Diagnosis and Management Guides
Clinical diagnosis guides covering urgent differentials, red flags, workup, management, and disposition.
Chest Pain
Key considerations: Acute Coronary Syndrome (ACS), Aortic Dissection, Pulmonary EmbolismPalpitations
Key considerations: Ventricular tachycardia, Atrial fibrillation with rapid ventricular response, Wolff-Parkinson-White (WPW) with pre-excited AFSyncope
Key considerations: Cardiac arrhythmia (VT, bradycardia, heart block), Aortic stenosis, Pulmonary embolismHypertensive Emergency
Key considerations: Hypertensive encephalopathy, Aortic dissection, Acute heart failure / pulmonary edemaDyspnea
Key considerations: Pulmonary embolism, Tension pneumothorax, Acute heart failure / pulmonary edemaPulmonary Embolism
Key considerations: Massive PE with hemodynamic collapse, Saddle PE, Right heart failure from PEAcute Asthma Exacerbation
Key considerations: Status asthmaticus, Anaphylaxis mimicking asthma, Foreign body aspirationCOPD Exacerbation
Key considerations: Pneumothorax, Pulmonary embolism, Acute heart failureHeadache
Key considerations: Subarachnoid hemorrhage (SAH), Meningitis / Encephalitis, Intracranial mass / tumorStroke / TIA
Key considerations: Large vessel occlusion (LVO), Hemorrhagic stroke (ICH), Basilar artery occlusionSeizure
Key considerations: Status epilepticus (seizure >5 minutes), Meningitis / Encephalitis, Intracranial hemorrhageAltered Mental Status
Key considerations: Hypoglycemia, Stroke, Meningitis / EncephalitisAbdominal Pain
Key considerations: Ruptured AAA, Mesenteric ischemia, Ectopic pregnancyGI Bleeding
Key considerations: Massive hemorrhage with hemodynamic instability, Variceal bleeding (esophageal varices), Aortoenteric fistulaNausea and Vomiting
Key considerations: Bowel obstruction, DKA, Acute coronary syndrome (atypical)Flank Pain / Renal Colic
Key considerations: Ruptured AAA (mimics renal colic), Pyelonephritis with sepsis, Obstructing stone with solitary kidneyTesticular Pain
Key considerations: Testicular torsion, Incarcerated inguinal hernia, Fournier gangreneSepsis
Key considerations: Septic shock, Meningococcemia, Necrotizing fasciitisHead Trauma / Mild TBI
Key considerations: Epidural hematoma, Subdural hematoma, Traumatic subarachnoid hemorrhageAnkle and Foot Injury
Key considerations: Open fracture, Compartment syndrome (foot), Lisfranc injuryPediatric Fever
Key considerations: Meningitis, Sepsis / Bacteremia, Urinary Tract Infection (pyelonephritis)Pediatric Respiratory Distress
Key considerations: Foreign body aspiration, Epiglottitis, Severe croup with impending obstructionPediatric Seizure
Key considerations: Status epilepticus, Meningitis / Encephalitis, Intracranial hemorrhage (NAT)Pediatric Dehydration
Key considerations: Hypovolemic shock, Diabetic ketoacidosis (DKA), Pyloric stenosisPediatric Abdominal Pain
Key considerations: Appendicitis, Intussusception, Malrotation with midgut volvulusNon-Accidental Trauma (Child Abuse)
Key considerations: Abusive head trauma (shaken baby), Occult fractures, Abdominal organ injury from abusePediatric Asthma Exacerbation
Key considerations: Status asthmaticus, Foreign body aspiration mimicking wheeze, AnaphylaxisCroup (Laryngotracheobronchitis)
Key considerations: Epiglottitis, Bacterial tracheitis, Retropharyngeal abscessPediatric Head Injury
Key considerations: Epidural hematoma, Subdural hematoma, Cerebral contusion or hemorrhagePediatric DKA
Key considerations: Cerebral edema (most feared complication), Severe hypokalemia, Cardiac arrhythmia from electrolyte derangementBronchiolitis
Key considerations: Respiratory failure requiring escalation, Apnea (especially <2 months or premature infants), Myocarditis mimicking bronchiolitisPediatric Urinary Tract Infection
Key considerations: Pyelonephritis (upper UTI), Urosepsis, Renal abscessPediatric Rash
Key considerations: Meningococcemia (petechiae/purpura + fever + toxic), Kawasaki disease, Stevens-Johnson Syndrome / TENPediatric Limp
Key considerations: Septic arthritis, Osteomyelitis, Legg-Calve-Perthes diseaseNeonatal Jaundice
Key considerations: Kernicterus (bilirubin encephalopathy), Biliary atresia, Hemolytic disease (Rh/ABO incompatibility, G6PD)Pediatric Anaphylaxis
