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DDx Flashcards

1
Q

Assault/Rape questions

A

DORRA SEXPLOER

Description 
Onset
Report?
Recognition of ppl involved
Assault Method (How assault?)
Sexual assault?
Ejaculation occurred?
X
Pain/Past Menses?
Latex (condoms?)
Oral, vaginal, anal (what type of sexual assault?)
Estrogen Replacement (OCPs?)
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2
Q

Assault/Rape Other Q’s

A 
LOC,
weakness, numbness
vag bleeding
changes vision
blood in urine/stool
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3
Q

Assault/Rape always include in dx

A

STI

Pregnancy

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4
Q

Assault/Rape w/u

A

Pelvic exam
wet mount, KOH, cervical cx, vaginal pH
STI, HIV, syphilis

urine hCG

skeletal survey XR
CXR

CBC

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5
Q

Assault/Rape

make sure u do

A

offer tissue

support pt - know u are there for them
let the know not their fault and could have happened to anyone
tell them to report
emergency contraceptives

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6
Q

Child with Diabetes

A

T-DIABETES MISS H-MELLITUS

type?
description when first diagnosed
irritability
abnormal thirst and urination now?
birth hx
eating habits 
tiredness (fatigue)
emotion of child/parents about dx
sugar levels (last? range?)

meds?? compliant
injector (who)
site of injection
schedule for insulin

hypoglycemic episodes 
mood
lmp
loc
itchy skin
tingling/n/w
urinary habits
super child (weight gain/loss)
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7
Q

Child with Diabetes ddx

A

type 1
type 2
cushing’s

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8
Q

Child with Diabetes w/u

A

BMP
HbA1c/glucose
insulin/c-peptide
islet cell ab

UA/microalbumin
24 hr urine cortisol

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9
Q

CHILD WITH NOISY BREATHING (STRIDOR):

q’s

A

CBS DASH

CYANOSIS/cough (productive, amt, color, blood, odor)
barking (can u explain sound)
SOB

Drooling
allergy hx
snore/swallowing diff
hoarseness

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10
Q

CHILD WITH NOISY BREATHING (STRIDOR):

ddx

A

Foreign body aspiration

Croup

Laryngitis - sore throat, dry cough, hoarseness, drooling

epiglottitis- drooling, tripoding

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11
Q

CHILD WITH NOISY BREATHING (STRIDOR):

w/u

A

ABG
CBC

CXR
neck XR

laryngoscopy
bronchoscopy

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12
Q

COUGH

q’s

A

B PRODUCTIVE

blood in sputum
productive cough
recent travel
odor
duration
uri sx
color sputum
tb exposure (last ppd, night sweats, weight loss)
infection
volume of sputum
energy loss (fatigue)
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13
Q

COUGH things to do

A

offer water or tissue if coughing

if holding tissue, ask to see if blood

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14
Q

COUGH physical exam

A

ask for permission before start
proper draping- tie gown
dont repeat painful maneuvers

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15
Q

COUGH ddx

A

tb
lung cancer
pna
copd exacerbation

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16
Q

COUGH w/u

A

CBC, PPD, blood cx

sputum gs, acid fast smear

CXR, Chest CT

bronchoscopy, lung biopsy

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17
Q

Depression w/u

A

physical exam - thyroid, eye contact, disheveled
mental status exam

CBC
TSH
HbA1c

Urine drug test

CT head

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18
Q

Diabetes follow up

q’s

A

DIABETIC - NPH

duration
insulin- regularity, compliant, side effect
a1c 
blurry vision (last eye) 
emotion/energy/erection
trauma/foot ulcer
infection (cough, URI)
cardiac risk factors (HTN, high cholesterol, stroke, heart diz)

numb/tingling/weakness
perfect control of bs
home glucose/hypoglycemic episodes

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19
Q

Diabetes follow up

w/u

A

genital exam (erectile)

CBC, HbA1c, glucose, BUN/Cr

UA, Urine microalbumin

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20
Q

Diabetes follow up

counseling

A

MEDOWS

medication (regularity/compliance)
exercise
diet modification
ophthalmoscopic exam - every year
weight management 
sugar check daily
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21
Q

Dizziness

q’s

A

DTH FFFUN

dizziness (description, onset, duration, freq, allev/aggrav)
tinnitus
hearing loss

fever
fullness in ear
falls
uri
nausea
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22
Q

