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EMS Diff. Diagnosis

EMS Medical/Trauma Pathopysiology and Differential Diagnosis Practice

QuestionAnswer
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 on 2011-12-09



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