1

CHEST PAIN

ACUTE CAUSES CHRONIC CAUSES

ISCHEMIA CARDIAC [ISCHEMIA,PERICARDITIS,AS 1

PLEURITIC RESPIRATORY [PLEURISY,EMBOUSM,PNEUMONIA 1

PULMO~ARY EMBOLISM MUSCULAR

. ... · . .
PERICARDITIS GERD

PNEUMOTHORAX NERVE ROOT PAIN

-AORTIC DISSECTION RADICULOPATHY

OTHERS

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BREATHLESSNESS [DYSPNOEA]

ACUTE CAUSES
PUlMONARY EMBOliSM

PNEUMOTHORAX

ANXIETY

ACUTE ON CHRONIC CAUSES

CHRONIC CAUSES
CARDIAC [ISCHEMIA, CHF [LVF, RHF], VALVULAR HEART DISEASE, CARDIOMYOPATHIES)

PULMONARY [ASTHMA, COPD, BRONCHIECTASIS, SARCOIDOSIS, ILD, PPH, PH)

INFECTIONS [PNEUMONIA, TB, ABSCESS, EMPYEMA, ABPA)

TUMOR [LUNG CA, METASTASIS)

ANEMIA

NEUROLOGICAL [GBS, MYSTHENIA GRAVIS,]

OSA

PSYCHOlOGICAL [ANXIETY, HYPERVENTILATION)

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10

COUGH

HESPJHATORY CAUSES (RTI,PU£UMOUIA,COPD.ASHtMA,IlO,SACROIDOSIS

MAUG~IA,CY,TB,BROtiOU£ Cl ASIS,Alll ~GYJ

Gil (GH\0 I

CVS (tVF)

COtiN£CTIVE TISSUE DISORDERS

INFLAMMATION ( P£RJCl\ROITIS,Pl(URITl~J

rOREIGN BODY

CNS ( ASPIRATIONS J

ENT (RHINITIS,SINUSHIS I

DRUGS (ACE,AMIOOAJIOUE,USAJD,A.SP1RJrl,tlllRATE,CA CHANNEL BLOCKER I

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14

HAEMOPTYSIS

j!ESPIRATORV CAUSES

INFECTION [PNEUMONIA,TB,LUNG ABSCESS,ACUTE BRONCHITIS

BRONCHIEaASIS,ASPERGILLOSIS 1

NEOPLASTIC [LUNG CARCINOMA,METASTASIS,KAPOSI SARCOME 1

VASCULAR [PULMONA~Y EMBOLISM, WEGENER GRANULOMATOSIS,GGOD PASTURE,HHT 1

CARDIAC CAUSES

PULMONARY OEDEMA

MITRAL STENOSIS

OTHER CAUSES

BLEEDING DISORDER

THORACIC ENDOMETRIOSIS

DRUGS [ANTICOAGULANT 1

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16

HOARSE VOICE

.UPPER RT I

INHAtA TIO rlfl l IPIJUWf

IPIHCliON (CM IOIOIASIS 1

GE RO

CVS (M IJ M L SH tiOSlS 1

TltYAOIO OIS£1\St

ACROMEGI\l Y

SURG(RY ON THROM

MAlGUAHCY (lARnf rot.Y'P I

OCCUPA TIQf:M l

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26

PALPITATION

ANXIETY

THYROID DISEASE

PHEOCROMOCYTOMA

CARDIAC [ IHD,ARRYTHMIA,VALVULAR HEART DISEASE,STRUCTURAL DISEASE]

HYPOGLYCEMIA

CEREBROVASCULAR DISEASE

ANEMIA

DRUGS [BETA AGONIST,THEOPHYLLINE,THYROXINE,SYMPATHOMIMETIC,RECREATIONAL DRUGS,DRUG~

PROLONGING QT INTERVAL] . . . . .. .

