Disease Symptom Clusters

	Disease	Symptom cluster (as the exam presents it)
1	STEMI	55-year-old diabetic man · crushing retrosternal chest pain for 2 h radiating to left arm and jaw + diaphoresis + nausea mistaken for "indigestion"
2	NSTEMI / unstable angina	60-year-old smoker · rest or crescendo exertional chest pain, now freezing at rest (unstable) — vs brief exertional pain eased by rest in stable angina
3	Stable angina	Exertional retrosternal tightness lasting <10 min, eased by rest · no pain at rest · same trigger every time · female patient may report only fatigue or dyspnoea
4	Aortic dissection	40–60-year-old hypertensive man · sudden tearing chest pain radiating to the back between the shoulders + unequal BP or pulses between arms
5	Pericarditis	Young man after viral prodrome · sharp chest pain made worse lying flat and breathing in, eased sitting forward + low-grade fever
6	Cardiac tamponade	Patient with cancer or TB · severe dyspnoea + distended neck veins rising on inspiration + muffled heart sounds + falling BP
7	Infective endocarditis	Dental procedure or IV drug user weeks earlier · fever for weeks + weight loss + night sweats + splinter haemorrhages / painful finger nodules
8	Acute rheumatic fever	Child 5–15 years, 2–3 weeks after sore throat · migratory large-joint pain + breathlessness + later uncontrolled limb movements
9	Rheumatic mitral stenosis	Woman in 30s–40s with childhood sore-throat illness · effort breathlessness + flushing cheeks — first decompensation on pregnancy or any fast heart rate
10	Mitral regurgitation (rheumatic)	Rheumatic heart disease patient · breathlessness lying flat / on exertion + fatigue — murmur heard at apex radiating to axilla
11	Mitral valve prolapse	Thin young woman · palpitations + occasional sharp chest pain + anxiety-like episodes — heart beat "skipping"
12	Degenerative aortic stenosis	Man over 65 (or 60s with congenital valve) — progression triad in order: effort breathlessness → chest pain on exertion → sudden faint on exertion
13	Hypertrophic obstructive cardiomyopathy	Young athlete · faints or chest pain during sport (worse standing) — family history of sudden unexplained death
14	Dilated cardiomyopathy	Young–middle-aged man, heavy drinker or post-viral · progressive breathlessness lying flat + swelling of ankles + easy fatigue
15	Atrial fibrillation	Elderly or hyperthyroid patient · palpitations with irregular "beat-to-beat chaos" + effort intolerance + no warning spells — may present as sudden stroke
16	Paroxysmal supraventricular tachycardia	Young person with no heart disease · sudden fast pounding heart starting and stopping like a switch (over minutes/hours), anxiety and light-headedness during a run
17	Deep vein thrombosis	Post-bed-rest / post-surgery / long flight / on pills · one-sided calf pain + swelling + warmth, worse on standing
18	Pulmonary embolism	Postoperative or post-immobilised patient · sudden breathlessness + sharp chest pain worse on breathing in + fast heart rate, sometimes fainting — calf was swollen days earlier

	Disease	Symptom cluster (as the exam presents it)
1	Lobar pneumonia (pneumococcal)	Adult · sudden shaking fever + cough with rust-coloured sputum + one-sided sharp chest pain on breathing in
2	Atypical pneumonia (Mycoplasma)	Young adult / hostel student · dry cough lasting weeks + gradual low fever + malaise, chest findings minimal despite patient looking ill
3	Pulmonary tuberculosis	Weight loss + evening fever + drenching night sweats + cough >2 weeks with blood-streaked sputum + close TB contact
4	Miliary / extrapulmonary TB	Elderly or immunosuppressed · indolent fever + weight loss with no cough, or neck swelling / back pain only
5	Pneumocystis pneumonia	AIDS patient with CD4 below 200 · weeks of dry cough + breathlessness on stairs + low-grade fever, chest mostly clear
6	Acute asthma	Child / young adult · sudden wheeze + breathlessness + night coughing spells, often after cold air, dust, exercise or infection
7	Life-threatening asthma	Asthmatic silent on listening, blue lips, drowsy or struggling to finish sentences — the quiet chest, not the loud one, is the emergency
8	COPD	60-year-old heavy smoker · years of morning productive cough + slowly progressive breathlessness + barrel-shaped chest
