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Differentials Flashcards

1
Q

Abdominal/Pelvic Mass

A

Adult:
1. Tumor (cholangiocarcinoma, pancreatic adenocarcinoma, fallopian tube tumor, etc)
2. Gallstones
3. Hepatitis
4. Infections
5. AAA

Child:
1. Intussusception
2. Kidney (50% are renal in origin)
3. Fecal impaction
4. Hepatomegaly/splenomegaly
5. Tumor (Wilm’s, renal cell carcinoma)*

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2
Q

Abdominal Distention

A

Adult:
1. Infection (H. pylori, toxic megacolon)
2. Bowel obstruction
3. Ascites (cirrhosis)
4. Ectopic pregnancy
5. Irritable bowel syndrome
6. Misplaced endotracheal tube

Child:
1. Trauma
2. Allergic/dietary
3. Neoplastic mass
4. Volvulus*
5. Bowel obstruction

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3
Q

Abdominal Pain

A

Adults:
1. Tumor/neoplasm
2. Hernia
3. Infection
4. Pancreatitis
5. Gall stones

Children:
1. Tumor
2. Trauma/abuse
3. Dietary (colic)
4. Appendicitis
5. Gastroenteritis

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4
Q

Abnormal Heart Sounds & Murmurs

A

Aortic
Pulmonic
Mitral
Tricuspid

S1
S2
S3
S4
Splitting

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5
Q

S3 Differential

A
  • Volume overload in the ventricle
  • Best hear in left lateral decubitus
  1. Normal under age 40
  2. Normal in third trimester
  3. Mitral regurgitation
  4. Tricuspid regurgitation
  5. Congestive heart failure
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6
Q

S4 Differential

A
  • Represents rapid active ventricular filling
  1. Normal in athletes and elderly
  2. Stiff left ventricle
    a. HTN
    b. Coronary artery disease
    c. Aortic stenosis
    d. Cardiomyopathy
    e. Ventricular hypertrophy
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7
Q

Abnormal Liver Function Tests

A

AST: multiple sources (esp muscle)
ALT: more specific to liver

Adult:
1. Cirrhosis
2. Hepatitis
3. Infectious
4. Gallstones
5. Pregnancy

Children:
1. Medication
2. Virus
3. Celiac
4. Non alcoholic fatty liver disease
5. Immune (primary sclerosing cholangitis, autoimmune hepatitis, etc)

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8
Q

Abnormal Serum Lipids

A

Adults:
1. Hypercholesterolemia
2. Obesity
3. Drugs (steroids, estrogen)
4. Diabetes
5. Alcohol

Children:
1. Familial hypercholesterolemia
2. Medications
3. Nephrotic syndrome*
4. Diabetes
5. Obesity

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9
Q

Acid Base Abnormality

A

Adult:
1. Diabetic ketoacidosis
2. Kidney injury
3. Vomiting
4. Drugs
5. Hypoventilation

Child:
1. Renal disorder
2. Pneumonia
3. Drugs
4. Diarrhea
5. Vomiting

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10
Q

Allergic Reactions

A
  1. Drugs
  2. Food allergens
  3. Insect bites
  4. Physical stress
  5. Dust/pollen
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11
Q

Anxiety

A
  1. Generalized anxiety disorder
  2. Panic disorder
  3. Medication induced
  4. Separation anxiety
  5. Social anxiety
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12
Q

Ataxia

A

Adult:
1. Neuromuscular disorder (MS)
2. Alcohol induced
3. Stroke
4. Tumor
5. Degenerative (Parkinson’s)

Child:
1. Tumor
2. Developmental delay
3. Medication
4. Traumatic bleed
5. Hereditary

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13
Q

Upper Gastrointestinal Bleed

A

Adult:
1. Vomiting (Mallory Weiss tear)
2. Infection
3. Ulcer
4. Cancer
5. Varices

Child:
1. Gastritis
2. Stress ulcer
3. MW tear
4. Esophagitis
5. Varices

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14
Q

Lower Gastrointestinal Bleed

A

Adult:
1. Anorectal disease
2. Diverticulosis
3. Colorectal cancer
4. Rectal trauma
5. Enterocolitis*

Child:
1. Infection (bacteria, parasite)
2. C dif.
3. Hirschsprung disease*
4. Allergy
5. Anal fissure

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15
Q

Hypertension

A

Adult:
1. Anxiety
2. Diet
3. Catecholamines
4. Renal disorder
5. Vascular disorder (heart attack, etc)

Child:
1. Pheochromocytoma
2. Renal artery stenosis
3. Coarctation of aorta
4. Anxiety
5. Congenital renal disease

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16
Q

Hypotension

A

Adult:
1. Hemorrhage
2. Heart failure/myopathy/ischemia
3. Pneumothorax
4. Aortic dissection
5. Substance abuse

Child:
1. Hemorrhage
2. Anaphylaxis
3. Drugs
4. Addison’s
5. Sepsis

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17
Q

Blood in Sputum (Hemoptysis)

A

Adult:
1. Alcohol (Mallory Weiss)
2. Infection
3. Inflammatory
4 Pulmonary embolism
5. Neoplasm

Child:
1. Infection (bacteria, viral)
2. Foreign body
3. Neoplasm
4. Bleeding disorder
5. AV malformation

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18
Q

Blood in Urine (Hematuria)

A

Adult:
1. Kidney stones
2. Neoplasm
3. STI
4. Autoimmune (SLE)
5. Medications/food

Child:
1. Food
2. Abuse
3. Renal tumor or stone
4. Coagulopathy*
5. Renal vein thrombosis

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19
Q

Breast Discharge

A

Adult:
1. Prolactinoma
2. Breast cancer
3. PCOS
4. Medication
5. Pituitary tumors

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20
Q

Breast Mass

A

Adult:
1. Breast cancer
2. Medication
3. Benign mass
4. Infection
5. Lactation

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21
Q

Burns

A
  1. Assess severity and degree
  2. Treatment modalities and wound care
  3. Critical lab values
  4. Pain control
  5. Psychosocial effects
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22
Q