Key considerations: Biphasic anaphylaxis (recurrence 1-72 hours later), Refractory anaphylaxis, Anaphylaxis masquerading as asthma or urticariaAcute Kidney Injury
Key considerations: Post-renal obstruction (bilateral ureteral, bladder outlet), Renal artery thrombosis/dissection, Thrombotic microangiopathy (TTP/HUS)Hyponatremia
Key considerations: Severe hyponatremia with seizures or coma, Adrenal crisis (acute adrenal insufficiency), Cerebral salt wasting (post-neurosurgery)Acute Decompensated Heart Failure
Key considerations: Cardiogenic shock, Acute MI as precipitant, Acute valvular emergency (MR, AR)Acute Appendicitis
Key considerations: Perforated appendicitis with sepsis, Appendiceal abscess, Appendiceal neoplasm (especially in elderly)Small Bowel Obstruction
Key considerations: Closed-loop obstruction with strangulation, Volvulus, Internal herniaAcute Cholecystitis
Key considerations: Gallbladder perforation, Cholangitis (Charcot triad/Reynolds pentad), Emphysematous cholecystitisAcute Psychosis
Key considerations: Substance-induced psychosis (stimulants, PCP, synthetic cannabinoids), Anti-NMDA receptor encephalitis, Delirium (medical cause masquerading as psychosis)Alcohol Withdrawal
Key considerations: Delirium tremens (DTs), Withdrawal seizures, Wernicke encephalopathySuicidal Ideation
Key considerations: Active plan with intent and means, Recent suicide attempt, Command auditory hallucinations to harm selfIschemic Stroke
Key considerations: Large vessel occlusion (LVO) amenable to thrombectomy, Posterior circulation stroke (basilar artery), Hemorrhagic stroke mimicking ischemicVertigo / Acute Vestibular Syndrome
Key considerations: Posterior circulation stroke (cerebellar/brainstem), Vertebral artery dissection, Cerebellar hemorrhagePreeclampsia / Eclampsia
Key considerations: Eclampsia (seizures), HELLP syndrome, Placental abruptionPostpartum Hemorrhage
Key considerations: Uterine atony (most common cause — 80%), Retained placenta/products, Uterine ruptureEctopic Pregnancy
Key considerations: Ruptured ectopic with hemoperitoneum, Heterotopic pregnancy (concurrent IUP + ectopic, especially after IVF)Hypertension Management
Key considerations: Secondary hypertension (renal artery stenosis, pheochromocytoma, Cushing, primary aldosteronism, coarctation), Hypertensive emergency with end-organ damage, Resistant hypertension (uncontrolled on 3+ drugs including diuretic)Type 2 Diabetes Management
Key considerations: DKA or HHS, Undiagnosed Type 1 (autoimmune markers), Hypoglycemia from treatmentMajor Depressive Disorder
Key considerations: Suicidal ideation with plan, Bipolar disorder (screen before starting antidepressant), Medical causes: hypothyroidism, B12 deficiency, anemia, malignancyAsthma Exacerbation
Key considerations: Status asthmaticus, Pneumothorax, AnaphylaxisUrinary Tract Infection
Key considerations: Pyelonephritis, Urosepsis, Urinary obstructionCOPD Exacerbation
Key considerations: Pneumonia, PE, PneumothoraxDeep Vein Thrombosis
Key considerations: Pulmonary embolism, Phlegmasia cerulea dolens, Compartment syndromeCellulitis
Key considerations: Necrotizing fasciitis, Sepsis, DVTNSTEMI / Unstable Angina
Key considerations: STEMI evolution, Aortic dissection, MyocarditisAcute Heart Failure
Key considerations: Cardiogenic shock, Acute MI causing CHF, Valvular emergencyCommunity-Acquired Pneumonia
Key considerations: Sepsis, Empyema, Lung abscessUpper GI Bleeding
Key considerations: Variceal hemorrhage, Aortoenteric fistula, Perforated ulcerAcute Kidney Injury
Key considerations: Obstructive uropathy, Rhabdomyolysis, TTP/HUSDiabetic Ketoacidosis
Key considerations: Sepsis as trigger, MI as trigger, Euglycemic DKA (SGLT2 inhibitors)Sepsis / Septic Shock
Key considerations: Septic shock, Necrotizing fasciitis, MeningitisAcute Ischemic Stroke
Key considerations: Large vessel occlusion, Hemorrhagic stroke, Hypoglycemia mimicking strokeNew-Onset Seizure
Key considerations: Status epilepticus, CNS infection, Brain tumorMigraine Headache
Key considerations: Subarachnoid hemorrhage, Meningitis, Cerebral venous thrombosisLow Back Pain
Key considerations: Cauda equina syndrome, Spinal epidural abscess, Vertebral fractureAnaphylaxis
