Differential Diagnosis for a 43-year-old Female with Worsening Headaches and New Onset of Right Lower Quadrant Abdominal Bruise
- Single most likely diagnosis:
- Hypertension: This could be a likely cause for worsening headaches due to elevated blood pressure. The abdominal bruise could be related to a bleeding disorder or vasculitis, but without more information, hypertension is a common condition that could explain the headaches.
- Other Likely diagnoses:
- Bleeding disorder or coagulopathy: The presence of an abdominal bruise without injury suggests a possible bleeding disorder or coagulopathy, which could also contribute to headaches if there is any intracranial bleeding.
- Vasculitis: Conditions like polyarteritis nodosa or giant cell arteritis could cause both headaches and bruising due to inflammation of blood vessels.
- Medication side effect: Certain medications can cause bruising and headaches as side effects.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Abdominal aortic aneurysm (AAA): Although less common in women, an AAA could cause abdominal bruising and potentially headaches if there is associated hypertension or pain.
- Intracranial hemorrhage: This is a medical emergency that could present with sudden onset of headache and potentially systemic symptoms like bruising if there is an underlying coagulopathy.
- Pheochromocytoma: A rare tumor that causes episodic hypertension, which could lead to headaches and potentially other systemic symptoms including bruising due to hypertension-induced vascular damage.
- Rare diagnoses:
- Ehlers-Danlos syndrome: A genetic disorder that affects connective tissue and could lead to easy bruising and potentially headaches due to vascular or neurological complications.
- Sickle cell disease: Although typically diagnosed in childhood, sickle cell disease could cause a variety of systemic symptoms including headaches and bruising due to vaso-occlusive crises.
- Thrombotic thrombocytopenic purpura (TTP): A rare blood disorder characterized by clotting in small blood vessels throughout the body, which could lead to bruising and potentially headaches due to microvascular occlusion.