Calcium Disorder

A

Adult:
1. Autoimmune
2. Malignancy
3. Thyroid disorder
4. Parathyroid disorder
5. Vitamin D

Child:
1. Malabsorption
2. Malignancy
3. Vitamin D
4. Medications
5. Kidney disorder

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23
Q

Cardiac Arrest

A
  1. Conduction abnormality
  2. Coronary artery disease
  3. Myocardial infarction
  4. Trauma
  5. Pulmonary embolism
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24
Q

Cerebrovascular Accident and Transient Ischemic Attack (stroke)

A

Ischemia vs hemorrhagic

Adult:
1. Uncontrolled hypertension
2. Trauma
3. Medication
4. Seizure
5. Atrial fibrillation

Child:
1. Seizure
2. Meningitis
3. Trauma
4. Tumor
5. Embolism

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25
Q

Chest Pain

A

Adult:
1. Myocardial infarction
2. Breathing abnormality (mechanical obstruction? trauma?)
3. Anxiety
4. Malignancy
5. Peptic ulcer disease

Child:
1. Breathing abnormalities (asthma)
2. Mechanical obstruction
3. Tumor
4. Vascular (MI?)
5. Anxiety and stress

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26
Q

Clinical Infomatics

A
  1. Importance of longitudinal, efficient and concise patient records
  2. EMR
  3. Telehealth modalities
  4. Security of information (HIPPA)
  5. Risks and benefits
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27
Q

Coagulation Abnormalities

A

Adult:
1. Coagulopathy
2. Medication
3. Cancer
4. Traumatic (abrasion, laceration)
5. Platelet disorders

Child:
1. Mechanical (epistaxis)
2. Traumatic
3. Cancer
4. Medication
5. Genetic conditions

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28
Q

Constipation

A

Adult:
1. Dietary/allergy
2. Colorectal cancer
3. Drugs and medication
4. Pregnancy
5. Obstruction

Child:
1. Dietary
2. Hirschsprung
3. Cystic fibrosis
4. Bowel obstruction
5. Psychological

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29
Q

Contraception

A
  1. Hormone
  2. Barrier
  3. IUD
  4. Abstinence
  5. Sterilization (male vs female)
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30
Q

Cough

A

Adult:
1. Pneumonia
2. Asthma or COPD
3. Irritant (toxicity, exposure)
4. Medication
5. Reflux

Child:
1. Allergy
2. Environmental/exposure to irritant
3. Asthma
4. Obstruction
5. Infection

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31
Q

Cyanosis

A

Adult:
1. ARDS*
2. Cystic fibrosis*
3. Pulmonary embolism
4. Restrictive lung disease
5. High altitude

Child:
1. Tetralogy of Fallot and other congenital heart diseases
2. Hypothermia
3. Airway obstruction
4. Seizure
5. Sepsis

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32
Q

Developmental Delay

A

Adult:
1. Trisomy 21
2. Autism
3. CNS infection (meningitis?)
4. Malnourished (vitamin deficiencies?)

Child:
1. Autism
2. Fetal alcohol syndrome
3. Brain injury

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33
Q

Diarrhea

A

Adult:
1. Dietary (celiac)
2. IBS
3. Food poisoning
4. Infection (C. dif, viral, bacterial)
5. Drugs/toxins
6. Carcinoid tumor

Child:
1. Malabsorption
2. Drugs
3. Laxatives
4. Diet related intolerance
5. Intussusception
6. Infections

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34
Q

Diplopia

A

Adult:
1. Intracranial mass
2. Stroke
3. Trauma (fracture of orbital floor?)
4. Glaucoma
5. Hypertension

Child:
1. Strabismus
2. Anxiety and stress
3. Intracranial mass
4. Hyperthyroid

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35
Q

Dizziness (vertigo)

A

Adult:
1 Drugs
2. Meniere’s
3. Presyncope
4. Peripheral neuropathy
5. Multiple sclerosis

Child:
1. Ear infection
2. Seizures
3. Poor mobility
4. Anxiety or panic disorder

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36
Q

Dying Patients

A
  1. Palliative Care
  2. Communication
  3. Pronouncing death
  4. End of life directives and substitute decision maker
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37
Q

Dysphagia (difficulty swallowing)

A

Adult:
1. Structural abnormality (Zenker, tumor, pharyngitis, strictures)
2. Neuromuscular (stroke)
3. Achalasia
4. Trauma
5. Reflux

Child:
1. Esophageal structures or mass
2. GERD
3. Neuromuscular (myasthenia gravis)
4. Cleft lip or palate
5. Swallowing disorders

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38
Q

Dyspnea (Shortness of breath)

A

Adult:
1. Heart failure
2. Asthma or other respiratory problem
3. Pneumonia
4. Anxiety
5. Anaphylaxis

Child:
1. Mechanical obstruction
2. Congenital condition
3. Valvular disease
4. Arrhythmia
5. Pneumonia

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39
Q

Ear Pain

A

Adults:
1. Sinusitits
2. Otitis externa/media
3. Trauma (frost bite, piercing)
4. Trigeminal neuralgia
5. TMJ

Children:
1. Trauma (perforation, foreign body)
2. Otitis externa/media
3. Auricular cellulitis
4. Abscess
5. Cerumen impaction

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40
Q

Early Pregnancy Loss/Spontaneous Abortion

A
  1. Drug toxicity
  2. Chromosomal abnormality
  3. PCOS (endocrine)
  4. Uterine anomalies (ruptured ectopic)
  5. Prothrombotic factors
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41
Q

Edema (Generalized)

A

Adults:
1. Heart failure
2. Renal abnormality
3. Alcoholic cirrhosis
4 Endocrine abnormality
5. Pregnancy

Children
1. Nephrotic syndrome (protein loss)
2. Allergic reaction
3. Malnutrition
4. Medication
5. Cardiac

