CK Presentations Flashcards
40yo obese F presents with fatigue, weight gain, sleepiness, cold intolerance, constipation, and dry skin
HYPOTHYROIDISM (mdd, dm, anemia)
TSH
CBC
Fasting glucose
HbA1c
20yo M presents with fatigue, thirst, increased appetite, and polyuria
DM (atypical depression, primary polydipsia, di)
Glucose tolerance test HbA1c UA CBC Electrolytes, BUN/Cr, gluc
35yo M policeman c/o feeling tired and sleepy during the day after having changed to the night shift last week
SHIFT WORK SLEEP D/O (sleep apnea, depression, anemia)
CBC, noc ox, polysomnography
30yo M immigrant from Africa with night sweats, cough, and swollen glands of 1 months duration.
TB (acute HIVinfxn, lymphoma, leukemia, hyperthyroidism)
PPD, CBC, CXR, sputum gram, HIVantibody, TSH, T4
45yo F with excessive sweating, unintentional wt loss, palps, diarrhea, and SOB
HYPERTHYROIDISM (Pheo, carcinoid, tb)
TSH, T4 24-hour urinary catecholamines 5-HIAA CBC PPD
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.
STRESSINDUCEDINSOMNIA (caffeine-induced, insomnia with circadian rhythym sleep d/o, insomnia related to mdd)
polysomnography MMSE UDS CBC TSH
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
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
26yo M with sore throat, fever, rash, and wt loss. He has a history of IVdrug abuse and sharing needles
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
46yo F with fever and sore throat
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
30yo SOB, cough, wheezing that worsens in cold air. similar episodes in past 4 months
ASTHMA (gerd, bronchitis, pneumonitis, foreign body)
CBC, CXR, PFTs, peak flow measurement, methacholin challenge
56yo F SOB and productive cough x3months/yr x2yrs. Heavy smoker
COPD-bronchitis predominant (bronchiectasis, lung cancer, tb)
CBC sputum gram stain and cx CXR PFTs CT-chest ppd
58yo M 1 week pleuritic chest pain, F/C, and cough with purulent sputum. H/o COPD
PNA COPD exacerbation lung abscess lung cancer tb pericarditis
CBC, sputum gram and cx, CXR, CT-chest, ECG, ppd
25yo F with 2 wks nonproductive cough. 3 weeks ago with sore throat and runny nose
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
65yo M with worsening cough x6months w/ hemoptysis, dyspnea, weakness, and wt loss. Smokes
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
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
MI (unstable angina, costochondritis, pericarditis, PE)
EKG, CPK-MB and trops x3, CXR, CBC, electrolytes, BMP, ECHO, cardiac cath, D-dimer
45yo F with retrosternal burning sensation that occurs after heavy meals and when lying down. sxs relieved by antacids
GERD (esophagitis, pud, esophageal spasm)
Barium swallowi
Upper endoscopy
esophageal ph monitoring
34yo F with episodic palpitations accompanied by lightheadedness and sharp, atypical chest pain
Mitral valve prolapse (cardiac arrythmia, panic attack, pheo)
EKG, ECHO, holter, 24-hr urinary catecholamines
42yo F with 15.5lb wt loss w/in past 2 months. She has a fine tremor and pulse is 112
HYPERTHYROIDISM (cancer, HIV infection, Dieting/drugs, anorexia nervosa, malabsoprtion)
TSH, T4 CBC Electrolytes HIV antibody UDS
30yo F with wt gain x3months, w/ tremor, palps, anxiety, and hunger relieved by eating
INSULINOMA (reative postprandial hypoglycemia, cushings syndrome)
blood glucose and plasma insulin
glucose tolerance test
24-hr urine free cortisol
USPSTF screening guidelines for lung cancer
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
Tetrad of plummer vinson syndrome
DIGS Dysphagia IDA Glossitis SCC
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
ACHALASIA (plummer vinson syndrome, esophageal cancer, esophagitis)
CXR Upper endoscopy Barium swalling esophageal manometry XR-neck
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
MESENTERIC ISCHEMIA/INFARCTION (diverticulitis, pud, gastroenteritis)
Rectal exam CBC Amylase, lipase, lactate EKG CT abdomen Mesenteric angiography
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
IBS (Crohns, celiac, endometriosis)
Rectal exam, stool for occult blood
urine HCG
peliv exam
CBC
electrolyes
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
PID (endometriosis), endometriosis, dysmenorrhea, vaginitis, cystitis
Pelvic exam, urine HCG, cervical cxs, CBC, ESR, UA, U/s pelvis
Diagnostic w/u of GERD
upper endoscopy
pH and manometry measurements (with probe)
Hematuria: differential
HITTERS hematologic Infection Trauma tumor exercise renal d/os stones
w/u of suspected pregancy
urine HCG
U/S–pelvis
breast/pelvic exams
blood type, Rh status, antibody screen