9	Cor pulmonale	Long-standing COPD patient · swollen ankles + distended tender liver + neck veins full while lying at 45°, plus the smoker's cough
10	Bronchiectasis	Lifelong or post-measles/pneumonia · daily large-volume purulent sputum, worse leaning forward, + recurrent chest infections + finger clubbing
11	Lung carcinoma	50+ smoker · change in habitual cough + blood-streaked sputum + weight loss + hoarse voice / drooping eyelid on one side
12	Superior vena cava obstruction	Lung cancer patient · face fullness and puffiness worse in the morning + distended neck veins + dilated chest veins
13	Malignant pleural effusion	Older patient, known or unknown cancer · months of gradually increasing breathlessness + dull ache, no fever
14	Spontaneous pneumothorax	Tall thin young man · sudden one-sided sharp pain + breathlessness during rest or exertion
15	Tension pneumothorax	Trauma / ventilated / asthmatic · rapidly worsening breathlessness + drifting BP down and heart rate up + distended neck veins with trachea shifted away
16	Sarcoidosis	Young adult · dry cough + breathlessness + skin lumps in scars + painful shins + facial palsy-like weakness, often found on a routine film
17	Asbestosis / silicosis	Years in asbestos, construction, mining, grinding work · progressive breathlessness + dry cough + finger clubbing (asbestos) years after exposure ends
18	Croup	Child 6 months–3 years · barking cough like a seal + hoarse cry + noise on breathing in, worse at night, after 1–2 days of runny nose

	Disease	Symptom cluster (as the exam presents it)
1	GERD	Overweight 40s man · burning behind the breastbone after meals and at night when lying down + sour taste in mouth, eased by sitting up
2	Achalasia	Young adult · difficulty swallowing BOTH food and liquids, intermittent for months · food "sticking in the chest" + regurgitation of undigested meals
3	Oesophageal varices rupture	Known cirrhotic · sudden large-volume vomiting of blood + faintness, preceded by retching or nothing at all
4	Mallory-Weiss tear / Boerhaave	Heavy alcohol binge · forceful retching, then blood-streaked vomit (tear) — vs sudden severe chest and upper abdominal pain with crunching under the skin (rupture)
5	Duodenal ulcer (H. pylori)	40s man, smoker · burning pain in the upper abdomen 2–3 h after meals and waking at night, eased by food — pain eats when he eats
6	Gastric cancer	Over 50, long-standing indigestion turned different · early fullness after small meals + anorexia + weight loss + iron deficiency
7	Small bowel obstruction	Old hernia scar or previous operation · crampy central colic + effortless bilious vomiting + swollen abdomen + absolute constipation and no gas
8	Large bowel obstruction	60+ patient · progressive constipation then absolute · marked abdominal distension with late vomiting — changing bowel habit first is the clue to a stenosing cancer
9	Acute appendicitis	Young patient · pain starting near the navel then settling lower right + anorexia + low fever + nausea; pain worsened by the ride to hospital
10	Diverticulitis	Older patient · persistent left lower abdominal pain + fever + change in bowel habit — often blotches of blood in stool
11	Crohn's disease	Young adult · cramping right-lower abdominal pain + non-bloody diarrhoea + weight loss + mouth ulcers + perianal skin fissures and pits + night sweats
12	Ulcerative colitis	Young adult · bloody, mucous-loaded small-volume stools many times a day + urgency + tenesmus, improving then relapsing
13	Acute mesenteric ischaemia	Elderly atrial-fibrillation patient · pain out of proportion to findings — severe pain, soft abdomen, then rapid collapse with blood in stool
14	Ischaemic colitis	60+ vascular patient after low-flow episode · sudden left-sided abdominal pain + diarrhoea with fresh blood, low-grade
15	Acute pancreatitis	Alcoholic or gallstone patient · severe constant boring upper abdominal pain boring through to the back + repeated vomiting easing nothing + worse lying flat — gallstone patient often still, painless-jaundiced before the attack
16	Chronic pancreatitis	Long-term alcoholic · recurrent episodes of upper abdominal pain boring to the back + steatorrhoea (greasy floating stools) + weight loss + later sugar in blood
