DDX 1 Final v1 Flashcards
Name 2 conditions caused by varicella.
- Herpes zoster
2. Mumps/ measles
What is the appendicitis test?
Psoas sign
What is associated history of an elderly patient with vision loss?
Provocation by prolonged time in a dark room; nausea/ vomiting, eye hard on palp = acute closed-angle glaucoma (medical emergency)
Asthma theories
Exposure to TB, measles, hepatitis A infection ; younger siblings, exposure to daycare, exposure to animals in first 6 months
What does it suggest if breathing difficulty improves slowly, when before even minimal activity left the patient breathless? The patient is a non-smoker.
(Difficulty breathing without exertion = position related)
Bulimia nervosa patient findings?
Puffy cheeks, bruised knuckles, dental erosion
Candida presentation?
(Vaginal discharge) extreme puritis but w/ scant discharge
Causes for chronic non-productive cough?
- Post-nasal drip -> relieved by sitting up/ propping head up by pillows
- Cough-Variant Asthma-> cold, dry environment* (hyperactive airway disease)
- Chronic bronchitis (smoker), GI reflux, bronchiectasis
Causes of epigastric pain?
- Reflux esophagitis
- Peptic ulcer
- Pancreatitis
Cells for endometriosis?
Come from epithelium
Chest with nitro?
Angina
Classes presentation of appendicitis?
Anorexia & pain mid-abdomen; nausea/ vomiting
How do you dx?
Middle age, older female
- -
- Severe abdominal pain associated w/ nausea & vomiting* ; occurred right after eating fatty meal, pain 12-18 hours and then resolves w/ little residual pain
Classic presentation of ectopic pregnancy?
Lower abdominal pain and missed “spotty” period
Classic presentation of IBS?
Early morning chronic, persistent constipation, non-bloody stool, and mucus found in stool
COPD (airway disorder)
- obstruction due to mucus production
- decrease in FEV1*
- exhalation most affected
- Increase in residual volume
- Wheeze & cough
Definitive dx of appendicitis
Ultrasonography (US)
Detrusor innervation
Parasympathetic -> pudendal nerve S2-S4 -> constriction
Diarrhea under stress
Ulcerative Colitis (UC)
Ear pain
TMJ/ teeth, Csp, glasses, infection
Ear pain and infection
Primarily in babies, uncommon in adults
Evaluation of ectopic pregnancy
- (+) pregnancy test (subunit B-hCG) w/
Seeing “flashes of light” indicate?
Vitro retinal traction
What does gradual loss of CENTRAL VISION indicate?
Red reflex = absent cataract
CATARACT, RETINAL DETACHMENT
What does gradual loss of vision, but improved w/ looking through a PINHOLE indicate?
Refractive error (need contacts)
What does seeing “halos” around light indicate?
Glaucoma
What is the hiatal hernia test?
X-ray
How does pancreatitis feel?
Pain radiates to back w/ “band like” pattern; fetal position to relieve pain
How to determine if diarrhea is due to osmotic mechanism?
Fasting
How would you describe non-cardiac pain?
(neurological/ musculoskeletal)
pain is brief-continuous pain in a specific location
Reproduced by movement dermatome along rib
Lower leg swelling management for CHF
Reduction of salt
M/C peptic ulcer?
duodenal ulcers; H. pylori infection
Muscular non-cardiac pain presents?
- Strain/ trauma
- Deep breath hurts significatntly
Obese patient w/ hx of dyspnea while recumbent - what do you examine for?
CHF (if suspected from hx)
How does Otosclerosis present?
- Difficulty listening on the phone, BUT in crowded room, can hear quite well
- No associated dizziness or tinnitus
- Bilateral
Patient claims chronic cough is worse while lying on his/ her back?
Unrelieved by sitting up & has early morning onset? = asthma
Relieved by sitting up? =CHF/ pulmonary edema
Patient claims that chronic cough is worse after a large meal?
GERD
Patient w/ gall stones management?
Decrease fat intake, increase exercise, decrease coffee (stimulants)
Patient has productive cough for 3 consecutive weeks- MOI?
Chronic bronchitis
Patient has pain that radiates from back to groin, renal/ ureter problem?
Renal inflammatory pathology; costovertebral angle to the inguinal &/or testicular area
Patient is losing weight, but still eating normal/ increased kcal intake- DDx?
- Hyperthyroidism
- Malignant cancer
Patient states they feel “out of breath” with activity - ddx?
- CHF = chest x-ray
- If patient in good physical shape? = EIBS -> perform warm up activity for ~1 hr prior to exercise, avoid intense exercise, shorter workouts
Patient with weight loss, why do a chest x-ray?
CHF
or
-lung mass, infiltrate, adenopathy
Peripheral loss of vision w/ halos around light suggests what?
Chronic open-angle glaucoma
PID organisms?
Gonorrhea, Chlamydia
What is a “Pink Puffer”?
(COPD-A) Emphysema
- Paracinar -> destruction of distal alveoli
- Breathes through pursed lips, uses 2 respiration muscles to assist barrel-chest appearance*
- Thin, frail, flushed appearance
What helps preventing kidney stones?
Increase water intake
What helps prevention of cholithiasis?
Exercises and 2-4+ cups of coffee/ day
What can cause profuse nose bleeds other than trauma?
- Hypertension, anticoagulant drugs
Prophylactic drug for asthma?
Corticosteroids
Prostatitis (non-bacterial)
Self-resolving; obstructive bladder, antibiotics unsuccessful
Psychogenic overlay w/ chest pain?
Depression/ stress, cardiac exam is normal
Reflux esophagitis
Often older and overweight, epigastric pain after earring large meals and lying down
Severe dizziness for 1 week, with gradual improvement, no hearing loss suggests what?
Vestibular neuritis
Stress incontinence
Often d/t pelvic floor instability/ laxity; coughing, sneezing, laughing = small amounts of urine
Sudden painless loss of vision in ONE eye; describes a “pulling a curtain” over the eye and recovers sign within a few minutes?
Amaurosis fugax
Sudden painless loss of vision in ONE eye w/ temporal headache?
Temporal arteries (medical emergency)
Testing for extrinsic asthma?
Spirometry w/ challenge allergy testing
Trigeminal neuralgia
Facial pain that came on without warning and has recurred every time he lightly touches his cheek or attempts to shave.
- Pain is severe, burning and stabbing lasting for less than a minute.
- Pain pattern from cheek to corner of mouth
UC presentation
Bouts of bloody diarrhea, joint pain associated with diarrhea attacks & induced by stress
Vaginal bleeding for children (5 years)?
Suspect sexual abuse
Vaginal bleeding with patient in reproductive years: not pregnant, not taking oral contraceptives; Bleeding usually not cyclic (irregular) & painless
ANOVULATORY bleeding = endocrine condition, physiologic (hormone imbalance)
Vaginal bleeding w/ patient who is post menopausal (>60 yo)
Cancer
What would you suspect if a patient says his heart races?
Supra ventricular tachycardia
X-ray for rib fx
Oblique
