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Aquifer - DDx Flashcards

1
Q

DDx - RUQ Mass + Pallor
(9-month-old infant)
6

A
  1. Hepatic neoplasm
  2. Hydronephrosis
  3. Neuroblastoma
  4. Teratoma
  5. Wilms’ tumor (nephroblastoma)
  6. Constipation
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2
Q

DDx - Abdominal Pain + Vomiting
(Adolescent female)
10

A
  1. Appendicitis
  2. Cholecystitis
  3. Pregnancy
  4. Hepatitis
  5. Pancreatitis
  6. PID
  7. UTI
  8. Acute gastroenteritis
  9. Mesenteric adenitis
  10. Ovarian torsion
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3
Q

DDx - Abdominal Pain + Bloody Stools
(school-aged)
6

A
  1. IBD
  2. Celiac disease
  3. Bacterial gastroenteritis
  4. Giardiasis
  5. Peptic Ulcer Disease
  6. HSP
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4
Q

DDx - Apnea (CNS)
(infants)
3

A
  1. Seizures (due to CNS bleeding, infection, structural abnormalities, metabolic disorders, electrolyte abnormalities, genetic syndromes, epilepsy)
  2. Breath-hold spells
  3. Increased ICP (bleed, trauma, tumor, infection) affecting the respiratory center
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5
Q

DDx - Apnea (Cardiac)
(infants)
2

A
  1. Bradycardia secondary to congenital heart block or long QT syndrome
  2. Congenital heart disease (particularly ductal-dependent lesions), unrepaired Tetralogy of Fallot may have acute episodes of cyanosis associated with a drop in pulmonary blood flow
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6
Q

DDx - Apnea (Pulmonary)
(infants)
3

A
  1. RSV (most common respiratory cause)
  2. Pertussis
  3. Other lower respiratory infections
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7
Q

DDx - Apnea (GI)
(infants)
3

A
  1. GER has been blamed, but a true correlation has not been proven - some experts think that apnea occurs first, leading to hypoxia, relaxation of the LES, and reflux; others believe reflux may cause choking, gagging, color changes, and laryngospasm
  2. Swallowing abnormalities
  3. TE fistula (chronic history of coughing or difficulty with feeds)
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8
Q

DDx - Apnea (Systemic)
(infants)
5

A
  1. Systemic sepsis (apnea, pallor, tachycardia, tachypnea, fever, hypothermia, decreased feeding, change in tone)
  2. Inborn errors of metabolism
  3. Ingestions of medications and other toxins (respiratory depression, cardiac arrhythmias, seizures)
  4. Exposure to botulinum toxin (soil or honey -> hypotonia, constipation, paralysis, respiratory failure)
  5. Environmental exposure (CO -> mental status changes, hypoxia, respiratory distress)
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9
Q

DDx - School Failure
(school-aged)
5

A
  1. Sensory impairment
  2. Sleep disorder
  3. Mood disorder
  4. Learning disability
  5. Conduct disorder
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10
Q

DDx - Chest Pain
(children and adolescents)
5

A
  1. Cardiac cause (HCM, etc.)
  2. Precordial catch syndrome
  3. Costochondritis
  4. GI causes (GERD, gastritis, esophagitis)
  5. Asthma or exercise-induced bronchospasm
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11
Q

DDx - Microcytic Anemia

5

A
  1. Iron deficiency
  2. Thalassemia
  3. Sideroblastic
  4. Chronic inflammation/disease*
  5. Lead poisoning*
    * Can be normocytic
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12
Q

DDx - Normocytic Anemia

7

A
  1. Acute blood loss
  2. Immune hemolytic anemia
  3. Hereditary spherocytosis
  4. G6PD deficiency
  5. Sickle cell anemia
  6. Renal disease
  7. Transient erythroblastopenia of childhood (TEC)
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13
Q

DDx - Macrocytic Anemia

6

A
  1. Folate deficiency
  2. B12 deficiency
  3. Hypothyroidism
  4. Neoplasms
  5. Bone marrow failure syndromes (aplastic anemia, Diamond-Blackfan anemia, and congenital dyserythropoietic anemia)
  6. Liver disease/failure*
    * Can be normocytic
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14
Q

DDx - Anemia due to Decreased Production

12

A
  1. Iron, folate, or B12 deficiency
  2. Lead toxicity
  3. Thalassemia
  4. Aplastic anemia
  5. Chronic inflammation
  6. Neoplasms
  7. TEC
  8. DBA
  9. Renal disease
  10. Hypothyroidism
  11. CDEA?
  12. Sideroblastic anemia
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15
Q