Key considerations: Anaphylactic shock, Angioedema with airway compromiseThyroid Storm
Key considerations: Thyroid storm (mortality 10-30%), Sepsis mimicking thyroid stormBacterial Meningitis
Key considerations: Bacterial meningitis, HSV encephalitis, Brain abscessAcute Appendicitis
Key considerations: Perforated appendicitis, Appendiceal abscess, Ectopic pregnancyHip Fracture
Key considerations: Pathologic fracture, Open fracture, Vascular injuryAtrial Fibrillation
Key considerations: Rapid AFib with hemodynamic instability, WPW with AFib, New AFib from PE, sepsis, or MISmall Bowel Obstruction
Key considerations: Strangulated/ischemic bowel, Closed-loop obstruction, PerforationPulmonary Embolism
Key considerations: Massive PE with shock, Saddle PE, Right heart strainHyponatremia
Key considerations: Severe hyponatremia with seizures/AMS, Cerebral edema, Osmotic demyelination from overcorrectionEctopic Pregnancy
Key considerations: Ruptured ectopic with hemorrhagic shock, Heterotopic pregnancyHyperkalemia
Key considerations: Cardiac arrest from hyperkalemia, Pseudo-hyperkalemia (hemolyzed sample)Croup (Laryngotracheobronchitis)
Key considerations: Epiglottitis, Foreign body aspiration, Bacterial tracheitisBronchiolitis
Key considerations: Pertussis, Foreign body, Congenital heart diseaseFever in Young Child
Key considerations: Meningitis, Bacteremia, UTIKawasaki Disease
Key considerations: Coronary artery aneurysm, Myocarditis, Macrophage activation syndromeSuicide Risk Assessment
Key considerations: Active suicidal ideation with plan and means, Recent suicide attempt, Self-harm with medical injuryPanic Attack / Panic Disorder
Key considerations: Myocardial infarction, Pulmonary embolism, ThyrotoxicosisPreeclampsia
Key considerations: Eclampsia, HELLP syndrome, Placental abruptionPostpartum Hemorrhage
Key considerations: Uterine rupture, DIC, Retained placentaChild Abuse / Non-Accidental Trauma
Key considerations: Abusive head trauma (shaken baby), Internal organ injury, Occult fracturesSLE Flare
Key considerations: Lupus nephritis, Lupus cerebritis, Catastrophic APSAcute Cholecystitis
Key considerations: Ascending cholangitis, Gallstone pancreatitis, Cholecystoenteric fistulaAcute Pancreatitis
Key considerations: Necrotizing pancreatitis, Infected pancreatic necrosis, Organ failureGuillain-Barre Syndrome
Key considerations: Respiratory failure requiring intubation, Autonomic dysfunction, Spinal cord compression mimicking GBSVertigo / Dizziness
Key considerations: Posterior circulation stroke, Cerebellar hemorrhage, Vertebral artery dissectionST-Elevation Myocardial Infarction
Key considerations: STEMI, Aortic dissection with coronary involvement, MyocarditisPneumothorax
Key considerations: Tension pneumothorax, Open pneumothorax, HemopneumothoraxInguinal Hernia
Key considerations: Incarcerated hernia, Strangulated hernia, Testicular torsionAdolescent Depression
Key considerations: Active suicidality, Bipolar disorder presenting as depression, Substance abusePlacental Abruption
Key considerations: Massive abruption with fetal demise, DIC, Hypovolemic shockTesticular Torsion
Key considerations: Testicular torsion (surgical emergency), Fournier gangreneToxic Ingestion (Pediatric)
Key considerations: Lethal in one pill/dose: calcium channel blockers, beta-blockers, opioids, sulfonylureas, TCAs, clonidine, Button battery ingestion, Iron toxicityChronic Kidney Disease Management
Key considerations: Rapidly progressive GN, Reversible causes of CKD decline, Uremic emergencyHypertensive Emergency
Key considerations: Aortic dissection, Hypertensive encephalopathy, EclampsiaSpinal Cord Compression
Key considerations: Metastatic spinal cord compression, Epidural abscess, Cauda equina syndromeDiabetic Foot Infection
Key considerations: Osteomyelitis, Necrotizing fasciitis, Charcot neuroarthropathyADHD Evaluation
Key considerations: Learning disability, Anxiety disorder, Hearing/vision impairmentAortic Dissection
Key considerations: Stanford Type A (ascending) — surgical emergency, Malperfusion syndrome, Cardiac tamponadeAlcohol Withdrawal
Key considerations: Delirium tremens, Withdrawal seizures, Wernicke encephalopathyInfective Endocarditis
