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Differentials 2.0 Flashcards

1
Q

S4

A

Sound made by atria filling hypertrophic ventricle causing turbulent flow, always abnormal

Left ventricular hypertrophy
Aortic stenosis
HTN
CAD
Cardiomyopathy

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2
Q

Cyanosis

A

Adult: Drug intoxication, choking, brain injury, cystic fibrosis, PE, high altitude

Child: Obstructed airway, asthma, RSV, Tetralogy of Fallot, hypothermia, seizure

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3
Q

Developmental Delay

A

Trisomy 21, toxins (drugs, fetal alcohol), autism, malnourished/neglect, brain tumor, cerebral palsy

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4
Q

Anxiety

A

OCD, social anxiety, GAD, panic disorder medications, separation

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5
Q

Upper GI Bleed

A

Adult: Epistaxis, esophageal varices, neoplastic, MW tear, ulcer

Child: Gastritis, ulcers, varices, coagulopathy

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6
Q

Abdominal/Pelvic Mass

A

Adult: Hepatocellular carcinoma, splenomegaly, appendicitis, fibroids, polycystic kidney, hepatitis, AAA

Child: Fecal impaction, intussusception, kidney, neoplastic (Wilm’s, renal cell carcinoma)

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7
Q

Diarrhea

A

Adult: Drugs/medication, food intolerance/dietary, IBS, C. dif, carcinoid tumor

Child: Food intolerance, laxatives, infections, medications, malabsorption

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8
Q

Constipation

A

Adult: Low fiber intake, neoplasm (colorectal cancer), pregnancy, drugs, hernia

Child: Diet, medication, cystic fibrosis, psychological, Hirschsprung’s

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9
Q

Diplopia

A

Adult: Stroke, brain tumor, cataracts, Bell’s palsy, CN palsy, traumatic, HTN, dislocated lens

Child: Strabismus, intracranial mass, thyroid abnormality, keratoconus, refractive error

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10
Q

Dizziness/Vertigo

A

Adult: Refractive error, benign paroxysmal positional vertigo, Meniere’s, neuronitis, zoster, stroke

Child: Ear infection, head trauma, acoustic neuromas, MS, panic disorder, seizures

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11
Q

Hypotension

A

Adult: Hemorrhage, heart failure, pneumothorax, aortic dissection, AAA, substance abuse

Child: Anaphylaxis, shock, drugs, Addison’s, dehydration

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12
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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13
Q

Dysphagia

A

Adult: Achalasia, neoplasm, neuromuscular (stroke), reflux, structural (Zenker’s, tumor, strictures)

Child: Mechanical obstruction, neoplasm, cleft lip/palate, swallowing disorders

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14
Q

Dyspnea

A

Adult: Lung cancer, asthma, COPD, PE ,CHF, MI, toxins

Child: Asthma, mechanical obstruction, panic attack/hyperventilation, anemia, CF

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15
Q

Ear Pain

A

Adults: TMJ, sinusitis, trauma (frost bite piercing), otitis media/externa, trigeminal neuralgia

Child: Otitis media, trauma, foreign body, abscess, cerumen impaction

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16
Q

Early Pregnancy Loss/Spontaneous Abortion

A

Drugs/toxins, chromosomal abnormality, PCOS, ectopic pregnancy, coagulopathy, uterine abnormalities

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17
Q

Edema (generalized)

A

Adult: Heart failure, nephritic syndrome, DVT, cirrhosis, pregnancy

Child: Nephritic syndromes, allergy, malnutrition, medication, cardiac failure, thyroid disorders

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18
Q

Hemoptysis

A

Adult: MW tear, AAA, lung infection, lung cancer, PE, TB

Child: Trauma, foreign body, AVM, bacterial pneumonia

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19
Q

Edema (Localized)