17	Colorectal cancer	50+ with change in stool calibre to ribbon-like + blood mixed in stool + tenesmus (feeling of incomplete evacuation) + iron deficiency in a man
18	Pseudomembranous colitis	After any antibiotic course · profuse watery diarrhoea with mucus, cramping, fever, dehydration

	Disease	Symptom cluster (as the exam presents it)
1	Biliary colic	Obese fertile woman in her 40s ("fat, forty, fertile") · severe steady right-upper pain 30–60 min after fatty meals, radiating to right shoulder, eased after hours — no fever
2	Acute cholecystitis	Same woman · right-upper pain constant >6 h + fever + vomiting + pain on breathing in under the ribs on the right, tender point below the ribs
3	Choledocholithiasis	Gallstone patient · episodic dark urine + pale stools + itching + mild jaundice WITHOUT fever or rigors — stone sitting quietly in the common duct
4	Ascending cholangitis	Same patient plus infection · jaundice + rigors and swinging fever + right-upper pain — fever and shaking push it above plain duct blockage
5	Hepatitis A / E	Adult after street food or contaminated water · 5–10 days of malaise, nausea, aversion to cigarettes then jaundice + passing dark urine — hepatitis E is dangerous in pregnancy
6	Hepatitis B (chronic)	Often silent · discovered on screening; flares give fatigue + right-upper discomfort + jaundice; late presentation = ascites, variceal bleeding
7	Alcoholic hepatitis	Heavy drinker · jaundice appearing over days + low-grade fever + tender enlarged liver on the right + anorexia
8	Decompensated cirrhosis	Known liver patient · swollen abdomen + oozing bleed from gums, then vomited blood + confusion worse in the evening + yellow eyes
9	Spontaneous bacterial peritonitis	Cirrhotic with ascites · new abdominal pain + fever + worsening confusion, sometimes only confusion with NO pain
10	Hepatic encephalopathy	Cirrhotic · day-night reversal + flapping tremor of outstretched hands + constructional apraxia (cannot draw a star) — trigger = bleed, constipation, infection, sedatives
11	Hepatorenal syndrome	Advanced cirrhosis · urine output falling over days with no protein in urine, no blocks, no slumping BP — creatinine climbing in a patient otherwise only cirrhotic
12	Wilson's disease	Child / young adult · clumsiness and slurred speech with strange grimacing + stiffness, or sudden worsening of jaundice in a young cirrhotic + tremor resting-irregular
13	Haemochromatosis	Man in 40s–50s · grey-bronzed skin + aching joints (2nd/3rd knuckles) + fatigue + sugar in blood + liver enlargement
14	Budd-Chiari syndrome	Young woman on pills or clotting disorder · sudden abdominal distension + right-upper pain + tender enlarged liver, no mouth yellowing early
15	Amoebic liver abscess	Man with amoebic dysentery weeks earlier · swinging fever + night sweats + right-upper pain referred to right shoulder + tender swollen liver
16	Hepatocellular carcinoma	Cirrhotic or hepatitis-B carrier · stable patient deteriorating — weight loss + right-upper ache + rapidly growing liver + sudden abdominal bleed

	Disease	Symptom cluster (as the exam presents it)
1	Ischaemic stroke (MCA)	Older hypertensive · sudden face droop + arm > leg weakness + slurred or garbled speech on waking
2	TIA	Same patient · identical episode which fully recovers in minutes to <24 h — transient one-eye blindness lasting seconds counts too
3	Intracerebral haemorrhage	Hypertensive · progressive headache + vomiting + hemiparesis evolving over minutes-hours WITH intact consciousness early
4	Subarachnoid haemorrhage	40s–50s · "worst headache of my life" hitting like a thunderclap during straining + vomiting + neck rigidity, no focal weakness
5	Subdural haematoma	Elderly or alcoholic after trivial stumble (days–weeks earlier) · slowly fluctuating drowsiness + confusion + headache, one pupil later dilating
6	Extradural haematoma	Young man hit on the temple · brief blackout, then lucid interval of hours, then rapid dilating pupil + weakness on the opposite side + vomiting
7	Bacterial meningitis	Young adult / child · fever + severe headache + vomiting + neck stiffness + photophobia; child may show only fever + lethargy + refusal to feed + high-pitched cry, bulging fontanelle if <18 months
