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First Aid: Step 2 CS > Differential & Work-up: Sore throat, Cough & Shortness of Breath > Flashcards

Differential & Work-up: Sore throat, Cough & Shortness of Breath Flashcards

1
Q

26 yo F presents with sore throat, fever, severe fatigue, and loss of appetite for the past week. She also reports epigastric and LUQ discomfort. She has cervical lymphadenopathy and a rash. Her boyfriend recently experienced similar symptoms.

A
  1. Infectious mononucleosis
  2. Hepatitis
  3. Viral or bacterial pharyngitis
  4. Acute HIV infection
  5. Secondary syphilis
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2
Q

WORK UP FOR:

  1. Infectious mononucleosis
  2. Hepatitis
  3. Viral or bacterial pharyngitis
  4. Acute HIV infection
  5. Secondary syphilis
A
  1. CBC with differential & peripheral smear
  2. Monospot test
  3. Throat culture
  4. AST/ALT /bilirubin/alkaline phosphatase
  5. HIV antibody and viral load
  6. Anti-EBV antibodies
  7. VDRL/RPR
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3
Q

26 yo M presents with sore throat, fever, rash, and weight loss. He has a history of IV drug abuse and sharing needles.

A
  1. HIV, acute retroviral syndrome
  2. Infectious mononucleosis
  3. Hepatitis
  4. Viral pharyngitis
  5. Streptococcal tonsillitis/Scarlet fever
  6. Secondary syphilis
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4
Q

WORK UP FOR:

  1. HIV, acute retroviral syndrome
  2. Infectious mononucleosis
  3. Hepatitis
  4. Viral pharyngitis
  5. Streptococcal tonsillitis/Scarlet fever
  6. Secondary syphilis
A
  1. CBC with differential & peripheral smear
  2. Throat culture
  3. HIV antibody and viral load
  4. CD4 count
  5. Monospot test
  6. LFTs
  7. VDRL/RPR
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5
Q

46 yo F presents with fever and sore throat.

A
  1. Pharyngitis (bacterial or viral)
  2. Mycoplasma pneumonia
  3. Acute HIV infection
  4. Infectious mononucleosis
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6
Q

WORK UP FOR:

  1. Pharyngitis (bacterial or viral)
  2. Mycoplasma pneumonia
  3. Acute HIV infection
  4. Infectious mononucleosis
A
  1. Centor criteria
  2. Throat swab for culture & rapid streptococcal antigen
  3. Monospot test
  4. CBC
  5. Serologic test (cold agglutinin titer) for Mycoplasma
  6. HIV antibody and viral load
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7
Q

30 yo M presents with shortness of breath, cough, and wheezing that worsen in cold air. He has had multiple, similar episodes in the past 4 months.

A
  1. Asthma
  2. GERD
  3. Bronchitis
  4. Pneumonitis
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8
Q

WORK UP FOR:

  1. Asthma
  2. GERD
  3. Bronchitis
  4. Pneumonitis
A
  1. CBC
  2. CXR
  3. Peak flow measurement
  4. PFTs
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9
Q

56 yo F presents with shortness of breath and a productive cough that has lasted for at least 3 months bronchitis each year over the past 2 years. She is a heavy smoker.

A
  1. COPD-chronic bronchitis
  2. COPD-emphysema
  3. Bronchiectasis
  4. Lung Cancer
  5. Tuberculosis
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10
Q

WORK UP FOR:

  1. COPD-chronic bronchitis
  2. COPD-emphysema
  3. Bronchiectasis
  4. Lung Cancer
  5. Tuberculosis
A
  1. CBC
  2. Sputum Gram stain and culture
  3. CXR
  4. PFTs
  5. CT-chest
  6. QuantiFERON-TB Gold
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11
Q

58 yo M presents with 1 week of pleuritic chest pain, fever, chills, and cough with purulent yellow sputum. He is a heavy smoker with preexisting COPD.

A
  1. Pneumonia
  2. COPD exacerbation (bronchitis)
  3. Lung abscess
  4. Lung cancer
  5. Tuberculosis
  6. Pericarditis
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12
Q

WORK UP FOR:

  1. Pneumonia
  2. COPD exacerbation (bronchitis)
  3. Lung abscess
  4. Lung cancer
  5. Tuberculosis
  6. Pericarditis
A
  1. CBC
  2. Sputum Gram stain and culture
  3. CXR
  4. CT-chest
  5. ECG
  6. QuantiFERON-TB Gold
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13
Q

25 yo F presents with 2 weeks of nonproductive cough. Three weeks ago, she had a sore throat and a runny nose.