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42
Q

Edema (Localized)

A

Adults:
1. DVT (Well’s criteria)*
2. Injury
3. Infection
4. Venous insufficiency
5. Lymphedema

Children:
1. Injury/trauma
2. Infection
3. Inflammation

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43
Q

Erectile Dysfunction

A
  1. Psychiatric (depression, anxiety)
  2. Medication
  3. Alcohol/medication
  4. Hormonal
  5. Neurologic (diabetes)
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44
Q

Eye Redness

A

Adult:
1. EKC
2. Uveitis
3. Alcoholic
4. Dry eye
5. Medication

Child:
1. Traumatic injury
2. EKC
3. Keratitis
4. Blepharitis
5. Allergic reaction

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45
Q

Frailty in the Elderly

A
  1. Medication
  2. Social (isolation, poverty, elder abuse)
  3. Disease
  4. Malnutrition
  5. Psychiatric
  6. Visual or auditory changes
  7. Mobility
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46
Q

Failure to Thrive (infant)

A
  1. Malnutrition
  2. Child abuse/neglect/poverty
  3. Maternal use of medication or drugs
  4. Sucking/swallowing difficulty (cleft palate)
  5. Metabolic disorder
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47
Q

Falls

A
  1. Medical condition (vertigo, syncope)
  2. Socioeconomic factors (malnutrition)
  3. Decreased vision
  4. Choice of footwear
  5. Medication
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48
Q

Fatigue

A

Adult
1. Depression or other psychiatric disorder
2. Medication
3. Vitamin insufficiency
4. Heart failure/cardiac instability
5. Cancer

Child:
1. Malnourished
2. Child abuse
3. Anxiety/depression
4. Metabolic disorder
5. Medication

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49
Q

Fatigue

A

Adult
1. Depression or other psychiatric disorder
2. Medication
3. Vitamin insufficiency
4. Heart failure/cardiac instability
5. Cancer

Child:
1. Malnourished
2. Child abuse
3. Anxiety/depression
4. Metabolic disorder
5. Medication

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50
Q

Genetic Concerns

A
  1. Chromosomal
  2. Prenatal exposure to disease or toxins
  3. Neural tube defect
  4. Autosomal dominant/recessive
  5. Malnutrition
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51
Q

Congenital Anomalies (Dysmorphic Features)

A
  1. Fetal alcohol
  2. Trisomy 21
  3. Fragile X
  4. Mechanical
  5. Hypothyroidism
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52
Q

Glucose Abnormality

A
  1. Diabetes
  2. Malnutrition
  3. Medication
  4. Endocrine disorder (adrenal insufficiency)
  5. Obesity
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53
Q

Diabetes Mellitus

A

Type 1:
1. Autoimmune
2. Idiopathic

Type 2:
1. Obesity
2. Genetic predisposition
3. Medication

Gestational

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54
Q

Headache

A

Adult:
1. Brain hemorrhage
2. Migraine
3. Medication overuse
4. Intracranial infection
5. Carbon monoxide

Child:
1. Viral infection
2. Sinusitis
3. Hypertension
4. Brain tumor
5. Migraine

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55
Q

Health and the Climate Crisis

A
  1. Heat
  2. Malnutrition
  3. Infectious disease
  4. Refugees and immigrants
  5. Physical/social consequences
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56
Q

Health of Special Populations

A
  1. Homeless
  2. Disabled
  3. Immigrants
  4. Poverty
  5. Other
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57
Q

Hearing Loss

A

Adult:
1. Aging
2. Infection
3. Tumor or mass
4. Trauma (perforation)
5. Horner’s

Child:
1. Infection
2. Foreign body
3. Congenital (Alport’s)
4. Cerumen build up
5. Noise induced hearing loss

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58
Q

Hemoglobin Abnormality (Anemia)

A
  1. Excessive bleeding
  2. Decreased red cell production (marrow)
  3. Increased destruction (sickle)
  4. Hemoglobinopathies
  5. Vitamin B12/folate deficient
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59
Q

Hemoglobin Abnormality (Elevated)

A
  1. Polycythemia vera
  2. Secondary erythrocytosis
  3. Decreased plasma volume
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60
Q

Hypothermia

A
  1. Severity
  2. Precipitating events
  3. Life saving measures
  4. Long term treatment plan
  5. Active vs passive rewarming
  6. Need for specialized care
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61
Q

Incontinence (urine)

A

Adult:
1. Infection
2. Polyuria
3. Medication
4. Prostate enlargement
5. Mobility issues

Child:
1. Abuse
2. Anxiety
3. UTI
4. Vesicoureteral reflux

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62
Q

Incontinence (fecal)

A
  1. Neurological
  2. Impaction
  3. Infection
  4. Dietary
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63
Q

Indigenous Health

A
  1. Demonstrate awareness of root cause of inequitable health care and outcomes experienced by Indigenous Peoples
  2. Provide anti-racist and culturally appropriate care
  3. Describe health services delivered to IP
  4. Four key themes of United Nations Declaration on the Rights of Indigenous people (right to self-determination; right to cultural identity; right to free, prior and informed consent; and the right to be free from discrimination)
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64
Q

Immunization

A
  1. Assess immunization status
  2. Recommend appropriate schedule
  3. Counselling
  4. Contraindications
  5. Special at risk groups
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65
Q

Jaundice (elevated bilirubin and evidence of scleral icterus)

A

Adult:
1. Alcoholic cirrhosis
2. Congestive heart failure
3. Drugs
4. Sepsis
5. Fatty liver

Neonatal:
1. Hemolytic (Coombs)
2. Gilbert syndrome
3. Hypothyroid
4. Infection
5. Biliary atresia

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66
Q

Joint Pain - Back pain and related symptoms

A

Adult:
1. Sciatica
2. Herniated disc
3. Ankylosing spondylitis or arthritis
4. Fracture
5. Neoplasm

