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step 2 cs > cases differential memnoics > Flashcards

cases differential memnoics Flashcards

1
Q

chest pain
physical
dx exam for each differential

A 
MP3 GCDC
MI, Pneumonia , PE, Pericarditis, 
Gerd, costochondritis, dissecting aortic aneurysm cocaine
JVD carotid auscultation 
CV exam IAP
pulmonary exam
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2
Q

hematuria
phsyical exam
diagnostic tests

A 
HITTERS
hemolytic, infection, trauma, tumor, excercise, gomerulnephrtitis, rental stone, 
abdominal exam and CVA tenderness
cat p
painless or full amount, clots timing
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3
Q

back pain
DIFFERENTIAL
WITH WNT
W/O WNT

A 
RSS WNT GLIP  CITRUS
gait
lifting 
incontinence  
postion
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4
Q

abdominal pain UPPER
LEFT UPPER
UPPER EPIGASTRIUM
UPPER RIGHT

A

TRYS DHIBE P G

timing, food relationship, yellowing skin , distension, Gerd, infection, bowel ( diarrhea/constipation/ color stool/urine)
eating out, Pancreas

-
-----
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--
-
-
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-
-]

RIGHT-
CHOLECYSTITIS-RADIATES SHOULDER SCAPULAE N/V FEVER + murphy HIDA/ US
BILIARY COLICK- US + FATTY FOOD PAIN RADIAT TO SHOULDER
CHOLANGITIS- JAUNDICE FEVER HYPOTENSION

PERFORATED DUODENAL ULCER- GUARDING REBOUND TENDERNESS ABDOMINAL RIGIDITY, WORSENING ABDMONIAL PAIN RADIATES TO RIGHT SHOULDER
HEPATITIS - an

LEFT
SPLENIC RUPTURE
IBS

EPIGASTRIUM
PANCREATISI- PAIN TENDER ACUTE NAUSEA VOMITING RADIATES TO BACK
PUD
GASTRITIS

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5
Q

knee pain

DIFFERENTIALS

A

WRSS WNT CHOEF CITRUS

C- DISCOLORRATION FINGER TO COLD 
H-AIR LOSS
O- , OTHER JOINT PAIN
E - EXPOSURE TO SUNLIGHT SENSITIVE 
Fatigue
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6
Q 
neck pain 
MEMNOIC 
differential 
with WNT
w/o WNT
exam
A

WRSS WNT GLIP BP CITRUS
Breathing, photosensitivity

x ray- c spine
MRI- c spine
nerve conduction test.

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7
Q

jaundice

A 
JAUNDICE B
JOURNEY/ JOINT PAN 
ABDMONIAL PAIN 
UP TEMPERATUVE
DIARRHEA/ CONSTIPATION 
ITCHY (SEVERITY 0/10)/IMMUNIZATION 
COLOR URINE STOOL 
EATING OUT + PAIN RELATIONSHIP TO MEALS)/WEIGHT LOSS/APPEITITE

BLOOD TRANSFUNSION

VAA PAP

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8
Q

bloody stool

A 
CHAD UF LPG
colon cancer, 
hemorrhoids
angiodysplasia
diverticulosis 
ulcerative colitis 
fistula 
liver
peptic ulcer
Gerd
CAT P 
COLOR,AMOUNT,TIMING, PAINLESS/PAINFUL
UC (JIRR)

DURING ULCERATIVE COLITIS DIFFERENTIAL ASK ABOUT
DIAHRREA OR CONSTIPATION.
MAKE SURE TO ASK DIAHREA( FREQUENCY DESCRIPTION) CONSTIPATION FREQUENCY DESCRIPTION)

-any colonoscopy

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9
Q 
ARM PAIN
DIFFERNTIAL 
BONE
MUSCLE 
CAPSULE 
HEART
A

WRSS WNT

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10
Q

LOWER ABDOMINAL PAIN

A 
NV B (EFI) B (COCA  B) DIE
bowel changes 
blood in stools
diet 
IBS
incomplete Evacuation of school UC
LMP RT VS PAP
RIGHT
APPENDICITIS 
LEFT
DIVERTULOTITIS 
 BOTH 
OVARIAN CYST RUPTURE, OVARIAN TORISION, ECTOPIC PREGNANCY
IBS/IBD
GASTROENTRISIS
KIDNEY STONE
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11
Q

COUGH
PRODUCTIVE
NON PRODUCTIVE
PRODUCTIVE WITH BLOOD

A

abcdefg
asthma , atypcial pneumonia, bronchitis, Drugs
fibrosis ,gerd
CCCA-
CHF, COPD, Community acquired pneumonia, aspiration pneumonia
TB, bronchitis, cancer

PRODUCTIVE COCA B

asthma - > wheezing, post vomiting asthma,

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12
Q

FATIGUE

A

I3 M2P A3 DHD & SHEEHAN SYNDROME

infection( mono, TB HIV)
M ( malignancy, MG)
A- anemia sleep apnea  adjustment disorder, 
Postraumatic stress
DM, depression, 
Hypothyroidsm 
SIGECAPS
SLEEP
INTEREST PLEASURE ACTIVITY LOSS OF INTEREST
GUILTY OR WORRED
ENERGY
CONCENTRATION
APPETITE
PHYSCOMOTOR FEELING AGITATED OR SLOWER THAN USUSAL
SUCIDE
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13
Q