Key considerations: Septic emboli (stroke, splenic/renal infarcts), Valvular destruction, Heart failurePediatric Dehydration
Key considerations: Severe dehydration with shock, DKA, IntussusceptionWernicke Encephalopathy
Key considerations: Wernicke encephalopathy (confusion + ophthalmoplegia + ataxia), Korsakoff psychosis (irreversible), Hypoglycemia mimicking presentationElectrical Injury
Key considerations: Cardiac arrhythmia (can be delayed), Rhabdomyolysis, Internal burns greater than external appearanceAcute Mesenteric Ischemia
Key considerations: SMA embolism (most common — atrial fibrillation source), SMA thrombosis, Non-occlusive mesenteric ischemia (NOMI)SIADH
Key considerations: Cerebral salt wasting (vs SIADH — volume status differentiates), Adrenal insufficiency, Hypothyroidism causing hyponatremiaInfective Endocarditis
Key considerations: Embolic stroke from vegetation, Mycotic aneurysm, Perivalvular abscessAcute Pancreatitis
Key considerations: Necrotizing pancreatitis, Infected necrosis, Pancreatic abscessAbdominal Compartment Syndrome
Key considerations: Intra-abdominal hypertension progressing to ACS, Missed in ICU post-damage control surgery, Multiorgan failure from untreated ACSHemorrhagic Shock
Key considerations: Class III-IV shock (>30% blood volume loss), Occult hemorrhage (retroperitoneal, pelvic, thoracic), Coagulopathy of traumaSurgical Site Infection
Key considerations: Deep space infection vs superficial SSI, Anastomotic leak presenting as SSI, Necrotizing fasciitis masquerading as cellulitisCOPD Stable Management
Key considerations: Lung cancer (shared risk factors), Heart failure masquerading as COPD, Alpha-1 antitrypsin deficiency in young patientsAdult Preventive Screening
Key considerations: Missed colorectal cancer screening, Undiagnosed hypertension, Undiagnosed diabetesPolypharmacy and Medication Reconciliation
Key considerations: Anticholinergic burden causing cognitive impairment, Drug-drug interactions causing toxicity, Inappropriate medications per Beers Criteria in elderlyNeonatal Hypoglycemia
Key considerations: Persistent hyperinsulinism (congenital), Inborn errors of metabolism, Adrenal insufficiencyPediatric UTI
Key considerations: Pyelonephritis with bacteremia in young infants, Underlying urological abnormality (VUR, posterior urethral valves), Missed diagnosis causing renal scarringPediatric DKA
Key considerations: Cerebral edema (0.5-1% of peds DKA — highest risk young children and new-onset), Hypoglycemia from over-aggressive insulin, Hypokalemia causing arrhythmiaSerotonin Syndrome
Key considerations: NMS (differentiate: SS has rapid onset/clonus vs NMS has slow onset/lead-pipe rigidity), Anticholinergic toxicity, Malignant hyperthermiaAlcohol Intoxication and Withdrawal Spectrum
Key considerations: Subdural hematoma (alcoholics fall and have coagulopathy), Wernicke encephalopathy, HypoglycemiaFirst Episode Psychosis Workup
Key considerations: Anti-NMDA receptor encephalitis, Substance-induced psychosis, CNS infection/tumorPosterior Circulation Stroke
Key considerations: Basilar artery occlusion (locked-in syndrome, high mortality), Cerebellar infarct with edema (obstructive hydrocephalus), Vertebral artery dissectionHypertensive Encephalopathy
Key considerations: Ischemic stroke (do not lower BP aggressively), Hemorrhagic stroke, PRES (posterior reversible encephalopathy syndrome)Syncope Evaluation
Key considerations: Seizure mimicking syncope, Cardiac arrhythmia causing syncope, Vertebrobasilar TIAHyperemesis Gravidarum
Key considerations: Molar pregnancy (markedly elevated hCG), Multiple gestation, Hyperthyroidism of pregnancyPlacental Abruption
Key considerations: Concealed abruption (no visible bleeding), DIC from massive abruption, Fetal distress and demiseOvarian Hyperstimulation Syndrome
Key considerations: Ovarian torsion (enlarged stimulated ovaries at higher risk), Ectopic pregnancy in IVF patients, Pulmonary embolism (hypercoagulable state)Chest Pain Risk Stratification
Key considerations: ACS, Aortic dissection, PEHypotension
Key considerations: Tension pneumothorax, Cardiac tamponade, Massive pulmonary embolismSickle Cell Crisis
Key considerations: Acute Chest Syndrome (ACS) — most common cause of death in sickle cell disease, Stroke — ischemic or hemorrhagic, Splenic sequestration crisis — life-threatening in children