A

Adult: DVT, injury, infection, lymphedema

Child: Infection, injury, inflammation, allergy

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20
Q

Lower GI Bleed

A

Adult: Anorectal disease, colorectal cancer, trauma, enterocolitis

Child: C. dif, Hirschsprung’s, allergy, anal fissure

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21
Q

Erectile Dysfunction

A

Depression, alcohol, medications, drugs, diabetes

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22
Q

Eye Redness

A

Adult: EKC, corneal ulcer, bacterial infection, HSV keratitis, iritis, glaucoma

Child: Traumatic (eye rubbing), adenovirus, GPC, foreign body, blepharitis

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23
Q

Frailty in the Elderly

A

Dementia, delirium, medication, social (isolation, poverty, elder abuse), malnutrition, visual/auditory change, mobility

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24
Q

Breast Discharge

A

Prolactinoma, lactation, medication induced galactorrhea, mastitis, duct papilloma

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25
Q

Abdominal Distention

A

Adult: Hepatomegaly, fibroids, AAA, pregnancy, IBS, constipation, H pylori, bowel obstruction

Child: Volvulus, trauma, allergic, dietary, bowel obstruction

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26
Q

Failure to Thrive (infant)

A

Malnutrition, poor prenatal care, neglect, feeding problems (cleft lip/palate, malabsorption

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27
Q

Falls

A

Vertigo, syncope, malnutrition, decrease vision, choice of footwear, medication

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28
Q

Calcium Disorder

A

Adult: Renal insufficiency, hypoparathyroidism, malignancy, vitamin d deficiency

Child: Poor nutrition, malabsorption, medications

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29
Q

Abdominal Pain

A

Adult: Ulcer, appendicitis, colic, gastroenteritis, cholecystitis, pancreatitis

Child: Bowel obstruction, pyelonephritis, dietary, appendicitis

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30
Q

Fatigue

A

Adult: Malignancy, anemia, depression, stress, hypothyroid

Child: Psychosocial (poverty, poor living conditions, abuse), anemia

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31
Q

Genetic Concerns

A

Chromosomal, prenatal exposure, neural tube defects, auto dom/rec

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32
Q

Congenital Anomalies (Dysmorphic Features)

A

Trisomy 21, Turner’s, Fragile X, fetal alcohol, hypothyroidism

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33
Q

Glucose Abnormality

A

Adult: Diabetes, dehydration, diet, DKA, obesity, adrenal insufficiency, medication

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34
Q

Diabetes Mellitus

A

Type 1: autoimmune, idiopathic
Type 2: obesity, genetic, iatrogenic (medications)
Gestational: pregnancy

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35
Q

Headache

A

Adult: Migraine, tension, cluster, temporal arteritis, medication overuse, glaucoma, subarachnoid hemorrhage, carbon monoxide

Child: Meningitis, traumatic hemorrhage, medication, sinusitis, eye strain, post concussion

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36
Q

Health and Climate Crisis

A

Heat
Malnutrition
Infectious disease
Refugee and immigrants
Physical/social consequences

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37
Q

Contraception

A

Hormone
Barrier
IUD
Abstinence
Sterilization

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38
Q

Health of Special Populations

A

Homeless
Disabled
Immigrants
Poverty

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39
Q

Hearing Loss

A

Adult: Aging, cerumen, otitis media/externa, Meniere’s, medication (streptomycin, gentamycin, ASA)

Child: Foreign body, inner ear infection, perforation of tympanic membrane, vitamin deficiency, Alport’s

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40
Q

Cardiac Arrest

A

Adult: Coronary artery disease, conduction abnormalities, myocardial abnormalities, PE, hypothermia

Child: Structural abnormalities (Marfan’s, congenital), respiratory (pneumonia, bronchiolitis), infection (sepsis, meningitis), traumatic child abuse

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41
Q

Hemoglobin (Anemia)

A

Normocytic: cell loss, cell destruction, decreased production, chronic disease

Microcytic: iron deficiency, hemoglobinopathies

Macrocytic: vitamin b12 or folate deficiency, alcohol abuse

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42
Q

Hemoglobin Elevation

A

Elevated EPO (hypoxemia, EPO secreting tumor)
Decreased plasma volume
Polycythemia vera

