Notes in Approaches

To Subscribe, use this Key

Status	Last Update	Fields
Published	09/17/2024	Approach to secondary hypertension {{c1::CardiovascularCoarctation of aortaLarge vessel vasculitis FHRenalRenal artery stenosisGlomeruloneph…
Published	10/01/2024	Approach to polyuria{{c1::Osmotic diuresis (Uosm >1000)DMMannitolPost AKI (urea driven)Water diuresis (Uosm <800)DI: Central, nephrogenic (UOsm …
Published	09/17/2024	Approach to diabetes insipidus{{c1::Central - UOsm increase post DDAVPBrain/pituitary tumourBrain trauma/surgeryNephrogenic - UOsm unchanged post…
Published	09/17/2024	Approach to hypercalcemia{{c1::Low PTHMalignancy: PTHrp, osteoclastic bone metastasis, Vit D excessExcess vitamin D: intoxication, granulomatous …
Published	09/17/2024	Approach to hypoglycemia{{c1::DiabeticExcess insulinOHGA overdoseWorsening CKD/AKINon diabeticIncreased insulin: insulinomaDecreased glucose prod…
Published	09/17/2024	Approach to chest pain{{c1::CardiacACS/anginaDissectionPericarditisRespiratoryPneumoniaPneumothoraxPulmonary embolismGIBoerhaave/MW tear GERDOthe…
Published	09/17/2024	Approach to PR bleed{{c1::ExcludeMassive UBGITColorectalColorectal neoplasmDiverticular bleedColitis: IBD, infectious, ischemicAngiodysplasiaPerianalH…
Published	09/17/2024	Approach to altered mental state{{c1::Neurological Haemorrhage/ischaemiaTumourCNS infectionsNon Neurological: VascularHypertensive crisisHyp…
Published	10/01/2024	Approach to shortness of breath{{c1::Fluid overloadCHF, CKD, CLD, Nephrotic CardiacRespiratoryAirway: FB/Anaphylaxis, COPD/asthma, bronchiectasis…
Published	09/17/2024	Approach to vomiting{{c1::Gastrointestinal+Diarrhea: GE+Constipation: IO+Abdo pain: Organic/functional GI disordersCNS+Vertigo: Peripheral, central+He…
Published	09/17/2024	Approach to intestinal obstruction{{c1::IntraluminalStricturesFBFecal impactionLuminalMalignancy: Colorectal, GIST, lymphomaExtraluminalAdhesions&nbsp…
Published	09/17/2024	Approach to hemoptysis {{c1::ExcludeHematemesisAspirated upper airway blood (NPC)Oral mucosal bleedInfectionsBronchiectasisPneumoniaTBAspergillom…
Published	10/01/2024	Approach to palpitations{{c1::CardiacArrhythmiaPEEndocrineHyperthyroidismPheochromocytomaHypoglycemiaHyperdynamic circulationAnemiaPregnancyPsychiatri…
Published	09/17/2024	Approach to polyarticular joint pain{{c1::InfectionBacterial: gonococcal, lymeViral: HBV, HCV, HIVInflammatoryPolyarthritis: RA, CTD (SLE, scleroderma…
Published	09/17/2024	Approach to lower back pain{{c1::Reed flagsTrauma: secondary osteoporosisInfection: osteomyelitis, discitis, psoas abscessTumourNon spinalAortic …
Published	09/17/2024	Approach to lower limb swelling{{c1::UnilateralVascular/lymphatic: DVT, CVI, lymphedemaInfectious: Cellulitis, lymphangitisMSK: Gout, Trauma, Compartm…
Published	09/17/2024	Approach to metabolic alkalosis{{c1::Chloride depletion - saline responsiveGI losses: vomiting, NG lossesDiureticsVolume lossPost hypercapnic statePot…
Published	09/17/2024	Approach to weight gain {{c1::FluidCHF / CKD / CLDNephrotic syndrome EndocrineDM HypothyroidCushingsAcromegalyPCOSPregnancyDrugsSteroid…
Published	09/17/2024	Approach to weight loss{{c1::Decreased appetiteGI diseases: oral, dysphagia, vomiting, malabsorption, diarrheaChronic diseases: DM, CHF, CLD, CKDMalig…
Published	09/17/2024	Approach to cough{{c1::Non respiratoryGERDUACSACEi induced InfectionsURTI / post infectious PneumoniaAspiration TB Airway diseaseA…
Published	09/17/2024	Approach to chronic diarrhoea {{c1::Bloody (inflammatory)Infective colitisIBDIschemic colitisNeoplasmWateryOsmotic: Laxatives, lactose intoleranc…
