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First Aid: Step 2 CS > Differential & Work-up: Fatigue & Sleepiness, Night Sweats > Flashcards

Differential & Work-up: Fatigue & Sleepiness, Night Sweats Flashcards

1
Q

40 yo F c/o feeling tired, hopeless, and worthless and of having suicidal thoughts. She lost her job and has been having fights with her husband about money.

A
  1. Depression
  2. Adjustment disorder
  3. Hypothyroidism
  4. Anemia
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2
Q

WORK UP FOR:

  1. Depression
  2. Adjustment disorder
  3. Hypothyroidism
  4. Anemia
A
  1. PHQ-9
  2. Beck Depression Inventory
  3. TSH
  4. CBC
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3
Q

44 yo M presents with fatigue, insomnia, and nightmares about a murder that he witnessed in a mall 1 year ago. Since then, he has avoided the mall and has not gone out at night.

A
  1. Post-traumatic stress disorder
  2. Depression
  3. Generalized anxiety disorder
  4. Psychotic or delusional disorder
  5. Hypothyroidism
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4
Q

WORK UP FOR:

  1. Post-traumatic stress disorder
  2. Depression
  3. Generalized anxiety disorder
  4. Psychotic or delusional disorder
  5. Hypothyroidism
A
  1. PHQ-9
  2. Beck Depression Inventory
  3. CBC
  4. TSH
  5. Urine toxicology
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5
Q

55 yo M presents with fatigue, weight loss, and constipation. He has a family history of colon cancer.

A
  1. Colon cancer
  2. Hypothyroidism
  3. Renal failure
  4. Hypercalcemia
  5. Depression
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6
Q

WORK UP FOR:

  1. Colon cancer
  2. Hypothyroidism
  3. Renal failure
  4. Hypercalcemia
  5. Depression
A
  1. Rectal exam with stool guaiac test
  2. CBC
  3. CMP
  4. TSH
  5. Colonoscopy
  6. Barium enema
  7. CT -abdomen/pelvis
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7
Q

40 yo F presents with fatigue, weight gain, sleepiness, cold intolerance, constipation, and dry skin.

A
  1. Hypothyroidism
  2. Depression
  3. Diabetes
  4. Anemia
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8
Q

WORK UP FOR:

  1. Hypothyroidism
  2. Depression
  3. Diabetes
  4. Anemia
A
  1. TSH, FT 3, FT 4
  2. CBC
  3. Fasting glucose
  4. HbA1c
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9
Q

50 yo obese F presents with fatigue and daytime sleepiness. She snores heavily and naps 3 to 4 times per day but never feels refreshed. She also has hypertension.

A
  1. Obstructive sleep apnea
  2. Hypothyroidism
  3. Chronic fatigue syndrome
  4. Narcolepsy
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10
Q

WORK UP FOR:

  1. Obstructive sleep apnea
  2. Hypothyroidism
  3. Chronic fatigue syndrome
  4. Narcolepsy
A
  1. CBC
  2. TSH
  3. Nocturnal pulse oximetry
  4. Polysomnography
  5. ECG
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11
Q

20 yo M presents with fatigue, thirst, increased appetite, and polyuria.

A
  1. Diabetes mellitus
  2. Atypical depression
  3. Primary polydipsia
  4. Diabetes insipidus
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12
Q

WORK UP FOR:

  1. Diabetes mellitus
  2. Atypical depression
  3. Primary polydipsia
  4. Diabetes insipidus
A
  1. HbA1c
  2. Glucose tolerance test
  3. UA
  4. CBC
  5. Electrolytes, BUN/Cr, fasting glucose
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13
Q

35 yo M policeman c/o feeling tired and sleepy during the day. He changed to the night shift last week.

A
  1. Shift work sleep disorder
  2. Sleep apnea
  3. Depression
  4. Anemia
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14
Q

WORK UP FOR:

  1. Shift work sleep disorder
  2. Sleep apnea
  3. Depression
  4. Anemia
A
  1. CBC
  2. Nocturnal pulse oximetry
  3. Polysomnography
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15
Q

30 yo M presents with night sweats, cough, and swollen glands of 1 month’s duration. He recently emigrated from the African subcontinent.

A
  1. Tuberculosis
  2. Acute HIV infection
  3. Lymphoma
  4. Leukemia
  5. Hyperthyroidism
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16
Q

WORK UP FOR:

  1. Tuberculosis
  2. Acute HIV infection
  3. Lymphoma
  4. Leukemia
  5. Hyperthyroidism
A
  1. PPD/QuantiFERON-TB Gold
  2. CBC
  3. CXR
  4. Sputum Gram stain, acid-fast stain, and culture
  5. HIV antibody /RNA levels
  6. TSH, FT4
  7. CT-chest
17
Q

45 yo F presents with excessive sweating, unintentional weight loss, palpitations, diarrhea, and shortness of breath.

A
  1. Hyperthyroidism
  2. Pheochromocytoma
  3. Carcinoid syndrome
  4. Tuberculosis
18
Q

WORK UP FOR:

  1. Hyperthyroidism
  2. Pheochromocytoma
  3. Carcinoid syndrome
  4. Tuberculosis
A
  1. TSH, FT4
  2. 24-hour urinary catecholamines
  3. 5-HIAA
  4. CBC
  5. PPD

First Aid: Step 2 CS (23 decks)

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