8	HSV encephalitis	Adult · fever + confusion behaving bizarrelly + olfactory/smell hallucinations or unpleasant drinking of previously tolerated food — often mis-sent home
9	Multiple sclerosis	Young woman · blurred vision in one eye with pain moving the eye + numb patches + electric shock down the back on neck bending, relapsing and remitting
10	Guillain-Barré syndrome	Young adult 2–4 weeks after diarrhoea or flu · symmetric weakness climbing legs → arms over days + absent reflexes + backache; breathing effort is the danger
11	Myasthenia gravis	Young woman / older man · drooping eyelids and double vision worsening through the day + difficulty chewing meat at dinner but fine at breakfast — fatigue improves with rest
12	Parkinson's disease	Man over 60 · pill-rolling finger tremor at rest + smaller handwriting + shuffle + staring face, all beginning on one side
13	Huntington's disease	Man in 30s–40s · facial grimacing + writhingpurposeless limb movements + personality change and irritability, parent died the same way
14	Motor neuron disease (ALS)	Man over 50 · wasted hand muscles + jumping twitches + slurred speech + stumbling, NO sensory loss, NO eye or bladder involvement
15	Bell's palsy	Overnight · one-sided whole-half face droop + inability to wrinkle the forehead or close the eye + taste blunted on the front tongue; forehead sparing = stroke, not Bell's
16	Trigeminal neuralgia	Over 50 · electric-shock jabs on one side of the face from eating, washing, cold wind; completely painless between attacks, never crosses midline
17	Migraine vs cluster	Young woman · one-sided throbbing headache preceded by flashing lights, nausea, light intolerance, sleep fixes it — vs a man smoker: sudden eye-tearing one-sided knife-stab behind the eye at the same clock time nightly for weeks
18	Wernicke's encephalopathy	Alcoholic or vomiting post-op young man · confusion + walking like a sailor + darting eye movements/jerks — never wait for the classic three; give the vitamin first

	Disease	Symptom cluster (as the exam presents it)
1	Schizophrenia (first episode)	Young adult 18–25 · months of social retreat and strange preoccupations, then clear auditory commentary voices + fixed false beliefs + flattened affect
2	Acute psychotic mania	Young adult · three sleepless nights + grandiose pressure speech + spending sprees + sexual disinhibition
3	Bipolar depression	Same patient · opposite phase: retarded movement + guilt-heavy hopelessness + early-morning waking in low mood
4	Major depressive disorder	Middle-aged woman · >2 weeks of pervasive disinterest + fatigue + early-morning waking + appetite drop + worthlessness; ask about plans to harm self
5	Persistent depressive disorder	Years of "always been like this" mildly-flat mood, never a clear episode — two years minus brief relief
6	Panic disorder	Young woman · sudden 10-minute surge of racing heart + choking + dread of dying or going mad, peaks at 10 min then subsides, leaving dread of the next one
7	Generalised anxiety	Years of constant worry about many things + restlessness + poor sleep + tension headaches + irritable bowel
8	PTSD	After a road accident or violence witnessed · months of nightmares/flashbacks of the event + avoiding that junction/shop/vehicle + constant startle + irritability
9	OCD	Young adult · hours spent washing, checking, praying counting; knows it is irrational, distressing, but cannot stop — eating time stealing the day
10	Anorexia nervosa	Adolescent girl · starvation-thin yet insists she is fat + exercises compulsively + period stops + soft hair on the arms + cold intolerance + bradycardia
11	Bulimia nervosa	Normal-weight young woman · binge-empties in secret, then vomiting or laxative abuse + eroded enamel + swollen parotids + fresh stretch-scars on knuckles
12	Alcohol withdrawal	Drinker 6–48 h after last drink · coarse tremor + sweating + anxiety, then 24–72 h: hallucinations, confusion, seizures; later vivid visual hallucinations of small animals, fully awake
13	Delirium vs dementia	— sudden onset + fluctuating consciousness + visual hallucinations + worse at night = delirium; years-slow decline with clear consciousness = dementia
