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EMS Diff. Diagnosis
EMS Medical/Trauma Pathopysiology and Differential Diagnosis Practice
| Question | Answer |
|---|---|
| Chest pain, dyspnea, tachycardia, jvd, rales, arrhythmias | Cardiogenic Shock |
| Beck’s traid (JVD, muffled heart sounds, narrowing pulse pressure) OR Dyspnea, anxiety, tachycardia, tachypnea, decreased tidal volume, falling BP, difficulty in ventilation | Obstructive Shock |
| Septic Shock, Neurogenic Shock, Anaphylactic Shock and Psychogenic Shock | Distributive Shock |
| Warm skin, peripheral and pulmonary edema, tachycardia, low BP | Septic Shock |
| Bradycardia or normal HR, low BP, absence of sweating, normal warm skin, mechanism for spinal injury | Neurogenic Shock |
| Sudden onset of itching, urticaria (hives), flushed appearance, generalized edema, weak pulse, decreasing BP, tightness in chest, wheezing, dsypnea | Anaphylactic Shock |
| Rapid and weak pulse, thirst, decreasing LOC, cool and clammy skin, low BP | Hypovolemic Shock |
| Anxiety, tachypnea, tachycardia, weak radial pulse, cool and clammy skin, weakness, dyspnea, thirst | Compensated Shock |
| AMS, tachypnea, tachycardia, hypotension (< 90 systolic), narrowing pulse pressure, dull and dilated pupils, diaphoresis, cyanosis, orthostatic vitals | Decompensated Shock |
| Loss of appetite, nausea/vomiting, fever, jaundice, fatigue, muscle and joint pain | Hepatitis |
| Wheezing, bronchospasm | Asthma |
| Chronic cough, wheezing, cyanosis, productive cough, pulmonary edema, tachypnea | Bronchitis (COPD) |
| Dependent edema or pulmonary edema, rales, orthopnea, JVD, productive cough, chronic dyspnea, A-Fib | Congested Heart Failure |
| Fever, barking cough, stridor, pedi | Croup |
| Barrel chest, pursed lip breathing, dyspnea on exertion | Emphysema (COPD) |
| Dyspnea, fever, chills, cough, dark sputum, “heavy chest”, rales, rhonchi | Pneumonia |
| Sudden chest pain with dyspnea, decreased lung sounds on affected side | Pneumothorax |
| Sudden onset of dyspnea, sharp pin-point pain (often on deep inspiration), hemoptysis, cyanosis, tachypnea, Hx of surgery or childbirth | Pulmonary Embolism |
| Prolonged coughing spells, fever, pedi, whooping sound subsequent to cough | Pertussis (Whooping Cough) |
| Gradual or sudden onset dyspnea, decreased breath sounds over affected area | Pleural Effusion |
| Deep and rapid respirations, anxiety, dizziness, numbness, tingling in hands and feet | Hyperventilation (panic attack) |
| Chronic productive cough with thick discolored mucus, tachypnea, dyspnea, pedi, barrel chest, clubbed fingers, cyanosis | Cystic Fibrosis |
| Sudden onset of sore throat, high fever, drooling, dyspnea, stridor | Epiglottitis |
| Short (3-8 min.) episode of crushing chest pain, pain that radiates to the jaw or arm, dyspnea, diaphoresis, anxiety, abnormal or irregular heart rate, pain relieved by rest | Angina Pectoris |
| Sudden onset of weakness, anxiety, nausea, diaphoresis, heavy pressing chest pain, pain that radiates to jaw or arm, dyspnea, pain unrelieved by rest or medication | Acute Myocardial Infarction |
| Sudden onset of sharp tearing or burning pain in the chest or between the shoulder blades, difference in BP between arms, significant hypertension | Aortic Aneurysm |
| Aphasia, unilateral weakness (hemiparesis) or paralysis (hemiplegia), severe headache, AMS or decreasing LOC, blurred vision, slurred speech (dysarthria), memory loss | CVA (stroke) or TIA |
| Generalized abdominal pain developing into RLQ pain/referred pain around navel, rebound tenderness, N/V, anorexia, fever, chlls | Appendicitis |
| Upper midabdomen or upper back pain especially about three hours after eating, pain may also be relieved by eating, bloating, N/V, hematemesis, melena | Peptic Ulcer (Duodenal or Gastric) |
| LLQ pain, fever, malaise, body aches, chills, N/V | Diverticulitis |
| Retropubic (lower midabdomen) pain | Cystitis (bladder inflammation) |
| Upper abdomen pain (both quadrants), ETOH abuse, N/V, distention and tenderness, fever and tachycardia (late signs) | Pancreatitis |