Published	09/17/2024	Approach to constipation{{c1::GastrointestinalMechanical obstructionFunctional GI disorderLifestyle factors: diet, dehydration, immobilityNeurogenicCe…
Published	09/17/2024	Approach to unconjugated jaundice{{c1::Increased bilirubin: Hemolytic anemiaImpaired bilirubin conjugation: Gilbert syndrome, Crigler-Najjer…
Published	09/17/2024	Approach to transaminitis {{c1::InfectionsHep A/B/C/D/EVZV, EBV, CMVDengueLeptospirosis Metabolic diseaseMAFLDWilson's ToxinsAlcoholPar…
Published	09/17/2024	Approach to dysphagia{{c1::OropharyngealMechanical: Zenker, Goitre, RadiationNeuromuscular: Bulbar, pseudobulbar palsyEsophagealMechanical: - Int…
Published	09/17/2024	Approach to leg pain{{c1::AcuteVascular: acute limb ischemia, critical limb ischemia, DVTNeurological: radiculopathyInfection: cellulitis, necrot…
Published	09/17/2024	Approach to lethargy{{c1::Sleep disordersOSAMood disordersNot sleep relatedChronic disease: Anemia, CKD, CHF, CLDMalignancyAutoimmuneInfections: HIV, …
Published	09/17/2024	Approach to monoarticular joint pain{{c1::TumourInfectionSeptic arthritisGonococcal infectionInflammatoryCrystal: Gout, calcium pyrophosphateRheu…
Published	09/17/2024	Approach to Chronic Cognitive Loss{{c1::NeurologicalMalignancySDHNPHMetabolicB12/folate deficiencyKorsakoff InfectionsHIV Neurosyphilis&nbs…
Published	09/17/2024	Approach to Metabolic Acidosis{{c1::HAGMAKetoacidosis: DKA, starvationLactic: Type A - hypoxia, shock, Type B - liver dysfunction, drugs (MALA)&n…
Published	09/17/2024	Approach to Renal Tubular Acidosis{{c1::T2 RTA (Proximal)Primary: Fanconi syndromeSecondary: Paraproteins (amyloid, MM), PNH, heavy metals, aceta…
Published	09/17/2024	Approach to Hyponatremia{{c1::Non hypotonic hyponatremiaHyperglycemia, mannitolHyperlipidemia, hyperglobulinemiaHypovolemic hypontaremiaRenal los…
Published	09/17/2024	Approach to hypokalemia {{c1::Extra-renal losses (UKCR <1.5)GI: Vomiting, diarrheaSweating Renal losses (UKCR >1.5) Hyperten…
Published	09/17/2024	Causes of shortness of breath in rheumatological illness
Published	09/17/2024	Malignancy resulting in hypercalcemia
Published	09/17/2024	Causes of altered mental state in oncological patients
Published	10/01/2024	Approach to Hypocalcemia{{c1::PTH relatedHypoparathyroidism: iatrogenic, Wilson's / haemochromatosis, congenital (DiGeorge syndrome), autoimmune …
Published	09/17/2024	Causes of anemia in rheumatoid arthritis
Published	09/17/2024	Approach to concomitant potassium and acid base disorderBP, K+, Bicarb
Published	09/17/2024	Causes of haematuria in polycystic kidney disease
Published	09/17/2024	Approach to Cushing's Syndrome
Published	09/17/2024	Approach to hyperaldosteronism
Published	09/17/2024	Approach to adrenal insufficiency
Published	09/17/2024	Approach to Hypopituitary syndromes
Published	09/17/2024	Approach to Secondary osteoporosis
Published	09/17/2024	Approach to hyperlipidemia
Published	09/17/2024	Approach to Secondary amenorrhea
Published	09/17/2024	Approach to cholestasis {{c1::Extrahepatic Painful- Biliary stones- Biliary infectionPainless- Periampullary obstruction- Primary scler…
Published	09/17/2024	Approach to hyperglycemia{{c1::Insulin dependentT1DMLatent autoimmune diabetes in adults (LADA) - T1DM in adultsNon insulin dependent T2DMMature …
Published	09/17/2024	Approach to hyperprolactinemia{{c1::PhysiologicalLactationPregnancyPharmacologicalAntidopaminergicsPathologicalIncreased production: Prolactinoma…
Published	09/17/2024	Approach to Raynaud's phenomenon
Published	09/17/2024	Causes of hip pain in rheumatoid arthritis{{c1::Osteoporotic fractureAtypical femoral fractureAvascular necrosis Osteoarthritis Rheumat…