Dizziness

exam

A

HEENT - nystagmus, weber, rinne, whisper, otoscopy, fundoscopic, mouth, throat

Neuro - CN, motor, sens, DTR, gait, romberg, dix-hallpike

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23
Q

Dizziness ddx

A

meniere’s (vertigo, tinnitus, hearing loss)
orthostatic hyptension (diarrhea, vomit, diuretic)
BPPV - changing position, nystagmus
labyrinthitis- URI, hearing loss, vertigo
vestibular neuronitis- URI, no hearing loss

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24
Q

Dizziness

w/u

A

VDRL/RPR

Tilt table test
audiometry

MRI

brain stem evoked potential

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25
Q

Domestic Violence

q’s

A

SAFE GARDS

safe at home/safety of children
afraid of husband or spouse
family & friends knowledge about situation?
emergency plan (leave or divorce)

gun at home
alcohol or drugs
relationship with spouse
depression
support system
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26
Q

Dysphagia

q’s

A

HARD PC FOOD

Heartburn
appetite change/anemia
regurgitation/raynaud phenomenon
detail - onset, solids and liquids

pain on swallowing
cough at night

food cravings
odor
overseas travel
drug

27
Q

Dysphagia w/u

A

cbc
iron, ferritin, tibc

throat cx

hiv abx, cd4

cxr
barium swallow
endoscopy
chest CT

28
Q

Dysphagia

ddx

A

esophageal ca (start with solid then liquid, etoh, smoking, wt loss)
achalasia (both solid and liquid)
esophagitis (pain with swallow)
zenkers (halitosis, regurg)

29
Q

Enuresis

q’s

A

ENURESIS

environ change (parental divorce, changing school)
nocturia, nighttime awakening, neurologic problems
urinary habits (volume, # diapers, freq, color, blood, dysuria, urgency, burning)
reward or punishment/relatives (fhx)
eating or drink before bedtime
stress to child/parent
interventions, drugs used before
snoring/stress

30
Q

Enuresis

ddx

A

primary nocturnal
secondary (stress, environ change, abuse)
UTI
DM

31
Q

Enuresis w/u

A

genital exam

ua, ucx

hba1c

renal u/s

32
Q

Erectile Dysfunction

Q’S

A

LIMP PENIS

Libido
injury
medication
present med condditions

prostate exam in past
erection at all 
nocturnal erection/morning erection
incontinence
stress/depression
33
Q

Erectile Dysfunction ddx

A

drug induced- bblockers, ssri
htn induced
diabetes induced

34
Q

Erectile Dysfunction w/u

A

genital exam

ua/urine microalbumin

cbc, glucose, hba1c, bun/cr

doppler u/s, nerve conduction

35
Q

headache q’s

A

AT & T WIRELESS

aura
timing
nausea/vomiting
tearing

weakness, numbness
injury
runny nose
estrogen exposure
leg pain
energy level
stress
speech changes
36
Q

headache w/u

A

cbc, esr

brain mri, ct head, ct sinuses

lumbar puncture

37
Q

hearing loss

q’s

A

EAR HAT SOUNDDS

exposure to loud sounds/ear ache
all sounds or specific sounds
ringing in ears

headache
abnormal gait/balance
trauma to head

source of sound located by patient?
object insertion into ear
neurologic problems (weakness, numbness, tingling)
dizziness, discharge from ear
distorted speech (words sound distoted, problem understanding)
spinning sensation (vertigo)
38
Q

hearing loss w/u

A 
audiometry
tympanography
brain sem auditory evoked potentials
ct head
vdrl/rpr
39
Q

Hematuria

q’s

A

B FUN HIDE PISS

burning

freq
urgency
nocturia

hematuria
incomplete bladder sensation
dribbling
episodes in past

painful urination, prostate exam
incontinence
stone hx, std hx
stream (weak?), straining