Key considerations: Acute Coronary Syndrome (ACS), Aortic Dissection, Pulmonary EmbolismPalpitations
Key considerations: Ventricular tachycardia, Atrial fibrillation with rapid ventricular response, Wolff-Parkinson-White (WPW) with pre-excited AFSyncope
Key considerations: Cardiac arrhythmia (VT, bradycardia, heart block), Aortic stenosis, Pulmonary embolismHypertensive Emergency
Key considerations: Hypertensive encephalopathy, Aortic dissection, Acute heart failure / pulmonary edemaDyspnea
Key considerations: Pulmonary embolism, Tension pneumothorax, Acute heart failure / pulmonary edemaPulmonary Embolism
Key considerations: Massive PE with hemodynamic collapse, Saddle PE, Right heart failure from PEAcute Asthma Exacerbation
Key considerations: Status asthmaticus, Anaphylaxis mimicking asthma, Foreign body aspirationCOPD Exacerbation
Key considerations: Pneumothorax, Pulmonary embolism, Acute heart failureHeadache
Key considerations: Subarachnoid hemorrhage (SAH), Meningitis / Encephalitis, Intracranial mass / tumorStroke / TIA
Key considerations: Large vessel occlusion (LVO), Hemorrhagic stroke (ICH), Basilar artery occlusionSeizure
Key considerations: Status epilepticus (seizure >5 minutes), Meningitis / Encephalitis, Intracranial hemorrhageAltered Mental Status
Key considerations: Hypoglycemia, Stroke, Meningitis / EncephalitisAbdominal Pain
Key considerations: Ruptured AAA, Mesenteric ischemia, Ectopic pregnancyGI Bleeding
Key considerations: Massive hemorrhage with hemodynamic instability, Variceal bleeding (esophageal varices), Aortoenteric fistulaNausea and Vomiting
Key considerations: Bowel obstruction, DKA, Acute coronary syndrome (atypical)Flank Pain / Renal Colic
Key considerations: Ruptured AAA (mimics renal colic), Pyelonephritis with sepsis, Obstructing stone with solitary kidneyTesticular Pain
Key considerations: Testicular torsion, Incarcerated inguinal hernia, Fournier gangreneSepsis
Key considerations: Septic shock, Meningococcemia, Necrotizing fasciitisHead Trauma / Mild TBI
Key considerations: Epidural hematoma, Subdural hematoma, Traumatic subarachnoid hemorrhageAnkle and Foot Injury
Key considerations: Open fracture, Compartment syndrome (foot), Lisfranc injuryPediatric Fever
Key considerations: Meningitis, Sepsis / Bacteremia, Urinary Tract Infection (pyelonephritis)Pediatric Respiratory Distress
Key considerations: Foreign body aspiration, Epiglottitis, Severe croup with impending obstructionPediatric Seizure
Key considerations: Status epilepticus, Meningitis / Encephalitis, Intracranial hemorrhage (NAT)Pediatric Dehydration
Key considerations: Hypovolemic shock, Diabetic ketoacidosis (DKA), Pyloric stenosisPediatric Abdominal Pain
Key considerations: Appendicitis, Intussusception, Malrotation with midgut volvulusNon-Accidental Trauma (Child Abuse)
Key considerations: Abusive head trauma (shaken baby), Occult fractures, Abdominal organ injury from abusePediatric Asthma Exacerbation
Key considerations: Status asthmaticus, Foreign body aspiration mimicking wheeze, AnaphylaxisCroup (Laryngotracheobronchitis)
Key considerations: Epiglottitis, Bacterial tracheitis, Retropharyngeal abscessPediatric Head Injury
Key considerations: Epidural hematoma, Subdural hematoma, Cerebral contusion or hemorrhagePediatric DKA
Key considerations: Cerebral edema (most feared complication), Severe hypokalemia, Cardiac arrhythmia from electrolyte derangementBronchiolitis
Key considerations: Respiratory failure requiring escalation, Apnea (especially <2 months or premature infants), Myocarditis mimicking bronchiolitisPediatric Urinary Tract Infection
Key considerations: Pyelonephritis (upper UTI), Urosepsis, Renal abscessPediatric Rash
Key considerations: Meningococcemia (petechiae/purpura + fever + toxic), Kawasaki disease, Stevens-Johnson Syndrome / TENPediatric Limp
Key considerations: Septic arthritis, Osteomyelitis, Legg-Calve-Perthes diseaseNeonatal Jaundice
Key considerations: Kernicterus (bilirubin encephalopathy), Biliary atresia, Hemolytic disease (Rh/ABO incompatibility, G6PD)Pediatric Anaphylaxis