Child:
1. Neoplasm
2. Fracture
3. Infection
4. Spinal stenosis
5. Abuse

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67
Q

Joint Pain - Neck Pain

A

Adult:
1. Infection (meningitis, etc)
2. Neoplasm
3. Fracture
4. Nerve root entrapment
5. Thyroid/pharynx

Child:
1. Trauma
2. Infection (mumps, etc)
3. Neoplasm
4. Cord compression
5. Arthritis

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68
Q

Joint Pain - Non Articular Musculoskeletal Pain (pain in the muscles but not the joints)

A

Adult:
1. Trauma
2. Fibromyalgia
3. Autoimmune
4. Infection
5. Vascular (sickle)

Child:
1. Trauma
2. Neoplasm
3. Necrotizing fasciitis
4. Neuropathic
5. Infection

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69
Q

Joint Pain - Oligoarthralgia (pain in 1-4 joints)

A

Adult:
1. RA/OA
2. SLE
3. Fracture
4. Scleroderma
5. Gout

Child:
1. Early RA
2. Lyme
3. Post viral
4. Rheumatic fever
5. Leukemia

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70
Q

Joint Pain - Polyarthralgia (pain in more than 4 joints)

A

Adult:
1. RA
2. OA
3. Fibromyalgia
4. Polymyalgia rheumatica
5. Neuropathy

Child:
1. Juvenile polyarthritis
2. Sarcoidosis
3. Ankylosing spondylitis
4. Hypercalcemia
5. Infection/sepsis

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71
Q

Language and Speech Disorders

A

Adult:
1. Neurological (Parkinsons, etc)
2. Head injury
3. Head/neck neoplasm
4. Stroke
5. Autism

Child:
1. Deafness
2. Autism
3. Neglect
4. Head injury
5. Cleft palate

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72
Q

Legal, Ethical and Organizational Aspects of Medicine - Confidentiality

A
  1. Know what the exceptions are
  2. Who to release information to
  3. Mandatory disclosures
  4. Limitations
  5. Alternate decision makers
73
Q

Legal, Ethical and Organizational Aspects of Medicine - Consent

A
  1. How to obtain informed consent
  2. Know steps to take for substitute decision makers
  3. Implied consent
  4. Issues with verbal/written consent
  5. Identify information that must be provided
74
Q

Legal, Ethical and Organizational Aspects of Medicine - Legal System

A
  1. Federal vs provincial statutes
  2. Regulatory bodies
  3. Awareness of when consultation is important
75
Q

Legal, Ethical and Organizational Aspects of Medicine - Negligence

A
  1. Elements required to prove negligence
  2. Differences in standard of care based on health care provider
  3. Appropriate communication with patient
  4. CMPA
76
Q

Legal, Ethical and Organizational Aspects of Medicine - Truth Telling

A
  1. Communicate effectively
  2. Identify challenging situations and how to best address them
  3. Ascertain personal/cultural context of patient or professional
  4. Recognize when it is necessary to disclose personal beliefs or values that could be in conflict with patient choices
77
Q

Limp in Children

A
  1. Trauma/fracture/abuse
  2. Bone deformity
  3. Tumor
  4. Growing pains
  5. Referred
78
Q

Lump/Mass (Musculoskeletal)

A

Adult
1. Neoplasm
2. Bone (cyst vs Ewing)
3. Rheumatoid nodule
4. Osteomyelitis

Child
1. Traumatic hematoma
2. Cyst

79
Q

Lymphadenopathy (submandibular, axillary or inguinal nodes that are abnormal in either size, consistency or number)

A

Localized:
1. Strep (look for tender cervical nodes, sore throat)
2. Mononucleosis (symmetric adenopathy, usually cervical but sometimes axillae or inguinal)
3. Skin and soft tissue infection (cat scratch, cellulitis, etc look for erythema and tenderness of isolated node)
4. TB (cough)
5. Kawasaki (tender cervical nodes in children)

Generalized:
1. Idiopathic
2. Neoplastic (painless adenopathy, look for fever and weight loss)
3. HIV (look for fever, malaise, rash)
4. SLE (look or malar rash, arthritis)
5. Sarcoidosis (look for cough, muscle weakness, weight loss, could also be localized)

80
Q

Mediastinal Mass

A

Adult:
1. Tumor (lymphoma, thymoma)
2. AAA
3. Sarcoidosis
4. Esophageal cancer
5. Hiatal hernia

Child:
1. Foreign body
2. Lymphoma (non Hodgkin and Hodgkin)
3. Congenital anomaly
4. Teratoma
5. Cyst

81
Q

Menopause (12 months of amenorrhea after the final menstrual period)

A
  1. Physiological
  2. Autoimmune disorder
  3. Turner’s Syndrome
  4. Radiation
  5. Chemotherapy
82
Q

Menstrual Cycle - Amenorrhea (absence) and Oligomenorrhea (infrequent, fewer than 6-8 periods per year)

A
  1. Pregnancy
  2. Menopause
  3. Hypothalamus/pituitary gland abnormalities
  4. PCOS
  5. Lifestyle changes (Low weight, nutritional deficiencies, strenuous exercise)
83
Q

Menstrual Cycle - Dysmenorrhea (painful periods)

A

Primary:
Secondary (clinically identifiable/underlying pathology):
1. Endometriosis (endometrial tissue that grows outside of the uterus and breaks down during menstruation causing bleeding in pelvis or abdominal cavity causing inflammation and scarring of the surrounding tissue)
2. Adenomyosis (endometrial tissue growing into the myometrium of the uterus)
3. Fibroids (growth of smooth muscle cells and fibrous connective tissue)
4. Imperforate hymen
5. IUD

84
Q

Menstrual Cycle - Premenstrual Dysphoric Disorder and OMS

A
  • PMDD is similar to PMS but causes more severe symptoms and impairment of functioning
  • Approach should include:
    1. Symptom diary
    2. Ruling out other disorders (depression, hypothyroidism, anemia, etc)
    3. Assess their effect on ADLs
    4. Creating a management plan
    5. Counselling patient
85
Q