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43
Q

Hypothermia management

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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44
Q

Urinary Incontinence

A

Adult: Dementia, UTI, stress, cystitis, outflow obstruction, immobility

Child: Anxiety, delayed development, UTI, diabetes

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45
Q

Fecal Incontinence

A

Adult: Cauda equina, rectal prolapse, colorectal cancer, IBS

Child: Anxiety, dietary, neurological

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46
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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47
Q

Immunizations

A
  1. Assess immunization status
  2. Recommend appropriate schedule
  3. Counselling
  4. Contraindications
  5. Special at risk groups
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48
Q

Jaundice

A

Adult: Hepatitis, alcoholic cirrhosis, gallstones, pancreatic carcinoma, hepatic carcinoma

Child: Hemolytic, Gilbert’s, hypothyroid, infection, biliary atresia

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49
Q

Back Pain

A

Adult: Muscle strain, disc herniation, vertebral fractures, cancerous metastasis, vertebral osteomyelitis, seronegative spondyloarthropathies, pancreatitis, AAA

Child: Trauma (falls, abuse), malingering, neoplastic mass

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50
Q

Ataxia

A

Adult: Neurological disorder (Parkinson’s, multiple sclerosis), traumatic, osteoarthritis, disc herniation, head injury, alcohol

Child: Neurological (cerebral palsy), stroke, toxins, neoplastic, vitamin b12 deficiency

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51
Q

Neck Pain

A

Adult: Disc herniation, muscle strain, whiplash, fracture, neoplasm, arthritis

Child: Meningitis, mumps, neoplasm, arthritis

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52
Q

Chest Pain

A

Adult: MI, angina, asthma, pneumothorax, drugs/toxins, GERD, costochondritis, shingles, AAA

Child: Stress/anxiety, hyperventilation, cardiac abnormality, fractured rib

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53
Q

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

A

Adult: Multiple sclerosis, overuse, depression, polymyalgia rheumatica, medications (statins), fibromyalgia

Child: Vitamin D deficiency, Guillan Barre, hypothyroid, connective tissue disorder (SLE, RA, PAN, etc)

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54
Q

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

A

Adult: Ankylosing spondylitis, osteoarthritis, osteoporosis, RA, psoriatic arthritis, hepatitis, giant cell arteritis, gout

Child: Rubella, connective tissue disease (SLE, PAN), spondyloarthropathies (AS, juvenile arthritis, Reiter’s), sickle cell

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55
Q

Coagulation Abnormalities

A

Adult: VWB, medication, cancer, traumatic (abrasion, laceration), platelet disorder

Child: Hemophilia A/B, vitamin deficiency, neoplastic, epistaxis

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56
Q

Coagulation Abnormalities

A

Adult: VWB, medication, cancer, traumatic (abrasion, laceration), platelet disorder

Child: Hemophilia A/B, vitamin deficiency, neoplastic, epistaxis

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57
Q

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

A

Adult: RA, osteoarthritis, fibromyalgia, polymyalgia rheumatica, septic arthritis

Child: Juvenile polyarthritis, SLE, fractures

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58
Q

Language and Speech Disorders

A

Adult: Head injury, Parkinson’s, loss of hearing, stroke, neck neoplasms

Child: Stuttering, deafness, autism, neglect/abuse, cleft lip/palate

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59
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
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60
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
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61
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
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62
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
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63
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
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64
Q

Limp in Children

A

Abuse, trauma, neuromuscular disorders, bone deformity, referred pain, tumor

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65
Q

Lump/Mass (Musculoskeletal)

A

Benign: Lipoma, epidermoid cysts, osteomyelitis, hematoma, rheumatoid nodules, granuloma

Malignant: sarcomas (leiomyosarcoma, Ewing’s sarcoma)

