MLA Domain 5 · Presentation

Night sweats

7 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.

classic presentation · 4

Infective endocarditis

Heart failure from valve destruction, uncontrolled infection or large/embolising vegetations → early surgery

Lymphoma (Hodgkin & non-Hodgkin)

Mediastinal mass with SVC obstruction, or airway/cord compression → oncological emergency

Menopause / perimenopause

Postmenopausal bleeding (PMB) → urgent exclusion of endometrial cancer

Pulmonary tuberculosis

TB meningitis / disseminated (miliary) TB → urgent treatment; airborne isolation for suspected active pulmonary TB

recognised feature · 1

Pyrexia of unknown origin

Don't give blind/empirical antibiotics or steroids before a diagnosis (unless septic) — they obscure the picture

differential of the above · 2

Lung cancer

Haemoptysis/persistent cough/weight loss in a smoker → urgent 2-week-wait referral + urgent CXR (NICE NG12)

Sarcoidosis

Cardiac sarcoid (arrhythmia/heart block), neurosarcoidosis, or sight-threatening uveitis → urgent specialist treatment