Mental Status - Coma

A

Adult:
1. Stroke
2. Intoxication
3. Traumatic bleed
4. Hypertensive episode
5. Metabolic (uremia, hypercalcemia, hypoglycemia)

Child:
1. Traumatic bleed (abuse): look for bruises
2. Infection: look for fever
3. Seizures
4. Metabolic (hypoglycemic): look for preceding somnolence
5. Neoplasm: look for ataxia, confusion or loss of milestones in recent weeks

86
Q

Mental Status - Delirium

A

Adult:
1. Hypoxia
2. Stroke
3. Dementia
4. Infection
5. Withdrawal

Child:
1. Intoxication (sedative, anticholinergic, drugs)
2. Metabolic (DKA?)
3. Trauma
4. Infection
5. Mental health

87
Q

Mental Status - Neurocognitive Disorders and Dementia

A

Adult:
1. Alzheimer’s (neurodegenerative disorder of uncertain cause and pathogenesis that primarily affects older adults with no cure)
2. Huntington
3. Intracranial masses
4. Infection (HIV, neurosyphilis)
5. Toxins (heavy metals)

Child:
1. Down’s
2. Brain trauma
3. Drugs
4. Nutritional disorders
5. Endocrine (hypothyroid, B12)

88
Q

Mood Disorders - Depressed Mood

A

Adult:
1. Major depressive disorder
2. Bipolar
3. Grief
4. Substance abuse
5. PTSD

Child:
1. Adjustment disorder
2. Bipolar
3. Anxiety
4. Sleep disturbances
5. Bullying/abuse

89
Q

Mood Disorders - Mania/Hypomania

A

Adult:
1. Bipolar
2. Excessive steroid or HGH use
3. Stimulant intoxication (cocaine, amphetamine, PCP, nicotine)
4. Schizophrenia
5. Borderline personality disorder

Child:
1. Bipolar
2. Substance abuse
3. Cyclothymic disorder (emotional ups and downs not as severe as bipolar)
4. OCD
5. Drugs

90
Q

Movement Disorders - Involuntary or Tic Disorders

A

Adult:
1. Medication overuse
2. Drug overdose
3. Neurological (Huntington’s, Parkinson’s, Wilson’s)
4. Essential tremor
5. Myoclonus

Child:
1. Tourette’s
2. Autism
3. Infection (encephalitis)
4. Multiple sclerosis
5. Drugs

91
Q

Neck Mass - Goiter

A
  1. Congenital (thyroglossal duct cyst)
  2. Inflammatory (lymph nodes)
  3. Neoplasms (lipoma)
  4. Lymphoma
  5. Thyroid cancers
92
Q

Neonatal Distress

A
  1. Premature
  2. Meconium aspiration
  3. Decreased respiratory drive
  4. Cardiovascular disease
  5. Infection
93
Q

Numbness/Tingling

A

Adult:
1. Multiple sclerosis
2. Medication
3. Disc herniation
4. Neuropathy
5. Herpes zoster

Child:
1. Trauma
2. Neuropathy
3. Panic attacks
4. Diabetes
5. Spine abnormalities/mass

94
Q

Obsessive Compulsive Disorder

A
  1. Abuse
  2. Anxiety
  3. Depression
  4. Substance abuse
  5. Infections
95
Q

Oral Conditions

A

Adult:
1. Candida
2. Drugs (methamphetamines)
3. Xerostomia
4. Behcet’s*
5. Malignancy

Child:
1. Cleft palate
2. Poor hygiene
3. Trauma
4. Toxins
5. Infections

96
Q

S3 Differential

A
  • Volume overload in the ventricle
  • Best hear in left lateral decubitus
  1. Normal under age 40
  2. Normal in third trimester
  3. Mitral regurgitation
  4. Tricuspid regurgitation
  5. Congestive heart failure
97
Q

Pain - Central/Peripheral Neuropathic Pain

A

Adult:
1. Diabetic neuropathy
2. Herniated disc
3. Spine mass or mass impinging on spine
4. Trauma
5. Post herpetic neuralgia

Child:
1. Spinal cord injury or abnormality
2. Neurotoxic drug
3. Brain injury
4. Multiple sclerosis
5. Cancer

98
Q

Generalized Pain Disorders

A

Adult:
1. Fibromyalgia
2. Polymyalgia rheumatica
3. Depression
4. Rheumatoid arthritis
5. SLE

Child:
1. Anxiety
2. Depression
3. Adjustment disorder
4. Trauma/abuse
5. Osteomalacia

99
Q

Palpitations

A

Adult:
1. Shock
2. Cardiac (myocardial infarction, a fib, SVT)
3. Cocaine, caffeine
4. Metabolic (pheochromocytoma or carcinoid)
5. Pregnancy

Child:
1. Drug use
2. Anxiety
3. Dehydration
4. WPW
5. Thyrotoxicosis

100
Q

Pediatric - Crying Child

A
  1. Hunger
  2. Colic
  3. Trauma
  4. Infection
  5. Sleep disturbances
101
Q

Pediatric - Hypotonic Infant (decreased muscle tone)

A
  1. Cerebral palsy
  2. Down’s
  3. Marfan’s
  4. Prader-Willi*
  5. Sepsis
102
Q

Pelvic Pain

A

Adult
1. Pregnancy/ectopic
2. Menstruation
3. UTI
4. Hernia
5. Appendicitis

Child:
1. UTI
2. Abuse
3. Irritable bowel
4. Depression
5. Endometriosis

103
Q

Preventative Health - Immunizations

A
  1. Contraindications
  2. Proper communication and informed consent
  3. Counselling those who refuse
  4. Organizing a schedule
  5. At risk populations
  6. Vaccine storage and administration
104
Q

Preventative Health - Newborn Assessment

A
  1. Maternal and perinatal history
  2. Psychosocial history
  3. Screen for acute illness and congential malformations
  4. Caregiver concerns
  5. Specialized care
105
Q

