cases differential memnoics Flashcards
chest pain
physical
dx exam for each differential
MP3 GCDC MI, Pneumonia , PE, Pericarditis, Gerd, costochondritis, dissecting aortic aneurysm cocaine JVD carotid auscultation CV exam IAP pulmonary exam
hematuria
phsyical exam
diagnostic tests
HITTERS hemolytic, infection, trauma, tumor, excercise, gomerulnephrtitis, rental stone, abdominal exam and CVA tenderness cat p painless or full amount, clots timing
back pain
DIFFERENTIAL
WITH WNT
W/O WNT
RSS WNT GLIP CITRUS gait lifting incontinence postion
abdominal pain UPPER
LEFT UPPER
UPPER EPIGASTRIUM
UPPER RIGHT
TRYS DHIBE P G
timing, food relationship, yellowing skin , distension, Gerd, infection, bowel ( diarrhea/constipation/ color stool/urine)
eating out, Pancreas
- ----- - - -- - - - - -]
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
knee pain
DIFFERENTIALS
WRSS WNT CHOEF CITRUS
C- DISCOLORRATION FINGER TO COLD H-AIR LOSS O- , OTHER JOINT PAIN E - EXPOSURE TO SUNLIGHT SENSITIVE Fatigue
neck pain MEMNOIC differential with WNT w/o WNT exam
WRSS WNT GLIP BP CITRUS
Breathing, photosensitivity
x ray- c spine
MRI- c spine
nerve conduction test.
jaundice
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
bloody stool
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
ARM PAIN DIFFERNTIAL BONE MUSCLE CAPSULE HEART
WRSS WNT
LOWER ABDOMINAL PAIN
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
COUGH
PRODUCTIVE
NON PRODUCTIVE
PRODUCTIVE WITH BLOOD
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,
FATIGUE
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
HOARSNESS
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
SORE THROAT
PHIGNS pharyngitis HIV infectious mono gern postNasal drip
CALF PAIN
WRSS VOIS palpable/painful veins oral contraceptive immobility SOB
DM HTN FOLLOW UP
INTRO SCRIPT
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
PREEMPLOYMENT
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?
- For Heart: (Past Hx of MI, SOB, Pacing of heart, Chest pain, Sweating)
- For Pulmonary: (Cough)
- For GIT: (Pain, distension, Bowel habits color of stool, Polyphagia, Abnormal Discomfort-GERD)
- For Genitourinary: (Polyuria, Polydipsia)
- For Obs/Gynae: (LMP RT CVS PAP)
- 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
LOSS OF CONSIOUSNESS
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
DIZZINESS
BV PALM
HEARING LOSS
OCP needs I.D in PALMsprings
.
HEADACHE
M2B CRS2 T5 GC
INSOMINIA
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?
WEIGHT GAIN
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:
TREMOR
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?
