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DDx > Common and life-threats from QuickEM part 2 and DDx and Tx in primary care part 1 > Flashcards

Common and life-threats from QuickEM part 2 and DDx and Tx in primary care part 1 Flashcards

1
Q

Wound/laceration

A 
Human bite
Animal bite
Rabies
Tetanus
Wound infection
Laceration through deep structures
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2
Q

Hyperkalemia

A 
Renal failure
Crush injury
Compartment syndrome
Tumor lysis syndrome
Adrenal insufficiency
Potassium-sparing diuretics
Pseuohyperkalemia: hemolyzed specimen, prolonged tourniquet use, thrombocytosis, or leukocytosis
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3
Q

Toxic ingestion

A

Anticholinergic: atropine, antihistamines, antipsychotics
Exam findings: AMS, mydriasis, dry skin/mouth, urinary retention, hyperthermia
Cholinergic: organophosphates
Exam findings: Killer B’s
-Bradycardia
-Bronchorrhea
-Bronchospasm
Salivation
Lacrimation
Urination
Diarrhea
GI pain
Emesis
Miosis
Nicotinic: muscle weakness, fasciculations, paralysis
Sympathomimetic: amphetamines, cocaine
Exam findings: agitation, tachycardia, HTN, diaphoresis, mydriasis, hyperthermia
Opioid: heroin, cocaine, morphine
Exam findings: miosis, respiratory depression, AMS/unresponsive
Hypoglycemic: insulin, sulfonylureas
Exam findings: sleepy/unresponsive, tachycardia, diaphoresis
Alcoholic: ethanol
Exam findings: sleepy/unresponsive, ataxia, dysarthria, odor of ethanol
Serotonergic: SSRIs, MAOIs, TCAs, amphetamines, St. John’s wort
Exam findings: AMS, hyperreflexia, hypertonia, clonus, diaphoresis, tachycardia, HTN
Neuroleptic malignant syndrome: antipsychotics
Exam findings: AMS, hypertonia, diaphoresis, tachycardia, HTN
Salicylate: PCP, psilocybin, mescaline, LSD
Exam findings: hallucinations, dysphoria, anxiety, nausea, diaphoresis, mydriasis, tachycardia, HTN, hyperthermia
Sedative/hypnotic: BZDs, barbiurates
Exam findings: Sleepy/unresponsive, ataxia, dysarthria, bradycardia, resp depression
Caustic

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4
Q

Suicidal ideation

A 
Suicidal ideation
Homicidal ideation
Passive death wish
Decompensated mental state
Acute psychosis
Toxic ingestion
Self-harm
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5
Q

Fever in one-month-old or younger

A 
Meningitis
UTI
Pneumonia HSV
RSV
Influenza
Bundling/environmental
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6
Q

Seizure in one-month-old or younger

A 
MC: hypoxic-ischemic encephalopathy
INFECTION:
Meningitis/encephalitis
Simple/complex febrile seizure
CNS;
Hypoxic-ischemic encephalopathy (MC, >50%)
Head trauma/intracranial hemorrhage
Brain tumor
AVM
METABOLIC:
Inborn error of metabolism
Hypoglycemia
Hyponatremia
Hypocalcemia
Hypomagnesemia
Pyridoxine deficiency
Overdose/ingestion/drug withdrawal (from intrauterine exposure)
OTHER:
Benign idiopathic neonatal convulsions
Benign familial neonatal convulsions
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7
Q

Fussy/inconsolable crying in infant

A 
95% of crying is non-pathological
Mneumonic:
Infections
Trauma
Testicular torsion
Cardiac
Reflux, Reactions to medications/formulas
Immunizations
Eye
Surgical (volvulus, intussusception, hernia)
Strangulation (hair/fiber tourniquet)
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8
Q

Vomiting in one-month-old or younger

A 
MC: GERD
GI:
Esophageal atresia/stenosis (nonbilious)
Pyloric stenosis (nonbilious)
Malrotation +/- volvulus (bilious)
NEC (nonbilious)
Incarcerated hernia
Meconium ileus/plug
Hirschsprung disease
Imperforate anus
INFECTIOUS:
Meningitis
UTI
Gastroenteritis
Sepsis
NEUROLOGIC:
Intracranial bleeding/mass
Hydrocephalus
Cerebral edema
RENAL: obstructive nephropathy
METABOLIC/ENDOCRINE:
Kernicterus
Inborn error of metabolism
CAH
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9
Q

Shock in one-month-old or younger

A 
Mneumonic:
Trauma
Heart disease/hypovolemia/hypoxia
Endocrine
Metabolic
Inborn errors of metabolism
Sepsis
Formula mishaps
Intestinal catastrophes
Toxins
Seizure
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10
Q

Fever in peds older than neonate

A 
Meningitis
PNA
UTI
Otitis media
Strep pharyngitis
Kawasaki
Leukemia
STSS
Appendicitis
Viral exanthem
Viral syndrome
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11
Q

Seizure in peds older than infant

A 
INFECTION:
Meningitis/encephalitis
Simple/complex febrile seizure
CNS:
Head trauma
Brain tumor
AVM
METABOLIC:
Hypoglycemia
Hyponatremia
Hypocalcemia
Hypomagnesemia
Overdose/ingestion
SEIZURE MIMICS:
Breath-holding spell
Vasovagal
Pseudoseizure
Hypovolemia
Cataplexy/narcolepsy
Movement d/o
ALTE (Apparent Life-Threatening Event)
Migraine
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12
Q

