Common Symptoms Flashcards
1
Q
Initial tests in patients with back pain if malignancy is suspected
A
Plain radiography and ESR measurement
MKSAP 20
2
Q
Treatment of persistent postural-perceptual dizziness
A
Vestibular and balance rehabilitation, SSRI/SNRI therapy
MKSAP 20
3
Q
Physical examination maneuver to evaluate for cervical radiculopathy
A
The Spurling test
MKSAP 20
4
Q
Suspected causes of neck pain for which MRI is indicated
A
Cancer, infection, myelopathy, or progressive neurologic symptoms
MKSAP 20
5
Q
Medication class most associated with acute cough
A
ACE inhibitors
MKSAP 20
6
Q
Common causes of hindgut pain with symptoms usually located in the lower quadrants or suprapubic area
A
Diverticulitis, IBD/colitis, urinary tract obstruction, severe constipation
MKSAP 20
7
Q
Diagnosis for pain at base of thumb elicited with Finkelstein test
A
De Quervain tendinopathy
MKSAP 20
8
Q
First-line drug treatment of chronic neuropathic pain
A
Gabapentinoids and duloxetine
MKSAP 20
9
Q
Worsening pain with opioid dosage escalation
A
Opioid-induced hyperalgesia
MKSAP 20
10
Q
Initial therapy for musculoskeletal or inflammatory nociceptive pain
A
NSAIDs, acetaminophen
MKSAP 20
11
Q
Common causes of drug-induced edema
A
Vasodilators, NSAIDs, gabapentinoids, hormones, antiestrogens, thiazolidinediones, CCBs
MKSAP 20
12
Q
Back pain “red flags” on exam
A
Fever, abnormal neurologic findings
MKSAP 20
13
Q
Required diagnostic test for prepatellar bursitis
A
Fluid aspiration and analysis
MKSAP 20
14
Q
Management goals in patients with medically unexplained symptoms
A
Maintaining an effective relationship with the patient, restoration of function, decreased focus on symptoms, acquisition of coping mechanisms
MKSAP 20
15
Q
Diagnosis for poorly localized pain on the superior shoulder and lateral clavicle, pain on crossed-arm shoulder adduction, pain on shoulder abduction beyond 120 degrees
A
Acromioclavicular joint degeneration
MKSAP 20
16
Q
Diagnosis for neck pain with decreased range of motion, normal neurologic findings
A
Cervical strain
MKSAP 20
17
Q
Best drug choices for short-term relief of refractory insomnia
A
Zolpidem, eszopiclone, zaleplon
MKSAP 20
18
Q
Nonpharmacologic treatments for musculoskeletal neck pain
A
Multimodal approach (range-of-motion exercise, physical therapy, ice/heat applications, analgesics)
MKSAP 20
19
Q
Rotator cuff disease surgical indication
A
Acute full-thickness tear
MKSAP 20
20
Q
Role of brain imaging to confirm BPPV
A
Not indicated
MKSAP 20
21
Q
Imaging test for suspected cauda equina syndrome
A
MRI
MKSAP 20
22
Q
Adhesive capsulitis treatment
A
Intra-articular glucocorticoids, physical therapy
MKSAP 20
23
Q
Diagnosis for severe subacute cough paroxysms and posttussive emesis
A
Bordetella pertussis infection
MKSAP 20
24
Q
Essential physical exam component in syncope evaluation
A
Orthostatic BP measurement, along with thorough cardiac and neurologic exams
MKSAP 20
25
Treatment of medically unresponsive, unexplained chronic cough
Multimodal speech therapy, antitussives, gabapentin
| MKSAP 20
26
Diagnosis of pain between metatarsal heads and sensation of walking on a pebble
Morton neuroma
| MKSAP 20
27
Constipation prophylaxis for patients taking scheduled opioids
Senna or bisacodyl
| MKSAP 20
28
Imaging test for suspected cervical myelopathy
MRI
| MKSAP 20
29
Therapy for all patients with chronic noncancer pain
Physical therapy
| MKSAP 20
30
Clinical features requiring chest radiography for pneumonia in patient with cough
Abnormal vital signs or lung exam; altered mental status
| MKSAP 20
31
Features that favor seizure in patient with syncope
Abnormal posturing, involuntary head turning, tongue laceration, auras, incontinence, prolonged post-episode confusion
| MKSAP 20
32
Most common causes of chronic cough
Smoking, ACE inhibitor use, UACS, GERD, asthma
| MKSAP 20
33
Findings that rule out need for ankle imaging
Ability to walk 4 steps; no tenderness at posterior malleolus, navicular bone, 5th metatarsal
| MKSAP 20
34
Initial medication for chronic low back pain unresponsive to nondrug treatment
NSAIDs
| MKSAP 20
35
When to offer opioid overdose prevention education and naloxone kits
Opioid dosage ≥50 MME/d, concurrent benzodiazepines, substance use disorder
| MKSAP 20
36
Diagnosis for posterior elbow swelling with normal range of motion
Olecranon bursitis
| MKSAP 20
37
Recommended imaging for acute nonspecific low back pain
None
| MKSAP 20
38
Diagnosis in a patient with positive painful arc and drop arm tests and weakness in shoulder external rotation
Rotator cuff tear
| MKSAP 20
39