Key considerations: Biphasic anaphylaxis (recurrence 1-72 hours later), Refractory anaphylaxis, Anaphylaxis masquerading as asthma or urticariaAcute Kidney Injury
Key considerations: Post-renal obstruction (bilateral ureteral, bladder outlet), Renal artery thrombosis/dissection, Thrombotic microangiopathy (TTP/HUS)Hyponatremia
Key considerations: Severe hyponatremia with seizures or coma, Adrenal crisis (acute adrenal insufficiency), Cerebral salt wasting (post-neurosurgery)Acute Decompensated Heart Failure
Key considerations: Cardiogenic shock, Acute MI as precipitant, Acute valvular emergency (MR, AR)Acute Appendicitis
Key considerations: Perforated appendicitis with sepsis, Appendiceal abscess, Appendiceal neoplasm (especially in elderly)Small Bowel Obstruction
Key considerations: Closed-loop obstruction with strangulation, Volvulus, Internal herniaAcute Cholecystitis
Key considerations: Gallbladder perforation, Cholangitis (Charcot triad/Reynolds pentad), Emphysematous cholecystitisAcute Psychosis
Key considerations: Substance-induced psychosis (stimulants, PCP, synthetic cannabinoids), Anti-NMDA receptor encephalitis, Delirium (medical cause masquerading as psychosis)Alcohol Withdrawal
Key considerations: Delirium tremens (DTs), Withdrawal seizures, Wernicke encephalopathySuicidal Ideation
Key considerations: Active plan with intent and means, Recent suicide attempt, Command auditory hallucinations to harm selfIschemic Stroke
Key considerations: Large vessel occlusion (LVO) amenable to thrombectomy, Posterior circulation stroke (basilar artery), Hemorrhagic stroke mimicking ischemicVertigo / Acute Vestibular Syndrome
Key considerations: Posterior circulation stroke (cerebellar/brainstem), Vertebral artery dissection, Cerebellar hemorrhagePreeclampsia / Eclampsia
Key considerations: Eclampsia (seizures), HELLP syndrome, Placental abruptionPostpartum Hemorrhage
Key considerations: Uterine atony (most common cause — 80%), Retained placenta/products, Uterine ruptureEctopic Pregnancy
Key considerations: Ruptured ectopic with hemoperitoneum, Heterotopic pregnancy (concurrent IUP + ectopic, especially after IVF)Hypertension Management
Key considerations: Secondary hypertension (renal artery stenosis, pheochromocytoma, Cushing, primary aldosteronism, coarctation), Hypertensive emergency with end-organ damage, Resistant hypertension (uncontrolled on 3+ drugs including diuretic)Type 2 Diabetes Management
Key considerations: DKA or HHS, Undiagnosed Type 1 (autoimmune markers), Hypoglycemia from treatmentMajor Depressive Disorder
Key considerations: Suicidal ideation with plan, Bipolar disorder (screen before starting antidepressant), Medical causes: hypothyroidism, B12 deficiency, anemia, malignancyAsthma Exacerbation
Key considerations: Status asthmaticus, Pneumothorax, AnaphylaxisUrinary Tract Infection
Key considerations: Pyelonephritis, Urosepsis, Urinary obstructionCOPD Exacerbation
Key considerations: Pneumonia, PE, PneumothoraxDeep Vein Thrombosis
Key considerations: Pulmonary embolism, Phlegmasia cerulea dolens, Compartment syndromeCellulitis
Key considerations: Necrotizing fasciitis, Sepsis, DVTNSTEMI / Unstable Angina
Key considerations: STEMI evolution, Aortic dissection, MyocarditisAcute Heart Failure
Key considerations: Cardiogenic shock, Acute MI causing CHF, Valvular emergencyCommunity-Acquired Pneumonia
Key considerations: Sepsis, Empyema, Lung abscessUpper GI Bleeding
Key considerations: Variceal hemorrhage, Aortoenteric fistula, Perforated ulcerAcute Kidney Injury
Key considerations: Obstructive uropathy, Rhabdomyolysis, TTP/HUSDiabetic Ketoacidosis
Key considerations: Sepsis as trigger, MI as trigger, Euglycemic DKA (SGLT2 inhibitors)Sepsis / Septic Shock
Key considerations: Septic shock, Necrotizing fasciitis, MeningitisAcute Ischemic Stroke
Key considerations: Large vessel occlusion, Hemorrhagic stroke, Hypoglycemia mimicking strokeNew-Onset Seizure
Key considerations: Status epilepticus, CNS infection, Brain tumorMigraine Headache
Key considerations: Subarachnoid hemorrhage, Meningitis, Cerebral venous thrombosisLow Back Pain
Key considerations: Cauda equina syndrome, Spinal epidural abscess, Vertebral fractureAnaphylaxis
Key considerations: Anaphylactic shock, Angioedema with airway compromiseThyroid Storm
