What is the diagnosis for a middle-aged lady with ongoing dizziness and palpitations for the past 3 days, presenting to the emergency department?

Differential Diagnoses for Each Case

Case 1: Child with Sore Throat, Jaundice, and Hepatosplenomegaly

• Single Most Likely Diagnosis: Infectious Mononucleosis (EBV) - justified by the combination of sore throat, jaundice, hepatosplenomegaly, and the child feeling tired.
• Other Likely Diagnoses:
  • Viral Hepatitis - could explain jaundice and hepatosplenomegaly.
  • Toxoplasmosis - might cause similar symptoms in immunocompromised individuals.
• Do Not Miss Diagnoses:
  • Leukemia - although less likely, it's crucial to rule out due to its severe implications.
  • Sickle Cell Disease - could cause hepatosplenomegaly and other systemic symptoms.
• Rare Diagnoses:
  • Lymphoma - a rare cause of hepatosplenomegaly and systemic symptoms.
  • Autoimmune Hemolytic Anemia - could explain jaundice and hepatosplenomegaly.

Case 2: Video of a Patient with Borderline Personality Disorder

• Single Most Likely Diagnosis: Borderline Personality Disorder - based on the video presentation.
• Other Likely Diagnoses:
  • Histrionic Personality Disorder - shares some similarities with borderline personality disorder.
  • Post-Traumatic Stress Disorder (PTSD) - could be a comorbid condition.
• Do Not Miss Diagnoses:
  • Bipolar Disorder - important to differentiate due to treatment implications.
  • Substance Use Disorder - could mimic or complicate borderline personality disorder.
• Rare Diagnoses:
  • Factitious Disorder - a rare condition where a person acts as if they have an illness.
  • Dissociative Identity Disorder - although rare, it might present with similar symptoms.

Case 3: Patient with GCS 10

• Single Most Likely Diagnosis: Traumatic Brain Injury - given the low GCS score.
• Other Likely Diagnoses:
  • Stroke - could cause altered mental status and low GCS.
  • Metabolic Encephalopathy - various metabolic issues could lead to a decreased level of consciousness.
• Do Not Miss Diagnoses:
  • Status Epilepticus - a medical emergency that requires immediate intervention.
  • Meningitis/Encephalitis - infections that could cause severe neurological symptoms.
• Rare Diagnoses:
  • Brain Tumor - although rare, it could cause increased intracranial pressure and low GCS.
  • Subarachnoid Hemorrhage - a severe condition with high morbidity and mortality.

Case 4: Erectile Dysfunction

• Single Most Likely Diagnosis: Vasculogenic Erectile Dysfunction - given the patient's age and late working hours.
• Other Likely Diagnoses:
  • Psychogenic Erectile Dysfunction - stress and relationship issues could contribute.
  • Neurogenic Erectile Dysfunction - possible if there are underlying neurological conditions.
• Do Not Miss Diagnoses:
  • Hypogonadism - low testosterone levels could cause erectile dysfunction.
  • Peyronie's Disease - a condition that causes curved, painful erections.
• Rare Diagnoses:
  • Priapism - a rare condition where erections are prolonged and painful.
  • Penile Fracture - a rare injury that could cause erectile dysfunction.

Case 5: Asthma Action Plan

• This case does not require a differential diagnosis as it involves explaining and demonstrating the use of an asthma action plan and spacer.

Case 6: Patient with Known BMD Under Lithium

• Single Most Likely Diagnosis: Bipolar Disorder (BMD) - as stated in the scenario.
• Other Likely Diagnoses:
  • Schizoaffective Disorder - could be considered if there are psychotic symptoms.
  • Major Depressive Disorder - might be a comorbid condition.
• Do Not Miss Diagnoses:
  • Lithium Toxicity - a serious condition that requires immediate attention.
  • Thyroid Dysfunction - lithium can affect thyroid function.
• Rare Diagnoses:
  • Cyclic Mood Disorder - a rare condition characterized by rapid cycling of mood symptoms.
  • Schizophrenia - although less likely, it's essential to rule out due to treatment implications.

Case 7: 9-Month-Old Child with Weight Concerns

• Single Most Likely Diagnosis: Failure to Thrive - given the child's weight and age.
• Other Likely Diagnoses:
  • Gastroesophageal Reflux Disease (GERD) - could cause feeding difficulties and weight loss.
  • Lactose Intolerance - might lead to malabsorption and failure to thrive.
• Do Not Miss Diagnoses:
  • Celiac Disease - an autoimmune disorder that causes malabsorption.
  • Congenital Heart Disease - could lead to failure to thrive due to increased metabolic demand.
• Rare Diagnoses:
  • Prader-Willi Syndrome - a rare genetic disorder that causes failure to thrive and other systemic symptoms.
  • Williams Syndrome - a genetic disorder that could cause failure to thrive and developmental delays.

