What counseling is recommended for a smoker admitted to the hospital with chest pain diagnosed as muscle pain?

Differential Diagnoses for Each Case

Case 1: Rt hand and Fingers pain with stiffness in the morning

• Single most likely diagnosis: Rheumatoid Arthritis (RA) - Morning stiffness and pain in the hands and fingers are common symptoms of RA.
• Other Likely diagnoses:
  • Osteoarthritis (OA) - Although OA is more common, the morning stiffness and elbow rash make RA more likely.
  • Psoriatic Arthritis (PsA) - The elbow rash could be psoriatic, suggesting PsA.
• Do Not Miss:
  • Septic Arthritis - Although less likely, septic arthritis is a medical emergency that requires prompt treatment.
• Rare diagnoses:
  • Scleroderma - A rare autoimmune disease that can cause hand and finger pain.

Case 2: Young male with behavioural changes and hallucinations

• Single most likely diagnosis: Schizophrenia - The presence of auditory hallucinations, thought insertion, and persecutory delusions are characteristic of schizophrenia.
• Other Likely diagnoses:
  • Bipolar Disorder with Psychotic Features - Although less likely, bipolar disorder can present with psychotic symptoms.
  • Substance-Induced Psychosis - The patient's symptoms could be caused by substance use.
• Do Not Miss:
  • Neurosyphilis - A rare but serious condition that can cause psychiatric symptoms.
• Rare diagnoses:
  • Temporal Lobe Epilepsy - A rare condition that can cause hallucinations and other psychiatric symptoms.

Case 3: H/o fall, left side u/L and lower limb weakness

• Single most likely diagnosis: Stroke - The patient's symptoms, including weakness and upgoing plantar reflex, suggest a stroke.
• Other Likely diagnoses:
  • Spinal Cord Injury - The patient's history of fall and weakness suggest a possible spinal cord injury.
  • Multiple Sclerosis (MS) - Although less likely, MS can cause weakness and neurological symptoms.
• Do Not Miss:
  • Spinal Epidural Hematoma - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Amyotrophic Lateral Sclerosis (ALS) - A rare neurodegenerative disease that can cause weakness.

Case 4: Father with b/l Red eyes

• Single most likely diagnosis: Viral Conjunctivitis - The patient's symptoms, including red eyes and a history of similar symptoms in his child, suggest viral conjunctivitis.
• Other Likely diagnoses:
  • Bacterial Conjunctivitis - Although less likely, bacterial conjunctivitis is a possible diagnosis.
  • Allergic Conjunctivitis - The patient's symptoms could be caused by an allergic reaction.
• Do Not Miss:
  • Gonococcal Conjunctivitis - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Sjögren's Syndrome - A rare autoimmune disease that can cause conjunctivitis.

Case 5: Rectal bleeding

• Single most likely diagnosis: Hemorrhoids - The patient's symptoms, including rectal bleeding, suggest hemorrhoids.
• Other Likely diagnoses:
  • Diverticulitis - Although less likely, diverticulitis can cause rectal bleeding.
  • Inflammatory Bowel Disease (IBD) - The patient's symptoms could be caused by IBD.
• Do Not Miss:
  • Colorectal Cancer - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Angiodysplasia - A rare condition that can cause rectal bleeding.

Case 6: Lady trying to be pregnant

• Single most likely diagnosis: Infrequent Intercourse - The patient's symptoms, including infrequent intercourse, suggest that this is the most likely cause of her infertility.
• Other Likely diagnoses:
  • Polycystic Ovary Syndrome (PCOS) - Although less likely, PCOS is a common cause of infertility.
  • Male Factor Infertility - The patient's husband's fertility could be a contributing factor.
• Do Not Miss:
  • Tubal Damage - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Endometriosis - A rare condition that can cause infertility.

Case 7: 36wk pregnant lady with abdominal pain

• Single most likely diagnosis: Pre-eclampsia - The patient's symptoms, including abdominal pain and hypertension, suggest pre-eclampsia.
• Other Likely diagnoses:
  • Placental Abruption - Although less likely, placental abruption can cause abdominal pain.
  • Urinary Tract Infection (UTI) - The patient's symptoms could be caused by a UTI.
• Do Not Miss:
  • Eclampsia - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Hepatitis - A rare condition that can cause abdominal pain during pregnancy.

