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Step 2 CS > DDx > Flashcards

DDx Flashcards

1
Q

Behavioral problems in childhood

A 
ADHD
ODD
Conduct disorder
Manic episode
Adjustment disorder
Hyperthyroidism
Substance use
Age-appropriate behavior
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2
Q

Work-up - behavioral problems in childhood

A

Physical exam
Mental status exam
Urine toxicology
TSH, free T4

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3
Q

Child with short stature

A

Constitutional short stature
Genetic disorders
Medical problems - chronic renal insufficiency, hypothyroidism, GH deficiency

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4
Q

Work-up - child with short stature

A 
CBC w/diff, BMP (lytes, BUN/Cr)
TSH, free T4
GH stimulation test, IGF-1 levels
XR - hand
U/S - renal, cardiac
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5
Q

Child with red eye

A 
Viral conjunctivitis
Bacterial conjunctivitis
Allergic conjunctivitis
Keratitis
Uveitis
Orbital cellulitis
Preseptal cellulitis
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6
Q

Work-up - child with red eye

A 
Ophthalmoscopic eye exam
Discharge cultures
Slit lamp exam
CT - orbit
CBC, BMP (electrolytes)
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7
Q

Child with GI symptoms - 1 month infant, vomiting (non-bloody, non-bilious)

A 
Pyloric stenosis
Partial/complete duodenal atresia
GERD
Gastroenteritis
Hepatitis
UTI
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8
Q

Child with GI symptoms - 3 y/o with constipation

A 
Hirschsprung disease
Low-fiber diet
Anal stenosis
Hypothyroidism
Lead poisoning
Celiac disease
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9
Q

Child with GI symptoms - 8 mo with sudden-onset colicky abdominal pain, vomiting, bloody diarrhea

A 
Intussusception
Appendicitis
Meckel diverticulum
Volvulus
Gastroenteritis
Enterocolitis
Blunt abdominal trauma
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10
Q

Child with GI symptoms - 7 y/o with generalized abdominal pain, missing many school days

A 
Somatoform disorder
Malingering
IBS
Lactose intolerance
Child abuse
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11
Q

Child with GI symptoms - 2 mo with episodes of crying, subside after passing flatus

A 
Colic
Formula allergy
GERD
Lactose intolerance
Strangulated hernia
Testicular torsion
Gastroenteritis
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12
Q

Work-up - child with GI symptoms

A

Rectal exam, stool for occult blood

Labs: CBC, BMP, LFTs, alkaline phosphatase, UA, UCx, TSH, free T4, serum lead level, anti-tissue transglutaminase, anti-endomysial and total IgA antibodies, amylase, lipase, stool ova/parasites, CDiff toxin

Imaging: U/S (abdomen, testicular), barium swallow, esophageal pH probe, endoscopy, barium enema, contrast enema, rectal biopsy, anorectal manometry, CT - abdomen

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13
Q

Child with fever - 20-day-old infant

A

Neonatal sepsis
Meningitis
Pneumonia
Pyelonephritis

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14
Q

Child with fever - 3 y/o pulling on ear

A

Acute otitis media
URI
Meningitis
Pyelonephritis

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15
Q

Child with fever - 12 mo with rash

A 
Measles (or other viral exanthem)
Rubella
Roseola
Fifth disease
Varicella
Scarlet fever
Meningitis
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16
Q

Child with fever - 4 y/o with diarrhea, vomiting

A 
Gastroenteritis (viral, bacterial, parasitic)
Food poisoning
UTI
URI
Intusussception
Volvulus
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17
Q

Work-up - child with fever

A

Labs: CBC, BMP, blood culture, LP (CSF analysis), UA, UCx, viral antibodies/titers, throat swab for culture, stool exam and culture

Imaging: CXR, abdominal XR

18
Q

Low back pain

A 
Lumbar muscle strain
Disk herniation
Lumbar spinal stenosis
Tumor in the vertebral canal
Vertebral compression fracture
PVD
Malingering
Knee or leg fracture
Osteoarthritis
Osteomyelitis
Epidural abscess
Ankylosing spondylitis
19
Q

Work-up - Low back pain

A

Imaging: XR, CT, MRI (lumbar spine)

ABI, Doppler U/S - lower extremity, angiography

ESR, CRP, CBC

20
Q

Joint/limb pain - wrist pain, numbness/burning in hand

A

Carpal tunnel syndrome
Median nerve compression in the forearm or arm
Radiculopathy of nerve roots C6 and C7 in the cervical spine
De Quervain tenosynovitis

21
Q

Work-up - joint/limb pain (wrist pain, numbness/burning in hand)