Preventative Health - Preoperative Medical Evaluation

A
  1. Medical/social/family history
  2. Relevant diagnoses (sleep apnea, malignant hyperthermia)
  3. Special concerns in management (mobility, positioning, post op care)
  4. Communication with health professionals
  5. Management of stress
106
Q

Preventative Health - Well Child

A
  1. Growth
  2. Development (milestones)
  3. Motor skills
  4. Communication and language
  5. Cognitive abilities
  6. Self care
  7. Behavioral and emotional health
107
Q

Personality Disorders

A

Cluster A (MAD):
1. Paranoid
2. Schizotypal
3. Schizoid

Cluster B (BAD):
1. Borderline
2. Narcissistic
3. Antisocial

Cluster C (SAD):
1. Avoidant
2. OCD
3. Dependent

108
Q

Pleural Effusion

A

Adult:
1. PE
2. Congestive heart failure
3. Nephrotic syndrome
4. Cirrhosis
5. Neoplasm

Child:
1. Infection
2. Trauma
3. Mesothelioma*
4. Nephrotic syndrome
5. PE?

109
Q

Poisoning

A
  1. Household cleaners
  2. Environmental (plants, insecticides)
  3. Drugs (cocaine, THC, etc)
  4. Medications
  5. Alcohol
110
Q

Population Health and Its Determinants - Administration of Effective Health Programs at the Population Level

A
  • Methods of regulation of health profressional and institutions
  • Regulated vs non regulated health care providers
  • Ethical issues
  • Adjustment of programs to fit population needs
  • What can be improved
111
Q

Population Health and Its Determinants - Assessing and Measuring Health Status at the Population Level

A
  • Collecting information
  • Critical evaluation
  • Assessing risk
  • Analyze populations
  • Interpret results
112
Q

Population Health and Its Determinants - Concepts of Health and Its Determinants

A

Define and discuss the determinants/concepts of health, wellness, illness, disease and sickness

113
Q

Population Health and Its Determinants - Disaster Preparedness

A
  • How to determine when to announce emergency
  • Cause of disaster
  • Management of patients and peers
  • Collaboration
  • Mitigation
  • Participation in emergency response
  • Assist with emergency recovery
114
Q

Population Health and Its Determinants - Environment

A
  • Identify common environmental hazards
  • How to perform risk assessment
  • Regulatory agencies
  • Interventions
  • Communication to community
115
Q

Population Health and Its Determinants - Health of Special Populations

A
  • Health outcomes for special populations
  • Cultural perspectives
  • Countries of origin and their specific risks for illness
  • Provide culturally safe care
  • Public policy
116
Q

Population Health and Its Determinants - Indigenous Health

A
  • Connection between historical and current government policies
  • Disruption due to colonization
  • Availability of health services
  • Racism and cultural sensitivity
  • Four key themes of the United Nations Declaration on the Rights of Indigenous Peoples and how they link to health outcomes
  • Equal rights
117
Q

Population Health and Its Determinants - Interventions at the Population Level

A
  • Levels of prevention
  • Community needs
  • Understand role as physician
  • Public policy
118
Q

Population Health and Its Determinants - Outbreak Management

A
  • Characteristics and management of an outbreak
  • Risk factors
  • Communication skills
  • Preventing or reduce risk
119
Q

Population Health and Its Determinants - Work Related Health Issues

A
  1. Ergonomic hazards (e.g. awkward postures and movements, poor lighting)
  2. Chemical hazards (e.g. organic solvents, metals, asbestos, toxic gases)
  3. Physical hazards (e.g. noise, vibration, radiation)
  4. Biological hazards (e.g. blood or other body fluids, animal and bird droppings)
  5. Psychological and work organization hazards (e.g. workplace stressors, workplace bullying)
120
Q

Potassium - Hyperkalemia*

A
  • Mild moderate 5-7 with tall peaked T
  • Severe >7 with flattened P and wide QRS

Adult:
1. Insulin deficiency
2. Rhabdomyolysis*
3. Kidney injury or missed dialysis
4. Medication (decreased secretion)
5. Transfusions

Tx:
Protect heart: calcium gluconate
Shift K+ into cells: D50W + insulin,
NaHC03, salbutamol
Remove K+: fuids + furosemide, dialysis

Child (>5.5):
1. Diet
2. Poisoning
3. Medication
4. Kidney disease
5. Addison’s*

121
Q

Potassium - Hypokalemia

A
  • Mild 3-3.5 usually asymptomatic
  • Severe <3

Adult:
1. Decreased intake (dietary)
2. Increased loss (diarrhea, laxatives, vomiting)
3. DKA
4. Medications
5. Hyperaldosteronism

122
Q

Pregnancy - Intrapartum and Postpartum Care

A
  • History and physical
  • Emotional and psychosocial needs
  • Onset, stages and progression
  • Complications
  • Management plan
123
Q

Pregnancy - Prenatal Care

A
  • Informed decision making
  • Counselling (vitamins, smoking cessation, weight management)
  • Risks
  • Genetic counselling
  • Partner violence
  • Preterm labor
124
Q

Prescribing Practices

A
  • History
  • Contraindications
  • Writing a prescription clearly
  • Communicating with patient to ensure adherence
  • Care given their socioeconomic status
125
Q

Preterm Labor

A
  1. Placental abruption
  2. Substance abuse
  3. Infection or illness
  4. Neonatal distress
  5. Eclampsia*
126
Q

Proteinuria*

A
  1. Dehydration
  2. Multiple myeloma*
  3. Kidney abnormality
  4. Amyloidosis
  5. Autoimmune
127
Q

Pruritis

A

Adult:
1. Psoriasis
2. Allergy
3. Biliary disease
4. Polycythemia vera*
5. Psychiatric disorder

Child:
1. Allergy
2. Anxiety
3. Infection
4. Parasite
5. Carcinoid

128
Q

Psychosis

A

Adult:
1. Substance abuse
2. Psychiatric disorder (bipolar, schizophrenia)
3. Traumatic brain injury
4. Brain tumor
5. Sepsis