DDx - Anemia due to Increased Destruction

10

A 
1. Immune hemolytic disease
2/ Hereditary spherocytosis
3. G6PD deficiency
4. Sickle cell disease
5. Thalassemia
6. DIC
7. Mechanical heart valves
8. Burns
9. Paroxysmal nocturanl hemoglobinuria (PNH)
10. Hypersplenism
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16
Q

DDx - Anemia due to Blood Loss

5

A
  1. Acute hemorrhage
  2. Dysfunctional uterine bleeding (heavy/prolonged menses)
  3. Pulmonary hemosiderosis (hemorrhage)
  4. Goodpasture’s disease
  5. GI blood loss (PUD, other GI conditions)
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17
Q

DDx - Unresponsiveness
(children)
7

A
  1. Toxic ingestion
  2. Seizures
  3. Syncope
  4. Closed Head Injury
  5. Infection

Less common:
Intracranial process, intusussception

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18
Q

DDx - Seizure
(age?)
8

A
  1. CNS infection (meningitis/encephalitis)
  2. Febrile seizure
  3. Head injury/post-traumatic seizure
  4. Ingestion/poisoning
  5. Idiopathic seizure/epilepsy
  6. Hypoglycemia
  7. Brain tumor
  8. Breath-holding spell
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19
Q

DDx - Acquired Ataxia
(age?)
10

A
  1. Post-infectious cerebellitis (aka acute cerebellar ataxia)
  2. Infectious cerebellitis
  3. Medication or toxin
  4. Intracranial mass
  5. Opsoclonus-myoclonus syndrome
  6. Migraine headache
  7. Hydrocephalus
  8. Metabolic disease (MSUD, pyruvate decarboxylase deficiency, etc.)
  9. Neurodegenerative disease (ataxia-telangeictasis and Friedreich ataxia)
  10. Psychiatric illness (conversion disorder)
20
Q

DDx - Fever and Petechiae
(Adolescent)
4

A
  1. Meningococcal sepsis
  2. Toxic shock syndrome
  3. Rocky Mountain Spotted Fever
  4. Bacterial endocarditis
21
Q

DDx - Acute Onset Altered Mental Status
(2-year-old)
4

A
  1. Infection (sepsis, meningitis, encephalitis)
  2. Toxic ingestion
  3. Trauma
  4. Seizure
  5. Electrolyte/glucose abnormalities
22
Q

DDx - Altered Mental Status
(general)
9 (AIEOU TIPS)

A
  1. Alcohol, ingested toxins
  2. Epilepsy, encephalitis, endocrine, electrolyte
  3. Infection (meningitis/sepsis)
  4. Overdose, opiates, oxygen deprived
  5. Uremia (renal failure)
  6. Trauma, temperature
  7. Insulin
  8. Psychosis
  9. Stroke, shock, space occupying lesions
23
Q

DDx - Hepatomegaly
(infant)
5

A
  1. CHF
  2. Congenital infections
  3. Inborn errors of metabolism
  4. Anemias
  5. Tumors
24
Q

DDx - Bruising and Leg Pain
(age?)
9

A
  1. Coagulation disorder
  2. Henoch-Schnolein purpura (HSP)
  3. Idiopathic thrombocytopenic purpura (ITP)
  4. Leukemia
  5. Viral infection
  6. Bacterial endocarditis
  7. Meningococcal septicemia
  8. Rocky Mountain spotted fever (RMSF)
  9. Systemic lupus erythematosus (SLE)
25
Q

DDx - Fever, Respiratory Distress, Chest Pain
(child with SCD)
5

A
  1. ACS
  2. Pericarditis
  3. CHF
  4. Rib infarction
  5. Sepsis
26
Q

DDx - Wheezing
(infants and toddlers)
7

A
  1. Viral bronchiolitis
  2. Asthma
  3. Foreign body aspiration
  4. Gastroesophageal reflux
  5. Tracheomalacia
  6. Extrinsic compression (adenopathy, mass, vascular ring/sling, other anatomic lesion)
  7. CF
27
Q

DDx - Cough
(age?)
5

A
  1. Viral URI
  2. Pneumonia
  3. Post-nasal drip due to allergies and/or sinusitis
  4. Foreign body aspiration
  5. GER
28
Q

DDx - Congestion, Cough, Fever
(age?)
4

A
  1. AOM
  2. Pneumonia
  3. Sinusitis
  4. URI
29
Q

DDx - Periorbital Swelling
(age?)
5

A
  1. URI
  2. Season/perennial allergic rhinitis and conjunctivitis
  3. Sinusitis (ethmoid, frontal, maxillary)
  4. Acute allergic reaction 5. Periorbital cellulitis
30
Q

DDx - Fatigue, Periorbital Edema, Increasing Abdominal Girth
(age?)
4

A
  1. Acute glomerulonephritis
  2. CHF
  3. Hepatic failure
  4. Nephrotic syndrome
31
Q

