Common and life threats from QuickEM Flashcards
1
Q
Diffuse abdominal pain
A
BOWEL: Early appendicitis Bowel obstruction Hernia (umbilical, incisional) Gastroenteritis Volvulus VASCULAR: METABOLIC/TOXICOLOGIC: AAA Mesenteric ischemia Aortic dissection DKA Opiate withdrawal Familial Mediterranean fever Heavy metal poisoning Addisonian crisis INFECTIOUS, NOS: Herpes zoster
2
Q
Epigastric pain
A
PANCREATIC: Pancreatitis GASTRIC: Gastritis PUD BILIARY: Cholecystitis Choledocholithiasis Biliary colic Ascending cholangitis Referred thoracic pain: -PE -ACS -PNA INFECTIOUS, NOS: Shingles
3
Q
RUQ pain
A
PANCREATIC: Pancreatitis GASTRIC: Gastritis PUD BILIARY: Cholecystitis Choledocholithiasis Biliary colic Ascending cholangitis LIVER: Hepatic abscess Fitz-Hugh-Curtis (female) Referred thoracic pain: -PE -ACS -PNA INFECTIOUS, NOS: Shingles
4
Q
LUQ pain
A
PANCREATIC: Pancreatitis GASTRIC: Gastritis PUD Thoracic pain, referred: -PE -ACS -PNA INFECTIOUS, NOS: Shingles
5
Q
RLQ and LLQ pain
A
GI: Appendicitis Diverticulitis (cecal) Crohn's Ureterolithiasis Bowel obstruction Bowel perforation Hernia (inguinal, femoral) Epiploic appendagitis Mesenteric adenitis Constipation Meckel's diverticulum VASCULAR: Mesenteric ischemia (>50 yo) Ischemic colitis (>50 yo) Gonadal vein thrombosis RENAL/URINARY: Pyelonephritis UTI Shingles Psoas abscess
6
Q
RLQ and LLQ pain- female
A
NONPREGNANT: PID Ovarian torsion TOA Ovarian cyst (ruptured) Hemorrhagic ovarian cyst Endometriosis MIttelschmerz Uterine fibroid (>40 yo) FIRST TRIMESTER: Ectopic pregnancy Ovarian hyperstimulation syndrome Threatened abortion SECOND/THIRD TRIMESTER: Placenta previa Placental abruption Round ligament pain POSTPARTUM: Septic pelvic thrombophlebitis Endometritis
7
Q
RLQ and LLQ pain-male
A
Testicular torsion
Epididymitis
8
Q
AMS
A
Alcohol
Electrolytes (hyponatremia, hypocalcemia), Endocrine (myxedema coma, thyroid storm), Encephalopathy (hepatic, hypertensive, heat stroke)
Infection (encephalitis, systemic infection)
Overdose (drugs, also withdrawal from drugs or deficiency of thiamine, niacin, or B12), Oxygen (hypoxia, methemoglobinemia, carbon monoxide poisoning)
Uremia
Trauma (i.e., hemorrhagic shock, severe TBI, etc), Temperature (hypothermia)
Insulin (i.e., hypoglycemia)
Psychogenic (i.e., pseudoseizures, severe depression, psychosis)
Stroke, Seizure, Subarachnoid hemorrhage, Space-occupying lesion
MC in elderly: hypoglycemia, sepsis, stroke
MC in other age groups: EtOH, drugs, hypoglycemia
9
Q
HA
A
Infectious: Meningitis Encephalitis Herpes (shingles, ophthalmicus, oticus) Sinusitis Vascular: SAH Hemorrhagic stroke Venous sinus thrombosis Cervical artery dissection Pituitary apoplexy Other life-threats and maimers: Idiopathic intracranial HTN Carbon monoxide poisoning Acute angle closure glaucoma Giant cell arteritis (>50 yo) Neoplasm Others: Migraine Tension HA Trigeminal neuralgia TMJ pain Post-LP (within 48 hrs of LP)
10
Q
Head injury
A
Intracranial hemorrhage/hematoma: SAH Subdural hematoma Epidural hematoma Intraparenchymal hemorrhage Everything else: Cervical artery dissection TBI (concussion) Diffuse axonal injury