HOARSNESS

A

PM CAP LGH

PAIN WITH SPEAKING
hx of stroke or TIA
MS- any cough
any history of throat cancer, thyroid cancer in you family
exposure to dust or cold weather cause hoarseness
laryngitis cough

any swelling or bumps in your head or neck
PM CAP LGH

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14
Q

SORE THROAT

A 
PHIGNS
pharyngitis 
HIV
infectious mono
gern
postNasal drip
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15
Q

CALF PAIN

A 
WRSS VOIS
palpable/painful veins
oral contraceptive
immobility 
SOB
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16
Q

DM HTN FOLLOW UP

INTRO SCRIPT

A 
how long have you had diabetes for?
you said you were taking/ what med are you taking
have you experience any side efffects
do you take this medication everyday 
do you check your blood pressure 
regular  how often what are your usual readings
what was your last reading 
what was your last HAbc1
GESS GLUCOSE/ HTNESS
sideeffects/speech./sight/sax
ccarss + mi , speech, hx stroke
u polyuria/polyphagia/b bloating
NEURO/GLUCOSE/SE/EYE HX OF MI STROKE
17
Q

PREEMPLOYMENT

A

employers usually request a medical assessment of their employees just to make sure their fit for the job. Also to ensure that they don’t have a medical condition that can be hazardous to others in the work environment. I will ask you a few question and then perform a physical exam. and on the basis of what I find I may or may not order some tests. Hopefully everything will be fine.

For how long? Taking Meds? Compliant? Side effects? Check BSL regularly? Under control? Last reading? Last visit to the doctor? What was your last HBA1c?

H(+STROKE)ENT
CCARSS
U/B
SS
SKIN/PHYSC
HEESN PHYSC
1. For Head:
a. Do you have a Hx of head trauma?
b. Do you have a Hx of Dizziness, LOC/ fainting spells?
c. Do you have a Hx of Stroke or TIA?
d. Do you have a Hx of seizures?
2. For Eyes:
a. Have you noticed any changes in your vision?
3. For Ear:
a. Have you noticed any changes in your hearing?
b. Have you noticed any problem with your balance or gait?
4. For Sinus:
a. Have you noticed chronic facial pain or nasal stuffiness?
5. For Neck:
a. Have you noticed any pain or swellings in your neck?

  1. For Heart: (Past Hx of MI, SOB, Pacing of heart, Chest pain, Sweating)
  2. For Pulmonary: (Cough)
  3. For GIT: (Pain, distension, Bowel habits color of stool, Polyphagia, Abnormal Discomfort-GERD)
  4. For Genitourinary: (Polyuria, Polydipsia)
  5. For Obs/Gynae: (LMP RT CVS PAP)
  6. For Psychiatric:
    a. Do you have a Hx of psychiatric illness or admission? 12. For Skin:
    a. Have you
    noticed a rash or any other skin problems?

PAMHUGSFOSS
FCN SAW N/V

18
Q

LOSS OF CONSIOUSNESS

A 
HAD CAMPUS
hypoglycemia 
alcohol 
dehydration 
cardiac arrhythmia 
malignancy 
panic attack
For Panic Disorder:
a. Is there any particular event associated with the racing of heart?
b. Does your breathing rate increase during the episode?
c. Do you feel dizzy during the episode?
unexplained vasovagal 
seizure
19
Q

DIZZINESS

A

BV PALM

20
Q

HEARING LOSS

A

OCP needs I.D in PALMsprings

.

21
Q

HEADACHE

A

M2B CRS2 T5 GC

22
Q

INSOMINIA

A 
CCHADDS
caffeine
circadian rythamn
hyperthyroidism 
sleep apnea 
drugs
depression
stress - adjustment disorder acute stress ( job loss) symptoms - jumpy on guard, nightmares , startled easily  tense muscles

After the introduction, ask the following questions:
 What do you do before you go to bed?
 Have you noticed any trouble falling asleep?
 Do you have night time awakenings?
 What time do you wake up in the morning?
 Do you feel sleepy or take naps during the days?

23
Q

WEIGHT GAIN

A 
Differential Diagnosis:  P2HD in FCS
pregnant
polycystic 
depression 
Hypothyroidism 
family 
cushing 
smoking cessation

Questions
How much weight have you gained? Over how much time? Intentional or unintentional?
1. For Depression: (Mood + SIGECAPS)
2. For Pregnancy: (LMP + Morning sickness)
3. For HypoThyroidism: (Temp intolerance, skin changes, bowel habits)
4. For Familial tendency:
a. Any family Hx of obesity?
5. For Cushing’s:
a. Have you noticed any stria on your body?
B. any muscle weakness
c. hairy, irregular periods,
6. For PCOS:
a. Have you noticed any excessive hair growth recently?
b. Have you noticed any abnormal pigmentation of the
body?
C. OB/GYN HISTORY
7. For Smoking Cessation:

24
Q

TREMOR

A 
PC we learned that PE has high LDH
Parkinson 
cerebellar ataxia
Physiological 
Essential 
Liver 
Drugs
Hyperthyroidism

Tremors

At Activity: Cerebellar, Liver Disease
At Rest: Parkinsonism
At Both : Essential, Physiological, Hyperthyroidism, Drugs
QuestionsAre the tremors at rest?

step 2 cs (7 decks)

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