Case 8: Daughter Admitted with BMD

• Single Most Likely Diagnosis: Bipolar Disorder (BMD) - as stated in the scenario.
• Other Likely Diagnoses:
  • Borderline Personality Disorder - might be considered if there are impulsivity and emotional dysregulation.
  • Schizoaffective Disorder - could be a differential if there are psychotic symptoms.
• Do Not Miss Diagnoses:
  • Substance-Induced Psychotic Disorder - important to rule out due to treatment implications.
  • Postpartum Psychosis - if the daughter has recently given birth.
• Rare Diagnoses:
  • Brief Psychotic Disorder - a rare condition characterized by a short duration of psychotic symptoms.
  • Cyclothymic Disorder - a rare mood disorder with periods of hypomania and depression.

Case 9: 36-Week Pregnant Woman with Itchy Lower Abdomen

• Single Most Likely Diagnosis: Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) - given the itchy rash in the lower abdomen during pregnancy.
• Other Likely Diagnoses:
  • Intrahepatic Cholestasis of Pregnancy (ICP) - could cause itching without a rash.
  • Polymorphic Eruption of Pregnancy (PEP) - a condition that causes a rash and itching.
• Do Not Miss Diagnoses:
  • Pemphigoid Gestationis - a rare autoimmune disorder that causes blistering and itching.
  • Cholestasis due to other causes - important to rule out due to potential fetal risks.
• Rare Diagnoses:
  • Prurigo of Pregnancy - a rare condition characterized by itchy nodules.
  • Atopic Eruption of Pregnancy - a rare condition with itchy, eczematous lesions.

Case 10: Young Male with Pain in Left Leg on Walking

• Single Most Likely Diagnosis: Intermittent Claudication - given the pain in the leg on walking.
• Other Likely Diagnoses:
  • Deep Vein Thrombosis (DVT) - could cause leg pain and swelling.
  • Peripheral Artery Disease (PAD) - might cause claudication and leg pain.
• Do Not Miss Diagnoses:
  • Pulmonary Embolism - a medical emergency that requires immediate attention.
  • Aortic Dissection - a severe condition with high morbidity and mortality.
• Rare Diagnoses:
  • Buerger's Disease - a rare condition that causes inflammation and clots in blood vessels.
  • Popliteal Artery Entrapment Syndrome - a rare condition that causes leg pain and claudication.

Case 11: Young Male with Left Submandibular Lymph Node Pain

• Single Most Likely Diagnosis: Infectious Mononucleosis (EBV) - given the lymph node pain and potential for sore throat.
• Other Likely Diagnoses:
  • Bacterial Pharyngitis - could cause lymph node pain and sore throat.
  • Dental Abscess - might cause localized lymph node pain.
• Do Not Miss Diagnoses:
  • Tuberculosis (TB) - important to rule out due to public health implications.
  • Lymphoma - a rare but serious condition that requires prompt diagnosis.
• Rare Diagnoses:
  • Cat-Scratch Disease - a rare condition that causes lymph node pain and swelling.
  • Kikuchi-Fujimoto Disease - a rare condition that causes lymph node pain and fever.

Case 12: Young Lady Starting a New Relationship

• This case does not require a differential diagnosis as it involves taking a history and advising on testing for sexually transmitted infections (STIs).

Case 13: 82-Year-Old Lady with Hip Surgery and T10 >20% Wedge Fractures

• Single Most Likely Diagnosis: Osteoporosis - given the wedge fractures and age.
• Other Likely Diagnoses:
  • Osteopenia - might be considered if bone density is lower than normal but not osteoporotic.
  • Vertebral Compression Fracture - could be caused by osteoporosis or trauma.
• Do Not Miss Diagnoses:
  • Multiple Myeloma - a rare condition that causes bone lesions and fractures.
  • Metastatic Cancer - important to rule out due to treatment implications.
• Rare Diagnoses:
  • Osteogenesis Imperfecta - a rare genetic disorder that causes brittle bones.
  • Fibrous Dysplasia - a rare condition that causes bone lesions and fractures.

Case 14: Eye Examination

• This case does not provide enough information for a differential diagnosis.

Case 15: Old Lady with Fracture of the Head of Femur and Cognitive Impairment

• Single Most Likely Diagnosis: Dementia - given the cognitive impairment.
• Other Likely Diagnoses:
  • Delirium - might be considered if there are acute changes in mental status.
  • Depression - could cause cognitive impairment and functional decline.
• Do Not Miss Diagnoses:
  • Normal Pressure Hydrocephalus (NPH) - a rare condition that causes cognitive decline and gait disturbances.
  • Chronic Subdural Hematoma - a serious condition that requires prompt diagnosis and treatment.
• Rare Diagnoses:
  • Creutzfeldt-Jakob Disease - a rare prion disease that causes rapid cognitive decline.
  • Frontotemporal Dementia - a rare condition that causes cognitive and behavioral changes.