Differential Diagnosis

The patient presents with short-term memory affected, no focal neurology, and a very high D-dimer level. The following differential diagnoses are considered:

• Single most likely diagnosis
  • Pulmonary Embolism (PE): The high D-dimer level is a strong indicator of PE, which can cause short-term memory issues due to hypoxia. The absence of focal neurology and the unremarkable abdominal, cardiovascular, and respiratory systems do not rule out PE, as it can present with non-specific symptoms.
• Other Likely diagnoses
  • Acute Coronary Syndrome (ACS): Although the cardiovascular system is reported as unremarkable, ACS can cause short-term memory issues due to decreased cardiac output and subsequent hypoxia. The high D-dimer level can also be seen in ACS.
  • Sepsis: Sepsis can cause short-term memory issues due to the systemic inflammatory response. The high D-dimer level can be seen in sepsis, and the absence of focal neurology does not rule out this diagnosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Disseminated Intravascular Coagulation (DIC): Although less likely, DIC can cause a high D-dimer level and short-term memory issues due to microthrombi formation. Missing this diagnosis can be fatal.
  • Fat Embolism Syndrome: This condition can cause short-term memory issues due to hypoxia and can have a high D-dimer level. It is a rare but potentially deadly condition that should not be missed.
• Rare diagnoses
  • Cerebral Vasculitis: This condition can cause short-term memory issues and can have a high D-dimer level. However, it is a rare diagnosis and would require further investigation to confirm.
  • Paraneoplastic Syndrome: This condition can cause short-term memory issues and can have a high D-dimer level. However, it is a rare diagnosis and would require further investigation to confirm.