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'
ANKLE SWELLING

ASYMMETRICAL SYMMETRICAL
VENOUS THROMBOSIS CARDIAC FAILURE

TRAUMA COR PULMONALE

CELLULITIS CLD

ARTHRITIS MALABSORPTION

LYMPHOEDEMA NEPHROTIC SYNDROME

LOWER LIMB VENOUS OBSTRUCTION RENAL DISEASE

DEPENDANT OEDEMA HYPOTHYROIDISM

EXTRiNSIC VENOUS COMPRESSION ·

DRUGS

HYPOALBUMINEMIA [NEPHROTIC
SYNDROME,CLD,NUTRITION]

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2

HYPERTENSION

PRIMARY
ESSENTIAL

WHITE COAT INDUCED

ANXIETY PROVOKED

SECONDARY

RENAL (~USES [DIABATIC NEPHROPATHY, GN, APKD, RENOVASCULAR DISEASE, TUBULO

INTERSTITIAL NEPHRITIS]

ENDOCRINE [HYPERTHYROIDISM, ACROMEGALY, CUSHING SYNDROME, CONN; S SYNDROME,

PHEOCROMOCYTOMA, ADRENAL HYPERPLASIA

CARDIORESPIRATORY [COARCTATION OF AORTA, OSA]

DRUGS [NSAIDS, NASAL DECONGESTANT, OCP, STEROIDS, CYCLOSPORIN, ILLICIT ORUGS, ANABOLIC
STEROIDS]

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23

NECK LUMP

THYROID DISEASE

GOITRE [GRAVES',MNG,HASHIMOTOS,SUB ACUTE THYROIDITIS J

SOLITARY NODULE

ADENOMA

THYROID CANCER

CONGENITAL [ THYGLOSSAL CYST]

LYMPHADENOPATHY [INFECTIVE.MALIGNANT)

NEOPLASIS HEAD AND NECK [ESOPHAGEAL,STO~ACH,LUNG, LARYNX

CERVICAL RIB

VASCULAR [CROTID ARTERY ANEURYSM,CHEMODECTOMA]

SALIVARY GLAND DISEASE [PAROTITIS, NEOPLASM]

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17

HYPERCALCEMIA '

DIETARY

IMMOBILITY

MALIGNANCY [PARATHYROID ,MEN l,MEN 2 1

SOL BRAIN [ACROMEGALY,CUSHING 1

METASTASIS

SARCOIDOSIS

MULTIPLE MYLOMA

DRUGSSS

·'.

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20

LOSS OF WEIGHT

WITH PRESERVED APETITE WITH LOSS OF APETITE

OM MALIGNANCY

HYPERTHYROIDISM SEVERE CARDIAC OR RESPIRATORY DISEASE

MAlABSORPTION ADVANCED CRF

PHEOCROMOCYTOMA OESOPHAGEAL DISEASE

ADDISON DISEASE DEPRESSION

EXERCISE HIV

DIETING · · · · CHRONIC INFAMMATORY DISEASE OF ANY CAUSE

INFECTIVE ENDOCARDITIS

LAXATIVE ABUSE ·

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31

WEIGHT GAIN

METABOLIC CAUSES OTHER CAUSES

CUSHING SYNDROME PELVIC/ABDOMINAL MASS

HYPOTHYROIDISM OBESITY

PCO SEDENTARY LIFESTYLE

INSUUNOMA PREGNANCY

HYPOTHAlAMIC DISEASE NICOTINE WITHDRAWL

FLUID RETENTION ...

CCF

ASCITES OF ANY CAUSE ·

· · NEPHROTIC SYNDROME

DRUGS

INSULIN ,SULPHONYLUREA

OCP

STEROIDS

TRICYCLICANTI DEPRESSANT

ATYPICAL ANTIPSYCHOTIC

ANTI EPILEPTICS

h
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30

...
FATIGUE

OM

ADDISON

THYROID DISEASE

ANEMIA

MYSTHENIA GRAVIS

POST VIRAL

CHRONIC FATIGUE SYNDROME

OSA··

DEPRESSION

. Mf\LIGNANCY

. CHRONIC ILLNESS

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37.