Key considerations: Thyroid storm (mortality 10-30%), Sepsis mimicking thyroid stormBacterial Meningitis
Key considerations: Bacterial meningitis, HSV encephalitis, Brain abscessAcute Appendicitis
Key considerations: Perforated appendicitis, Appendiceal abscess, Ectopic pregnancyHip Fracture
Key considerations: Pathologic fracture, Open fracture, Vascular injuryAtrial Fibrillation
Key considerations: Rapid AFib with hemodynamic instability, WPW with AFib, New AFib from PE, sepsis, or MISmall Bowel Obstruction
Key considerations: Strangulated/ischemic bowel, Closed-loop obstruction, PerforationPulmonary Embolism
Key considerations: Massive PE with shock, Saddle PE, Right heart strainHyponatremia
Key considerations: Severe hyponatremia with seizures/AMS, Cerebral edema, Osmotic demyelination from overcorrectionEctopic Pregnancy
Key considerations: Ruptured ectopic with hemorrhagic shock, Heterotopic pregnancyHyperkalemia
Key considerations: Cardiac arrest from hyperkalemia, Pseudo-hyperkalemia (hemolyzed sample)Croup (Laryngotracheobronchitis)
Key considerations: Epiglottitis, Foreign body aspiration, Bacterial tracheitisBronchiolitis
Key considerations: Pertussis, Foreign body, Congenital heart diseaseFever in Young Child
Key considerations: Meningitis, Bacteremia, UTIKawasaki Disease
Key considerations: Coronary artery aneurysm, Myocarditis, Macrophage activation syndromeSuicide Risk Assessment
Key considerations: Active suicidal ideation with plan and means, Recent suicide attempt, Self-harm with medical injuryPanic Attack / Panic Disorder
Key considerations: Myocardial infarction, Pulmonary embolism, ThyrotoxicosisPreeclampsia
Key considerations: Eclampsia, HELLP syndrome, Placental abruptionPostpartum Hemorrhage
Key considerations: Uterine rupture, DIC, Retained placentaChild Abuse / Non-Accidental Trauma
Key considerations: Abusive head trauma (shaken baby), Internal organ injury, Occult fracturesSLE Flare
Key considerations: Lupus nephritis, Lupus cerebritis, Catastrophic APSAcute Cholecystitis
Key considerations: Ascending cholangitis, Gallstone pancreatitis, Cholecystoenteric fistulaAcute Pancreatitis
Key considerations: Necrotizing pancreatitis, Infected pancreatic necrosis, Organ failureGuillain-Barre Syndrome
Key considerations: Respiratory failure requiring intubation, Autonomic dysfunction, Spinal cord compression mimicking GBSVertigo / Dizziness
Key considerations: Posterior circulation stroke, Cerebellar hemorrhage, Vertebral artery dissectionST-Elevation Myocardial Infarction
Key considerations: STEMI, Aortic dissection with coronary involvement, MyocarditisPneumothorax
Key considerations: Tension pneumothorax, Open pneumothorax, HemopneumothoraxInguinal Hernia
Key considerations: Incarcerated hernia, Strangulated hernia, Testicular torsionAdolescent Depression
Key considerations: Active suicidality, Bipolar disorder presenting as depression, Substance abusePlacental Abruption
Key considerations: Massive abruption with fetal demise, DIC, Hypovolemic shockTesticular Torsion
Key considerations: Testicular torsion (surgical emergency), Fournier gangreneToxic Ingestion (Pediatric)
Key considerations: Lethal in one pill/dose: calcium channel blockers, beta-blockers, opioids, sulfonylureas, TCAs, clonidine, Button battery ingestion, Iron toxicityChronic Kidney Disease Management
Key considerations: Rapidly progressive GN, Reversible causes of CKD decline, Uremic emergencyHypertensive Emergency
Key considerations: Aortic dissection, Hypertensive encephalopathy, EclampsiaSpinal Cord Compression
Key considerations: Metastatic spinal cord compression, Epidural abscess, Cauda equina syndromeDiabetic Foot Infection
Key considerations: Osteomyelitis, Necrotizing fasciitis, Charcot neuroarthropathyADHD Evaluation
Key considerations: Learning disability, Anxiety disorder, Hearing/vision impairmentAortic Dissection
Key considerations: Stanford Type A (ascending) — surgical emergency, Malperfusion syndrome, Cardiac tamponadeAlcohol Withdrawal
Key considerations: Delirium tremens, Withdrawal seizures, Wernicke encephalopathyInfective Endocarditis
Key considerations: Septic emboli (stroke, splenic/renal infarcts), Valvular destruction, Heart failurePediatric Dehydration