14	Somatic symptom / illness anxiety	Multiple doctors later, no organic findings fit the fixed conviction of disease; multiple organ complaints for years starting before 30
15	Conversion (functional neuro) disorder	After an emotional upset · weakness/blindness/seizure that fails anatomically — no dissonance (patient calm), reflexes intact, imaging clean
16	Opioid overdose / withdrawal	Overdose: pinpoint pupils + slowed breathing + unconsciousness — withdrawal: gooseflesh + runny eyes + cramps + diarrhoea + dilated pupils + yawning

	Disease	Symptom cluster (as the exam presents it)
1	Diabetic ketoacidosis	Young diabetic missing insulin or first presentation · 1–2 days of rapid laboured breathing + fruit-smelling breath + vomiting + abdominal pain + drowsiness
2	Hyperosmolar hyperglycaemic state	Elderly bed-bound type-2 · days to weeks of polyuria + confusion or coma, NO quick breathing, NO fruit breath — serum syrup-high
3	Type 1 diabetes (first presentation)	Child/young adult · weeks of drinking gallons + urinating round the clock + weight falling despite eating + bedwetting returning
4	Type 2 diabetes	Overweight 40s–50s with family history · often silent; fatigue + recurrent skin/genital infections + slow-healing wounds + blurred vision after meals
5	Hypoglycaemia	Diabetic on insulin / sulfonylurea · trembling + cold sweat + hunger, coming on as intoxication; unexplained episodes → alcohol-like behaviour at wrong times = insulinoma
6	Graves' disease	Young woman · weight loss with large appetite + palpitations + heat intolerance + eye prominence + neck swelling + pretibial flesh swelling
7	Toxic multinodular goitre	Older woman with long-standing neck swelling · suddenly hyperthyroid (— no eye signs)
8	Thyroid storm	Hyperthyroid after infection/surgery · delirium + fever >40 + tachyarrhythmia + vomiting = an emergency cluster
9	Hypothyroidism	Middle-aged woman · weight gain with poor appetite + cold intolerance + constipation + dry skin + hoarse voice + heavy periods + slow reflex relaxation
10	Myxoedema coma	Long-standing hypothyroid stopped medication, elderly in winter · hypothermia + coma + slow breathing + facial puffiness
11	Subacute (de Quervain's) thyroiditis	After viral sore throat · painful neck swelling moving to jaw + transient hyperthyroidism then swing to low
12	Primary hyperparathyroidism	Man/woman over 50 on routine chemistry · "moans, stones, groans": fatigue/depression + recurrent kidney stones + bone aches + constipation + peptic ulcer
13	Cushing syndrome	Middle-aged or young · moon face + central fat with thin limbs + purple stretch marks + easy bruising + high BP + sugar; woman also stalls cycles + body-hair excess
14	Addison's disease / adrenal crisis	Young woman · weeks of fatigue + salt craving + nausea + weight loss + darkening of skin creases/nipples; crisis on infection/stop steroid: vomiting + collapse + low BP unresponsive to drips
15	Pheochromocytoma	50s patient · paroxysmal attacks: pounding headache + drenching sweats + palpitations + pale pallor with BP spiking — between attacks completely asymptomatic
16	Primary hyperaldosteronism	Young-middle-aged hypertensive with potassium LOW and no clear other cause — muscle cramps + numbness + palpitations + polyuria
17	Acromegaly	Adult · rings and shoes tightening over months + enlarged hands/feet/jaw + sweating + headaches + snoring, plus carpal-tunnel symptoms
18	Prolactinoma	Young woman · absent or absent periods + milk leaking from breasts without pregnancy + headaches; man: headaches + vision loss + lost libido

	Disease	Symptom cluster (as the exam presents it)
1	Nephrotic syndrome	Child / young adult · periorbital puffiness on waking + frothy urine + swollen legs and scrotum + triggers by cold/past infection; no blood in urine notably
2	Post-infectious glomerulonephritis	Child 1–3 weeks after sore throat or skin boil · tea-coloured urine + puffy face + mild hypertension — recovers
3	IgA nephropathy	Young man · blood in urine appearing 1–2 days after each throat infection (not 2–3 weeks) — episodes recur for years
4	Rapidly progressive glomerulonephritis	Adult, often smoker with lung bleeding · weeks of rapidly falling kidney numbers + blood in urine + haemoptysis