A

Nerve conduction studies
EMG
U/S - wrist
MRI - spine

22
Q

Joint/limb pain +/- systemic symptoms

A

SLE
RA
Psoriatic arthritis
OA

Gout
Pseudogout

Septic arthritis
Reactive arthritis
Lyme arthritis
Disseminated gonorrhea
Parvovirus B19 infection
23
Q

Work-up - joint/limb pain +/- systemic symptoms

A

Labs: CBC, ESR, CRP, cervical/blood culture, uric acid

Antibodies: ANA, anti-dsDNA (SLE), anti-Sm (SLE), C3, C4, antiphospholipid antibodies, RF, anti-CCP (RA), parvovirus B19, Lyme titers (IgG, IgM)

Arthrocentesis and synovial fluid analysis (cell count, Gram stain, culture, crystals)

Imaging: XR - hands, knees, pelvis/SI joints

24
Q

Joint/limb pain - hip pain, fall/trauma

A

Hip fracture
Hip dislocation (+/- traumatic)
Pelvic fracture

25
Q

Work-up - hip pain

A 
XR - hip/pelvis
CT or MRI - hip
CBC, serum Ca or vitamin D
DEXA
PT/PTT
UDS, BAL
U/S - abdomen (FAST exam)
26
Q

Joint/limb pain - knee pain

A 
OA
Gout
Pseudogout
Meniscal or ligament damage
Septic arthritis
Lyme arthritis
Trauma
Reactive arthritis
27
Q

Joint/limb pain - foot pain

A 
Stress fracture
Plantar fasciitis
Sprain or strain
Heel fracture
Splinter/foreign body
28
Q

Work-up - joint/limb pain - foot pain

A

XR - foot
Bone scan - foot
MRI - foot

29
Q

Joint/limb pain - calf (red, tender, swollen)

A 
DVT
Baker cyst rupture
Myositis
Cellulitis
Superficial venous thrombosis
30
Q

Work-up - joint/limb pain - calf (red, tender, swollen)

A

Doppler U/S - leg

CBC, CPK, D-Dimer

31
Q

Joint/limb pain - shoulder pain

A

Shoulder dislocation
Humerus fracture
Rotator cuff injury

32
Q

Work-up - joint/limb pain - shoulder pain

A

XR - shoulder, arm

MRI - shoulder

33
Q

Dyspareunia

A 
Atrophic vaginitis
Endometriosis
Cervicitis
Vaginismus
Vulvodynia
PID
Depression
34
Q

Work-up - dyspareunia

A

Pelvic exam
LH/FSH
Wet mount, KOH prep, cervical cultures
Laparoscopy

35
Q

Vaginal discharge

A

Bacterial vaginosis
Vaginitis - candida, trichomonal
Cervicitis (chlamydia, gonorrhea)

36
Q

Work-up - vaginal discharge

A

Pelvic exam
Wet mount, KOH prep, “whiff test”
pH of vaginal fluid
Cervical cultures/NAAT

37
Q

Vaginal bleeding

A 
Dysfunctional uterine bleeding
Coagulation disorder (eg, von Willibrand disease, hemophilia)
Hypothyroidism

Spontaneous abortion
Ectopic pregnancy
Molar pregnancy

Cervicitis
PID
Ruptured ovarian cyst
Ovarian torsion
Trauma
Atrophic endometrium
Endometrial hyperplasia
Endometrial polyps
Atrophic vaginitis
Endometrial cancer
Cervical cancer
38
Q

Work-up - Vaginal bleeding

A 
Pelvic exam
Pap smear
U/S - pelvis, abdomen
Endometrial biopsy, curettage
Colposcopy/biopsy
HPV testing
Hydro-ultrasonography?

CBC, PT/PTT, ESR, LH/FSH, TSH, Prl urine hCG, cervical culture, quantitative serum hCG

39
Q

Amenorrhea

A 
Pregnancy
Anovulatory cycle
Hyperprolactinemia/prolactinoma
Hypothyroidism
PCOS
Ovarian or adrenal malignancy
Premature ovarian failure
Pituitary tumor
Menopause
Pituitary infarction (Sheehan syndrome)
Asherman syndrome
Anorexia nervosa
Hyperthyroidism
Anxiety-induced
PTSD
Depression
40
Q

Work-up - amenorrhea

A

Urine hCG, CBC, Prl, TSH, free T4, LH/FSH, estradiol, testosterone, DHEAS, ACTH, urine cortisol, progesterone challenge test

Pelvic exam, U/S transvaginal and transabdominal, hysteroscopy

Pap smear

MRI - brain

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