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66
Q

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

A

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

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

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67
Q

Mediastinal Mass

A

Adult: Thymoma, lymph nodes, esophageal abnormalities, cardiac tumor

Child: Ectopic thyroid, teratoma, lymphadenopathy, meningomyelocele, cystic hygroma

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68
Q

Menopause

A

12 months of amenorrhea
Give HRT for symptom control of hot flashes (beneficial effects on bone mineral density but increases risk of breast cancer after 5-7 years)

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69
Q

Amenorrhea

A

Adult: Pregnancy, menopause, PCOS, premature ovarian insufficiency, rapid weight loss

Teen: Pregnancy, PCOS, hypothalamic dysfunction, ovulatory dysfunction, OCP, anorexia

70
Q

Oligomenorrhea (infrequent less then 6-8 periods per year)

A

Adult: Premature ovarian insufficiency, fibroids, endometritis, PCOS, polyps

Teen: Breakthrough bleeding on OCP, cervical polyp, coagulopathy (VWB)

71
Q

Dysmenorrhea (painful periods)

A

Endometriosis, chronic PID, IUD, polyp, cysts, cervical stenosis, adenomyosis

72
Q

Premenstrual Dysphoric Disorder (Approach)

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
73
Q

Abnormal Heart Sounds and Murmurs

A

Adult: Stenotic or regurgitant valve, mitral valve prolapse, endocarditis, pericarditis, MI

Child: Innocent murmur, bacterial endocarditis, transposition of the great arteries, hypoplastic left heart syndrome, ASD

74
Q

Coma

A

Adult: Trauma (MVA, attack), stroke, cardiac arrest, respiratory arrest, intoxication, uremia

Child: Shock, trauma, seizure, hypoglycemia (look for preceding somnolence), neoplastic (look for loss of milestones in recent weeks), encephalitis

75
Q

Delirium

A

Adult: Dehydration, Bipolar, neuroleptic malignant syndrome, drugs/toxins, neurosyphilis

Child: Viral or bacterial infection (pneumonia), antihistamine or other med side effect, concussion, high fever, hypoglycemic

76
Q

Mental Status - Neurocognitive Disorders and Dementia

A

Adult: Alzheimer’s, vascular dementia, brain trauma, drugs/medications/toxins, Parkinson, intracranial mass, infections

77
Q

Depressed Mood

A

Adult: Major depressive disorder, bipolar, drugs/toxins, medication, hypoglycemic, grief, PTSD

Child: Anxiety, malnourished, bullying/abuse, poor living conditions, drugs/toxins

78
Q

Mania/Hypomania

A

Adult: Bipolar, substance abuse, cyclothymic, other medical conditions, TBI, neurosyphilis, heavy metal poisoning, substance withdrawal, borderline

Child: Bipolar, TBI, thyroid disorders, ADHD, schizophrenia

79
Q

Abnormal Liver Function Tests

A

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

Adult: Hepatitis, hepatocellular carcinoma, cirrhosis, alcoholism, live failure, biliary obstruction, pregnancy, gallstones

Child: Gibert’s, renal disease, medications, autoimmune, Celiac, virus

80
Q

Involuntary Movement or Tic Disorders

A

Adult: Parkinson, Wilson’s, Huntington’s, Tourette’s, substance abuse, essential tremor, myoclonus

Child: Tourette’s, autism, infection, MS, medication

81
Q

Goiter

A

Adult: Thyroid disease (Grave’s), lymphadenopathy, salivary gland tumor, vascular aneurysm,

Child: Thyroid disease (Hashimoto’s), infectious mononucleosis, cyst

82
Q

Neonatal Distress

A

Premature, maternal medications, decreased respirations, heart disease, infection

83
Q

Numbness/Tingling

A

Adult: Peripheral neuropathy, medications, Raynaud’s, spinal stenosis/osteoarthritis/osteoporosis, MS, HSV