5	Prerenal AKI	Post-diarrhoea / vomiting / heart failure patient · creatinine climbing + concentrated urine + concentrated sodium-high urine sign
6	Acute tubular necrosis	AKI after prolonged low BP or tubular-toxin (dye, aminoglycoside) · culture-negative, no rash, urine dilute — climbs then falls over 2–3 weeks
7	Obstructive uropathy / BPH retention	Man 60+ · weak stream + hesitancy + dribbling + nocturia; sudden anuria + loin pain = blockage — check before diuretics
8	Uncomplicated cystitis	Young woman · burning on passing urine + urgency + frequency + cloudy urine, NO fever or flank pain
9	Acute pyelonephritis	Woman with lower-tract symptoms + fever + chills/rigors + flank pain tender to thump + vomiting
10	Renal colic (nephrolithiasis)	Adult · sudden severe loin pain colicking waves radiating groin + writhing position + blood in urine, no fever
11	Contrast / drug nephrotoxicity	AKI within 48–72 h of contrast, aminoglycoside, NSAIDs in a fragile patient — creatinine climb, urine dilute
12	Hyperkalaemia	CKD / on ACE inhibitor or spironolactone · muscle weakness + palpitations + narrow T waves on film — often asymptomatic until dangerous
13	Hypokalaemia	Diuretic or diarrhoea/vomiting patient · weakness + cramps + constipation + flat T waves with ECG-driven U waves
14	Hyponatraemia (SIADH)	Lung cancer / post-op / on carbamazepine elderly · gradually: confusion + anorexia + seizures if sodium fast-drop, no swelling, concentrated urine
15	Hypernatraemia	Infant, elderly, or lithium / central DI patient · thirst (unless elderly) + agitation → lethargy + dry mucosa
16	Diabetes insipidus	Neurosurgery patient or pituitary lesion · sudden gallons of dilute urine + raging thirst + waking at night to drink; women often present with postpartum failure to lactate
17	Metabolic acidosis	Diabetic/DKA, septic, poisoned, or chronic-kidney patient · deep rapid breathing + fruity breath or anorexia, low BP with volume loss
18	Uraemia / advanced CKD	Weeks of anorexia + nausea worse mornings + itchy skin + hiccups + fatiguability + halitosis of urine + pale sallow skin

	Disease	Symptom cluster (as the exam presents it)
1	Iron deficiency anaemia	Menstruating woman / man over 50 · years-slow onset + fatigue + restless legs + brittle nails + spoon nails; in a man it always means finding the bleed
2	Vitamin B12 deficiency	Vegetarian / gastric surgery / on metformin long-term · anaemia + lemon-yellow skin + burning feet + position/vibration loss in legs + sore tongue
3	Thalassaemia minor / trait	Healthy young person with life-long microcytic anaemia — normal iron, no symptoms, family trait; do not transfuse
4	Sickle cell crisis	Child / young adult of African or Sindhi-Baloch stock · recurrent bony pain triggered cold-infection + jaundice episodes + priapism, lives on pain relief
5	Autoimmune haemolytic anaemia	Adult with anaemia + jaundice + dark urine + recent viral illness or on a pill; spleen palpable
6	ITP	Young woman or child · sudden petechiae on shins + gum bleed + epistaxis, no fever, no enlarged nodes, platelets <25
7	TTP	Adult woman · fever + confusion + petechiae + falling Hb + rising kidney marker (MAHA, thrombocytopenia, neuro + renal, fever)
8	DIC	After placental abruption / sepsis / trauma · bleeding from every puncture + oozing gums + microthrombi shutting organs down
9	Aplastic anaemia	Young adult after drug or chemical exposure · weeks of three-line failure: pallor + infection fevers + gum bleeding, fresh-looking films
10	AML	Adult · days–weeks: pallor + bruising + gum hypertrophy/bleed + fevers + bone pain; sometimes presents as DIC with clotting deranged
11	ALL	Child · days–weeks: pallor + fever + bruiselike petechiae + bone pain + enlarged nodes/gums + limb pain mistaken for juvenile arthritis
12	CML	40s–50s · weeks of fatigue + early fullness + left-side rib-cage ache + weight loss — spleen enormous, often incidentally found
13	CLL	Man 60+ · often silent for years, found on routine count; lymph nodes rubbery + splenomegaly + recurrent chest/skin infections + herpetic reactivation
14	Hodgkin lymphoma	Young adult · painless rubbery neck nodes + alcohol-triggered ache at node sites + drenching night sweats + weight loss + itching
