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Differential Diagnosis > Exam I > Flashcards

Exam I Flashcards

1
Q

what is pruritus?

A

itching

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2
Q

what is utricaria?

A

hives

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3
Q

what is xeroderma?

A

extreme dryness of the skin

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4
Q

what causes nail clubbing?

A

pulmonary conditions (80% of the time)

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5
Q

what causes Leukonychia of nails? (3)

A

(1) alcohol
(2) nutrition defects
(3) MI

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6
Q

what causes Splinter

hemorrhages of nails?

A

endocarditis

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7
Q

what causes Koilonychia (spoon) of nails? (3)

A

(1) anemia
(2) thyroid
(3) syphilis

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8
Q

what causes Beau’s lines in nails? (3)

A

(1) alcohol
(2) nutrition defects
(3) MI

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9
Q

what causes nail pitting?

A

psoriasis

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10
Q

what causes nail thickening?

A

poor circulation

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11
Q

what causes melanoma in nails?

A

malignance

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12
Q

the butterfly rash occurs with what condition?

A 
lupus erythematosus (systemic)
(NOT CHRONIC INTEGUMENTARY LUPUS)
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13
Q

what are the ABCs of screening for skin cancer?

A 
Asymmetry: unequal
Border: irregular
Color: multiple colors
Diameter: > 6mm
Elevation / Evolution: elevation or quick changes
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14
Q

what is the most common and slowest metastasizing type of skin cancer?

A

basal cell carcinoma

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15
Q

what is the second most common type of skin cancer?

A

squamous cell carcinoma

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16
Q

where do 80% of squamous cell carcinoma lesions occur?

A

head and neck regions

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17
Q

what is the most severe and fastest metastasizing skin cancer?

A

melanoma

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18
Q

what is psoriasis? what is the most common complaint?

A

(1) chronic skin disorder; red patches covered by dry silvery scales
(2) itching

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19
Q

what is systemic

sclerosis? what population is more affected?

A

(1) connective tissue disease that causes fibrosis of skin, joints, blood vessels, and organs
(2) women 2-3x more than men

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20
Q

what is lyme disease? how do patients present?

A

(1) infection caused by a deer tick

(2) fever, headache, stiff neck; may only present with shoulder or knee pain initially

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21
Q

what is herpes zoster? what are the symptoms?

A

(1) shingles; caused by varicella-zoster virus

(2) pain and tingling along affected spinal or cranial nerve dermatome; fever, chills, GI problems

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22
Q

what is rosacea?

A

a form of adult acne

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23
Q

what is tinea corporis?

A

ringworm

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24
Q

what is palmar erythema commonly caused by?

A

hepatic disorders

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25
Q

how can you differentiate between anxiety and stress?

A

panic and fear are associated with anxiety

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26
Q

what are the DASS and GDS scales? what are scores that require referral?

A

(1) Depression, Anxiety and Stress Scale (scores >7 in any sub scale require referral)
(2) Geriatric Depression Scale (6 or >)

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27
Q

what are the 6 types of somatoform disorders?

A

(1) somatization
(2) undifferentiated
(3) hypochondriac
(4) somatoform pain disorder (5) body dysmorphic disorder
(6) conversion disorder

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28
Q

what demographic has the lowest suicide rates?

A

African American females

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29
Q

what are the 5 types of anemia?

A

(1) iron deficiency
(2) anemia caused by inflammation
(3) aplastic anemia
(4) renal insufficiency
(5) megaloblastic anemia (lack of vitamin B12)

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30
Q

what is the most severe type of anemia?

A

aplastic (type III)

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31
Q

what is often the first symptom of aplastic anemia?

A

bleeding

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32
Q

what anemia is due to synthesis of abnormal hemoglobin?

A

sickle cell anemia

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33
Q

what type of anemia is due to decreased synthesis of structurally normal hemoglobin?

A

thalassemia

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34
Q

what form of sickle cell is more severe?

A

homozygotes

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35
Q

what does sickle cell anemia put the patient at risk for?

A

increased clotting puts the patient at increased risk for stroke

36
Q

which type of thalassemia is the most severe?

A

homozygotes

37
Q

what are the normal hemoglobin and hematocrit values in males and females?

A

MALES
Hgb: 13-17
Hct: 39-49

FEMALES
Hgb: 12-16
Hct: 36-48%

38
Q

what is polycythemia? what are the two types and what causes them?

A

increased hematocrit and hemoglobin
Types
I. primary: early bone morrow precursor cells
II. secondary: increased erythropoietin

39
Q

what is a common physical finding with polycythemia?

A

pressure in left upper quadrant due to an enlarged spleen

40
Q

what are common complications of polycythemia?

A

increased clot formation: stroke, MI, DVT, life threatening hermorrhage of upper GI tract

41
Q

what is thrombocytopenia?

A

decreased number of platelets

42
Q

what is nadir?

A

lowest point of WBC count following chemotherapy (usually occurs 7-14 days)

43
Q

what are normal INR levels? what INR level is at risk for hemarthrosis?

A

(1) normal: 0.8-1.2

(2) at risk: >3

44
Q

what are the two types of hemophilia?