40
Q

Hematuria w/u

A

genital exam
rectal exam

ua, urine cx

cbc, pt/ptt, bun/cr, psa

kidney u/s, cystoscopy, ct abd, pelvis, kidney

41
Q

HOARSENESS q’s

A

OPEN CHIN

overuse of voice
pain while talking
exposure to cold wether or dust
neck swelling

cva hx,
heartburn
infection (URI, HIV), ill contacts
night sweats, fever, chills

42
Q

HOARSENESS w/u

A

cbc
tsh, free t4

echo
laryngoscopy
ct scan chest and neck

43
Q

Sleeping Problem

A

INSOMNIA STRIKES HIM

interruption of sleep during night
naps during day
snoring during night
on the clock - time go to bed, total sleep time
morning awakening
narcolepsy- sudden sleep
illness, stress
activity before bed
sadness
tremor
irritability
k-caffeine
exercise
sweating, skin, hair

heat/cold intolerance
menstrual

44
Q

Sleeping Problem ddx

A

anxiety
caffeine induced
hyperthyroidism
depression

45
Q

Sleeping Problem w/u

A

cbc
free t4, tsh

urine drug test

polysomnography
ecg

46
Q

Jaundice

q’s

A

JAUNDICE B

journey, joint pain
abd pain
up temp (fever
nausea, vomiting
diarrhea, constipation
itchy, immuniz before travel
color urine and stool
eating habits, appetite, weight change

blood transfusion in past

47
Q

Jaundice exam

A

sclera, under tongue
murphy sign
asterixis, edema
spider nevi, telangiectasia, palmar erythema

48
Q

Jaundice w/u

A

cbc, ast, alt, bili, alk phos
viral hep serology

abd u/s, abd ct

ercp

49
Q

Knee Pain

q’s

A

CITRUS

color change, crackles on movement 
infection
trauma, time, temp of knee, tick bite
redness, rash, raydnaud
ulcer in mouth (photosensitivity, hair loss)
swelling, stiff, std hx
50
Q

Knee Pain w/u

A

pelvic exam

cervical culture

knee aspiration, fluid analysis

xr knee

cbc, blood cx, immunoglob assay

51
Q

MSK PAIN

Q’S

A

WET SURF

weakness, numb, tingling
exposure to cold
trauma, time of stiffness, tick bite, temp

stiffness, swelling
use (activities)
rash, redness, range of motion, rheum disease hx
fatigue, fever, chills, night sweats
disability
52
Q

MSK PAIN wu

shoulder

A

xr shoulder and arm
mri shoulder
dexa

53
Q

MSK PAIN wu

lower back pain

A

rectal exam

xr mri

psa
cbc, ca, bun/cr

54
Q

MSK PAIN wu

calf pain

A

cbc
cpk and myoglobin
hypercoag testing
d-dimer

doppler us
mri

55
Q

MSK PAIN wu

heel pain

A

xr, mri, bone scan

56
Q

hallucinations q’s

A

VOICES HARM ME

Visual hallucination (onset, context, freq, duration)
open eyes/closed during context
in control of hallucinations (control you)
changes in vision/vision loss
ear (auditory hallucination, heearing loss, onset, context, freq, duration)
sleep problems

head trauma, headache
attacking self or others
rec drug use - name, often, last time
mental fhx

major stress
enjoyng daily things

57
Q

hallucinations wu

A

mental status exam

cbc, tsh, electrolytes

u tox

58
Q

Chest Wall/Abdominal Wall q’s

A

COS CHEST WALL TRAUMA V

context of trauma
onset
severity of trauma

consciousness loss
head trauma, ha
exacerb, relieving
sputum
trauma anywhere else

weak, numb
abd pain
last meal, drink
liquor

temp
runny liquids
alertness
urination pain
memory loss
abnormal brain activity

vision change

59
Q

TREMOR q’s

A

TEACH FACT

tia sx (weak, numb, tingling)
emotion
alcohol use
caffeine intake
handwritings, headache

falls
adl
change in voice
trauma to head

60
Q

tremor

ddx

A

parkinson’s - resting
essential - postural tremor with outstretch hands
physiologic tremor- postural tremor, anxiety, caffeine

hyperthyroidism

61
Q

tremor

w/u

A

cbc, tsh, free t4

brain mri

62
Q

Forgetfulness memory loss q’s

A

FORGETS HIM + DEATH SHAFT

fall, fhx 
orthostatic hypotension (lightheadedness)
running urine- incontinence
gait abnormality
eye- vis change
trauma, tingling, numb, weak
seizure, speech, sleep, support

headache
infection
mood

adl:
dressing
eating
ambulatory
toiletry
hygiene
iadl
shopping
housework
accounting- bills
food prep
transportation
63
Q

Forgetfulness wu

A

cbc, electrolytes
glucose, bun/cr

b12, tsh, rpr

ct head, mri brain, eeg

64
Q

Forgetfulness don’t forget

A

ask permission speak with familt

talk with sw for home safety and supervision

CS (1 decks)

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