15	Multiple myeloma	Man over 60 · back pain (not relieved by bed rest) + recurring pneumonia + fatigue + thirst + raised creatinine + nerve symptoms from collapse
16	Polycythaemia vera	Man 50s–60s · red-purple suffused face + itching after hot showers + headaches + gout + clots at unusual sites

	Disease	Symptom cluster (as the exam presents it)
1	Dengue	Monsoon mosquito exposure · sudden high fever + severe retro-orbital headache + aching bones ("bone-break") + face flush then a fine rash, days 3–5 bleeding/petechiae danger
2	Malaria (falciparum)	Travel to endemic area weeks earlier · periodic fever with chills and drenching sweats + headache + anaemia; falciparum: confusion, jaundice, dark urine
3	Typhoid	Week 1: stepwise fever + headache + relative slow pulse + coated tongue; week 2: abdominal discomfort + pea-soup diarrhoea or constipation + rose-spot rash
4	Measles	Unvaccinated child · 3 Cs (cough, coryza, conjunctivitis) + fever spike + gray-blue dots inside cheeks (day 2) → rash from hairline downwards day 3–5
5	Rubella	Mild fever + swelling behind ears + lymph glands (posterior auricular, suboccipital) + fine rash starting on face same day — danger is a pregnant contact
6	Mumps	Child/adolescent · fever + painful jaw/ear swelling pushed up when chewing + tender ear lobe; adolescent male: testicular pain later
7	Chickenpox	Child · 1–2 days fever + "dew-drop on rose petal" vesicles in different stages all over, starting on trunk, intensely itchy
8	Herpes zoster	Adult · burning band-like pain on one side for 2–3 days BEFORE a unilateral dermatome cluster of grouped vesicles appears
9	Pertussis (whooping cough)	Unvaccinated infant / child · 1–2 weeks catarrh, then fits of 10–20 coughs in expiration with loud "whoop" on inspiration, often vomiting, face red
10	Tetanus	Contaminated wound / piercing days–weeks earlier · jaw lock + stiff neck + back arching + spasms triggered by sound/light, fully conscious between spasms
11	Rabies	Dog/animal bite weeks–months earlier · fever + pain/paraesthesia at old bite + hydrophobia (fear of water, unable to drink) + aerophobia + agitation
12	Leptospirosis	Flooding / cattle-rat exposure · sudden fever + severe muscle pain especially calves + red eyes + headache → jaundice + kidney injury in severe forms
13	Enteric fever / hepatitis A overlap	Street-food / contaminated water source · fever + abdominal discomfort + nausea + anorexia + dark urine — full-context contact history
14	Cellulitis	Leg skin break (tinea pedis, ulcer, IV) · hot, red, painful, swollen, sharply-bordered zone expanding over hours–days + fever + draining lymph nodes
15	Necrotising fasciitis	Immunosuppressed/diabetic · pain massively out of proportion to innocent-looking skin + rapid spread + crepitus + blisters + grey drainage + systemic collapse
16	Amoebic vs bacillary dysentery	Amoebic: gradual + abdominal cramps + mucus with blood, stool is non-fatty liquid · Shigella: abrupt + high fever + tenesmus + small-volume bloody stool + urgency

	Disease	Symptom cluster (as the exam presents it)
1	Rheumatoid arthritis	Woman 30–50 · symmetric small-joint pain with 1 h+ morning stiffness (fingers, wrists) improving with movement + swollen knuckles + fatigue
2	Systemic lupus erythematosus	Young woman · sun-exposed cheek rash + joint pain (non-erosive) + mouth ulcers + hair thinning + fatigue + unexplained fever + kidney involvement later
3	Acute gout	Man over 40 · sudden excruciating first-metatarsophalangeal (big toe) or ankle pain overnight after heavy meat or beer or diuretic start + red swollen joint — even the bedsheet hurts
4	Pseudogout (CPPD)	Elderly woman · acute knee/wrist pain overnight + chondrocalcinosis X-ray, mimics gout/sepsis
5	Osteoarthritis	Older patient · pain in weight-bearing joints worse with use by evening + brief <30 min stiffness + bony knuckle swellings (Heberden/Bouchard) + crepitus
6	Ankylosing spondylitis	Young man 20s–30s · insidious back pain + morning stiffness >30 min improving with exercise, worsening with rest + night pain that makes him get up and walk