HA in peds older than infant

A 
Meningitis/encephaliits (HA + fever)
SAH
Carbon monoxide poisoning
Migraine
Tension
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13
Q

Syncope in peds older than infant

A 
CARDIAC (rare):
Long QT
WPW
Lown-Ganong-Levine syndrome
HCM
Anomalous coronary arteries
Arrhythmogenic RV dysplasia
NONCARDIAC:
Seizure
Hypoglycemia
CO poisoning
Breath-holding spell
Psychiatric
Vasovagal
Orthostatic/hypovolemic
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14
Q

Sore throat in peds older than infant

A 
PTA
Retropharyngeal abscess
Epiglottitis
Strep pharyngitis
Mono
Viral pharyngitis
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15
Q

Vomiting in peds older than infant

A 
MC: gastroenteritis
GI:
Malrotation +/- vomiting (bilious)
Incarcerated hernia
Intussusception
Appendicitis
PUD
Foreign body
INFECTIOUS:
Meningitis
UTI
Sepsis
Gastroenteritis
Viral illness
NEUROLOGIC:
Intracranial bleeding/mass
Post-concussive
RENAL: obstructive nephropathy
METABOLIC/ENDOCRINE:
DKA
Inborn error of metabolism
Adrenal insufficiency
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16
Q

CP in peds older than infant

A 
CARDIAC:
Pericarditis
Anomalous coronary arteries
Kawasaki
Aortic/pulmonary stenosis
PULM:
PNA
Asthma
PE
PTX
GI:
GERD
Foreign body
Musculoskeletal
17
Q

Abdominal pain: birth to 12 yo

A 
<3 mo
EMERGENT:
Volvulus
Testicular torsion
Hernia
Trauma
Necrotizing enterocolitis
Toxic megacolon
Tumor
NONEMERGENT:
Colic
Gastroenteritis
Constipation
3 mo-3 yo
EMERGENT:
Intussusception
Testicular torsion
Trauma
Volvulus
Appendicitis
Toxic megacolon
Toxic ingestion
NONEMERGENT:
Gastroenteritis
Constipation
UTI
HSP
3 yo-12 yo
EMERGENT:
Appendicitis
DKA
Toxic ingestion
Testicular/ovarian torsion
Trauma
Toxic megacolon
Tumor
Hernia
Intussusception
Volvulus
SBO
IBD
NONEMERGENT:
DIFFUSE:
Constipation
Gastroenteritis
Viral syndrome
S. pharyngitis
HSP
UPPER:
Gastritis/PUD
Pancreatitis
Cholecystitis
LOWER:
UTI 
Ovarian cyst
Nephrolithiasis
In older children, the differential is often simple: constipation vs appendicitis
For >12 yo, see adult section on abdominal pain
18
Q

Penile pain in peds older than infant

A 
ATRAUMATIC:
Priapism
Phimosis
Paraphimosis
Balanoposthitis
Urethritis
TRAUMATIC:
Entrapment injury
Urethral foreign body
19
Q

Testicular pain in peds older than infant

A 
ATRAUMATIC:
Testicular torsion
Torsion of testicular appendage
Epididymitis/orchitis
Inguinal hernia
TRAUMATIC:
Testicular hematoma
Testicular fx
20
Q

Diarrhea in peds older than infant

A 
INFECTIOUS:
Viral: rota, Norwalk, entero, adeno, etc.
Bacterial: Salmonella, Shigella, Yersinia, Campylobacter, E. coli, Vibrio, C. diff
Parasitic: Giardia, Entamoeba
DIETARY:
Overfeeding
Food allergy
Starvation stools
MALABSORPTION/SECRETORY:
CF
Celiac dz
IBD
ANATOMIC ABNORMALITIES:
Intussusception
HIrschsprung dz
Partial obstruction
Appendicitis
21
Q

Hematuria in peds older than infant

A 
Hypercalciuria (MCC in infants)
UTI (MCC overall)
Glomerulonephritis
Henoch-Schonlein Purpura
Hemolytic-Uremic syndrome
SLE
Nutcracker syndrome
22
Q

Vaginal bleeding in peds older than infant

A

1st 2 wks of life, VB usually withdrawal from maternal estrogen (self-limited)
Dysfunctional uterine bleeding (vast majority of adolescents)
Vaginal foreign body
Urethral prolapse
Straddle injury
For menstruating females, see adult vaginal bleeding

23
Q

Limp in peds older than infant

A 
JOINT:
Septic arthritis
Dislocation
Acute rheumatic fever
HIP:
-Transient tenosynovitis
-JRA (usu 2-16 yo)
-Legg-Calve-Perthes (usu 4-10 yo)
-SCFE (usu 10-16 yo)
BONE:
Fx
Osteomyelitis
Tumor
Leukemia
24
Q

Allergic reaction in peds

A

Anaphylaxis
Mild/moderate allergic reaction
Erythema multiforme/TEN/SJS
Toxic shock syndrome

25
Q

BRUE in peds

A 
Brief Resolved Unexplained Event
CNS/PSYCH:
Seizure
Breath-holding
Apnea of prematurity
INFECTIOUS:
Meningitis
RSV
PNA
Croup
Pertussis 
UTI
NON-ACCIDENTAL TRAUMA:
Suffocation
Head injury
Poisoning
OTHER:
GERD
Electrolyte abnormality
Drug overdose
Arrhythmia

DDx (5 decks)

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