Child:
1. Psychiatric disorder
2. Medication
3. Dehydration/malnutrition
4. Seizure
5. Thyroid disorder

129
Q

Acute Renal Failure (abrupt reduction in kidney function and is defined as an increasing serum creatinine level from baseline over a short period)

A
  1. Pre
    - Renal hypoperfusion (RAS)
    - Systemic hypoperfusion (shock, hypovolemia)
  2. Renal
    - TTP
    - HUS
    - Glomerulonephritis
  3. Post
    - Calculi
    -Tumors
130
Q

Acute Renal Failure (abrupt reduction in kidney function and is defined as an increasing serum creatinine level from baseline over a short period)

A
  1. Pre
    - Renal hypoperfusion (RAS)
    - Systemic hypoperfusion (shock, hypovolemia)
  2. Renal
    - TTP
    - HUS
    - Glomerulonephritis
  3. Post
    - Calculi
    -Tumors
131
Q

Chronic Renal Failure (persistently elevated serum creatinine)

A
  1. Pre
    - Blood pressure
  2. Renal
    - Diabetic nephropathy
    - Drug toxicity
    - Ischemia
    - Polycystic kidney disease
    - Dysplasia
  3. Post
    - Obstruction
132
Q

Scrotal Mass

A

Adult:
1. Tumor
2. Inguinal hernia
3. Hydrocele
4. Seminoma
5. Testicular torsion

Child:
1. Varicocele
2. Orchitis (mumps)
3. Hematocele
4. Cyst
5. Tumor

133
Q

Scrotal Pain

A

Adult:
1. Epididymitis
2. Hernia
3. STI
4. Testicular neoplasm
5. Cellulitis

Child:
1. Torsion
2. Trauma
3. Orchitis
4. Henoch-Schönlein purpura
5. Kidney stone

134
Q

Seizure/Epilepsy

A

Adult:
1. Withdrawal
2. Brain neoplasm
3. Hypoglycemia
4. Encephalitis
5. Meningitis

Child:
1. Primary seizure disorder
2. Head trauma
3. Electrolyte imbalance
4. Toxicity (lead, drugs, etc)
5. Fever (febrile seizures)

135
Q

Sexual Dysfunction

A
  1. Erectile dysfunction (depression, diabetes, spinal cord injury, beta blocker, aging)
  2. Genito-pelvic pain (menopause, endometriosis, PID)
  3. Substance/medication induced
  4. Gender dysphoria
  5. Sexual disorders (arousal disorders, anorgasmia, paraphilic disorders)
136
Q

Abnormal Pubertal Development

A
  1. Exogenous androgens
  2. Chromosomal abnormality
  3. Malnutrition
  4. Hypothalamic/pituitary dysfunction
  5. Congenital adrenal hyperplasia
137
Q

Skin Rash - Urticaria & Angioedema

A

Adult:
1. Allergic reaction
2. Opiates
3. Infection
4. Mastocytosis
5. Cold (Raynaud’s?)

Child:
1. Allergic reaction
2. Infection
3. Connective tissue disease
4. Autoimmune disorder
5. Scabies

138
Q

Skin and Integument Conditions

A

Skin
1. Rash
2. Tumor
3. Ulcer

Nail
1. Fungus
2. Clubbing

Hair
1. Alopecia
2. Hirsutism
3. Hypertrichosis

139
Q

Sleep Wake Disorders

A

Adult:
1. PTSD
2. Sleep apnea
3. Substance abuse
4. Anxiety
5. Psychiatric disorders

Child:
1. Trauma
2. Poor environment
3. Stress and anxiety
4. Insomnia
5. Psychiatric

140
Q

Sodium - Hypernatremia (>145 mmol/L)

A
  1. Water depletion/dehydration
  2. Increased loss (renal, diarrhea, exercise)
  3. Increased gain (fluids)
  4. Diabetes insipidus
  5. Endocrine (Cushings?)
141
Q

Sodium - Hyponatremia (<136 mmol/L)

A
  1. Hyperglycemia
  2. Kidney failure
  3. SIADH
  4. CHF
  5. Hyperlipidemia
142
Q

Somatic Symptoms

A

Adult:
1. Malingering
2. Fibromyalgia
3. Substance abuse
4. PTSD
5. Undiagnosed medical condition

Child:
1. Physical abuse
2. Anxiety
3. Life change (move, parents separate, etc)
4. Factitious
5. Drugs

143
Q

Sore Throat and Rhinorrhea

A

Adult
1. Infection
2. Allergy
3. Abscess
4. SJS?
5. Foreign body

Child:
1. Physical obstruction
2. Infection
3. Polyp
4. Allergic
5. Epiglottitis

144
Q

Short Stature

A
  1. Down’s
  2. Turner’s
  3. Malnutition
  4. Toxins
  5. Low birth weight
145
Q

Tall Stature

A
  1. Marfan’s
  2. GH excess
    3.
146
Q

Strabismus and Amblyopia

A
  1. Muscle disease/inflammation
  2. CNS tumors
  3. Congenital
  4. Mechanical restriction (trauma?)
  5. CN paralysis
147
Q

Substance Use and Addictive Disorders

A
  1. Childhood trauma
  2. Family history
  3. Mental illness
  4. Chronic pain
  5. Psychosocial (unemployed, social isolation, etc)
148
Q

Sudden Infant Death Syndrone

A
  1. Young maternal age
  2. Smoking
  3. Alcohol use
  4. Poor perinatal care
  5. Sleep position (prone, room sharing)
  6. Sleep environment (swaddled, soft blankets)
149
Q

Brief Resolved Unexplained Event (characterized by a non-specific, resolved and episodic presentation, including any of the following: cyanosis or pallor; absent, decreased or irregular breathing; marked change in tone - hypertonia or hypotonia; and/or altered responsiveness)

A
  1. Misinterpretation
  2. Infection
  3. Sleep apnea
  4. Neurological disease (epilepsy)
  5. Child abuse
  6. Metabolic
150
Q