Case 8: Guy with sleep issues

• Single most likely diagnosis: Sleep Disorder - The patient's symptoms, including excessive sleepiness, suggest a sleep disorder.
• Other Likely diagnoses:
  • Depression - Although less likely, depression can cause sleep disturbances.
  • Anxiety - The patient's symptoms could be caused by anxiety.
• Do Not Miss:
  • Sleep Apnea - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Narcolepsy - A rare condition that can cause excessive sleepiness.

Case 9: Lady with dysthymia and major depression

• Single most likely diagnosis: Depression - The patient's symptoms, including feelings of loneliness and unhappiness, suggest depression.
• Other Likely diagnoses:
  • Anxiety - Although less likely, anxiety can contribute to the patient's symptoms.
  • Somatization Disorder - The patient's symptoms could be caused by a somatization disorder.
• Do Not Miss:
  • Bipolar Disorder - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Borderline Personality Disorder - A rare condition that can cause emotional dysregulation.

Case 10: Thin elderly female with a bruise on center of her chest

• Single most likely diagnosis: Rib Fracture - The patient's symptoms, including a bruise on the chest and rib fractures, suggest a rib fracture.
• Other Likely diagnoses:
  • Pulmonary Contusion - Although less likely, a pulmonary contusion can cause chest pain.
  • Cardiac Contusion - The patient's symptoms could be caused by a cardiac contusion.
• Do Not Miss:
  • Aortic Dissection - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Pneumothorax - A rare condition that can cause chest pain.

Case 11: Pt with high bp

• Single most likely diagnosis: Hypertension - The patient's symptoms, including high blood pressure, suggest hypertension.
• Other Likely diagnoses:
  • White Coat Hypertension - Although less likely, white coat hypertension can cause elevated blood pressure readings.
  • Secondary Hypertension - The patient's symptoms could be caused by an underlying condition.
• Do Not Miss:
  • Pheochromocytoma - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Hyperaldosteronism - A rare condition that can cause hypertension.

Case 12: NEONATE PE

• Single most likely diagnosis: Normal Newborn - The patient's symptoms, including a normal physical exam, suggest a normal newborn.
• Other Likely diagnoses:
  • Congenital Heart Disease - Although less likely, congenital heart disease can cause symptoms in a newborn.
  • Respiratory Distress Syndrome - The patient's symptoms could be caused by respiratory distress syndrome.
• Do Not Miss:
  • Infection - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Genetic Disorder - A rare condition that can cause symptoms in a newborn.

Case 13: THYROID PE- Goitre

• Single most likely diagnosis: Goiter - The patient's symptoms, including a goiter, suggest a goiter.
• Other Likely diagnoses:
  • Hypothyroidism - Although less likely, hypothyroidism can cause a goiter.
  • Hyperthyroidism - The patient's symptoms could be caused by hyperthyroidism.
• Do Not Miss:
  • Thyroid Cancer - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Thyroiditis - A rare condition that can cause a goiter.

Case 14: 3 month old Cough

• Single most likely diagnosis: Viral Infection - The patient's symptoms, including a cough and apneic episodes, suggest a viral infection.
• Other Likely diagnoses:
  • Respiratory Syncytial Virus (RSV) - Although less likely, RSV can cause symptoms in a 3-month-old.
  • Pertussis - The patient's symptoms could be caused by pertussis.
• Do Not Miss:
  • Pneumonia - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Congenital Heart Disease - A rare condition that can cause symptoms in a 3-month-old.

Case 15: 9 month old with yellowish Vomit

• Single most likely diagnosis: Pyloric Stenosis - The patient's symptoms, including yellowish vomit and a mass in the right epigastric region, suggest pyloric stenosis.
• Other Likely diagnoses:
  • Gastroesophageal Reflux Disease (GERD) - Although less likely, GERD can cause symptoms in a 9-month-old.
  • Intussusception - The patient's symptoms could be caused by intussusception.
• Do Not Miss:
  • Volvulus - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Congenital Diaphragmatic Hernia - A rare condition that can cause symptoms in a 9-month-old.

Case 16: Smoker with chest pain

• Single most likely diagnosis: Coronary Artery Disease - The patient's symptoms, including chest pain and a history of smoking, suggest coronary artery disease.
• Other Likely diagnoses:
  • Pulmonary Embolism - Although less likely, pulmonary embolism can cause chest pain.
  • Pneumonia - The patient's symptoms could be caused by pneumonia.
• Do Not Miss:
  • Aortic Dissection - A rare but serious condition that requires prompt treatment.
• Rare diagnoses:
  • Lung Cancer - A rare condition that can cause chest pain in a smoker.