa

• Macular degeneration

• Diabetic or hypertensive retinopathy

• Optic nerve compression of any cause

• Nutritional and toxic optic neuropathies

Objectives:• Lets learn, how to differentiate among

different causes of visual distrubance

by asking simple questions, with the

help of simple mneumonics:

• P3MAFTOSA

• ODPARA

MEDICAL HISTORY SERIES PART 1

W h i t e S h a d o w

M e d i c c a l e d u c a i o n

Differential Diagnosis

APPROACH TO A PATIENT WITH DOUBLE VISION

Youtube linkhttps://youtu.be/rGiNBTgVAwo

Objectives• Lets learn,how to differentiate among

different causes of double vision by asking

simple questions, with the help of simple

mneumonics:

• P3MAFTOSA

• ODPARA

MEDICAL

HISTORY SERIES

PART 2

Monocular diplopia:Cataract Lens dislocation Macular diseaseCorneal disease

Binocular diplopia: Orbital cellulitisGraves ophthalmopathyKearns-sayre syndrome Myasthenia Gravis Cranial nerve palsies cavernous sinus syndrome Miller Fisher syndrome

Wernicke's encephalopathy

Acute Onset Diplopia:Acute closed angle glaucomaCentral retinal artery occlusionRetinal detachmentAnterior uveitis Vitreous haemorrhageEndophthalmitisGiant cell arteritisOptic neuropathyLeber's hereditary neuropathyStroke

Chronic Onset Diplopia:Open angle glaucomaCataractsRetinitis PigmentosaMacular degenerationDiabetic RetinopathyOptic nerve compression

MEDICAL HISTORY SERIES PART 3

W h i t e S h a d o w

M e d i c a l E d u c a t i o n

Youtube link:https://youtu.be/mpb4hR522PQ

APPROACH TO A PATIENT WITH HEADACHE

Chronic headache: Tension headache Giant cell arteritisChronically elevated ICP Chronic daily headacheBenign intracarcial hypertensionCervical SpondylosisSpace occupying lesion (abscess, tuberculoma, lymphoma, Tumor)DepressionCaffeine withdrawlAnalgesic over use HeadacheMedicines for example CCB , Nitrates , OCPs

Acute single episode:MeningitisEncephalitisSubarachnoid hemorrhage Head injuryCarotid artery dissectionEyes (Uveitis, Glaucoma)

Acute recurrent attacks:Migraine Cluster headacheGlaucomaTrigeminal neuralgia

APPROACH TO A PATIENT WITH COLLAPSE

Neurological causes

Cardiac Causes

Neurocardiogenic causes

Differential Diagnosis

Objectives

• Lets learn, how to differentiate among

different causes of collapse by asking simple

questions, with the help of mneumonics:

• P3MAFTOSA

• ODPARA

Other causes:

• Orthostatic hypotension-collapse

• Subclavian steal syndrome

• Hypoglycemia

• Anexiety

1

2

3

Seizure

Stroke

subarachnoid haemorrhage

Aortic stenosis

Hypertrophic obstructive

cardiomyopathy

Vasovagal syncope

Situational syncope

Carotid sinus hypersensitivity

MEDICAL HISTORY SERIES PART 4

W h i t e S h a d o w

M e d i c a l E d u c a t n

Youtube link:https://youtu.be/JIlsE-NQZQg

APPROACH TO A PATIENT WITH DIZZINESS

Vestibular end organs &

vestibular nerve• Ménière's disease

• Vestibular neuritis

(acute labyrinthitis)

• Benign positional vertigo

• Motion sickness

• Ototoxicity

(aminoglycosides)

• Herpes zoster oticus

(Ramsay Hunt syndrome)

Brainstem, cerebellum, &

cerebello-pontine angle

• Multiple Sclerosis

• Transient ischemic attack

• Hemorrhage

• Migraine

• Vestibular schwannoma

• Arnold-Chiari malformation

• Friedreich's ataxia

• Spinocerebellar ataxia

Other Causes

• Alcohol intoxication

• Perilymph Fistula

• cardiac syncope

• Orthostatic hypotension

• Vasovagal syncope

• Situational syncope

• Carotid sinus hypersensitivity

• Hypoglycemia

• Anxiety

MEDICAL HISTORY SERIES PART 5

Youtube link: https://youtu.be/WKpfHCtrOGo

Differential Diagnosis

APPROACH TO A PATIENT WITH JOINT PAINS

Youtube link:

https://youtu.be/qMGrRUveg68

Symmetrical Joint Pains1. Viral Causes

2. SYSTEMIC LUPUS ERYTHEMATOSUS

3. Rheumatoid arthritis

4. Vasculitis

Asymmetrical Joint Pains1. Sero-negative arthro-pathies

2. Gout

3. Rheumatic Fever

4. Malignancy

MEDICAL HISTORY SERIES PART 6

DIFFERENTIAL DIAGNOSIS

Mono-articular Joint Pains1. OSTEOARTHRITIS

2. Gout

3. Pseudo-gout

4. Septic arthritis

Poly-articular Joint Pains:

1. Osteoarthritis

2. SYSTEMIC LUPUS ERYTHEMATOSUS

3. Rheumatoid arthritis

4. Psoriatic Arthritis

Age ranging from 15 to 30years:• Herniated disc

• Trauma

• Seronegative Arthropathies (ankylosing

spondylitis)

Age limit of 30 to 50 years: • Degenerative spinal disease

• Herniated disc

• Cauda equina Syndrome

• Malignancy of the lung, or breast, or prostate

Age beyond 50 years of age:

• Degenerative spinal disease

• Osteoporosis

• Compression fracture

• Paget's disease

• Malignancy

• Myeloma

• Lumbar spinal stenosis

1

2

3

https://youtu.be/cZJCux-k4b8Youtube link:

MEDICAL HISTORY SERIES PART 7

APPROACH TO A PATIENT WITH BACK PAIN

W h i t e S h d o w

M e d i c a l

E d u c a t i o n

Differential Diagnosis

APPROACH TO A PATIENT WITH ABDOMINAL PAINMEDICAL HISTORY SERIES PART 8

https://youtu.be/f8XFJ35f8zw

Youtube link:

Differential

Diagnosis

APPROACH TO A PATIENT WITH ACUTE CONFUSION

Neurological causes: • Meningitis

• Subdural hematoma

• Stroke

• Seizures

• Encephalitis

Gastrointestinal causes: • Hepatic encephalopathy

• Clostridium difficile colitis

3

5

6Urinary tract infection

Respiratory causes:• Chest infection

• Pulmonary embolus

Psychiatric causes

MEDICAL HISTORY SERIES PART 9

1 4 Cardiac causes: • Congestive heart failure

• Myocardial infarction

• Arrhythmia

2

Differential Diagnosis

Youtube link: https://youtu.be/dl3HwTKitoI

APPROACH TO A PATIENT WITH BREATHLESSNESS

MEDICAL HISTORY SERIES PART 10

Youtube link:

https://youtu.be/rRGnXX-qM_s

APPROACH TO A PATIENT WITH CHEST PAIN

Youtube link:https://youtu.be/qJzph12WsgA

Respiratory causes:• Asthma

• Collapsed lung

• Pneumonia

• Pulmonary embolism

• Pulmonary hypertension

• Pneumothorax

• Malignancy

MEDICAL HISTORY SERIES PART 11

Cardiac causes:• Angina

• Myocardial infarction

• Aortic dissection

• Pericarditis

• Myocarditis

• Hypertrophic cardiomyopathy Gastrointestinal causes:• Peptic ulcer disease

• Gastroesophageal reflux

disease (GERD)

• Esophageal

spasm/rupture

• Pancreatitis

• Musculoskeletal pain • Nerve root pain• Panic attack

Others:

APPROACH TO A PATIENT WITH COUGH

MEDICAL HISTORY SERIES PART 12

Objective:• How to differentiate among

different causes of cough by

asking simple questions, using:

• P3MAFTOSA

• ODPARA • Cardiac failure

• Medicines

• GERD

• COPD

• Asthma

• Bronchiectasis

• Foreign body

• Pneumonia

• TB

• Cancer

• ILD

• Sarcoidosis

• Chronic Pulmonary Embolism

• https://youtu.be/Y-cE8bpaE-g

Respiratory causes:

Others:

Youtube link:

APPROACH TO A PATIENT WITH HEMATURIA

MEDICAL

HISTORY SERIES

PART 13

Differentail Diagnosis• Urinary tract or kidney infections

• Bladder or kidney stones

• Glomerulonephritis

• Benign prostatic hyperplasia

• Prostate cancer

• Sickle cell anemia

• Aspirin, cyclophosphamide, heparin

• Cancer (bladder or kidney)

• Kidney injury

• Vigorous exercise

Wegener's Granulomatosis

Systemic lupus erythematosus

Systemic sclerosis

Bleeding disorder

Youtube link: https://youtu.be/zJzoObWSErQ

APPROACH TO A PATIENT WITH LIMB WEAKNESS

Differential DiagnosisStroke

Herniated disc

Space-occupying lesions

Subarachnoid hemorrhage

Seizures

Todd's paresis

Carotid dissection

Spinal cord compression

Malignancy

Chronic fatigue syndrome (CFS)

Peripheral neuropathy

Polymyositis

Immobilization

Alcoholic myopathy

MEDICAL HISTORY

SERIES PART 14

Youtube link:

https://youtu.be/lIRHlEmN_K4

APPROACH TO A PATIENT WITH

MEMORY LOSS

Youtube link:https://youtu.be/-fVtBavPJd4

MEDICAL HISTORY

SERIES PART 15

Stroke

Subdural hematoma

Lewy body dementia

Delirium

Parkinson's disease

Parkinson Plus syndromes

Space occupying lesion

Alcohol-related dementia

Wilson's disease

Huntington's disease

Frontotemporal dementia

Normal pressure hydrocephalus

Alzheimer's disease

Ccortical basal degeneration

Creutzfeldt-Jakob disease

Motor neuron disease

Progressive supranuclear palsy

Vascular Dementia

Differential Diagnosis

APPROACH TO A PATIENT WITH MUSCLE WEAKNESS

MEDICAL HISTORY

SERIES PART 16Youtube link:

https://youtu.be/V4qEmlaiSlY • Space-occupying lesions

• Botulism

• Organophosphate poisoning

• Lead poisoning

• Hyperthyroidism

• Cushing's syndrome

• Guillain-Barre syndrome

• Peripheral nervous lesions

• Motor neuron disease

• Transverse myelitis

• Stroke

• Myasthenia gravis

• Addison's disease• Hypokalaemic periodic paralysis

• Hyperkalaemic periodic paralysis

• Dermatomyositis

• Malignancy

• Depression

Youtube link:https://youtu.be/2oYITsga6LQ

Intra-cardiac:Arrhythmia

Valvular heart disease

Structural heart disease

Pacemaker 1

2

3

Thyrotoxicosis

Pheochromocytoma

Hypoglycemia

Differential

Diagnosis

APPROACH TO A PATIENT

WITH PALPITATIONS

High-output State:Anemia

Pregnancy

Fever

Paget's disease

Pharmacological:Amphetamine

Cocaine

Caffine

Nicotine

Medications

MEDICAL HISTORY

SERIES PART 17

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