CK Presentations Flashcards

1
Q

40yo obese F presents with fatigue, weight gain, sleepiness, cold intolerance, constipation, and dry skin

A

HYPOTHYROIDISM (mdd, dm, anemia)

TSH
CBC
Fasting glucose
HbA1c

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2
Q

20yo M presents with fatigue, thirst, increased appetite, and polyuria

A

DM (atypical depression, primary polydipsia, di)

Glucose tolerance test
HbA1c
UA
CBC
Electrolytes, BUN/Cr, gluc
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3
Q

35yo M policeman c/o feeling tired and sleepy during the day after having changed to the night shift last week

A

SHIFT WORK SLEEP D/O (sleep apnea, depression, anemia)

CBC, noc ox, polysomnography

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4
Q

30yo M immigrant from Africa with night sweats, cough, and swollen glands of 1 months duration.

A

TB (acute HIVinfxn, lymphoma, leukemia, hyperthyroidism)

PPD, CBC, CXR, sputum gram, HIVantibody, TSH, T4

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5
Q

45yo F with excessive sweating, unintentional wt loss, palps, diarrhea, and SOB

A

HYPERTHYROIDISM (Pheo, carcinoid, tb)

TSH, T4
24-hour urinary catecholamines
5-HIAA
CBC
PPD
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6
Q

25yo F with 3 wk h/o difficulty falling asleep. Sleeps 7 hours per night without nightmares or snoring. Recently began college and is having trouble with bf. Drinks 3-4 cups of coffee per day.

A

STRESSINDUCEDINSOMNIA (caffeine-induced, insomnia with circadian rhythym sleep d/o, insomnia related to mdd)

polysomnography
MMSE
UDS
CBC
TSH
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7
Q

26yo F with sore throat, fever, severe fatigue, and loss of appetite x1week. Also reports epigastric and LUQ discomfort. She has cervical lymphadenopathy and a rash. Her BF recently experienced the same sxs

A

INFECTIOUS MONONUCLEOSIS (Hepatitis, viral or bacterial pharyngitis, acute HIVinfxn, secondary syphilis)

CBC w/ PBS
Monospot test
throat culture
AST/ALT/bili/ALP
HIV antibody and viral load
Anti-EBV antibodies
VDRL/RPR
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8
Q

26yo M with sore throat, fever, rash, and wt loss. He has a history of IVdrug abuse and sharing needles

A

ACUTE HIV INFECTION (infectious, mono, hepatitis, viral pharyngitis, streptococcal tonsillitis/scarlet fever, secondary syphillis)

CBC w/ PBS
HIV antibody and viral load
CD4 count
Monospot test
Throat cx
VDRL/RPR
AST/ALT/bili/ALP
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9
Q

46yo F with fever and sore throat

A

PHARYNGITIS (mycoplasma pneumonia, acute HIV infection, infectious mono)

Throat swab for cx and rapid strep antigen

monospot test
CBC
Serologic testing for mycoplasma

HIV antibody and viral load

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10
Q

30yo SOB, cough, wheezing that worsens in cold air. similar episodes in past 4 months

A

ASTHMA (gerd, bronchitis, pneumonitis, foreign body)

CBC, CXR, PFTs, peak flow measurement, methacholin challenge

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11
Q

56yo F SOB and productive cough x3months/yr x2yrs. Heavy smoker

A

COPD-bronchitis predominant (bronchiectasis, lung cancer, tb)

CBC
sputum gram stain and cx
CXR
PFTs
CT-chest
ppd
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12
Q

58yo M 1 week pleuritic chest pain, F/C, and cough with purulent sputum. H/o COPD

A
PNA
COPD exacerbation
lung abscess
lung cancer
tb 
pericarditis 

CBC, sputum gram and cx, CXR, CT-chest, ECG, ppd

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13
Q

25yo F with 2 wks nonproductive cough. 3 weeks ago with sore throat and runny nose

A

atypical pna (reactive ariway disease, URI-associated postinfectious cough, post-nasal drip, gerd)

