general cases

Question 1

night sweats hx

Answer 1

socrates including patterns (waxing, waning) & triggers (food, meds), fever, recent uri’s, cough, hemoptsis, pleuritic chest pain, lymphadeno, rash, malaise, weight loss, itching, diarrhea, nv, anorexia/early satiety, contacts-sck or sexual or high risk, menstrual, travel

Question 2

night sweats ex

Answer 2

heent (lymphadeno), heart and lung, abdo for hepatospleno, skin, msk for joint pain

Question 3

night sweats wu

Answer 3

ppd, cbc, tsh/t4, cxr. tb: afb stain, sputum stain/culture, hiv Ab, 5hiaa and 24 hr catecholamines

Question 4

night sweats ddx

Answer 4

tb, tiv, lymphoma, leukemia, hyperthyroidism, pheo, carcinoid

Question 5

sore throat hx

Answer 5

fever, duration/socrates, ent sx (ear pain, nasal, sinus congestion), odynophagia (painful swallowing), swollen glands, cough, rash, sick contacts, hiv RFs, GI throat hx (ie zenker’s)

Question 6

sore throat ex

Answer 6

ent, oral thrush, tonsillar exudate, lymphadeno. lung, abdo (spleen larger), skin check

Question 7

sore throat wu

Answer 7

cbc (& peripheral smear), throat swab (rapid strep antigen and culture), monospot test, HIV Ab/viral load, anti ebv abs, vdrl/rpr, ast/alt/bili/alk phos, serologic test (cold Agg titer) for mycoplasma

Question 8

sore throat ddx

Answer 8

viral/ bacterial pharyngitis, mono, hepatitis, acute HIV (acute retroviral), strep tonsillitis/scarlet fever, mycoplasma pneumo, secondary syphilis

Question 9

LUQ discomfort& epigastric, cervical lymphadeno, rash. sorethroat, fever, fatigue, lost appetite

Answer 9

infectious mono. viral, bacterial pharyngitis, hepatitis,

Question 10

weight loss hx, ex

Answer 10

lbs and for how long, intended?, diet, exercise, anxiety/depression, b Sx, hyperthyroid (palpitations, tremor, diarrhea fatigue), diet pills, Fhx thyroid/depression, , HIV risk factors, drugs, meds. Cancer, blood in urine/stool.

Ex: vitals, all (since differentials are wide)

Question 11

weight loss ddx

Answer 11

hypterthyroidism, malignancy, diet(pills), anorexia, HIV, malabsorption

Question 12

weight loss wu

Answer 12

tsh/t4, cbc, euc, hiv Ab, utox

Question 13

weight gain hx

Answer 13

lbs, time, med changes or side effects, smoking cessation (lose avg 5 lbs), depression, hypothyroid (fatigue, constipation, skin/hair/nail changes, delayed reflexes), menstrual changes, hirsutism, EtOh and drugs

Question 14

weight gain ex

Answer 14

cushings (htn, central adiposity, moon face, buff hump, abdo striae, supraclav fat pads), edema (renal dz water retention)

Question 15

weight gain ddx

Answer 15

endo (hypothyroid, insulinoma, cushing’s, postprandial hypoglycemia, PCOS, DM), smoking cessation, Rx side effecct, atypical depression

Question 16

weight gain wu

Answer 16

cbc, euc, glucose and plasma insulin, glucose tolerance, tsh/4, 24 hr urine free cortisol, dex supression test

Question 17

abuse hx, ex

Answer 17

psych stuff, Hx accidents/injuries, mental illness, drugs, firearms

Question 18

abuse ddx

Answer 18

domestic violence / rape, osteogenesis imperfecta, substance abuse

Question 19

abuse wu

Answer 19

xr skeletal survey, ct, utox cbc

forensic/pelvic exam, urine hCG, wet mount/koh prep, cervical cultures, chlamydia/gono, hiv Ab, viral hepatitis serology