Role of brain imaging and carotid ultrasonography in routine syncope evaluation
None
| MKSAP 20
40
Nonpharmacologic therapies for acute low back pain
Physical therapy, local heat, massage, acupuncture, spinal manipulation
| MKSAP 20
41
Treatment of acute opioid overdose
Naloxone
| MKSAP 20
42
Diagnostic imaging necessary to confirm lateral or medial epicondylitis when clinical history and physical exam are consistent
None
| MKSAP 20
43
Most common cause of lower extremity ulcers
Venous stasis
| MKSAP 20
44
Initial therapy for carpal tunnel syndrome
Activity modification and wrist splinting
| MKSAP 20
45
Most important components in the diagnostic evaluation of dyspnea
Detailed history and physical exam
| MKSAP 20
46
Person who makes the final decision regarding aircraft diversion during an in-flight medical emergency
Captain
| MKSAP 20
47
Drug cause of spontaneous Achilles tendon rupture
Fluoroquinolone use
| MKSAP 20
48
Best initial test in a patient with high pretest probability of PE
CT angiography
| MKSAP 20
49
Clue from history suggesting cardiac syncope because of an arrhythmia
Sudden onset without prodrome
| MKSAP 20
50
Diagnosis of recurrent vertigo, tinnitus, hearing loss
Meniere disease
| MKSAP 20
51
Effects of long-term opioids for chronic noncancer pain
Worsened functional status, quality of life, and pain
| MKSAP 20
52
Diagnosis in a patient with chronic shoulder pain, loss of passive and active shoulder movement
Adhesive capsulitis
| MKSAP 20
53
Treatment of acute rhinosinusitis–related cough
Intranasal glucocorticoid; combination intranasal glucocorticoid and intranasal antihistamine for more significant or refractory symptoms
| MKSAP 20
54
Medial-inferior heel pain after prolonged rest (e.g., first morning steps), improved with walking
Plantar fasciitis
| MKSAP 20
55
Common causes of foregut pain with symptoms usually presenting in the upper abdominal area
Gastritis, PUD, pancreatitis, complications of cholelithiasis
| MKSAP 20
56
Diagnosis for tenderness over the lateral epicondyle that increases with resisted wrist extension
Lateral epicondylitis (tennis elbow)
| MKSAP 20
57
Physical exam assessment to perform on all patients with suspected central vertigo and early stroke
HINTS assessment
| MKSAP 20
58
Initial drug therapy for acute low back pain
NSAIDs
| MKSAP 20
59
Diagnosis of shoulder pain near deltoid insertion, worse with repetitive overhead activities
Rotator cuff disease
| MKSAP 20
60
Indications for polysomnography in insomnia
Presentation suggesting sleep apnea, narcolepsy, or sleep movement disorder
| MKSAP 20
61
Diagnosis for anterior hip pain associated with glucocorticoid use, SLE, sickle cell anemia, or alcohol use disorder
Avascular necrosis (osteonecrosis)
| MKSAP 20
62
Therapy for BPPV
Epley maneuver
| MKSAP 20
63
Initial drug therapy for allergic rhinitis–associated UACS
Intranasal glucocorticoids
| MKSAP 20
64
Risk mitigation strategies for opioid use in chronic noncancer pain
Urine drug testing, surveillance of state prescription drug monitoring programs
| MKSAP 20
65
Drugs used as adjuvant to NSAIDs for chronic low back pain
Nonbenzodiazepine muscle relaxants, duloxetine
| MKSAP 20
66
Diagnostic test for all patients with syncope
ECG
| MKSAP 20
67
Initial steps in evaluating medically unexplained symptoms
Thorough history and physical exam; review of previous diagnostic evaluations
| MKSAP 20
68
Nondrug interventions for dyspnea in chronic lung disease
Pulmonary rehabilitation, pursed lip and diaphragmatic breathing, fans
| MKSAP 20
69
Common causes of midgut pain with symptoms usually presenting in the periumbilical area
Small bowel obstruction, early appendicitis, mesenteric ischemia, gastroenteritis
| MKSAP 20
70
Initial management of acute and chronic meniscal tears
Rest, ice, strengthening of quadriceps and hamstring muscles
| MKSAP 20
71
Recurrent brief vertigo worsened by positional changes
BPPV
| MKSAP 20
72
Diagnosis for nonspecific dizziness despite adequate evaluation
Persistent postural-perceptual dizziness
| MKSAP 20
73
Most common cause of acute bronchitis
Viral respiratory pathogens
| MKSAP 20
74
Diagnosis for anterior knee pain after prolonged sitting, running, climbing
Patellofemoral pain syndrome
| MKSAP 20
75
Cause of arm paresthesia/pain worsened with activity and arm elevation
Neurogenic thoracic outlet syndrome
| MKSAP 20
76
Indications for imaging in acute back pain
Severe/progressive neurologic deficits; suspected infection, malignancy
| MKSAP 20
## Footnote
Imaging is recommended when there are serious underlying conditions suspected.
