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Physical Diagnosis II > Final-Differential Diagnosis Phys Di 1/2 > Flashcards

Final-Differential Diagnosis Phys Di 1/2 Flashcards

1
Q

Adult with recurrent substernal heartburn post heating

  • worse lying down at night
  • endoscopic exam to confirm
A

GERD

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2
Q

What sign is positive in chronic cholecystitis

A

Murphy’s

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3
Q

Low substernal chest pain that radiates through to back. Worse when stomach is empty. Food/antacids relieve pain. Dark, bloody, tarry stools due to long term use to NSAIDS>

A

Peptic ulcer

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4
Q

When must toxin assay be done?

A

Clostridium difficile colitis

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5
Q

Sudden onset, persistent fever, muscle aches (myalgia) with positive serologic tests-clinical differentiation may be possible

A

Influenza

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6
Q

Info on IBS

A

Late adolescence/early adulthood

under 50

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7
Q

Better sitting up and leaning forward

A

Pericarditis

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8
Q

Least common hernia

A

Femoral hernia

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9
Q

X-ray: barrel chest, increased retrosternal airspace, horizontal ribs, narrowed heart shadow, dark lung fields

A

Emphysema

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10
Q

Central vision loss, blurred vision (MC). Hazy appearance on cornea. No pain

A

Corneal scar

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11
Q

MC virus for pink eye

A

Adenoids virus

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12
Q

Insidious tunnel vision over many years. 40+.

A

Chronic Glaucoma

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13
Q

Pertussis aka

A

Whooping cough

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14
Q

Photophobia in ONE EYE. Pupillary responses sluggish in that eye. Secondary to trauma, AS** and infection

A

Acute iritis/anterior uveitis

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15
Q

Post trauma flashes and floaters, central vision preserved if macula intact. Flashes of light. Progressive curtain

A

Retinal detachment

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16
Q

MC hernia

A

Indirect inguinal hernia

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17
Q

Low substernal RUQ chest pain following fatty meals and may radiate to right scapula. Positive Murphy’s sign. X-ray comfirms. MC due to obstruction of what?

A

C. Cholecystitis

MC due to cystic duct obstruction from gallstones

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18
Q

MC cause of a. Gastroenteritis

A

Rotavirus in infants/children

Norovirus in adults

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19
Q

Lesion in geniculocalcarine tract

A

Homonymous contralateral hemianopia with macular sparing

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20
Q

Colon ca

A

Pencil thin stools/change in bowel habits
Obese males 50+
Colicky abdominal pain

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21
Q

Abdominal pain and vomiting, jaundice, tea colored/dark urine with gray/clay colored stools. AST, ALT and alkaline phosphates levels high

A

Hepatitis

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22
Q

Triphasic friction rub

A

Pericarditis

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23
Q

Redness, intense burning itching persistent or seasonal episodes.

A

Allergic conjunctivitis

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24
Q

50+ cigarette smoke or pollution. Weight loss with persistent cough and blood.

A

Bronchogenic neoplasm

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25
Q

Chronic dilation of bronchi or bronchioles with large amounts of sputum. Due to repeate infections. 50% = cystic fibrosis

A

Bronchiectasis

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26
Q

Burning, gnawing pain

Epigastric pain 2-3 hours after eating spicy, or fatty foods or alcohol

A

Duodenal ulcer

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27
Q

Positive markle, rovsing, Blumberg, psoas, obturator signs

A

Appendicitis

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28
Q

40+ slow central vision loss in one or both eyes. Central opacity of shadow in red reflex. Age, DM, tobacco, alcohol, steroid risks

A

Central cataract

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29
Q

Pain, swelling, redness in Canal. Hearing MC normal. Irritate canal my excessively cleaning or water.

A

Ottis externa/swimmers ear

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30
Q

Ulcerative colitis

A

20-30 bloody,pus stools per day

Young

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31
Q

MC men 40+ with vague pain that’s worse when coughing, sneezing.straining near groin

A

Direct inguinal hernia

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32
Q

Ear pain and clutching ear. Feeling of fullness, fever, fluid drainage. Red and bulging eardrum, with purulent discharge MC in preschoolers.

A

Suppurations otitis media

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33
Q

Genetic disorder causing breakdown and loss of cells in retina. Rods affected first. Night blindness, loss of acuity, insidious tunnel vision. Black bone-spicule pigmentation

A

Retinitis pigmentosa

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34
Q

Rusty sputum and bronchophony (spoken sounds transmitted better through consolidation). Increased fremitus and dull percussion. Affects one.

A

Lobar pneumonia

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35
Q

Lesion of optic tract

A

Homonymous contralateral hemianopia

Loss of opposite side field in both eyes. Lesion right. Loss of left field in both eyes.