A

(1) type A: hereditary (x-chromosome linked)

2) type B: acquired (liver failure, vitamin K deficiency, coumadin therapy

45
Q

what is the difference in clinical presentation between platelet disorders and clotting factor deficiencies?

A

(1) platelet disorder: bleed in superficial sites

(2) clotting factor: bleeding into muscles, joints, and cavities

46
Q

what is the most common finding with hemophilia? where does this usually occur?

A

(1) hemarthrosis (muscle bleeding 2nd most common finding)

2) knee, shoulder, hip, ankle elbow (larger joints

47
Q

what type of angina do women usually have and where does it present?

A

(1) microvascular disease

(2) localized to chest and mid back

48
Q

what type of angina do men usually have and where does it present?

A

(1) coronary artery disease

(2) pain that radiates into the shoulder, traps, and down the arm

49
Q

what is the difference between stable and unstable angina?

A

stable: predictable
unstable: can occur anytime, during sleep, throughout day etc.

50
Q

what is orthopnea?

A

shortness of breath while lying down

51
Q

what is syncope?

A

fainting

52
Q

what is vasovagal syncope?

A

fainting due to very strong parasympathetic response

53
Q

what are abnormal vital signs for CVD with exercise?

A

(1) systolic BP that doesn’t increase with intensity
(2) systolic BP that falls during exercise
(3) increased in diastolic BP >15-20 mm Hg

54
Q

with patients taking beta blockers, how is exercise prescribed?

A

RPE

55
Q

what is myalgia?

A

myotoxic event associated with statins

56
Q

what is rhabdomyolysis associated with?

A

impaired renal and liver function

57
Q

what are classic signs of liver impairment?

A

dark urine, white stools, asterixis (liver flap), bilateral carpal tunnel syndrome, ascites

58
Q

what is the most common symptom of HTN?

A

headache

59
Q

what is considered HTN?

A

> 140 systolic

>90 diastolic

60
Q

what is the number 1 risk factor that predisposed a person to CHF?

A

hypertension

61
Q

what is orthostatic hypotension?

A

(1) decrease of systolic BP by 20 mm HG or more

(2) decreased systolic and diastolic BP by 10 mm Hg AND increased HR by 15bpm

62
Q

what is a common MSK symptom of infective endocarditis?

A

(1) arthralgia (joint pain) most commonly the shoulder

(2) 1/3 of these patients have low back pain

63
Q

what can pericarditis mimic?

A

MI (pain radiates to the left shoulder)

64
Q

how do you differntiate between pericarditis and MI?

A

patient position wont be affected by MI; leaning forwards or going to all 4s makes pericarditis pain decrease

65
Q

what is an aneurysm?

A

stretching of the wall of an artery (50% greater than normal); most common site for arterial aneurysm is the aorta

66
Q

what are the most common symptoms of abdominal aorta aneurism?

A

(1) pulsating mass in abdomen (with or without pain)

(2) abdominal and back pain

67
Q

where do 95% of aortic aneurysms occur?

A

just below the renal arteries near the belly button

68
Q

who is at a higher risk for abdominal aorta aneurism?

A

(1) males

(2) congenital heart defects / diseases

69
Q

how is well’s clinical prediction rule for DVT graded?

A

0 - less than 5% chance of DVT
1-2 - 25% chance of DVT
3+ - 50% chance of DVT

70
Q

what are O2 saturation ranges required for exercise?

A

D/C exercise if O2 falls below:

  • 90% for medically monitored patients
  • 92% for outpatient
71
Q

what should O2 levels be at rest?

A

> 96% in young / adults at rest

>94% for healthy elderly at rest

72
Q

when should you send a patient for immediate referral with the use of nitroglycerin?

A

15-20 minutes if angina doesn’t subside following administration of nitroglycerin

73
Q

what is the most powerful risk factor for stroke?

A

HTN (>140mm Hg)

74
Q

what is the difference between hypoxemia and hypoxia?

A

hypoxemia: deficient oxygenation of arterial blood
hypoxia: diminished availability of oxygen to the body tissues

75
Q

what is hemoptysis?

A

coughing up blood

76
Q

what is hypercapnia?

A

a condition that decreases ventilation increases the retention of CO2

77
Q

what is pneumothorax?

A

collapsed lung; causes mediastinal shift towards unaffected side

78
Q

what is the primary symptom of pneumothorax?

A

dyspnea

79
Q

what is the most common symptom of GI disease? what is the 2nd most common?

A

(1) abdominal pain (including heart burn)

(2) nausea

80
Q

why do some people have back pain with constipation?

A

muscle guarding

81
Q

what is the difference in abdominal exam between diverticulitis and appendicitis?

A

(1) diverticulitis presents usually in left lower quadrant

(2) appendicitis usually presents in the right lower quadrant

82
Q

what does the heel jar test for?

A

peritonitis and appendicitis

83
Q

what MSK disorder can Crohn’s disease cause?

A

arthritis

84
Q

what is the most common GI problem?

A

IBS

85
Q

what is Kern’s sign most commonly associated with?

A

ruptured spleen or bleeding in peritoneal cavity

Differential Diagnosis (2 decks)

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