Key considerations: Severe dehydration with shock, DKA, IntussusceptionWernicke Encephalopathy
Key considerations: Wernicke encephalopathy (confusion + ophthalmoplegia + ataxia), Korsakoff psychosis (irreversible), Hypoglycemia mimicking presentationElectrical Injury
Key considerations: Cardiac arrhythmia (can be delayed), Rhabdomyolysis, Internal burns greater than external appearanceAcute Mesenteric Ischemia
Key considerations: SMA embolism (most common — atrial fibrillation source), SMA thrombosis, Non-occlusive mesenteric ischemia (NOMI)SIADH
Key considerations: Cerebral salt wasting (vs SIADH — volume status differentiates), Adrenal insufficiency, Hypothyroidism causing hyponatremiaInfective Endocarditis
Key considerations: Embolic stroke from vegetation, Mycotic aneurysm, Perivalvular abscessAcute Pancreatitis
Key considerations: Necrotizing pancreatitis, Infected necrosis, Pancreatic abscessAbdominal Compartment Syndrome
Key considerations: Intra-abdominal hypertension progressing to ACS, Missed in ICU post-damage control surgery, Multiorgan failure from untreated ACSHemorrhagic Shock
Key considerations: Class III-IV shock (>30% blood volume loss), Occult hemorrhage (retroperitoneal, pelvic, thoracic), Coagulopathy of traumaSurgical Site Infection
Key considerations: Deep space infection vs superficial SSI, Anastomotic leak presenting as SSI, Necrotizing fasciitis masquerading as cellulitisCOPD Stable Management
Key considerations: Lung cancer (shared risk factors), Heart failure masquerading as COPD, Alpha-1 antitrypsin deficiency in young patientsAdult Preventive Screening
Key considerations: Missed colorectal cancer screening, Undiagnosed hypertension, Undiagnosed diabetesPolypharmacy and Medication Reconciliation
Key considerations: Anticholinergic burden causing cognitive impairment, Drug-drug interactions causing toxicity, Inappropriate medications per Beers Criteria in elderlyNeonatal Hypoglycemia
Key considerations: Persistent hyperinsulinism (congenital), Inborn errors of metabolism, Adrenal insufficiencyPediatric UTI
Key considerations: Pyelonephritis with bacteremia in young infants, Underlying urological abnormality (VUR, posterior urethral valves), Missed diagnosis causing renal scarringPediatric DKA
Key considerations: Cerebral edema (0.5-1% of peds DKA — highest risk young children and new-onset), Hypoglycemia from over-aggressive insulin, Hypokalemia causing arrhythmiaSerotonin Syndrome
Key considerations: NMS (differentiate: SS has rapid onset/clonus vs NMS has slow onset/lead-pipe rigidity), Anticholinergic toxicity, Malignant hyperthermiaAlcohol Intoxication and Withdrawal Spectrum
Key considerations: Subdural hematoma (alcoholics fall and have coagulopathy), Wernicke encephalopathy, HypoglycemiaFirst Episode Psychosis Workup
Key considerations: Anti-NMDA receptor encephalitis, Substance-induced psychosis, CNS infection/tumorPosterior Circulation Stroke
Key considerations: Basilar artery occlusion (locked-in syndrome, high mortality), Cerebellar infarct with edema (obstructive hydrocephalus), Vertebral artery dissectionHypertensive Encephalopathy
Key considerations: Ischemic stroke (do not lower BP aggressively), Hemorrhagic stroke, PRES (posterior reversible encephalopathy syndrome)Syncope Evaluation
Key considerations: Seizure mimicking syncope, Cardiac arrhythmia causing syncope, Vertebrobasilar TIAHyperemesis Gravidarum
Key considerations: Molar pregnancy (markedly elevated hCG), Multiple gestation, Hyperthyroidism of pregnancyPlacental Abruption
Key considerations: Concealed abruption (no visible bleeding), DIC from massive abruption, Fetal distress and demiseOvarian Hyperstimulation Syndrome
Key considerations: Ovarian torsion (enlarged stimulated ovaries at higher risk), Ectopic pregnancy in IVF patients, Pulmonary embolism (hypercoagulable state)Chest Pain Risk Stratification
Key considerations: ACS, Aortic dissection, PEHypotension
Key considerations: Tension pneumothorax, Cardiac tamponade, Massive pulmonary embolismSickle Cell Crisis
Key considerations: Acute Chest Syndrome (ACS) — most common cause of death in sickle cell disease, Stroke — ischemic or hemorrhagic, Splenic sequestration crisis — life-threatening in children