Child: Toxins, nerve trapping (disc herniation?), spinal mass

84
Q

Obsessive Compulsive Disorder

A

Childhood abuse, anxiety, depression, substance abuse, infection

85
Q

Oral Conditions

A

Adults: Candidiasis, drugs (meth), xerostomia, malignancy

Child: Dental abscess/caries, cleft lip/palate, lichen planus, carcinoma

86
Q

S3

A

Sound made from the filling of compliant left ventricle

Congestive heart failure, MR, TR
Can be normal in pregnancy and athletes

87
Q

Central/Peripheral Neuropathic Pain

A

Adult: Fibromyalgia, MS, diabetic peripheral neuropathy, disc herniations or spinal mass, nerve entrapment, post herpetic

Child: Neurotoxic drugs, MS, TBI, spinal mass or abnormality

88
Q

Generalized Pain Disorders

A

Adult: Fibromyalgia, polymyalgia, depression, arthritis (?)

Child: Munchausen’s, malingering, growing pains, mitochondrial disease, adjustment disorder

89
Q

Palpitations

A

Adult: Medications, CHF, MI, a fib, PE, sepsis/shock, pheochromocytoma/carcinoid, pregnancy

Child: Substance abuse, anxiety, caffeine, thyrotoxicosis, WPW, dehydration

90
Q

Crying Child

A

Colic, food intolerance, infection, reflux, discomfort, teething, constipation, intussusception, hunger

91
Q

Acid Base Abnormality

A

Metabolic acidosis: methanol, kidney injury, ketoacidosis
Metabolic alkalosis: mineralocorticoid excess, vomiting, diuretic
Respiratory acidosis: hypoventilation, drug use, asthma
Respiratory alkalosis: hypoxemia, hepatic failure, PE

92
Q

Hypotonic Infant

A

Premature, infection, hypoglycemic, spinal muscle atrophy, congenital myopathy , systemic (sepsis, dehydration), genetic (Prader Willi)

93
Q

Pelvic Pain

A

Adult: Pyelonephritis, ectopic pregnancy, pregnancy, endometriosis, PID, UTI, IBS, hernia

Child: Colic, UTI, constipation, appendicitis

94
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
95
Q

Preventative Health - Newborn Assessment

A
  1. Maternal and perinatal history
  2. Psychosocial history
  3. Screen for acute illness and congenital malformations
  4. Caregiver concerns
  5. Specialized care
96
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
97
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
98
Q

Personality Disorders

A

Cluster A MAD
Paranoid, schizoid, schizotypal

Cluster B BAD
Antisocial, borderline, histrionic, narcissistic

Cluster C SAD
Avoidant, dependent, OCD

99
Q

Pleural Effusion (fluid in pleural space)

A

Adult: Heart failure, cirrhosis, nephrotic syndrome, trauma, malignancy, pneumonia, chylothorax (damaged thoracic duct)

Child: Infection (pneumonia, bacterial, etc), congestive heart failure, malignancy, post surgical, nephrotic syndrome, trauma

100
Q

Poisoning

A

Household cleaner, anticholinergic, alcohol, sedatives, analgesics, SSRIs, beta blockers

101
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
102
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
103
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

104
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
105
Q

Population Health and Its Determinants - Environment

A
  • Identify common environmental hazards
  • How to perform risk assessment
  • Regulatory agencies
  • Interventions
  • Communication to community
106
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
107
Q

Population Health and Its Determinants - Interventions at the Population Level

A
  • Levels of prevention
  • Community needs
  • Understand role as physician
  • Public policy
108
Q

Population Health and Its Determinants - Outbreak Management

A
  • Characteristics and management of an outbreak
  • Risk factors
  • Communication skills
  • Preventing or reduce risk
109
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)
110
Q

Hyperkalemia

A

Adult: Acidosis, insulin deficiency, beta blockers, tumor lysis, renal failure, hyperaldosteronism, medications

Child: Burns/trauma/tumor lysis syndrome, kidney disease, increased intake (IV or oral or transfusions), Addison’s, acidosis

