CASES - DDx

Question 1

Case 1 — Chest pain:

Answer 1

1. Myocardial ischemia or infarction.
2. Cocaine-induced myocardial ischemia.
3. GERD.

Question 2

Case 2 — Bloody urine:

Answer 2

1. Bladder cancer.
2. Urolithiasis.
3. BPH.

Question 3

Case 3 — Back pain (construction worker):

Answer 3

1. Disk herniation.
2. Lumbar spinal stenosis.
3. Metastatic prostate cancer.

Question 4

Case 4 — MVA:

Answer 4

1. PTX.
2. Hemothorax.
3. Pneumonia.

Question 5

Case 5 — Positive pregnancy test:

Answer 5

1. Normal pregnancy.
2. Ectopic pregnancy.
3. Molar pregnancy.

Question 6

Case 6 — 10yo child recently diagnosed with DM:

Answer 6

1. DM I.
2. DM II.
3. 2o causes of DM (eg Cushing).

Question 7

Case 7 — Right arm pain:

Answer 7

1. Humeral fracture.
2. Shoulder dislocation.
3. Osteoporosis.

Question 8

Case 8 — DM f/u:

Answer 8

1. Insulin-induced hypoglycemia.
2. Diabetic peripehral neuropathy.
3. Organic erectile dysfunction.

Question 9

Case 9 — 25yo F assaulted:

Answer 9

1. Rib fracture.
2. Sexually transmitted infection (gonorrhea, chlamydia, syphilis).
3. Pregnancy.

Question 10

Case 10 — Pain in her right calf:

Answer 10

1. Deep venous thrombosis.
2. Cellulitis.
3. Rupture of Baker cyst.

Question 11

Case 11 — Hoarseness:

Answer 11

1. Laryngeal cancer.
2. Laryngitis.
3. Vocal cord polyp/nodule.

Question 12

Case 12 — Neck pain 67yo F:

Answer 12

1. Spinal disk herniation.
2. Cervical fracture.
3. Neck muscle strain.

Question 13

Case 13 — 48yo F abdominal pain:

Answer 13

1. Biliary colic/cholecystitis.
2. Peptic ulcer disease.
3. Gastritis.

Question 14

Case 14 — 35yo F headache:

Answer 14

1. Migraine headache.
2. Tension headache.
3. Intracranial mass lesion.

Question 15

Case 15 — Amenorrhea:

Answer 15

1. Hyperprolactinemia.
2. PCOS.
3. Pregnancy.

Question 16

Case 16 — Dyspareunia:

Answer 16

1. Vulvovaginitis.
2. Cervicitis.
3. Endometriosis.

Question 17

Case 17 — Hearing loss:

Answer 17

1. Presbycusis.
2. Cochlear nerve damage.
3. Otosclerosis.

Question 18

Case 18 — 5day-old with yellow skin:

Answer 18

1. Physiologic jaundice.
2. ABO incompatibility.
3. Neonatal sepsis.

Question 19

Case 19 — 7mo with fever:

Answer 19

1. Viral URI.
2. Pneumonia.
3. Otitis media.

Question 20

Case 20 — Cough:

Answer 20

1. Pneumonia.
2. URI—associated cough (postinfectious cough).
3. Acute bronchitis.

Question 21

Case 21 — 52yo Yellow eyes and skin:

Answer 21

1. Extrahepatic biliary obstruction (eg pancreatic cancer, cholangiocarcinoma, ampullary carcinoma, sphincter of Oddi dysfunction).
2. Viral hepatitis.
3. Acetaminophen hepatotoxicity.

Question 22

Case 22 — Dizziness:

Answer 22

1. Meniere.
2. BPPV.
3. Orthostatic hypotension causing dizziness.

Question 23

Case 23 — Knee pain:

Answer 23

1. Gout.
2. RA.
3. SLE.

Question 24

Case 24 — Heel pain:

Answer 24

1. Plantar fasciitis.
2. Calcaneal stress fracture.
3. Achilles tendinitis.

Question 25

Case 25 — 18mo child with fever:

Answer 25

1. Acute otitis media.
2. Meningococcal meningitis.
3. Scarlet fever.

Question 26

Case 26 — 54yo F persistent cough:

Answer 26

1. Pulmonary TB.
2. Malignant neoplasm of the lung.
3. Typical pneumonia.

Question 27

Case 27 — 61yo fatigue:

Answer 27

1. Pancreatic cancer.
2. MDD.
3. Chronic pancreatitis.

Question 28

Case 28 — HTN f/u:

Answer 28

1. Medication-induced erectile dysfunction.
2. Erectile dysfunction secondary to vascular disease.
3. Hypogonadism.

Question 29

Case 29 — 20yo F sleeping problems:

Answer 29

1. GAD.
2. Caffeine-induced insomnia.
3. Hyperthyroidism.

Question 30

Case 30 — 2yo with noisy and strange breathing:

Answer 30

1. FBA.
2. Croup.
3. Epiglottitis.

Question 31

Case 31 — Abdo pain 21yo:

Answer 31

1. Appendicitis.
2. Pelvic inflammatory disease.
3. Ruptured ectopic pregnancy.

Question 32

Case 32 — 65yo forgetfulness and confusion:

Answer 32

1. Alzheimer.
2. Vascular dementia.
3. Dementia syndrome of depression.

Question 33

Case 33 — 46yo Fatigue:

Answer 33

1. MDD.
2. Hypothyroidism.
3. PTSD.

Question 34

Case 34 — 32yo fatigue:

Answer 34

1. Domestic violence.
2. DM.
3. Anemia.

Question 35

Case 35 — 27yo seeing strange writing on the wall:

Answer 35

1. PCP intoxication.

2. Substance-induced psychosis.

Question 36

Case 36 — Pre-employment checkup:

Answer 36

1. COPD/chronic bronchitis.
2. Pneumoconiosis.
3. Pulmonary TB.

Question 37

Case 37 — 55yo bloody stool:

Answer 37

1. CRC.
2. Hemorrhoids.
3. C.diff colitis.

Question 38

Case 38 — 66yo tremor:

Answer 38

1. Parkinson’s disease.
2. Essential tremor.
3. Physiologic tremor.

Question 39

Case 39 — 30yo weight gain:

Answer 39

1. Hypothyroidism.
2. Weight gain due to smoking cessation.
3. Lithium-related weight gain.

Question 40

Case 40 — 6mo diarrhea:

Answer 40

1. Viral gastroenteritis.
2. Bacterial diarrhea.
3. Malabsorption.

Question 41

Case 41 — 8yo bedwetting:

Answer 41

1. Monosymptomatic primary nocturnal enuresis.
2. UTI.
3. Secondary enuresis.

Question 42

Case 42 — 11mo seizure:

Answer 42

1. Simple febrile seizure.
2. Meningitis.
3. Hyponatremia.

Question 43

Case 43 — 21yo sore throat:

Answer 43

1. IM.
2. Acute HIV infection.
3. Streptococcal pharyngitis.

Question 44

Case 44 — 49yo passing out/loss of consciousness:

Answer 44

1. Convulsive syncope.
2. Cardiac arrhythmia.
3. Seizure.