| RUQ pain, referred pain to right shoulder, symptoms most prevalent after a fatty meal, N/V, indigestion | Gall Bladder Stone/Inflammation (Cholecystitis) |
| Painful urination, frequent urge to urinate, difficulty urinating, generalized discomfort evolving into extreme burning pain especially during urination, hematuria | Urinary Tract Infection (UTI) |
| Vague to extreme pain originating in the flank and may travel towards the genitalia, tachycardia, hypertension | Kidney Stone or Kidney Infection (Pyelonephritis) |
| Generalized edema, decreased or absent urine output, heart failure, hypertension | Acute Renal Failure |
| Altered LOC, seizures, lethargy, nausea, headaches, cramps | Chronic Renal Failure |
| Bradycardia, decreased metabolism, cold and dry skin, weight gain, weakness, constipation | Hypothyroidism |
| Tachycardia, skin hot and flushed, tremors, restlessness, irritability, diarrhea | Hyperthyroidism |
| Fatigue, nausea, frequent urination, thirst, unexplained weight loss, blurred vision, slowly healing wounds, cranky or confused mental status, unresponsive, seizures | Diabetes (undiagnosed Type 2) |
| Bizarre behavior, tachycardia, neurologic deficits, AMS, weakness, facial drooping, slurred speech, lack of coordination, anxiety, combativeness, pale moist and cool skin, dizziness | Hypoglycemia |
| Polyuria, vomiting, abdominal pain, deep and rapid breathing, fruity breath smell | Diabetic Ketoacidosis (DKA) |
| Slow and progressive decrease in LOC, severe dehydration, neurologic deficits | HONK (Hyperosmolar Nonketotic Coma) |
| Lower abdominal pain or low back pain, nausea, fever, pain during intercourse, bleeding between menstrual periods, rectal pain | Chlamydia |
| Dysuria, burning and itching of the genitals, yellowish or bloody discharge, foul odor, cramping, abdominal pain | Gonorrhea |
| Chancre, mucous membrane lesions, rash (generally on hands and feet), fever, swollen lymph glands, sore throat, hair loss, headaches, weight loss, muscle aches, fatigue, paralysis, dementia, blindness | Syphilis |
| Missed menstrual cycle, sudden onset of stabbing unilateral pain in lower abdomen, vaginal bleeding | Ectopic Pregnancy |
| Hematemesis (vomited blood), hemoptysis (cough up blood), melena (tarry stool), hematochezia (bloody stool), pain/tenderness, swelling, referred pain | Internal Bleeding |
| Irregular breathing pattern, widening pulse pressure, bradycardia, non-reactive or unequal pupils, amnesia, seizures, N/V, lacerations or contusions | Head Injury |
| Increased BP, bradycardia, irregular respirations | Increased Intracranial Pressure (Cushing’s Triad) |
| Loss of consciousness following injury, unilateral pupil fixation, later - increased BP, bradycardia, irregular respirations | Epidural Hematoma |
| Fluctuating LOC, unilateral hemiparesis, dysarthria (slurred speech), later - increased BP, bradycardia, irregular respirations | Subdural Hematoma |
| Short lived confusion and disorientation following injury, amnesia, dizziness, vomiting, visual changes, ringing in the ears, poor motor control, headache | Concussion |
| Unilaterally decreased or absent breath sounds, unequal chest rise, narrowing pulse pressure, hyperresonance to percussion, tachycardia, tachypnea, progressive dyspnea, decreasing LOC, JVD | Tension Pneumothorax |
| Tachycardia with weak pulse, respiratory distress, hypotension, narrowed pulse pressure, increased diastolic pressure, JVD, muffled heart tones | Pericardial Tamponade |
| Bradypnea, bradycardia, confusion, lethargy, aphasia, poor motor coordination, cool to cold skin, cyanosis, combativeness, exposure to cold | Hypothemia (progressive) |
| Dry tongue and thirst, dizziness, weakness, tachycardia, profuse sweating, Hx of prolonged exertion or exposure to extreme heat | Heat Exhaustion |
| Hot and dry skin, flushed appearance, falling LOC, AMS, seizures, tachycardia progressing to weak and thread pulse, tachypnea, Hx of prolonged exertion or exposure to extreme heat, cessation of sweating | Heat Stroke |
Created by:
jhinshaw
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