11
Q
Syncope
A
CARDIAC, CONDUCTION: Long QT WPW Brugada Heart block Tachydysrhythmia Short QT Arrhythmogenic RV dysplasia CARDIAC, PUMP: Aortic stenosis HCM ACS VASCULAR: PE Severe carotid stenosis Vertebrobasilar insufficiency AAA, ruptured Orthostatic hypotension METABOLIC: Hypoglycemia Hyperkalemia Anemia NEURO: Intracranial hemorrhage Seizure Vasovagal Hyperventilation Carotid sinus sensitivity PULM: Pneumothorax OB/GYN Ectopic pregnancy Vaginal bleeding
12
Q
Tests for cardiac conduction causes of syncope
A
EKG
Monitor
13
Q
Tests for cardiac pump causes of syncope
A
Auscultation
EKG
+/- troponin
14
Q
Tests for vascular causes of syncope
A
Ausculatation
+/- AAA u/s
15
Q
Tests for metabolic causes of syncope
A
D stick
+/-BMP
+/- CBC
+/- hemoccult
16
Q
Tests for neuro causes of syncope
A
+/- CT head
17
Q
Tests for pulm causes of syncope
A
+/- CXR
18
Q
Tests for ob/gyn causes of syncope
A
Beta-hCG
+/- pelvic u/s
19
Q
Dizziness
A
Central vertigo: -Cerebellar stroke -Vertebral basilar artery insufficiency -Vertebral artery dissection -Subclavian steal -Brain tumor -Infection (meningitis, encephalitis, abscess) -Vertebral basilar migraine -MS Peripheral vertigo: -Vestibular neuronitis -BPPV -Labyrinthitis -Meniere disease -Ramsay Hunt syndrome Lightheadedness: -Anemia -Decreased cardiac output -Bradycardia -Dehydration -Orthostatic hypotension -Hyperviscosity syndrome Ataxia: -Ethanol -Hyponatremia -Normal pressure hydrocephalus -Medications: --BZDs/barbiturates --Antieleptic toxicity (phenytoin, carbamazepine, valproic acid) --Aminoglycoside toxicity --Loop diuretic toxicity -Posterior column degeneration -Peripheral neuropathy -B12 deficiency -Neurosyphilis
20
Q
Weakness/fatigue
A
MCCs in elderly: stroke, urosepsis, hypoglycemia, anemia/GI bleed, hyperkalemia, or cardiac INFECTIOUS: Sepsis (most commonly UTI, PNA) Epidural abscess Encephalitis/meningitis Lyme dz Rabies Botulism Tick paralysis CARDIAC: Arrhythmia ACS Bradycardia CHF METABOLIC/ENDO Hypoglycemia Hyperkalemia Hyponatremia Hypothyroidism Malnutrition Hypokalemic/thyrotoxic periodic paralysis Acute intermittent porphyria NEURO: Stroke Subdural hemorrhage Myasthenia gravis Lambert-Eaten Guillain Barre Transverse myelitis MS Polymalgia rheumatica MUSCULOSKELETAL Muscular dystrophy Polymyositis/dermatomyositis HEME-ONC Anemia Leukemia/lymphoma Hyperviscosity syndrome TOX Organophosphate poisoning Ciguatera Drugs (CCBs, BBs, etc)
21
Q
Tests for infectious causes of weakness/fatigue
A
UA
CBC
+/-LP
22
Q
Tests for cardiac causes of weakness/fatigue
A
Monitor
EKG
+/- Troponin
+/- Pads
23
Q
Tests for metabolic/endo causes of weakness/fatigue
A
D stick (blood glucose) BMP Mg Ca \+/- TSH/FT4
24
Q
Tests for neuro causes of weakness/fatigue
A
+/- CT head
+/- MRI brain/spine
+/- LP
25
Q
Tests for musculoskeletal causes of weakness/fatigue
A
+/- ESR/CRP
26
Q
Tests for heme/onc causes of weakness/fatigue
A
CBC
+/- hemoccult
27
Q
Red eye
A