Published	09/17/2024	Approach to congenital heart disease with clubbing
Published	08/29/2024	Approach to Hyperkinesis (Chorea)
Published	09/17/2024	Approach to hand numbness / paresthesia / pain
Published	09/17/2024	Causes of Lethargy in Acromegaly{{c1::Hypopituitarism (hypocortisolism, hypothyroidism)OSAAnaemia from underlying colorectal cancer}}
Published	09/17/2024	Causes of Hyperprolactinemia{{c1::PhysiologicalPregnancy / LactationNipple stimulation, post-coitalPost-seizurePathologicalProlactinomaAcromegaly…
Published	09/17/2024	Causes of headache in Acromegaly{{c1::Mass effect of pituitary tumourPituitary apoplexyHypertensionOSA}}
Published	09/17/2024	Causes of Gynaecomastia{{c1::Drugs (Spironolactone, Estrogens)Organ failure (liver, renal, hyperthyroidism)Physiological (neonate, puberty)Idiopa…
Published	09/17/2024	Causes of Chorea{{c1::Copper (Wilson's)Huntington's diseaseOCP, levodopa, anti-psychotics, anti-epilepticsRheumatic heart disease (Sydenham chorea)End…
Published	09/17/2024	Approach to Visual Problems{{c1::Acute BOV + red eye / painful eyeAcute-subacute BOV (without red eye / painful eye)Chronic progressive painless BOVVi…
Published	09/17/2024	Approach to Visual Field DefectsBitemporal Hemianopia{{c1::Optic chiasmPituitary adenomaCraniopharyngioma}}Homonymous Hemianopia{{c1::Contralateral oc…
Published	09/17/2024	Causes of Chronic Painless Progressive Blurring of Vision {{c1::RetinaRetinitis PigmentosaDiabetic retinopathyChorioretinitisOptic NeuropathyComp…
Published	09/17/2024	Approach to pruritus{{c1::Systemic illnessThyrotoxicosisUremiaConjugated hyperbilirubinemiaHaematological Polycythemia vera Porphyria}}
Published	09/17/2024	Approach to orthostatic hypotension {{c1::Hypovolemia: shock (sepsis, blood loss, dehydration), secondary (DI, Addisons)Autonomic dysfunctio…
Published	09/17/2024	Causes of nephrotic syndromePrimary{{c1::Minimal change diseaseFocal segmental glomerulosclerosisMembranous glomerulopathy}}Secondary{{c1::Amyloidosis…
Published	09/17/2024	Approach to glomerulonephritis{{c1::ANCA vasculitisGPA, EGPA, MPAAnti GBM Lung: Goodpasture'sNo lung: Anti-GBM diseaseImmune complexPost inf…
Published	09/17/2024	Approach to tremors{{c1::Resting tremor: ParkinsonismPostural tremor: - Essential tremor- Endocrine: Hyperthyroid, pheo, hypoglycemia- Drugs…
Published	09/17/2024	Approach to anemia{{c1::MicrocyticIron deficiencyThalassaemiaACDSideroblastic: Alcohol, MDS Macrocytic B12 deficiencyFolate deficiencyLiver …
Published	09/17/2024	Causes of B12 deficiency{{c1::Decreased intake: veganismPernicious anemiaFood cobalamin malabsorption: gastrectomy, PPI, metforminDecreased intestinal…
Published	09/17/2024	Approach to haemolytic anemia{{c1::HereditaryEnzymopathy (G6PD)Membranopathy (spherocytosis)Haemoglobinopathy (Thal, sickle cell)Acquired - Immun…
Published	09/17/2024	Causes of AIHA{{c1::Cold (IgM - Intravascular)Lymphoproliferative disorders (Waldenstroms)Mycoplasma pneumoniaeInfectious mononucleosis Warm (IgG…
Published	09/17/2024	Approach to thrombocytopenia{{c1::Decreased productionBM pathology: malignancy, aplastic anemiaNutritional deficiency (B12, folate, alcohol) Infection…
Published	09/17/2024	Approach to non vertiginous dizziness {{c1::MetabolicAnemiaHypoglycemiaPresyncopeCardiacOrthostatic hypotensionVasovagal}}
Published	09/17/2024	Approach to vertigo{{c1::CentralPosterior circulation stroke PeripheralHearing loss: labyrinthitis, menierresNo hearing loss: BPPV, vestibular ne…
Published	09/17/2024	Approach to headache{{c1::Extracranial Eye: GlaucomaENT: sinusitis, OMTrigeminal neuralgiaSecondaryBleeds: ICH, pituitary apoplexyCNS infectionsS…