77
Diagnosis for fatigue ≥6 months with reduction in activities, postexertional malaise, unrefreshing sleep, and orthostatic intolerance or cognitive impairment
Systemic exertion intolerance disease
| MKSAP 20
## Footnote
This condition is often characterized by significant fatigue and cognitive difficulties.
78
Most common cause of syncope preceded by nausea and diaphoresis in healthy persons
Neurally mediated (vasovagal) syncope
| MKSAP 20
## Footnote
This type of syncope is often triggered by stress or pain.
79
Symptoms that cannot be attributed to a specific medical cause
Medically unexplained symptoms
| MKSAP 20
## Footnote
These symptoms often lead to frustration for both patients and healthcare providers.
80
Diagnosis for pain over the medial elbow and ventral forearm that worsens with resisted wrist flexion
Medial epicondylitis (golfer's elbow)
| MKSAP 20
## Footnote
This condition is commonly seen in athletes and repetitive motion workers.
81
Diagnosis for twisting injury, popping sound, rapid accumulation of knee effusion
ACL tear
| MKSAP 20
## Footnote
ACL tears are frequent in sports involving sudden stops or changes in direction.
82
Cause of neck pain, presenting with gait and coordination abnormalities
Cervical myelopathy
| MKSAP 20
## Footnote
This condition can result from spinal cord compression in the cervical region.
83
Initial management of GTPS
Activity modification, analgesia with acetaminophen or NSAIDs
| MKSAP 20
## Footnote
Greater trochanteric pain syndrome (GTPS) often requires conservative management.
84
Symptoms associated with cauda equina syndrome
Back pain, saddle anesthesia, bowel/bladder dysfunction
| MKSAP 20
## Footnote
Cauda equina syndrome is a medical emergency requiring immediate intervention.
85
Diagnosis for lateral knee pain proximal to lateral femoral condyle after exercise
Iliotibial band syndrome
| MKSAP 20
## Footnote
This syndrome is common among runners and cyclists.
86
Diagnosis for elbow pain with flexion, paresthesia/numbness in 4th to 5th digits
Ulnar nerve entrapment
| MKSAP 20
## Footnote
This condition is often referred to as cubital tunnel syndrome.
87
Initial imaging test to evaluate scoliosis
Full-length posteroanterior and lateral radiography of the spine and measurement of the Cobb angle
| MKSAP 20
## Footnote
Accurate measurement of the Cobb angle is essential for diagnosis.
88
Treatment of asymptomatic popliteal cysts
None
| MKSAP 20
## Footnote
Asymptomatic cysts typically do not require treatment.
89
Therapy for chronic venous insufficiency
Leg elevation, exercise, static compression, weight loss
| MKSAP 20
## Footnote
Management focuses on improving venous return.
90
Initial pharmacologic treatment for musculoskeletal neck pain
Topical and/or oral NSAIDs
| MKSAP 20
## Footnote
NSAIDs help reduce inflammation and pain.
91
Indication for exercise stress testing for evaluation of syncope
Exertional syncope
| MKSAP 20
## Footnote
This testing helps determine the underlying cause of syncope during physical activity.
92
Diagnostic test for BPPV
Dix-Hallpike maneuver
| MKSAP 20
## Footnote
This test is used to diagnose benign paroxysmal positional vertigo.
93
Best initial test in a patient with low pretest probability for PE
D-dimer
| MKSAP 20
## Footnote
A negative D-dimer can effectively rule out pulmonary embolism.
94
Pharmacologic palliation of medically unresponsive dyspnea
Opioids
| MKSAP 20
## Footnote
Opioids can provide relief in patients with severe dyspnea.
95
Diagnosis of fluid-filled swelling caused by herniated synovial tissue surrounding tendon sheaths or joints
Ganglion cyst
| MKSAP 20
## Footnote
These cysts are often benign and may resolve on their own.
96
Causes of peripheral vertigo
BPPV, vestibular neuronitis, labyrinthitis, Meniere disease, medications, Ramsay Hunt syndrome, vestibular schwannoma (acoustic neuroma)
| MKSAP 20
## Footnote
Peripheral vertigo is often associated with inner ear disorders.
97
First-line therapy for insomnia
CBT-I
| MKSAP 20
## Footnote
Cognitive Behavioral Therapy for Insomnia (CBT-I) is effective for long-term management.
98
Back pain “red flags” from the history
Recent infection or injection drug use, immunosuppression, chronic glucocorticoid use, pain unrelieved in the supine position, history of cancer or weight loss, recent trauma
| MKSAP 20
## Footnote
These red flags indicate potential serious underlying conditions.
99
Concomitant neurologic findings in patients with central vertigo secondary to vertebrobasilar stroke
Nystagmus, dysphagia, dysarthria, diplopia, ataxia, postural instability, hemiparesis, mental status changes
| MKSAP 20
## Footnote
These findings help differentiate central from peripheral causes of vertigo.
100
Diagnosis for localized pain over proximal medial tibia 2-3 cm below knee
Pes anserine bursitis
| MKSAP 20
## Footnote
This condition involves inflammation of the bursa located at the knee.
