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DDxPro
Possible Diagnoses
Gastroesophageal reflux disease
Gastroesophageal reflux disease
Hiatal hernia
Heartburn
Retrosternal burning pain
Substernal region warmth
Regurgitation
Postprandial
Pain radiate to neck
Dyspepsia
Globus sensation
Chronic cough
Dysphagia
Odynophagia
Chest pain
Laryngitis
Complication asthma
Bloating
Early satiety
Halitosis
Weight loss
Gnawing pain
Analgesic nephropathy
Analgesic nephropathy
Hematuria
Hypertension
Chronic interstitial nephritis
Papillary necrosis
Gastrointestinal symptoms
Renal insufficiency
Malaise
Ulcer-like symptoms
Weakness
Flank pain
Gross hematuria
Foreign body ingestion
Foreign body ingestion
Acute onset of dysphagia
Complete inability to swallow saliva
Alcohol misuse
Altered mental status
Chemical dependence
Dementia
Dental disorder
Down syndrome
Eosinophilic esophagitis
Fistula
Gastric outlet obstruction
Gastrointestinal tract narrowing
Hurried eating
Impaired gag reflex
Inflammatory process
Inmates engaged in criminal activities
Intellectual disability
Mechanical disorders of the gastrointestinal tract
Mental illness
Neurologic disorders
Obstructive sleep apnea
Obstructive sleep apnea
Obstructive apneas
Obstructive hypopneas
Poor concentration
Respiratory effort related arousals
Resuscitative snorts
Sleepiness
Large neck circumference
Large waist circumference
Fatigue
Nocturnal restlessness
Snoring
Nocturnal choking
Nocturnal gasping
Breathing pauses during sleep
Wake-time sleepiness
Retrognathia
Nasal congestion
Acromegaly
Adenoid hypertrophy
Asthma
Chronic kidney diseases
Chronic kidney diseases
Hypertension
Fatigue
Last three months
Bone disease
Facial puffiness
Flank pain
Metabolic acidosis
Nocturia
Pedal edema
Polyuria
Volume overload
Renal osteodystrophy
Cushing syndrome
Cushing syndrome
Irritability
Abdomen obesity
Anxiety
Central obesity
Face obesity
Neck obesity
Progressive obesity
Skin atrophy
Truncal obesity
Weight gain
Hypercortisolism
Hypertension
Round face
Amenorrhea
Decreased libido
Excess menses
Glucose intolerance
Menstrual changes
Oligomenorrhea
Variable menses
Myocardial infarction
Non-st-elevation myocardial infarction
Atherosclerosis
Diabetes mellitus
Dyslipidemia
Hypertension
Metabolic syndrome
Chest aching
Chest discomfort at minimal exertion
Chest discomfort at rest
Chest pain
Chest pain radiate to both arms
Chest pain radiate to the back
Chest pain radiate to the epigastrium
Chest pain radiate to the left arm
Chest pain radiate to the lower jaw
Chest tightness
Retrosternal chest pain
Chest burning
Chest discomfort
Chest heaviness
Chest pressure
Peptic ulcer
Duodenal ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs several hours after a meal
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Vomiting after eating
Radiate to back
Meal related
Epigastric tenderness
Nausea relieved by eating
Severe abdominal pain
Discomfort or pain in upper belly
Gastric ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Discomfort or pain in upper belly
Discomfort or pain near the ribs
Upset stomach
three months
Diarrhea
Burning
Symptom onset at least six months
Abdominal pain
Chronic heart failure
Chronic heart failure
Shortness of breath
Dyspnea on exertion
Fatigue
Dyspnea occurring in the recumbent position
Orthopnea
Relieved by sitting upright
Relieved by sleeping with additional pillows
Cool peripheral extremities
Cyanosis of the lips
Cyanosis of the nail beds
Dyspnea at rest
Dyspnea exacerbated in the supine position
Peripheral edema
Symmetric peripheral edema
Atherosclerotic
Cardiomyopathy
Dyspnea awaken the patient from sleep
Metabolic syndrome
Nocturnal cough
Paroxysmal nocturnal dyspnea
Adrenocortical carcinoma
Adrenocortical carcinoma
Progressive central obesity
Progressive obesity
Supraclavicular fat pads
Weight gain
Facial plethora
Skin atrophy
Hypertension
Insomnia
Nocturnal hyperarousal
Metabolic alkalosis
Wide purplish striae
Wide purplish striae on abdomen
Wide purplish striae on lower flanks
Low back pain
Proximal muscle weakness
Proximal myopathy
Thinning of the skin on the top of the hands
Weakness
Buffalo hump
Progressive face obesity
Hepatic encephalopathy
Hepatic encephalopathy
Bradycardia
Cerebral edema
Cough response to tracheobronchial suctioning
Increased intracranial pressure
Paralysis of corneal reflex
Paralysis of jaw reflex
Paralysis of oculocephalic reflex
Paralysis of other brain stem reflexes
Pupillary changes
Respiratory depression
Seizures
Systemic hypertension
Positive earlier stroop color word test
Positive portosystemic encephalopathy syndrome test
Hyperresponsive pupils
Pupils progress from normal response
Slowly responsive pupils
Amnesia
Anxiety
Apathy
Heartburn
History, Physical examination
Typical symptoms
PPI
Relief by PPI
Step-down therapy
Infrequent recurrence
Treat again
Frequent recurrence
Maintenance PPI
Failure by PPI
Twice-Daily PPI Therapy
Relief by twice-PPI
Maintenance PPI
Failure by twice-PPI
Document reflux: 24-hr pH on PPI
Normal 24-hr pH
Alternative therapy
Reflux 24-hr pH
Increase PPI dose
Upper endoscopy for patient at high risk for Barrett’s esophagus
Alarm symptoms and signs
Upper Endoscopy
Hypertension
Blood pressure (average of two readings at two separate times)
SBP 120–139 mmHg or DBP 80–89 mmHg
Prehypertension
Encourage lifestyle modifications, monitor closely
SBP >140 mmHg or DBP >90 mmHg
H/PE, lab tests, ECG
Lifestyle modifications: low-salt diet, weight loss, exercise
At target BP? <140/90 or 130/80 for diabetes mellitus, chronic kidney disease
Yes
Continue lifestyle modifications
No
Compelling indication
Treatment based on indication (see Table 1
No compelling indication
Stage 1: 140–159/80–89 Single-drug therapy with thiazide diuretic or ACE inhibitor
If not at target BP, add different class of drug based on side effect profile and/or indication
Stage 2: SBP >160 or DBP >90 two-drug combination
If not at target BP, add different class of drug based on side effect profile and/or indication
SBP >180 mmHg or DBP >120 mmHg
New onset or end- organ damage?
No
Treat with oral agents, Follow closely
Yes
Hypertensive crisis