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36
Q

Normal or yellow or dark TM with air bubbles/fluid line. Weber lateralizes to and rinne negative. Fullness, pressure, popping with swallowing

A

Serious otitis media/ otitis media with effusion

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37
Q

Poor sanitation and water purification leading to vomit/diarrhea watery stool. Fatal within 24 hours due to dehydration and hypovolemic shock

A

Cholera

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38
Q

Occlusion of pulmonary A. Prolonged sitting or rest. MC due to clots in legs that travel to lungs. Continuous chest pain. Crackles/wheezes

A

PE

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39
Q

Elderly who complain that people mumble. rinne AC>BC less than 2:1. Both early equally. High frequency are first to go

A

Presbycusis

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40
Q

Sudden epigastric pain with FEVER AND VOMITING. Fetal position may help.

A

Pancreatitis

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41
Q

Glandular autodigestion

A

Pancreatitis

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42
Q

Inflammation of large airways often secondary to an URI
Presents with crackles, wheezes, rhonchi

NORMAL FREMITUS/PERCUSSION

A

A. Bronchitis

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43
Q

Worse when stomach is empty and antacids/food help

A

Peptic ulcer

44
Q

Altered color/configuration of macula. Central vision loss. Positive ampler grid. Druses bodies. Leading cause of vision loss.

A

Macular degeneration

45
Q

Seen with blunt or penetrating trauma. Decreased breath sounds and decreased fremitis. Hyperresonance with percussion. Tracheal deviation AWAY from involved side.

A

Tension pneumothorax

46
Q

Presents as cold at first then high fever and lop like spots and maculopapular rash

A

Measles/rubeola

47
Q

Aka swimmers ear

A

Otitis externa

48
Q

Pleurisy aka

49
Q

Pain, hearing difficulties, feeling of fullness, tinnitus, allergies and common cold MC cause. retracted TM. Secondary to URI, swollen adenoids, NO inflammation. MC children (smaller shorter more horizontal)

A

Eustacian tube blockage

50
Q

Older adults with watery diarrhea 3x/day 2+ days MC after antibiotic use

A

Clostridium difficile colitis

51
Q

4x M. Result of atherosclerosis, tobacco, HTN, may be present with LBP, severe tearing/ripping pain

A

Dissection aneurysm

52
Q

Blurred vision, halo, nausea, vomiting. 90% open-angle. Large cup to disc ratio. Peripherally displaces vessels, pale white disc and pigment surrounding disc.

A

A. Glaucoma

53
Q

Drinking while lying down causes in infants

A

Suppurations otitis media

54
Q

Pulsation tinnitus

A

Sound matches heartbeats

55
Q

Female with pain in femoral triangle. MC on right. Coughing and sneezing etc. aggregates

A

Femoral hernia

56
Q

Prolonged expiration and wheezing

57
Q

Vomiting and unexpected weight loss. Unresponsive to antacids.

A

Gastric CA

58
Q

Recurrent indigestion and flatulence a few hours after eating

A

C. Cholecystitis

59
Q

Occurs at rest and unexpected. Lasts longer and may not disappear with rest. Due to plaques/clots that reduce flow. 911

A

Unstable angina

60
Q

Asthma aka

A

Reactive airways disease

61
Q

Leading cause of vision loss and + amsler grid

A

Macular degeneration

62
Q

Adult smoker over 50 with history of heart disease, HTN or high cholesterol. Presents with persistent cough and orthopnea. Find cardiomegaly, crackles and added heart beats

A

Left-sided congestive heart failure

63
Q

50+ smoker, COPD/CAD with fatigue, dyspnea, swollen ankles and ascites. Cardiomegaly, JVD, loud s2 possible s3. Left parasternal heave (feel), retractions

A

Right sided heart failure-cor pulmonale

64
Q

Clostridium difficile colitis

A

Recurrent bouts of diarrhea 3+/day for 2+ days that are watery

MC older adults post antibiotic use

Need to do toxin assay to detect toxin the bacteria produces

65
Q

Hyperresonant percussion, decreased fremitus, decreased breath sounds usually history of smoking

66
Q

50+ with history of cigarette smoking or exposure. Crackles, productive cough. Spirometry

A

C. Bronchitis

67
Q

MC secondary to URI with swollen adenoids. No inflammation with some hearing loss. MC in children

A

Eustachian tube blockage

68
Q

Middle aged, overweight, smoker with diabetes, HTN, high LDL, claudication, atherosclerosis. Continuous substernal pain radiation not relieved by rest. S4 present. Paine