7	Reactive arthritis	Young man, weeks after diarrhoea or urethral discharge · can't see, can't pee, can't climb the tree — conjunctivitis + urethritis + asymmetric lower-limb oligoarthritis
8	Psoriatic arthritis	Psoriasis patient · painful swollen single digit (sausage digit) + morning stiffness + back pain + nails pitted
9	Systemic sclerosis	Woman 30s–50s · fingers turning white then blue in cold (Raynaud) + skin thickening/tightening + heartburn + difficulty swallowing
10	Polymyositis / dermatomyositis	Middle-aged · weeks of climbing stairs/lifting arms impossible + weak neck flexion vs legs strong (proximal weakness) — dermatomyositis: purplish eyelid rash + knuckle bumps
11	Polymyalgia rheumatica	Patient over 50 · days-to-weeks: shoulder/hip girdle aching + morning stiffness >45 min, no real weakness + feels ten years old overnight
12	Giant cell arteritis	Patient 50+ · new temporal headache + scalp tenderness when combing + jaw claudication chewing + vision loss/or amaurosis fugax — usually coexists with polymyalgia
13	Takayasu arteritis	Young woman · arm claudication (pain when combing/exercising arms) + absent/weak pulses in arms ("pulseless disease") + BP difference between arms
14	Granulomatosis with polyangiitis (GPA)	Adult · months of sinusitis not responding + nose bleeds/crusting + saddle-nose + haemoptysis + blood in urine + ear involvement
15	Septic arthritis	Single hot red swollen joint (especially knee) + fever + cannot bear weight — a prosthetic joint makes this an emergency every time
16	Behcet's disease	Young adult · recurrent painful mouth ulcers + genital ulcers + red painful eye + skin pustules pricked by a needle + joint pain

	Disease	Symptom cluster (as the exam presents it)
1	Psoriasis	Young adult · silvery scale on red plaques over knees/elbows/scalp + nail pitting + morning joint stiffness + Koebner (rash appearing at sites of injury)
2	Atopic dermatitis	Child · dry itchy skin + family asthma/hayfever history + flexural folds itchy in children, face/neck in adults — worse with soaps, wool, sweat
3	Contact dermatitis	Adult · itching/burning red vesicular rash precisely matching the letter/document pattern of nickel, henna, fragrance, or a specific leather strap
4	Seborrhoeic dermatitis	Adult · greasy yellowish scale in eyebrows, nasolabial folds, scalp margins, ears + often in HIV patients more severe
5	Pemphigus vulgaris	Middle-aged · mouth erosions FIRST + flaccid fragile blisters everywhere + Nikolsky positive (skin slides off with finger rub) — older patient's tense blisters with mouth spared: bullous pemphigoid
6	Stevens-Johnson syndrome / TEN	On a new drug (sulfa, anticonvulsant, NSAID) · 1–2 days prodrome of fever + burning eyes/mouth, then rapid sheet-like skin peeling + blisters on face/trunk + mucosal erosions
7	Urticaria / anaphylaxis	After food/bee sting/drug · rapidly itchy weals lasting <24 h each + lip/tongue swelling + throat tightness + dizziness = escalate to emergency
8	Erythema nodosum	Young woman · tender red nodules on the shins + low-grade fever + joint aches; underlying: TB, sarcoidosis, strep throat, pills
9	Lichen planus	Adult · purple polygonal flat-topped itchy papules on wrists/forearms + white lacy pattern inside the mouth (Wickham striae)
10	Scabies	Family members all itching · intense nocturnal itch + burrows in finger webs, wrists, waistline + infant involvement of palms/soles
11	Tinea corporis / versicolor	Tinea corporis: ring with active raised itchy border and central pale patch · versicolor: painless finely-scaling patches on oil-rich trunk, less visible on tanned skin
12	Impetigo	Child · honey-coloured crusted sores around mouth/nose + contagious within household/daycare + itchy scratch marks spreading contamination
13	Tinea capitis / kerion	Child scalp · patchy hair loss with black-dot stubs + boggy painful swollen plaque (kerion) + broken hairs + posterior cervical nodes
14	Melanoma	Adult with a changing mole · ABCDE: asymmetry + irregular border + colour variation + diameter >6 mm + evolution; nodular: rapidly growing skin lump that bleeds
15	Basal cell / squamous cell carcinoma	Chronic fair-skinned sun-exposed site · BCC: pearly telangiectatic nodule with rolled edge that erodes — SCC: non-healing crusted verrucous nodule on the lip/ear/back of hand