DDx - Absent Red Reflex/Presence of Leukocoria (white pupil)?
7

A
  1. Cataract
  2. Glaucoma
  3. Opacified cornea (as in mucopolysaccharidosis)
  4. Inflammation of the anterior chamber
  5. Chorioretinitis
  6. Developmental anomalies of the eye
  7. Retinoblastoma
32
Q

DDx - Rash
(school-age, 5-year-old)
8

A
  1. Roseola
  2. Papular urticaria
  3. Streptococcal infection
  4. Erythema multiforme
  5. Erythema infectiosum (fifth disease)
  6. Urticaria due to type 1 hypersensitivity
  7. Erythema migrans
  8. Drug eruption
33
Q

DDx - Rash
(infant)
4

A
  1. Seborrheic dermatitis (cradle cap)
  2. Eczema or atopic dermatitis
  3. Candidal rash
  4. Psoriasis
34
Q

DDx - Pustular Conditions
(age?)
5

A
  1. Staph folliculitis/furunculosis
  2. Acne vulgaris
  3. Hidradenitis suppurativa
  4. Rosacea
  5. Perioral dermatitis
35
Q

DDx - Ringworm
(age?)
4

A
  1. Nummular eczema
  2. Psoriasis
  3. Pityriasis alba
  4. Pityriasis rosea
36
Q

DDx - Tachypnea
(newborn)
9

A
  1. Respiratory distress syndrome (RDS)
  2. Transient tachypnea of the newborn (TTN)
  3. Pneumothorax
  4. Meconium aspiration
  5. Hypoglycemia
  6. Hypothermia
  7. Cardiac abnormalities
  8. Neonatal sepsis
  9. Congenital diaphragmatic hernia
37
Q

DDx - Fever
(infant)
10

A
  1. UTI
  2. Pneumonia
  3. Sepsis/bacteremia
  4. Occult bacteremia
  5. Bacterial meningitis
  6. Viral meningitis
  7. Roseola
  8. Primary herpes simplex virus gingivostomatitis
  9. Otitis media
  10. Viral URI
38
Q

DDx - Fever and Rash
(toddler)
11

A
  1. Adenovirus infection (viral infection)
  2. Kawasaki disease
  3. Meningococcemia
  4. Measles
  5. RMSF
  6. Scarlet fever
  7. SJS
  8. Enteroviral infection (Coxsackie, echo, entero)
  9. Varicella
  10. Erythema infectiosum (5th disease)
  11. Roseola
39
Q

DDx - Unilateral Cervical Lymphadenopathy

5

A
  1. Reactive cervical adenitis
  2. Kawasaki disease
  3. Bacterial cervical adenitis
  4. Cat scratch disease
  5. Mycobacterial infection
40
Q

DDx - Infectious Causes of Generalized Lymphadenopathy

6

A
  1. Measles
  2. Infectious mononucleosis (EBV or CMV)
  3. HIV
  4. Histoplasmosis
  5. Toxoplasmosis
  6. Mycobacteria (can also be localized)
41
Q

DDx - Non-Infectious Causes of Generalized Lymphadenopathy

5

A
  1. Lymphomas
  2. Leukemias
  3. Histiocytosis
  4. Metastatic neuroblastoma
  5. Rhabdomyosarcoma
42
Q

DDx - Strawberry Tongue

3

A
  1. Streptococcal pharyngitis
  2. Kawasaki disease
  3. Toxic shock syndrome
43
Q

DDx - Vomiting and Diarrhea
(toddler)
5

A
  1. Viral gastroenteritis
  2. Bacterial gastroenteritis
  3. Small bowel obstruction
  4. Appendicitis
  5. IBD
44
Q

DDx - Recurrent Emesis
(infant)
9

A
  1. GER
  2. Milk protein allergy
  3. Viral gastroenteritis
  4. Malrotation +/- volvulus
  5. Inborn error of metabolism
  6. Pyloric stenosis
  7. Intussusception
  8. CNS disease
  9. UTI
45
Q

DDx - Vomiting
(school-age)
6

A
  1. Gastroenteritis
  2. GI obstruction
  3. Pyelonephritis
  4. DKA
  5. Increased ICP
  6. Appendicitis
46
Q

DDx - Fatigue
(adolescent female)
5

A
  1. Anemia
  2. Bleeding disorder
  3. Hypothyroidism
  4. Depression
  5. Substance abuse
47
Q

DDx - Limp or Refusal to Walk
(toddler)
8

A
  1. Leukemia
  2. Osteomyelitis
  3. Reactive arthritis
  4. Septic arthritis
  5. Transient synovitis
  6. Trauma
  7. JIA
  8. Slipped capital femoral epiphysis

Pediatrics Clerkship (14 decks)

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