DIARRHOEA

INFECTIOUS[ FOOD POISONING ) -. H/0 SURGERY

INFLAMMATORY [INFLAMMATORY BOWL DISEASE) H/0 RADIATION

IRRITABLE BOWL SYNDROME MICROSCOPIC COLITIS

LACTOSE INTOLERANCE DRUGS

ANKYLOSING SPONDYLITIS

COELIC DISEASE

TRAVELLERS DIARRHOEA

SECRETORY

PANCREATITIS

DM

HYPERTHROIDI$M

SYSTEMIC SCLEROSIS

CARCINOID SYNDROME

VITAMIN 812 DEFICIENCY

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21

LOWER GIT HAEMORRHAGE

ANAL FISSURE

HAEMORRHOIDS

COLITIS [INFLAMMATORY,INFECTIVE,RADIATION,ISCHEMIC]

DRUG INDUCED [PSEUDOMEMBRANOUS COLITIS,NSAID,WARFARIN)

DIVERTICULITIS

POLYP

MALIGNANCY

ANGIODYSPLASIA

Ill IT

TRAUMA [COLONOSCOPY]

CLD

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12

'
DYSPHAGIA

PAINFUL NEUROLOGICAL CAUSES

INFECTION (FUNGAL ,OM] MND

PILL [NSAID,CORROSIVE,BISPHOSPHONATE] STROKE

PHARYNGITIS, LARYNGITIS MYSTHENIA GRAVIS

PARKINSON

ACUTE CAUSES [FOREIGN BODY,ANGIODEMA]

CHRONIC CAUSES

· STRICTURES [GERD,ANEMIA,CORROSIVE]

GIT CAUSES [ACHALASIA]

.CT DISORDEnS [SCLERODERMA,POLYMYOSITIS,DERMATOMYOSITIS]

MALIGNANCY ESOPHAGEAL

CVS (MITRAL STENOSIS]

COMPRESSION [GOITRE ,LYMPH NODE]

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18

JAUNDICE '

ACUTE CAUSES OTHER CAUSES

GALLSTONE DISEASE CCF,RHF

ACUTE HEPATITIS COR PULMONALE

ACUTE BUDD CHIARI SYNDROME HAEMOLYTIC ANEMIA

HAEMOLYSIS POST HEPATIC CAUSES

SUB ACUTE CAUSES

PANCREATIC AND HEPATOBILIARY MALIGNANCY

INTRA HEPATIC CHOLESTASIS [DRUG INDUCED,AUTOIMMUNE,INFILTERATIVE LIVER DISEASE]

RIGHT HEART FAILURE

RECURRENT CAUSES
GALL STONE DISEASE

DISORDERS OF BILE TRANSPORT

COMMON CAUSES
HEPATITIS A

HEPATITIS B ,C

ALCOHOLIC HEPATITIS

PRIMARY BILIARY CIRRHOSIS

TRAVELLERS JAUNDICE

WILSON DISEASE

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37

22

' MACROCYTIC ANEMIA

JY1EGALOBLASTIC
VITAMIN 812 DEFICIENCY (PERNICIOUS ANEMIA,GASTRECTOMV,ILEAL RESECTION, BACTERIAL OVER
GROWTH,DIPHVLOBOTHRIUM LATUM INFECTION]

FOLATE DEFICIENCY (RENAL ANS SKIN DISEASE,ALCOHOL,DRUGS,MALABSORPTION,CONNECTIVE TISSUE

DISORDRS]

NON MEGALOBLASTIC

HYPOTHYROIDISM

ALCOHOL

CLD

MALABSORPTION

CONNECTIVE TISSUE DISOEDERSS

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29

HAEMATURIA

DIAGNOSIS IN < 45 YEARS OF AGE DIAGNOSIS IN ALL AGE GROUPS

PULMONARY RENAL DISEASE RENAL CALCULI

GOOD PASTURE SYNDROME INFECTION[PYLONEPHRITIS,CYSTITIS,TB

WEGENER GRANULOMATOSIS INFECTIVE ENDOCARDITIS I

MICROSCOPIC POLYANGITIS DRUGS [ANTI COAGULANT,STATIN

GLOMERULONEPHRITIS CYCLOPHOSPHAMIDE I

VASCULITIS BL~EDING DISORDER

POLYARTERTIS NODOSA · TRAUMA,CATHETERIZATION

HENOCH SCHONLEIN PURPURA RADIOTHERAPY

CONNECTIVE TISSUE DISORDERS RHABDOMYOLYSIS

LUPUS NEPHRITIS APKD

SYSTEMIC SCLEROSIS

DIAGNOSIS IN 45 YEARS OF AGE

MALIGNANCY [KIDNEY,BLADDER,PROSTATE]

