CS work up Flashcards
1
Q
Migraine (complicated), Tension headache, Cluster headache, Pseudotumor cerebri, Trigeminal neuralgia, CNS vasculitis, Partial seizure, Intracranial neoplasm
A
CBC, ESR, CT—head, MRI—brain, LP
2
Q
Cluster headache Migraine Tension headache Sinusitis Pseudotumor cerebri Trigeminal neuralgia Intracranial neoplasm
A
CBC ESR CT—head MRI—brain LP
3
Q
Temporal arteritis (giant cell arteritis) Migraine Cluster headache Tension headache Meningitis Carotid artery dissection Pseudotumor cerebri Trigeminal neuralgia Intracranial neoplasm
A
CBC ESR CRP Temporal artery biopsy Doppler U/S—carotid MRI—brain
4
Q
Sinusitis Migraine Tension headache Meningitis Intracranial neoplasm
A
CBC
XR—sinus
CT—sinus
LP
5
Q
Tension headache Migraine Depression Caffeine or analgesic withdrawal Hypertension Cluster headache Pseudotumor cerebri Intracranial neoplasm
A
CBC Electrolytes ESR CT—head LP
6
Q
Subarachnoid hemorrhage Migraine Meningitis/encephalitis Intracranial hemorrhage Vertebral artery dissection Intracranial venous thrombosis Acute hypertension Intracranial neoplasm
A
CT without contrast—head LP CBC PT/PTT MRI/MRA—brain
7
Q
Meningitis Migraine Subarachnoid hemorrhage Sinusitis/encephalitis Intracranial or epidural abscess
A
CBC CT—head MRI—brain LP—CSF analysis (cell count, protein, glucose, Gram stain PCR for antigens, culture)
8
Q
Pseudotumor cerebri Tension headache Migraine Cluster headache Meningitis Intracranial venous thrombosi Intracranial neoplasm
A
Urine hCG CBC CT—head LP—opening pressure and CSF analysis
9
Q
Trigeminal neuralgia Tension headache Migraine Cluster headache TMJ dysfunction Intracranial neoplasm
A
CBC
ESR
MRI—brain
10
Q
Alzheimer’s disease Vascular dementia Depression Hypothyroidism Chronic subdural hematoma Normal pressure hydrocephalus Intracranial neoplasm B12 defi ciency Neurosyphilis
A
CBC VDRL/RPR Serum B12 TSH MRI—brain (preferred) CT—head LP—CSF analysis (rare)
11
Q
Normal pressure hydrocephalus Alzheimer’s disease Vascular dementia Chronic subdural hematoma Intracranial neoplasm Depression B12 defi ciency Neurosyphilis Hypothyroidism
A
CT—head LP—opening pressure and CSF analysis Serum B12 VDRL/RPR TSH
12
Q
Creutzfeldt-Jakob disease Vascular dementia Lewy body dementia Wernicke’s encephalopathy Normal pressure hydrocephalus Chronic subdural hematoma Intracranial neoplasm Depression Delirium B12 defi ciency Neurosyphilis
A
CBC, electrolytes, calcium Serum B12 VDRL/RPR MRI—brain (preferred) CT—head EEG LP—CSF analysis Brain biopsy
13
Q
Hypoglycemia Transient ischemic attack Arrhythmia Delirium Angina
A
Glucose CBC, electrolytes Echocardiography ECG MRI—brain Doppler U/S—carotid
14
Q
Subdural hematoma
SIADH (causing hyponatremia)
Creutzfeldt-Jakob disease
Intracranial neoplasm
A
Electrolytes
CT—head
MRI—brain
LP
15
Q
Normal bereavement Adjustment disorder with depressed mood Major depressive disorder with psychotic features Schizoaffective disorder Depressive disorder not otherwise specifi ed (NOS)
A
Physical exam Mental status exam TSH CBC Urine toxicology
16
Q
Major depressive disorder
Substance-induced mood
disorder
Dysthymic disorder
A
Physical exam Mental status exam Blood alcohol level TSH CBC Urine toxicology
17
Q
Major depressive disorder
Substance-induced mood
disorder
Dysthymic disorder
A
Physical exam Mental status exam Blood alcohol level TSH CBC Urine toxicology
18
Q
Bipolar I disorder Bipolar II disorder Cyclothymic disorder Major depressive disorder Schizoaffective disorder
A
Physical exam
Mental status exam
Urine toxicology
19
Q
Schizophrenia Schizoid or schizotypal personality disorder Schizophreniform disorder Psychotic disorder due to a general medical condition Substance-induced psychosis Depression with psychotic features
A
Mental status exam Urine toxicology TSH CBC Electrolytes
20
Q
Substance-induced psychosis Brief psychotic disorder Schizophreniform disorder Schizophrenia Psychotic disorder due to a general medical condition
A
