FINAL REVIEW Flashcards
tests to rule in DVT
tests to rule out DVT
rule IN: WELLS, CONSTANS
rule OUT: D-dimer, doppler
5 diff dx for DVT
- lymphedema
- lipedema
- thrombophlebitis
- gout
- cellulitis
what is endometriosis
chronic inflammatory disease of endometrial tissue OUTSIDE UTERUS
3 types of endometriosis
- peritoneal
- deep infiltrating
- ovarian
etiology theories of endometriosis
hormonal/immune system
backflow
signs/symptoms of endometriosis
pain
infertility
issues with periods
fatigue
depression/anxiety
nausea/bloating
ASYMPTOMATIC
screens to RULE IN and RULE OUT endometriosis
RULE OUT: clin history
RULE IN: pelvic exam
diff dx of endometriosis
cervical stenosis
anovulation
pelvic muscle issues
cancer
dx test
laparoscopy (GOLD STANDARD)
-ultrasound
-MRI
-lab work
what is HERPES ZOSTER?
viral infection caused by VARICELLA ZOSTER VIRUS
*dormant in DRG
*reactivated as rash/blisters in dermatomal pattern (1 or 2-3 dermatomes)
signs of HERPES ZOSTER
pain/itching/tingling in rash
*stripe of blisters/vesicles on ONE SIDE OF BODY or FACE
*fever, headache, chills, tummy issues
etiology of herpes zoster: how does it spread?
respiratory droplets or blister contact
reactivation triggered by:
age
stress
immunocompromised
chicken pox
women
fam HX
what is a common complication of herpes zoster?
post-herpetic neuralgia
diff diagnosis of HERPES ZOSTER
- contact dermatitis (rash_
- impetigo (blisters)
- cellulities (infection of skin, red)
- eczema herpeticum (vesicular lesions)
gold standard for diagnosis herpes zoster
PCR VZV test!
(also clin diagnosis screen (100% sensitivity) and DFA (specificity))
hypothyroidism is WHAT
thyroid gland does not make T4 due to thyroid or pituitary
primary/overt hypothyroidism has
high TSH, low T4
central/secondary or 3rtiary hypothyroidism has
lowish TSH and low T4
subclinical hypothyroidism has
high TSH but normal T4
severe hypothyroidism can lead to ____
myxedema coma
(hypothermia, lethargy, slow HR, altered mental)
primary hypothyroidism can be due to
- hashimotos
- low iodine
- radiation
- thyroidectomy
- medication
secondary hypothyroidism is due to
pituitary
tumor or sheehan’s syndrome
how to diagnose hypothyroidism
2 step blood test
1. check TSH (high?)
2. check T4 (low?)
diff diagnoses for hypothyroidism
- anemia
- addisons
- depression
- iodine deficiency
- goiter
- myxedema
- dysmenorrhea
- erectile dysfunction
PT should be wary of what with hypothyroidism?
CARDIOPULM
joint pain, cramps, mm weakness, fatigue, SOB
*exercise tolerance
*CTS
what is acid reflux?
LOWER ESOPHAGEAL SPHINCTER doesn’t close, open too much
signs/symptoms
heartburn!
regurgitation
sour taste
sore throat
nausea
hard time swallowing
risk factors of acid reflux
females over 50
pregnant
obese, smokers, stressed
hiatial hernia
meds and diet
tests to rule out acid reflux
esophageal pH test
x-ray
test to rule in acid reflux
esophagoscopy (GO IN)
manometry (MEN GO IN)
diff dx for acid reflux
cancer (long term GERD –> cancer)
esophagitis (inflammation)
IBS (pain)
peptic ulcer disease (sores in stomach)
appendicitis is WHAT
inflammation due to filling with mucus, stool, parasites
*can lead to abscess, ileus, peritonitis, or death
when do symptoms present?
ACUTE IN 24 HOURS
*pain RLQ, SUDDEN
*nausea, vomiting
*loss of appetite
*pain increases with pressure (cough)
*GI symptoms
*FEVER
most common bacteria involved in appendicitis
E Coli
Bacteroides ssp
*can treat with antibiotics
what are causes of appendicitis?
stool
appendix mass, abscess
infection agents (virus, bacteria, parasites)
risk factors for appendicitis
10-30 age
men
fam hx (3x)
environmental factors (air pollution)
ethnic minorities
diff dx for appendicitis
crohns
SCREEN OUT appendicitis
mcBurneys (ASIS and belly button)
tests to rule IN appendicitis
alavarado score (high sens, low spec but MOST CITED) eats AAS (high, med, low risk for imaging) in the AIR (over 8)
dx tests for lab work APPENDICITIS
c reactive protein
WBC
procalcitonin
imaging for appendicitis
CT (most used)
-enlarged
-thick
-inflammation
-appendicolith
ultrasound
MRI
acute cholecystitis vs chronic cholecystitis
acute: gallstone obstructed bile duct
chronic: recurrent episodes
acalculous cholecystitis
acalculous: no stones! (illness, male, trauma, burns, nutrition, bone marrow transplant)
signs/symptoms of cholecystitis
- murphy’s sign
- colicky pain in RUQ/R scap/midback
- nausea, vomiting, bloated, fever
- WBC count HIGHER (12-15000)
tests to screen OUT cholecystitis
ultrasound
HIDA scan
CBC
CT scan with contrast
test to rule in cholecystitis
palpation RUQ
ultrasound
HIDA scan
gold standard for cholecystitis
ultrasound (95% pts have gallstones)
serum lipase levels (pancreatitis, peptic ulcers)
diff dx of cholecystitis
- MI
- herpatitis
- cholangitis
- appendicitis
- gastritis
- PUD, pancreatitis
what is UTI?
infection of bladder/urethra
E.coli!
signs/symptoms of UTI
need to pee lots, small amounts
pain
burning pee
pee is cloudy, red, brown, pink, SMELLY
complications of UTI
repeated infections
kidney damage
sepsis
delirium
diff diagnoses of UTI
cancer
overactive bladder
interstitial cystitis
STIs
kidney stones/infection
tests to rule OUT UTI
- nitrite and leukocyte esterase
- NGAL
tests RULE IN UTI
WBC
biomarkers (NGAL interleukins
eNOSE
diagnostic tests UTI
urine culture
CT scan/renal ultrasound
3 clinical tests for diabetic neuropathy
- superficial pain
- monofilament
- vibration
signs of UMN/cord compression
neck/back pain
2. bad sensation/weakness
3. B&B (loss of sex ability)
4. foot drop, coordination
(hyperreflex, spasticity, clonus/babinski)
most common cause of myelopathy in adults over 55
cervical spondylosis CT
what is most effective imaging for cervical myelopathy
MRI (GOLD STANDARD (gadolinium contrast enhanced)
groin hernia is what
bowel/ab tissue bulging through weak ab mm (inguinal or femoral)
signs symptoms of groin hernia
Visible bulge in the inguinal area that goes away when LYING SUPINE and applying mild pressure. Increased pain or bulge with activity or cough.
Discomfort that can progress to intense pain if not treated.
Burning sensation that may radiate down the leg.
More obstruction = more symptoms overtime.
diff dx of groin hernia
lymphadenopathy/adenopathy
femoral artery aneurysm
mm strains
psoas abscess
sebaceous cist
testicle
epididymitis
hydrocele
screen OUT groin hernia
herniography
CT
RULE IN groin hernia
ultrasonography
MRI with valsalva