BENIGN [BPH 1

INFECTION [PROSTATITIS 1

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27

'
POLYUREA

INABILITY TO CONCENTRATE URINE

DIABETES INSPIDUS [CRANIAL,NEPHROGENIC J

CRANIAL 01 [POST SURGICAL,HEAD

. ~ ·-
· INJURY,RADIOTHERAPY,NEOPLASTIC[CRANIOPHARYNGIOMA,PITUATARY METASTASIS],INFECTION
[TB,MENINGITIS ],INFALAMATION [SARCOIDOSIS,LANGERHAN CEll HISTIOCYTOSIS
],VASCULAR,IDIOPATHIC,FAMILIAL]

NEPHROGENIC 01 [CRF,ELECTROLYTE IMBALANCE [ HYPOKALEMIA,HYPERCALCEMIA ],DRUGS

. .
[UTHIUM,AMPHOTERICIN,OFLOXACIN,DEMECLOCYCLINE,FOSCARNETJ

OSMOTIC DIURESIS
DM

DIURETICS

CKD

PRIMARY POLYDYPSIA

PSYCHOGENIC

HABITUAL EXCESSIVE DRINKING

··.

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15

HEADACHE

ACUTE CAUSES ACUTE ON CHRONIC /CHRONIC

CAUSES

MIGRAINE MIGRAINE

CLUSTER CLUSTER HEDACHE

TEMPORAL ARTERITIS TEMPORAL ARTERITIS

SAH BENIGN INTRACRANIAL HYPERTENSION

INTRACRANIAL BLEEDING ANALGESIA INDUCED

SPORTS HEADACHE TENSION 'INDUCED

TRAUMA SOL/METASTASIS · · .·

PITUARY APOPLEXY SUBDURAL

.
HAEMATOMA
.

VENOUS SINUS THROMBOSIS ·MENINGITIS ·

FACIAL HEADACHE HYPERTENSION

TRIGEMINAL NEURALGIA BRAIN ABSCESS

TEMPORAL ARTERITIS

ACROMEGALY

POST HERPETIC

TOOTHACHE

EAR PROBLEM

LOCAL EYE CAUSES

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..
NEUROPATHY
SENSORY

MOTOR

AUTONOMIC

TRANSIENT CAUSES

TIA,EPILEPSY,ANXI ETY,M IGRAINE,MS, HYPOGLYCEMIA

ACUTE CAUSES

CVA.GBS,TOXIN,PORPHYRIA

CHRONIC CAUSES
DM OCCUPATIONAL HISTORY[VIBRATING TOOlS]

. CRF FAMILY HISTORY [HSMN]

NUTRITIONAL [VJT B12 DEF] SEXUAL HISTORY [HIV,SYPHILIS]

HYPOTHYROIDISM SOCIAL HISTORY [ALCOHOl 1

CONNECTIVE TISSUE DISORDERS DRUG HISTORY

[RHEUMATOID ARTHRITIS,SlE,SARCOIDOSIS] [SENSORY,M';>TOR,SENSORIMOTOR 1

MULTIPLE MYLOMA

.PARANEOPlASTICS

NEUROFIBROMATOSIS

AMYLOIDOSIS

CHURG STRAUSS SYNDROME

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FALL/COLLAPSE

WITH LOSS OF CONSCIOUSNESS

SYNCOPE,SEIZURE,HYPOGLYCEMIA

WITH RETAINED CONSCIOUSNESS

PROXIMAL MUSCLE WEAKNESS

SENSORY NEUROPATHY

CEREBELLAR DISEASE

PARKINSON DISEASE

AUTONOMIC NEUROPATHY (OM]

...