Painful: -Ruptured globe -Corneal ulcer -Corneal abrasion -Acute angle closure glaucoma -Iritis -HSV keratitis -Episcleritis -Scleritis -Endophthalmitis -Chemical burn -UV keratitis -Foreign body Painless: -Conjunctivitis -Subconjunctival hemorrhage -Hyphema -Epidemic keratoconjunctivitis -Inflamed pingueculum -Inflamed pterygium EXTRA-OCULAR: Blepharitis Hordeolum Orbital/periorbital cellulitis Cavernous sinus thrombosis Cluster HA
28
Q
Epistaxis
A
LOCAL ETIOLOGIES: Digital trauma Facial trauma Irritants SYSTEMIC ETIOLOGIES: Anticoagulants Liver failure Blood dyscrasias: -Leukemia/lymphoma -ITP -Polycythemia vera -Hemophilia
29
Q
Hemoptysis
A
AIRWAY DZ: Bronchitis/bronchiectasis Neoplasm Trauma Foreign body INFECTIOUS: TB PNA Fungal infection VASCULAR DZ: PE AV malformation Pulmonary HTN Vasculitis (SLE, Wegener's, Goodpasture's) OTHER: Coagulopathy Valvular heart disease (incl endocarditis) Cocaine
30
Q
Dental pain
A
ODONTOGENIC: Cary Pericoronitis Periradicular periodontitis Post-extraction pain Alveolar osteitis (dry socket) PERIODONTAL: Periapical abscess Peridontal abscess Acute necrotizing ulcerative gingivitis Ludwig's angina TRAUMATIC: Fracture Subluxation Avulsion
31
Q
Sore throat
A
INFECTIOUS: PTA/abscess Retropharyngeal/parapharyngeal abscess Epiglottitis Strep pharyngitis Mono Viral pharyngitis Gonococcal pharyngitis Ludwig's angina Diphtheria Acute retroviral syndrome NONINFECTIOUS: Caustic ingestion Foreign body Lymphoma
32
Q
CP
A
CARDIOVASCULAR: ACS Aortic dissection Pericarditis PULM: PE Pneumothorax PNA GI: Boerhaave's syndrome Pneumomediastinum GERD THORACIC WALL: Costochondritis Rib contusion/fx Shingles OTHER: Panic attack Referred pain (from intraabdominal pathology)
33
Q
SOB
A
PULM: PE Anaphylaxis Asthma COPD exacerbation Pleural effusion Noncardiogenic edema Pneumothorax PNA Airway obstruction CARDIAC: CHF exacerbation Pericardial effusion/cardiac tamponade ACS Arrhythmia Valvular dysfunction OTHER: Anemia Panic attack Trauma (pulmonary contusion, flail chest) DKA Toxins (ingestion, CO poisoning, organophosphates)
34
Q
Back pain
A
Life-threatening causes mneumonic: Compression (cauda equina, conus medullaris, epidural hematoma) Renal stone AAA Fracture Tumor Infection/inflammatory RARE: Pancreatitis PUD Ectopic pregnancy PID NON-LIFE-THREATENING CAUSES: Mechanical LBP Sciatica/radiculopathy Ankylosing spondylitis Spinal stenosis
35
Q
Diarrhea
A
BACTERIAL: Pseudomembranous colitis (C. difficile) Dysentery -Campylobacter -Shigella -Salmonela -E. coli O157:H7 C. botulinum VIRAL: HIV Enteroviruses PARASITIC: Entamoeba histolytica Giardia lambia OTHER: IBD Diverticulitis Meds Alcoholism
36
Q
GI bleed
A
UGIB: Gastric varices Boerhaave's syndrome PUD Dieulafoy lesion Gastritis Mallory-Weiss tear Lower-GI bleed, painless: -CA -Diverticulosis -Angiodysplasia Lower GI bleed, painful -Crohn's -UC -Diverticulitis -Aortoenteric fistula -Ischemic colitis -Mesenteric ischemia -Hemorrhoids
37
Q
Testicular/penile pain
A
Testicular torsion Epididymitis Torsion of testicular appendix Orchitis Testicular hematoma Testicular fx/rupture Scrotal abscess Fournier's gangrene Hydrocele Inguinal hernia Kidney stone AAA
38
Q
Hematuria
A
UTI CA Coagulopathy Kidney stone Nephropathy/nephritis Foreign body Sickle cell disease BPH