A
  1. Atypical pneumonia
  2. Asthma
  3. URI-associated cough (“ postinfectious”)
  4. Postnasal drip
  5. GERD
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14
Q

WORK UP FOR:

  1. Atypical pneumonia
  2. Asthma
  3. URI-associated cough (“ postinfectious”)
  4. Postnasal drip
  5. GERD
A
  1. CBC
  2. Induced sputum Gram stain and culture
  3. CXR
  4. IgM detection for Mycoplasma pneumoniae
  5. Urine Legionella antigen
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15
Q

65 yo M presents with 6 months of worsening cough accompanied by hemoptysis, dyspnea, weakness, and weight loss. He is a heavy smoker.

A
  1. Lung cancer
  2. Tuberculosis
  3. Lung abscess
  4. COPD
  5. Vasculitis ( eg. granulomatosis with polyangiitis)
  6. Interstitial lung disease
  7. CHF
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16
Q

WORK UP FOR:

  1. Lung cancer
  2. Tuberculosis
  3. Lung abscess
  4. COPD
  5. Vasculitis ( eg. granulomatosis with polyangiitis)
  6. Interstitial lung disease
  7. CHF
A
  1. CBC
  2. Sputum Gram stain, culture, and cytology
  3. CXR
  4. CT-chest
  5. QuantiFERON-TB Gold
  6. ANCA
  7. Bronchoscopy
  8. Echocardiography
17
Q

55 yo M presents with increased dyspnea and sputum production for the past 3 days. He has COPD and stopped using his inhalers last week. He stopped smoking 2 days ago.

A
  1. COPD exacerbation (bronchitis)
  2. Lung cancer
  3. Pneumonia
  4. URI
  5. CHF
18
Q

WORK UP FOR:

  1. COPD exacerbation (bronchitis)
  2. Lung cancer
  3. Pneumonia
  4. URI
  5. CHF
A
  1. CBC
  2. CXR
  3. ABG
  4. PFTs
  5. Sputum Gram stain and culture
  6. CT-chest
  7. Echocardiography
19
Q

34 yo F nurse presents with worsening cough of 6 weeks’ duration accompanied by weight loss, fatigue, night sweats, and fever. She has a history of contact with tuberculosis patients at work.

A
  1. Tuberculosis
  2. Pneumonia
  3. Lung abscess
  4. Vasculitis
  5. Lymphoma
  6. Metastatic cancer
  7. HIV/AIDS
  8. Sarcoidosis
20
Q

WORK UP FOR:

  1. Tuberculosis
  2. Pneumonia
  3. Lung abscess
  4. Vasculitis
  5. Lymphoma
  6. Metastatic cancer
  7. HIV/AIDS
  8. Sarcoidosis
A
  1. CBC
  2. PPD/QuantiFERON-TB Gold
  3. Sputum Gram stain, acid-fast stain, and culture
  4. CXR
  5. CT-chest
  6. Bronchoscopy
  7. HIV antibody
  8. Lymph node biopsy
21
Q

35 yo M presents with shortness of breath and cough. He has had unprotected sex with multiple sexual partners and was recently exposed to a patient with active tuberculosis.

A
  1. Tuberculosis
  2. Pneumonia (including Pneumocystis jirovecii)
  3. Bronchitis
  4. Asthma
  5. Acute HIV infection
  6. CHF (cardiomyopathy)
22
Q

WORK UP FOR:

  1. Tuberculosis
  2. Pneumonia (including Pneumocystis jirovecii)
  3. Bronchitis
  4. Asthma
  5. Acute HIV infection
  6. CHF (cardiomyopathy)
A
  1. CBC
  2. PPD/QuantiFERON-TB
  3. Gold
  4. Sputum Gram stain, acid-fast stain, silver stain, and culture
  5. CXR
  6. HIV antibody
  7. Echocardiography
23
Q

50 yo M presents with a cough that is exacerbated by lying down at night and improved by propping up on three pillows. He also reports exertional dyspnea.

A
  1. CHF
  2. Cardiac valvular disease
  3. GERD
  4. Pulmonary Fibrosis
  5. COPD
  6. Post-nasal drip
24
Q

WORK UP FOR:

  1. CHF
  2. Cardiac valvular disease
  3. GERD
  4. Pulmonary Fibrosis
  5. COPD
  6. Post-nasal drip
A
  1. CBC
  2. CXR
  3. ECG
  4. Echocardiography
  5. PFTs
  6. BNP
  7. CT-chest
25
Q

60 yo M presents with worsening dyspnea of 6 hours’ duration and a cough that is accompanied by pink, frothy sputum.

A
  1. Pulmonary edema
  2. Pneumonia
  3. CHF
  4. Mitral valve stenosis
  5. Arrythmia
  6. Asthma
26
Q

WORK UP FOR:

  1. Pulmonary edema
  2. Pneumonia
  3. CHF
  4. Mitral valve stenosis
  5. Arrhythmia
  6. Asthma
A
  1. CXR
  2. ECG
  3. CBC
  4. ABG
  5. PFTs
  6. BNP

First Aid: Step 2 CS (23 decks)

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