DRUGS (ACE,BETA BLOCKER,CALCIUM CHANNEL ~-~OCKER,INSULIN]

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9

'
PROXIMAL MUSCLE WEAKNESS

CUSHING SYNDROME

ACROMEGALY

THYROID DISEASE

POLYMYOSITIS

DERMATOMYOSITIS

POLYMYALGIA RHEUMATICA

OSTEOMALACIA

MYSTHENIA GRAVIS

ELECTROLYTE IMBALANCE

DRUG INDUCED

MUSCULAR DYSTROPHY

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}'j

PROXIMAL MYOPATHY

POLYMYOSrTIS

DERMATOMYOSITIS

POLYMVALGIA Rt1EUMATICA

OS1£0MALAOA

MVS1UH41A GRAVIS

THYROID OIS[M£

ACfiOMEGAlY

CUStiiUG

HEClROlYl( I .tSO\.U t"\CI

OHUG lt.IOUC£0

MUSCUlAR O'I"STHOPHYS

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11

..
DOUBLE VISION

MYSTHENIA GRAVIS

THYROID EYE DISEASE-

MILLER FISCHER

WERNICK$ ENCEPHALOPATHY

CRANIAl NERVE PALSIES (SINGLE/MUTIPLE]

MS

STROKE

INO

BRAINSTEM LESION

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19

JOINT PAINS

SYMMETRICAL POLYARTHRITIS MONOARTHRITIS

RHEUMATOID ARTHRITIS TRAUMA

SLE CRYSTAL ARTHRITIS

VASCULITIS OSTEOARTHRITIS

PSORIASIS INFCTION (GONOCOCCAL/NON GONO]

VIRAL SERONEGATIVE ARTHRITIS

ASYMMETRICAL POLYARTHRITIS HAEMOPHILIA

SERONEGATIVE ART~RITIS DRUGS [WARFARIN)

GOUT/ PSEUDO GOUT MALIGNANCY

BECHET LYME DISEASE

RHEUMATIC FEVER

MALIGNANCY/METASTASIS

OTHER CAUSESS
SARCOIDOSIS· ·

INFLAMMATORY BOWL DISEASE

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BACK PA1N
ACUTE CAUSES
TRAUMA

FRACTURE

OSTEOPOROSIS [DIET,FAMILY HISTORY,SEDENTARY LIFE STYLE,CIGGERRTE SMOKING, EARLY

MENOPAUSE,POST MENOPUSAL,H/0 OOPHORECTOMY,HYPERTHYROIDISM,HYPOGONADISM,DRUGS
LIKE STEROID]

DICS PROPALSE

SCIATICA

OSTEOMYUTIS

SPINAL CORD COMPRESSION [TUMOR, TRAUMA, ABSCESS, TB, HAEMATOMA]

CHRONIC CAUSES
OSTEOARTHRITIS

SERONEGATIVE ARTHRITIS

SPINAL STENOSIS

SPINAL CLAUDICATION

MYLOMA

PAGET$ DISEASE

MALIGNANCY/METASTASIS

DEPRESSION

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7

RAYNAUD"PHENOMENON
SYSTEMIC SCLEROSIS SEX HISTORY [HBV,HCV,HIV]

SLE FAMILY HISTORY [RAYNAUD]

RHEUMATOID ARTHRITIS OCCUPATIONAL HISTORY [VIBRATING TOOLS]

DERMATOMYOSITIS

POLYMYOSITIS

MYLOPROLIFERATIVE DISORDERS

HEPATITIS B ,C [CRYOGLOBULINEMIA]

CERVICAL RIB

ATHEROSCLE~OSIS [PVD] .

CARPAL TUNNEL SYNDROME

HYPOTHYROIDISM .

TRAUMA

DRUGS

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28

PRURITIS

ATOPY/ALLERGY/UTRICARIA

EQEMA

INFECTION [VIRAL,FUNGAL,BACTERIAL]

POLYCYTHEMIA RUBRAVERA

LIVER DISEASE [ PBC,OBSTRUCTIVE JAUNDICE,PSC]

CRF

OM

MALIGNANCY [MYLQPROLIFERATIVE AND LYMPHOPROLIFERTIVE DISEASE]

THYROID DISEASE

PSYCHOGENIC

OBSTETRIC CAUSES$

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24

PAINFUL SHINS '

STREPTOCOCCAL INFEGION

FUNGAL INFECTION

SARCOIDOSIS

TB •·· ·

IBD

BEHCET DISEASE

LEPROSY

MALIGNANCY [MYLOPROLIFERATIVE DISEASE 1

DRUGS [OCP,SULPHONYlUREA,SULPHONAMIDE,PENICILLIN,GOLD 1

hi
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