*Look for peaked T waves in moderate and flatted P with wide QRS in severe
* Alters the resting membrane potential so that cells do not repolarize leading to muscle paralysis
*Tx:
Protect heart: calcium gluconate
Shift K+ into cell: D50W + insulin, NaHC03, salbutamol
Remove K+: fluids + furosemide, dialysis

111
Q

Hypokalemia

A

Adult: Insulin excess, excessive sweating/dehydration, DKA, RTA, medications, alcoholic, diuretics

Child: Starvation, vomiting, kidney disease, diarrhea, laxatives

*Look for lengthened PR, ST depression, T inversion and appearance of U

112
Q

Pregnancy - Intrapartum and Postpartum Care

A
  • History and physical
  • Emotional and psychosocial needs
  • Onset, stages and progression
  • Complications
  • Management plan
113
Q

Pregnancy - Prenatal Care

A
  • Informed decision making
  • Counselling (vitamins, smoking cessation, weight management)
  • Risks
  • Genetic counselling
  • Partner violence
  • Preterm labor
114
Q

Prescribing Practices

A
  • History
  • Contraindications
  • Writing a prescription clearly
  • Communicating with patient to ensure adherence
  • Care given their socioeconomic status
115
Q

Preterm Labor

A
  1. Substance abuse
  2. Placental abruption
  3. Infection
  4. Neonatal distress
  5. Eclampsia
116
Q

Proteinuria

A

Adult: Nephrotic syndrome (membranous GN), SLE, diabetes, HIV, malignancy, multiple myeloma

Child: Nephrotic syndrome (minimal change), meds (NSAIDS, penicillin), ATN, rhabdomyolysis, dehydration

117
Q

Pruritis

A

Adult: Liver disease, allergy, iron deficiency, uremia, cholestasis, carcinoid

Child: Allergy, psoriasis, scabies, eczema, dry skin, congenital jaundice, parasite

118
Q

Psychosis

A

Adult: Substance abuse, high fever or infection, psychiatric disorder (bipolar, schizophrenia), hypoglycemia, brain injury

Child: Substance abuse, medication, brain malignancy, seizure, malnutrition

119
Q

Acute Renal Failure

A

Adult: Medication, diabetes, trauma, shock, RAS, kidney stone, bladder obstruction

Child: HUS, sepsis, toxins, glomerulonephritis, TTP, kidney tumor

120
Q

Chronic Renal Failure

A

Adult: HTN, diabetes, obstruction

Child: Toxins, PKD, kidney dysplasia

121
Q

Scrotal Mass

A

Adult: Hernia, cyst, hydrocele, post surgical swelling, testicular tumor

Child: Mumps orchitis, testicular torsion, varicocele, traumatic hematoma

122
Q

Scrotal Pain

A

Adult: Torsion, tumor, cellulitis, referred pain from ureteric stone

Child: Acute orchitis, cyst, undescended testes, idiopathic, HSP,

123
Q

Seizure/Epilepsy

A

Adult: Infection, diabetes, brain neoplasm, medication, withdrawal, meningitis

Child: Febrile seizure, infection, drug induced, head trauma, toxins

124
Q

Sexual Dysfunction

A

Erectile dysfunction (depression, diabetes, spinal cord injury, beta blocker, aging)
Genito-pelvic pain (menopause, endometriosis, PID)
Substance/medication induced
Gender dysphoria
Sexual disorders (arousal disorders, anorgasmia, paraphilic disorders)

125
Q

Abnormal Pubertal Development

A

Chromosomal abnormality, androgen dysfunction, malnutrition, HP axis dysfunction

126
Q

Skin Rash - Urticaria & Angioedema

A

Adult: Medication, allergic reaction, serum sickness, cold (Raynaud’s), mastocytosis