Published	09/17/2024	Approach to diffuse abdominal pain{{c1::SurgicalPerforationIntestinal obstructionHaemorrhage: AAA, Ectopic, HCCMedicalDKAMesenteric ischaemia}}
Published	09/17/2024	Approach to RUQ/Epigastric abdominal pain{{c1::AbdominalLiver: Hepatitis, abscessBiliary: Cholangitis, cholecystitis, biliary colicStomach: PUD, gastr…
Published	09/17/2024	Approach to lower abdominal pain{{c1::RIFAppendicitisDiverticulitisLIFConstipation colicSuprapubicARUCystitisFlankPyelonephritisNephrolithiasisMale sp…
Published	09/17/2024	Approach to type 1 respiratory failure  Increased A-a gradient {{c1::- VQ mismatch: airway (asthma, COPD), alveolar (pneumonia, CHF), v…
Published	09/17/2024	Approach to Type 2 respiratory failure Decreased respiratory drive{{c1::- Metabolic alkalosis- Neurological depression- Sedatives}}Decreased tida…
Published	09/17/2024	Approach to haematuria{{c1::RenalGlomerular disease: Immune complex, Anti GBM, VasculitisIschemia: Papillary necrosis, renal vein thrombosis, thrombot…
Published	09/17/2024	Approach to purpura
Published	09/17/2024	Approach to eosinophilia
Published	09/17/2024	Approach to polycythemia
Published	09/17/2024	Approach to multiple oral ulcers
Published	09/17/2024	Causes of recurrent urolithiasis
Published	09/17/2024	Approach to SIADH{{c1::Malignancy: Small cell CA, Pancreatic adenoCA, lymphomaLung disordersCNS disorders Drug induced: Antidepressants }}
Published	09/17/2024	Approach to difficulty urinating{{c1::ObstructionIntraluminal: stones, clotsLuminal: urothelial malignancy, stricturesExtraluminal: Male (BPH/pro…
Published	09/17/2024	Causes of musculoskeletal bleeding{{c1::PT prolongedWarfarin useVitamin K defaPTT ProlongedIrreversible: lupus anticoagulantReversible: Hemophilia A/B…
Published	09/17/2024	Approach to scrotal mass{{c1::Unable to get aboveHerniaInfantile hydroceleUnable to get above - testis undefinableTransilluminable: HydroceleNot trans…
Published	09/17/2024	Approach to epistaxis
Published	09/11/2024	Approach to chronic visual loss
Published	09/17/2024	Approach to acute painless visual loss
Published	09/17/2024	Approach to red eye
Published	09/17/2024	Causes of hypertension in Neurofibromatosis type 1
Published	09/17/2024	Causes of shortness of breath in acromegaly
Published	09/17/2024	Causes of Secondary Hypertension in Neurofibromatosis{{c1::Coarctation of aortaRenal artery stenosis (RAS)Phaeochromocytoma}}
Published	09/17/2024	Approach to gynaecomastia{{c1::Rule out PseudogynaecomastiaBreast cancer PhysiologicalPubertal gynaecomastiaEndocrinePituitary: Hyperth…
Published	10/01/2024	Approach to Acute kidney injury
New Card	10/19/2024	Approach to Haematuria{{c1::Isolated haematuriaIgA nephropathyThin BM diseaseAlport's syndromeGlomerulonephritisAnti-GBM, Goodpasture'sImmune com…
New Card	10/19/2024	Secondary causes of Nephrotic Syndrome (by etiology){{c1::MalignancyHodgkin's lymphonaMyelomaNPCOther solid organsAutoimmuneSLEAmyloidosisIn…
New Card	10/19/2024	Secondary causes of Nephrotic Syndrome (by histology){{c1::Minimal Change Disease (MCD)NSAIDsHodgkin's lymphomaFocal Segmental Glomeruloscle…
New Card	10/19/2024	Approach to Secondary Osteoporosis{{c1::CongenitalOsteogenesis imperfectaEndocrineCushing'sCa & Vit D deficiencyHyperPTHHyperthyroidismH…
New Card	10/19/2024	Approach to Bruising{{c1::CoagulopathyCLDVitamin K deficiencyHaemophilia (incl acquired)DIVCAnticoagulantsPlatelet disorderThrombocytopenia (vira…
New Card	10/19/2024	Approach to Pruritus / Itch{{c1::UraemiaCholestasis (esp PBC)Aquagenic pruritus (PRV, other myeloproliferative e.g. ET)Other haem malignancies (e.g. H…
Status	Last Update	Fields