Urine toxicology Mental status exam TSH CBC Electrolytes, BUN/Cr, AST/ ALT
21
Q
Schizoaffective disorder Mood disorder with psychotic features Schizophrenia Schizophreniform disorder Psychotic disorder due to a general medical condition
A
Mental status exam Beck Depression Inventory TSH CBC Electrolytes
22
Q
Ménière’s disease Vestibular neuronitis Labyrinthitis Benign positional vertigo Acoustic neuroma
A
CBC
VDRL/RPR (syphilis is a cause
of Ménière’s disease)
MRI—brain
23
Q
Orthostatic hypotension due to dehydration (diarrhea, diuretic use) Vestibular neuronitis Labyrinthitis Benign positional vertigo Vertebrobasilar insuffi ciency
A
Orthostatic vital signs CBC Electrolytes Stool exam (occult blood, fecal leukocytes)
24
Q
Drug-induced orthostatic hypotension Vestibular neuronitis Labyrinthitis Benign positional vertigo Brain stem or cerebellar tumor Acute renal failure
A
Orthostatic vital signs CBC Electrolytes BUN/Cr MRI—brain
25
Q
Benign positional vertigo
Vestibular neuronitis
Labyrinthitis
Ménière’s disease
A
MRI—brain
Audiogram
26
Q
Vestibular neuronitis Labyrinthitis Ménière’s disease Benign positional vertigo Vertigo associated with cervical spine disease/injury Vertebrobasilar insuffi ciency
A
CBC
Electrolytes
Electronystagmography
MRI/MRA—brain
27
Q
Labyrinthitis Vestibular neuronitis Ménière’s disease Acoustic neuroma Vertebrobasilar insufficiency
A
Audiogram
Electronystagmography
MRI/MRA—brain
28
Q
Seizure, grand mal (now called complex tonic-clonic seizure) Convulsive syncope Substance abuse/overdose Malingering Hypoglycemia
A
CBC, electrolytes, glucose Urine toxicology EEG MRI—brain CT—head LP—CSF analysis ECG
29
Q
Drug-induced orthostatic hypotension (causing syncope) Cardiac arrhythmia Syncope (vasovagal, other causes) Stroke MI Pulmonary embolism
A
Orthostatic vital signs CBC Electrolytes CT—head ECG V/Q scan CT—chest with IV contrast
30
Q
Cardiac arrhythmia (causing syncope) Severe aortic stenosis Syncope (other causes) Seizure Pulmonary embolism
A
ECG Holter monitoring CBC, electrolytes Glucose Echocardiography CT—head
31
Q
Transient ischemic attack (TIA) Hypoglycemia Seizure Stroke Facial nerve palsy
A
CBC Glucose Electrolytes ECG CT—head MRI—brain Doppler U/S—carotid Echocardiography EEG
32
Q
Stroke TIA Seizure Intracranial neoplasm Subdural or epidural hematoma
A
CBC, electrolytes PT/PTT CT—head MRI—brain (preferred) Doppler U/S—carotid Echocardiography
33
Q
Guillain-Barré syndrome Multiple sclerosis Polymyositis Myasthenia gravis Peripheral neuropathy Tumor in the vertebral canal
A
CBC, electrolytes CPK LP—CSF analysis MRI—spine EMG/nerve conduction study Tensilon test Serum B12
34
Q
Multiple sclerosis Stroke Conversion disorder Malingering CNS tumor Neurosyphilis Syringomyelia CNS vasculitis
A
CBC, ESR VDRL/RPR MRI—brain LP—CSF analysis Retinal evoked potentials
35
Q
Diabetic peripheral neuropathy Alcoholic peripheral neuropathy B12 defi ciency Hypocalcemia Hyperventilation Paraproteinemia/myeloma
A
HbA1c ESR Calcium Serum B12 Serum and urine protein electrophoresis
36
Q
Myasthenia gravis Horner’s syndrome Multiple sclerosis Intracranial tumor compressing CN III, IV, or VI Amyotrophic lateral sclerosis
A
Tensilon test ACh receptor antibodies (in serum) CXR CT—chest MRI—brain EMG
37
Q
Todd’s paralysis TIA Stroke Complicated migraine Malingering
A
CBC, electrolytes
EEG
MRI—brain
Doppler U/S—carotid
38
Q
Depression
Adjustment disorder
Hypothyroidism
Anemia
A
CBC TSH HIV/STD testing (given husband’s possible risk factors)
39
Q
Post-traumatic stress disorder (PTSD) Depression Generalized anxiety disorder Psychotic or delusional disorder Hypothyroidism
A
CBC
TSH
Calcium
Urine toxicology
40
Q
Colon cancer Hypothyroidism Renal failure Hypercalcemia Depression
A
Rectal exam, stool for occult blood CBC, electrolytes, calcium, BUN/Cr, AST/ALT, TSH Colonoscopy Barium enema
41
Q
Hypothyroidism
Depression
Diabetes
Anemia
A
TSH, FT3,FT4
CBC
Glucose, HbA1c
42
Q
Obstructive sleep apnea