Child: Allergic reaction, toxins, insect bite, C1 esterase inhibitor mutation

127
Q

Skin and Integument Conditions

A

Erythema: Cellulitis, gout, burns, rosacea
Macules: Allergy, drugs, sun freckle, chloasma, measles
Nodule: Wart, lipoma, cyst, BCC, xanthoma
Hirsutism: PCOS

128
Q

Abnormal Serum Lipid

A

Adult: Hypercholesterolemia, obesity, diabetes, cigarette smoking, chronic kidney disease, liver disease

Child: Sedentary lifestyle, familial hypercholesterolemia, steroid therapy, diabetes,

129
Q

Sleep Wake Disorders

A

Adult: Anxiety, PTSD, sleep apnea

Child: Anxiety, abuse, poor environment

130
Q

Hypernatremia

A

Adult: Dehydration, vigorous exercise, high fever, central diabetes insipidus, quick IV infusion,

Child: Kidney disorder (nephrogenic diabetes insipidus), poor diet, meds (lithium)

131
Q

Hyponatremia <136

A

Adult: 3rd spacing, diuretics, adrenal insufficiency, SIADH, cirrhosis, renal failure

Child: Hypothyroid, stress, renal failure

132
Q

Somatic Symptoms

A

Adult: Malingering, fibromyalgia ,substance abuse, PTSD, undiagnosed condition

Child: Physical abuse, anxiety, major life change, drug abuse

133
Q

Sore Throat and Rhinorrhea

A

Adult: Common cold, COVID, strep throat

Child: Sinus infection, tonsillitis, URTI, croup, allergy

134
Q

Short Stature

A

Chromosomal abnormality, maternal toxins, medications (steroids), malnutrition, IUGR, low birth weight

135
Q

Tall Stature

A

Hereditary, connective tissue disorder (Ehlers’s Danlos, Marfan’s), acromegaly, Klinefelter’s (46 XXY), precocious puberty

136
Q

Strabismus and Amblyopia

A

Adult: Trauma, cataract, CNS tumor

Child: Muscular deficit, cerebral palsy, brain tumor, thyroid eye disease

137
Q

Substance Use and Addictive Disorders

A

Childhood trauma, family history, mental illness, chronic pain, psychosocial

138
Q

Allergic Reactions

A

Drugs, allergens, toxins, insect bites, dust

139
Q

SIDS

A

Young maternal age, smoking, alcohol abuse, poor perinatal care, sleep position, sleep environment

140
Q

HTN

A

Adult: Apnea, renal disease, carcinoid tumor, drugs, diet, pheochromocytoma, sedentary, old age, primary hyperaldosteronism, Cushings

Child: Obesity, diet, smoking, fibromuscular dysplasia, medications, neuroblastoma

141
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

Infectious, missed diagnosis, epilepsy, metabolic

142
Q

Suicidal Behavior

A

Psychiatric psychosocial, substance abuse, malingering

143
Q

Syncope and Pre Syncope

A

Cardiac arrest, hypovolemia, shock, hypoglycemia, stress, medication

144
Q

Hematuria

A

Adult: UTI, bladder tumor, kidney stones, BPH, exercise

Child: Medications, food, infection, coagulopathy, HSP, UTI, PSGN

145
Q

Fever and Hyperthermia

A

Adult: Infection, hypoglycemia, heat stroke, drugs

Child: URTI, gastroenteritis, otitis media, tonsillitis

146
Q

Fever in Immunocompromised Individuals

A

Host deference (HIV, steroids, congenital), anatomic (surgery, burns), other (diabetes, splenectomy)

147
Q

Hypothermia and Cold Related Injuries

A

Cold injury, alcohol

148
Q

Tinnitus

A

Adult: Earwax, hearing loss, Meniere’s, head injury, medication overdose, TMJ

Child: Medications, ear infection, labyrinthitis, migraine

149
Q

Polyuria & Polydipsia

A

Adult: Diabetes, renal failure, increased intake, pyelonephritis, medications

Child: Conn’s, diabetes, anorexia, renal failure

150
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: Stones, UTI, STI, bladder cancer, urethral strictures

