Tiredness :: PLAB 2 Symptomatic Differential Stations
- examiner mla
- Mar 22
- 2 min read
Multiple Myeloma
Other presenting symptoms
Back pain
Weakness
Bleeding gums
FLAWS
Past history and PMAFTOSA Recurrent infections
Social DVLA, work for time off
Exam and Invs
GPE, vitals,
Back exam
Straight leg raise test
Oral exam
Abdominal exam
Lymph node exam
X-ray spine
Bone marrow biopsy
Referral Hematology
Treatment
Pain relief
Steroids/ Chemotherapy/ Stem cell transplant
Vaccinations
Erythropoeitin
Warning signs
Fever, cough, sore throat, bleeding
Leukaemia
Other presenting symptoms
Bruises
Bleeding
FLAWS
Past history and PMAFTOSA Recurrent infections
Social DVLA, work for time off
Exam and Invs
GPE, vitals,
Oral exam
Abdominal exam
Lymph node exam
Peripheral smear
CXR
Bone marrow biopsy
Referral Hematology
Treatment
Pain relief
Chemotherapy/ Radiotherapy/ Stem cell transplant
Vaccinations
Warning signs
Fever, cough, sore throat, bleeding
Iron deficiency anaemia (suspected Ca Colon)
Other presenting symptoms
FLAWS
Blood in stools
Altered bowel habits
Any other blood loss
Past history and PMAFTOSA
Social
Exam and Invs
GPE, vitals,
Abdominal exam
Lymph node exam
Colonoscopy
Referral Gastroenterology
Treatment
Blood transfusion
Chemotherapy/ Radiotherapy/ Surgery
Warning signs
bleeding
Addison's
Other presenting symptoms
Salt craving
Bronze pigmentation
Weakness
Polyuria/Polydipsia
Past history and PMAFTOSA Other autoimmune diseases
Social DVLA
Exam and Invs
GPE, vitals,
Sitting standing BP
Oral exam
Urine dipstick and GRBS
Synacthen test
Referral Endocrinologist
Treatment
Lifelong steroids
Chemotherapy/ Radiotherapy/ Surgery
Warning signs
Increase steroid dose during infections and surgeries
Steroid card
Hypothyroidism
Other presenting symptoms
Cold intolerance (feel cold when others are fine)
Constipation
Weight gain
Polyuria/Polydipsia
Loss of appetite
Low mood
Sleep problems
Past history and PMAFTOSA
Social DVLA
Exam and Invs
GPE, vitals,
Neck exam
Chest exam
TFT
Thyroid scan
Referral Endocrinologist
Treatment
Levothyroxine
Warning signs
Symptoms getting worse
Suicidal thoughts
Obstructive sleep apnoea
Other presenting symptoms
Snoring
Gasping for air
Daytime sleepiness
Past history and PMAFTOSA
Social DVLA (very important)
Exam and Invs
GPE, vitals,
Neck exam
Chest exam
TFT
Sleep study
Referral Sleep specialist
Treatment
CPAP
Mandibular advancement devices
General advice (head end elevation, avoid alcohol, weight loss)
Warning signs
DVLA
Chronic Fatigue Syndrome
Other presenting symptoms
Persistent fatigue for 4 months or more
Post-exertion malaise and/or fatigue
General malaise or flu-like symptoms
Cognitive dysfunction (difficulty concentrating, impairment of short-term memory)
Worsening of symptoms upon physical exercise
Past history and PMAFTOSA Rule out FLAWS, suicidal thoughts
Social
Exam and Invs
GPE, vitals,
Neck exam
Chest exam
Abdominal exam
Lymph node exam
TFT
Sleep study
Referral CFS specialist service
Treatment
Sleep hygiene
Stress management
Warning signs
Symptoms getting worse
Secondary to Hyponatremia from (Oxybutynin/Citalopram/Bendroflumethiazide/Lung cancer)
Other presenting symptoms
Mild: Anorexia, headache, nausea, vomiting
Moderate: Personality changes, muscle cramps, weakness, confusion
Severe: Confusion, drowsiness, fits, coma
FLAWS for lung cancer
Past history and PMAFTOSA Rule out FLAWS, suicidal thoughts
Social
Exam and Invs
Referral Acute medical unit
Treatment
Fluids
Change medication/ Lung cancer management
Warning signs
Symptoms getting worse, confusion, drowsiness
Comments