Suicidal Behavior

A
  1. Psychiatric
  2. Psychosocial
  3. Substance
  4. Serious chronic disease
  5. Malingering
151
Q

Syncope and Pre-Syncope

A
  1. Cardiac arrhythmia
  2. Hypovolemia
  3. Shock
  4. Hypoglycemia
  5. Medication
152
Q

Fever and Hyperthermia

A
  1. Infection
  2. Inflammation
  3. Medication
  4. Heat stroke
  5. Drugs
153
Q

Fever in Immunocompromised Individuals

A
  1. Host deference (HIV, steroids, congenital)
  2. Anatomic (surgery, burns)
  3. Other (diabetes, splenectomy)
154
Q

Hypothermia and Cold Related Injuries

A
  1. Cold injury (exposure)
  2. Hypothermia
  3. Alcohol
155
Q

Tinnitus

A
  1. Ear infection
  2. Trauma
  3. Impacted cerumen
  4. Acoustic neuroma
  5. Venous hum?
156
Q

Trauma - Abdominal Injury

A
  1. Blunt trauma
  2. Penetrating trauma
157
Q

Trauma - Bone or Joint Injury

A
  1. Abuse
  2. Accidental falls
  3. MVA (high energy trauma)
  4. Osteoporosis
158
Q

Trauma - Chest Injury

A
  1. Blunt
  2. Penetrating
159
Q

Trauma - Drowning

A
  1. Inability
  2. Risk
  3. Substance abuse
  4. Trauma
  5. Neglect
160
Q

Trauma -Facial Injury

A
  1. History
  2. Evaluate airway and neuro status
  3. Severity
  4. Priority of treatment
  5. Cosmesis and function
161
Q

Trauma - Hand and Wrist Injuries

A
  1. Tendons
  2. Nerves
  3. Joints
  4. Bones
162
Q

Trauma - Head Trauma and Transplant Donations

A
  1. Skull fracture
  2. Hemorrhage
  3. Contusion
  4. Edema
163
Q

Trauma - Nerve Injury

A
  1. Compression
  2. Contusion
  3. Laceration
164
Q

Trauma - Skin Wounds

A
  1. Laceration
  2. Puncture
  3. Crush
  4. Abrasion
165
Q

Trauma - Spinal Trauma

A
  1. Trauma
  2. Rupture
166
Q

Trauma - Urinary Tract Injuries

A
  1. Kidney
  2. Bladder
  3. Urethra (straddle injury, bike, monkey bars, pelvic fracture)
167
Q

Trauma - Vascular Injury

A
  1. Penetrating trauma
  2. Blunt trauma
168
Q

Polyuria (increased urination)
Polydipsia (increased thirst)

A

Adult:
1. Diabetes (look for low urine specific gravity)
2. Renal failure
3. Increased intake
4. Pyelonephritis
5. Medications

Child:
1. Diabetes
2. Conn’s syndrome
3. Anorexia
4. Renal failure
5. Addison’s

169
Q

Cystitis (syndrome of dysuria, urinary frequency and urgency, which is sometimes associated with suprapubic pain, and often found in the presence of pyuria)

A

Adult:
1. Kidney stones
2. Urinary tract infection
3. STI
4. Bladder carcinoma
5. Urethral strictures

Child:
1. UTI
2. Physical trauma
3. Psychological trauma
4. Vulvovaginitis
5. Urethritis

170
Q

Urinary Tract Obstruction

A

Adult:
1. Infection
2. Stone
3. Diabetes
4. Medication
5. BPH

Child:
1. Congenital
2. Ureterocele
3. Structural (narrowed/widened/misplaced urethra)
4. Stone
5. Inflammation???

171
Q

Uterine Prolapse

A

Adult:
1. Pregnancy
2. Neurogenic dysfunction
3. Genetic predisposition
4. Connective tissue disorder
5. Prior surgery

172
Q

Vaginal Bleeding

A
  1. Miscarriage
  2. Normal menstruation
  3. Neoplasm
  4. Trauma
  5. Endometriosis
  6. Trauma
  7. Abuse
  8. PCOS
  9. Pregnancy
  10. Benign growth
173
Q

Vaginal Discharge

A

Adult:
1. STI
2. UTI
3. Yeast infection
4. Normal variant
5. Menopause

Child:
1. Abuse
2. Yeast infection
3. Bacterial vaginosis
4. Contact vulvitis
5. HSV

174
Q

Acute Visual Disturbance

A

Adult:
1. TIA
2. Multiple sclerosis
3. Glaucoma
4. Trauma
5. Retina detachment

Child:
1. Traumatic retina detachment
2. Malingering
3. Uveitis
4. Corneal ulcer

175
Q

Chronic Visual Disturbance

A

Adult:
1. Glaucoma
2. Diabetic retinopathy
3. Macular degeneration
4. Persistent corneal ulcer
5. Cataract

Child:
1. Keratoconus
2. Strabismus
3. Corneal ulcer
4. Poor contact lens hygiene
5. Traumatic injury

176
Q

Vomiting

A

Adult:
1. GI upset
2. Pregnancy
3. Increased intracranial pressure
4. Sepsis
5. Drugs

Child:
1. Bowel obstruction
2. Appendicitis
3. Gall stones
4. Neoplastic
5. Food poisoning

177
Q

Weakness

A

Adult:
1. Muscular dystrophy
2. Myasthenia gravis
3. Encephalitis
4. Vascular
5. Degenerative

Child:
1. Infection
2. Traumatic
3. Drug toxicity
4. Allergic reaction
5. Hypoglycemic

178
Q

Weight Gain

A
  1. Diet
  2. Hormones
  3. Drugs/medications
  4. Sedentary lifestyle
  5. Psychological
179
Q

Weight Loss

A
  1. Neoplastic
  2. Eating disorder
  3. Drugs
  4. Excessive physical exercise
  5. Malabsorption

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