Child: UTI, physical trauma, vulvovaginitis, urethritis

151
Q

Urinary Tract Obstruction

A

Adult: Stone, malignancy, infection, diabetes, meds

Child: Structural, stone, uretocele

152
Q

Uterine Prolapse

A

Pregnancy, neurogenic dysfunction, genetic predispositon, connective tissue disorder, prior surgery

153
Q

Vaginal Bleeding

A

Adult: Miscarriage, menstruation, neoplasm, trauma, endometriosis

Child: Trauma, abuse, PCOS, pregnancy, benign growth

154
Q

Vaginal Discharge

A

Adult: STI, UTI, yeast infection, normal variant, menopause

Child: Abuse, yeast infection, contact vulvitis, HSV

155
Q

Acute Visual Disturbances

A

Adult: TIA, MS, glaucoma, trauma, retina detachment

Child: Retina detachment, uveitis, corneal ulcer

156
Q

Breast Mass

A

Cancer, medication, benign, endocrine disorders, infection, lactation

157
Q

Chronic Visual Disturbance

A

Adult: Glaucoma, DR, MD, cataract, corneal ulcer

Child: Keratoconus, strabismus, corneal ulcer, poor CL hygiene, traumatic injury

158
Q

Vomiting

A

Adult: Bulimia/anorexia, gall stones, increased ICP (mass, CVA, etc), GERD, IBD

Child: Overfeeding, esophageal atresia, intestinal obstruction, systemic infection

159
Q

Weakness

A

Adult: Intoxication, medication, aging, infection, neurological condition

Child: Infection, trauma, hypoglycemia

160
Q

Weight Gain

A

Adult: Obesity, hypothyroid, pregnant, alcohol

Child: Sedentary lifestyle, poor diet, edema, medication, PCOS, neglect

161
Q

Weight Loss

A

Adult: Exercise, eating disorder, neoplastic, chronic infections (HIV, parasitic), poverty

Child: Anorexia, bulimia, malnourished, neoplasm, hyperthyroid, malabsorption, neglect

162
Q

CVA and TIA

A

Adult: Aneurysm rupture, HTN, trauma, cocaine, atherosclerosis, fibromuscular dysplasia, endocarditis

Child: Seizure, meningitis, trauma, tumor, embolism

163
Q

Cough

A

Adult: Asthma, medication, COPD, lung tumor

Child: URTI, aspiration, rhinitis, exposure to irritants, obstruction

164
Q

Amenorrhea and Oligomenorrhea

A

Menopause, ovulatory dysfunction, hypothalamic dysfunction, cervical stenosis, lifestyle change (low weight, nutrition)

165
Q

Hypertension

A

Adult: Essential HTN (cause unknown), medications, diet, atherosclerosis, RAS, OSA, kidney disorders

Child: Cushing Syndrome, pheochromocytoma, hyperthyroid, acromegaly, coarctation of the aorta

166
Q

Hypotension

A

Adult: Diarrhea, vomiting, dehydration, anemia, MI, medications

Child: Starvation, endocrine disorders, fluid loss, hemorrhage

167
Q

Breast Discharge

A

Adult: Pregnancy, papilloma, mastitis, OCP

Child: Pituitary adenoma, Paget’s, PCOS

168
Q

Ataxia

A

Adult: Substance abuse, alcohol, medication, neurological dysfunction (Parkinson’s), hydrocephalus, MS, stroke

Child: Myasthenia gravis, medication, traumatic bleed, brain mass

169
Q

Calcium Disorders

A

Adult: Parathyroid neoplasm, autoimmune, lung cancer, acidosis

Child: Malabsorption, malignancy, vitamin D, medications

170
Q

Acid Base Abnormality

A

Adult: DKA, vomiting, drugs, hypoventilation, methanol

Child: Diarrhea, drugs, pneumonia, renal disorder

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