CBC, induced sputum gram stain and cx

CXR
IgM detection for mycoplasma pna
urine legionella antigen

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14
Q

65yo M with worsening cough x6months w/ hemoptysis, dyspnea, weakness, and wt loss. Smokes

A

Lung cancer (tb, lung abscess, copd, vasculitis, interstitial lung disease, chf)

CBC, sputum gram stain, cx, and cytology
CXR
CT-chest
ppd
ANCA
bronchoscopy
ECHO
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15
Q

60yo sudden onset substernal heavy chest pain that has lasted for 30min and radiates to L arm, accompanied by dyspnea, diaphoresis, N. H/o HTN, HLD, and smoking

A

MI (unstable angina, costochondritis, pericarditis, PE)

EKG, CPK-MB and trops x3, CXR, CBC, electrolytes, BMP, ECHO, cardiac cath, D-dimer

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16
Q

45yo F with retrosternal burning sensation that occurs after heavy meals and when lying down. sxs relieved by antacids

A

GERD (esophagitis, pud, esophageal spasm)

Barium swallowi
Upper endoscopy
esophageal ph monitoring

17
Q

34yo F with episodic palpitations accompanied by lightheadedness and sharp, atypical chest pain

A

Mitral valve prolapse (cardiac arrythmia, panic attack, pheo)

EKG, ECHO, holter, 24-hr urinary catecholamines

18
Q

42yo F with 15.5lb wt loss w/in past 2 months. She has a fine tremor and pulse is 112

A

HYPERTHYROIDISM (cancer, HIV infection, Dieting/drugs, anorexia nervosa, malabsoprtion)

TSH, T4
CBC
Electrolytes
HIV antibody
UDS
19
Q

30yo F with wt gain x3months, w/ tremor, palps, anxiety, and hunger relieved by eating

A

INSULINOMA (reative postprandial hypoglycemia, cushings syndrome)

blood glucose and plasma insulin
glucose tolerance test
24-hr urine free cortisol

20
Q

USPSTF screening guidelines for lung cancer

A

Annual screening with LDCT in adults 55-80yo with a 30py smoking h/o and currently smoke or have quit w/i past 15 years

21
Q

Tetrad of plummer vinson syndrome

A
DIGS
Dysphagia
IDA
Glossitis
SCC
22
Q

48yo F with dysphagia for both solids and liquids that has slowly progressed w/in past year. Associated with difficulty belching and regurg of undigested foods, wt loss

A

ACHALASIA (plummer vinson syndrome, esophageal cancer, esophagitis)

CXR
Upper endoscopy
Barium swalling
esophageal manometry
XR-neck
23
Q

70 yo M with acute onset severe, crampy abdominal pain. Recently vomited and had a massive dark bowel movement. H/o CHF and afib. Pain out of proportion to the exam

A

MESENTERIC ISCHEMIA/INFARCTION (diverticulitis, pud, gastroenteritis)

Rectal exam
CBC
Amylase, lipase, lactate
EKG
CT abdomen 
Mesenteric angiography
24
Q

30yo F with periumbilical pain for 6 months. Pain never wakens from sleep. Relieved by defecation and worsens with stress. Alternating constipation and diarrhea but no nausea, vomiting, wt loss, or anorexia

A

IBS (Crohns, celiac, endometriosis)

Rectal exam, stool for occult blood

urine HCG
peliv exam
CBC
electrolyes

25
Q

24yo F with BL lower abdominal pain that started with the 1st day of her menstrual period. Pain associated with fever and a thick, greenish-yellow discharge. Has had unprotected sex with multiple partners

A

PID (endometriosis), endometriosis, dysmenorrhea, vaginitis, cystitis

Pelvic exam, urine HCG, cervical cxs, CBC, ESR, UA, U/s pelvis

26
Q

Diagnostic w/u of GERD

A

upper endoscopy

pH and manometry measurements (with probe)

27
Q

Hematuria: differential

A
HITTERS
hematologic
Infection
Trauma
tumor
exercise 
renal d/os 
stones
28
Q

w/u of suspected pregancy

A

urine HCG
U/S–pelvis
breast/pelvic exams
blood type, Rh status, antibody screen