69
Q

A. Bronchitis usually seen after?

70
Q

Radiates to right scapula

A

Cholecystitis

71
Q

Adult with fever beyond 4-5 days. Cough with yellow or green mucus and crackles/wheezes. CBC—differentiation possible

A

Viral pneumonia —may lead to secondary bacterial pneumonia

72
Q

Lesion of optic chiasm (heteronomymous bitemporal hemianopia)

A

Tunnel vision

73
Q

Female, 40+ fat and flatulent and symptoms relieved with antacids

A

C. Cholecystitis

74
Q

Lesion of optic N

A

Blindness in ipsilateral eye

75
Q

Weber lateralized to and rinne is negative on affected side (negative means abnormal)

A

Suppurations otitis media

76
Q

Exam for A. Bronchitis

A

Crackles, wheezes, Rhône

Normal fremitus and percussion

77
Q

Diarrhea and constipation
Pain relieved by defecation
Lower fiber/overuse of laxatives

78
Q

50+ sudden severe waves of abdominal pain with visible peristalsis, frequency high-pitched peristaltic sounds

A

Intestinal obstruction

79
Q

S4 present

80
Q

1/3 of pneumonia cases

81
Q

Otitis media with effusion aka

A

Serious otitismedia

82
Q

Weight loss, night sweats, blood stained cough, lethargy. Fibrotic= bronchial breath and bronchophony, increased fremitus and dull percussion
Travel to Russia, africa, Latin America

A

Secondary TB

83
Q

1-3 days of severe pain in LLQ. Altered bowel habits, rectal bleeding. Bed rest helps. Male or female over 40

A

Diverticulitis

84
Q

RLQ pain migrated from umbilicus.

A

Appendicitis

85
Q

Inflammation in bronchi MC by bacteria. Crackles, wheezes and diminished breath sounds

A

Broncopneumonia

86
Q

Very contagious usually in kids post daycare. Crusting/gluing of eyelids during sleep=bacterial. Viral= adenoids virus. Usually little pain

A

Conjunctivitis/pink eye

87
Q

Crohn’s disease

A

Young adults
Recurrent bouts of diarrhea

RLQ pain
Terminal ileum/prod. Colon 
Perianal skin tags
Colonoscopy=cobblestone appearance
Vit b12 deficiency
88
Q

Violent coughing attaching and have inspiration stridor.

89
Q

Things that present with acute “surgical” abdomen

—sudden severe, persistent writhing abdominal pain—surgical intervention

A
  • a. Cholecystitis
  • appendicitis
  • perforated peptic ulcer
  • strangulated hernia
  • sup. Mesenteric A. Thrombosis
  • splenic rupture
90
Q

Cor pulmonale due to(RSHF)

A

Lung disease

91
Q

Hearing loss and retracted TM with no signs of inflammation.

A

Eustachian tube blockage

92
Q

Adult, sudden sharp chest pain especially with breathing. Coughing aggrevates. Hear friction rub and decrease breath sounds. May lead to what?

A

Pleurisy/pleuritis

Lead to pleural effusion or get infected empyema.

93
Q

+ Murphy’s sign

A

Cholecystitis

94
Q

Rinne AC>BC but less than 2:1 ratio. Sensorineural hearing loss. Gradual or sudden.

A

Noise induced hearing loss

95
Q

Pain, red eye, excessive tearing, “gritty” feeling. Photophobia, potentially decreased visual acuity

A

Corneal abrasion

96
Q

Inflammation of pericardium. Sharp stabbing chest pain worse with deep breaths or coughing. Dry cough. Better sitting up and leaning forward. Triphsic friction rub heart with heartbeat

A

Pericarditis

97
Q

Occurs at rest due to vasospasm of heart arteries with temp reduce flow. Due to smoking, stress, cocaine etc

A

Prinzmetal angina

98
Q

Central blind spot

A

Scotoma

Migraine, MS

99
Q

Pencil thin stools

100
Q

Male, first occurs in infancy and extends into scrotum, worse coughing or sneezing

A

Indirect inguinal hernia

101
Q

Maculopapular rash

102
Q

Disease of bones of middle ear. They become fused. stapes MC affected. Dizziness, balance problems, tinnitus. Usually inherited. Hearing loss 10-30yeras old.

A

Otosclerosis

103
Q

Morning sickness affects ____% of females

104
Q

Partial hearing loss, feeling of fullness, earache, tinnitus. Insidious onset or Q-tip use. Dark wax occluding canal. Weber lateralizes. Rinne negative

A

Excessive ear wax-blockage

105
Q

Virchow’s nodes present

A

Gastric CA

106
Q

Predictable chest pain with activity, stress, cold. Etc. disappears with rest/medication

A

Stable angina

Physical Diagnosis II (6 decks)

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