39
Q
Vaginal bleeding, pregnant
A
FIRST TRIMESTER: Ectopic pregnancy Spontaneous miscarriage Threatened abortion Post-coital bleeding SECOND/THIRD TRIMESTER: Placental abruption Placenta previa Placenta accreta
40
Q
Vaginal bleeding, nonpregnant
A
NONPREGNANT: CA: endometrial/cervical Uterine fibroids (leiomyomas) Adenomyosis Polyps Breakthrough bleeding on oral contraceptives Atrophic vaginitis Foreign body Menstruation with coagulopathy POST-PARTUM HEMORRHAGE: Uterine atony Uterine inversion Retained placenta Uterine rupture Vaginal/cervical lacerations Coagulopathy
41
Q
Urinary retention
A
MCCs: BPH, meds PROSTATIC OBSTRUCTION: BPH Prostate CA Prostatitis Prostate trauma/avulsion URETHRAL OBSTRUCTION: Stricture Foreign body BLADDER: CA Clots Calculi NEUROGENIC: Meds: -Anticholinergics -Antihistamines -Nifedipine -Sympathomimetics Diabetic neurogenic bladder Cauda equina/cord compression
42
Q
Knee pain
A
ORTHO/TRAUMA: Fx Knee dislocation Ligamentous tear Meniscal injury Muscle strain/rupture Hemarthrosis Bursitis Osteoarthritis INFECTIOUS: Septic joint Reactive arthritis Osteomyelitis Septic bursitis CRYSTALLINE: Gout Pseudogout OTHER: Tumor DVT Baker's cyst
43
Q
Hypothermia
A
INCREASED HEAT LOSS: Environmental Immersion Pharmacologic/toxicologic Burns DECREASED HEAT PRODUCTION: Endocrine abnormalities: hypothyroidism, hypopituitar, adrenal insufficiency IMPAIRED THERMAL REGULATION: CNS dysfunction
44
Q
Fever/hyperthermia
A
INFECTIOUS: PNA UTI TOXICOLOGIC: Anticholinergic Sympathomimetic (cocaine, meth, PCP, LSD) EtOH withdrawal BZD withdrawal Salicylate overdose Serotonin syndrome Neuroleptic malignant syndrome ENDOCRINE: Thyroid storm Pheochromocytoma DKA NEUROLOGIC: Hypothalamic hemorrhage/infarction Stroke Status epilepticus ENVIRONMENTAL: Heat exhaustion Heat stroke
45
Q
Tachycardia
A
NARROW COMPLEX REGULAR: Sinus tachy AVRT/AvnRT Atrial flutter IRREGULAR: AFib Multifocal atrial tachycardia Atrial flutter with variable block WIDE COMPLEX: VTach Antidromic AVRT Aberrancy Accelerated idioventricular rhythm
46
Q
Bradycardia
A
SINUS BRADYCARDIA: Mneumonic: Drugs Ichemia/infarction Electrolytes/endocrine: hyperkalemia, hypokalemia, hypomagnesemia, hypocalcemia, hypoglycemia, hypothyroidism Sick sinus syndrome COLD hypothermia NON-SINUS BRADYCARDIA: Mobitz II 3rd degree heart block Ventricular/junctional escape Nonconducted PACs
47
Q
Hypotension
A
DISTRIBUTIVE: Sepsis Anaphylaxis Neurogenic Addisonian crisis CARDIOGENIC: CHF MI Arrhythmia OBSTRUCTIVE: Cardiac tamponade Tension pneumo PE HYPOVOLEMIC: Hemorrhage Dehydration, severe
48
Q
HTN
A
Hypertension emergency: evidence of end-organ damage -Neuro: stroke, hypertensive encephalopathy, intracranial hemorrhage -Cardiac: CHF, ACS, aortic dissection -Pulmonary: pulmonary edema -Renal: AKI -Pregnancy-related: (pre-)eclampsia -Sympathomimetic crisis Asymptomatic HTN Drugs: sympathomimetics
49
Q
Allergic reaction
A
Anaphylaxis
Mild/moderate allergic reaction
Angioedema
Scromboid poisoning
50
Q
Burn
A
BURN: Chemical Thermal Electrical SKIN-SLOUGHING: TEN Staphylococcal toxic shock syndrome Pemphigus vulgaris