Hypothyroidism
Chronic fatigue syndrome
Narcolepsy
A
CBC TSH Nocturnal pulse oximetry Polysomnography ECG
43
Q
Diabetes mellitus
Atypical depression
Primary polydipsia
Diabetes insipidus
A
Glucose tolerance test, HbA1c
UA
CBC, electrolytes, glucose
BUN/Cr
44
Q
Sleep deprivation
Sleep apnea
Depression
Anemia
A
CBC
Nocturnal pulse oximetry
Polysomnography
45
Q
Tuberculosis Acute HIV infection Lymphoma Leukemia Hyperthyroidism
A
PPD CBC CXR Sputum Gram stain, acid-fast stain, and culture HIV antibody TSH, FT4
46
Q
Stress-induced insomnia Caffeine-induced insomnia Insomnia with circadian rhythm sleep disorder Insomnia related to major depressive disorder
A
Polysomnography Mental status exam Urine toxicology CBC TSH
47
Q
Obstructive sleep apnea Daytime fatigue in primary hypersomnia Insomnia with circadian rhythm sleep disorder Insomnia related to major depressive disorder
A
CBC
TSH
Polysomnography
ECG
48
Q
Insomnia related to major depressive disorder Primary hypersomnia Insomnia with circadian rhythm sleep disorder
A
Mental status exam
TSH
CBC
Polysomnography
49
Q
Infectious mononucleosis Hepatitis Viral or bacterial pharyngitis Acute HIV infection Secondary syphilis
A
CBC, peripheral smear Monospot test Throat culture AST/ALT/bilirubin/alkaline phosphatase HIV antibody and viral load Anti-EBV antibodies VDRL/RPR
50
Q
HIV, acute retroviral syndrome Infectious mononucleosis Hepatitis Viral pharyngitis Streptococcal tonsillitis/ scarlet fever Secondary syphilis
A
CBC Peripheral smear HIV antibody and viral load CD4 count Monospot test Throat culture VDRL/RPR AST/ALT/bilirubin/alkaline phosphatase
51
Q
Pharyngitis (bacterial or viral) Mycoplasma pneumonia Acute HIV infection Infectious mononucleosis
A
Throat swab for culture and rapid streptococcal antigen Monospot test CBC HIV antibody and viral load
52
Q
Asthma GERD Bronchitis Pneumonitis Foreign body
A
CBC CXR Peak fl ow measurement PFTs Methacholine challenge test
53
Q
COPD—chronic bronchitis
Bronchiectasis
Lung cancer
Tuberculosis
A
CBC Sputum Gram stain and culture CXR PFTs CT—chest PPD
54
Q
Pneumonia Bronchitis Lung abscess Lung cancer Tuberculosis Pericarditis
A
CBC Sputum Gram stain and culture CXR CT—chest ECG PPD
55
Q
Atypical pneumonia Reactive airway disease URI-associated (“postinfectious”) Postnasal drip GERD
A
CBC Induced sputum Gram stain and culture CXR IgM detection for Mycoplasma pneumoniae Urine Legionella antigen
56
Q
Lung cancer Tuberculosis Lung abscess COPD Vasculitis (i.e., Wegener’s) Interstitial lung disease CHF
A
CBC Sputum Gram stain, culture, and cytology CXR CT—chest PPD Bronchoscopy
57
Q
COPD exacerbation (bronchitis) Lung cancer Pneumonia URI CHF
A
CBC CXR PFTs Sputum Gram stain and culture CT—chest
58
Q
Tuberculosis Pneumonia Lung abscess Vasculitis Lymphoma Metastatic cancer HIV/AIDS Sarcoidosis
A
CBC PPD Sputum Gram stain, acid-fast stain, and culture CXR CT—chest Bronchoscopy HIV antibody
59
Q
Tuberculosis Pneumonia (including Pneumocystis jiroveci) Bronchitis CHF (cardiomyopathy) Asthma Acute HIV infection
A
CBC PPD Sputum Gram stain, acid-fast stain, silver stain, and culture CXR HIV antibody
60
Q
CHF Cardiac valvular disease GERD Pulmonary fi brosis COPD Postnasal drip
A
CBC CXR ECG Echocardiography PFTs BNP
61
Q
Myocardial infarction (MI) GERD Angina Costochondritis Aortic dissection Pericarditis Pulmonary embolism Pneumothorax
A
ECG CPK-MB, troponin CXR CBC, electrolytes Echocardiography Cardiac catheterization
62
Q
Sickle cell disease—pulmonary infarction Pneumonia Pulmonary embolism MI Pneumothorax Aortic dissection
A
CBC, reticulocyte count, LDH, peripheral smear ABG CXR CPK-MB, troponin ECG CT—chest with IV contrast
63
Q
GERD Esophagitis Peptic ulcer disease Esophageal spasm MI Angina
A
ECG
Barium swallow
Upper endoscopy
Esophageal pH monitoring
64
Q
Angina
Esophageal spasm
Esophagitis
A
ECG CPK-MB, troponin CXR CBC, electrolytes Exercise stress test Upper endoscopy/pH monitor Cardiac catheterization
