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Clinical DDx > Hx > Flashcards

Hx Flashcards

1
Q

recurrent ab

A

Old age
Genetics
Uterine abnormalities (Fibroids, Synechia)
Endocrine (Hypothy, HyperPRL, DM, PCOS)
Thrombophilia (Antiphospholipid AB, Factor V)

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2
Q

alopecia

A

FOCAL: Tinea capitis (+KOH), Alopecia areata, Androgenic alopecia (male-pattern, PCOS, Rxs like steroids/progesterone)
GENERALIZED: Chemo/Rad/Heavy metals, Telogen effluvium d/t Rxs/stress/thyroid/nutrition
IRREG: Traction alopecia, Trichotillomania, Syphilis

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3
Q

primary amenorrhea

A 
Absent uterus: Mullerian agenesis
Scarred uterus: TB
FSH/TSH WNL, DEC GnRH or INC PRL: Brain tumor/injury, Pituitary adenoma, Empty sella
Thyroid dysfxn
INC FSH, TSH WNL: PCOS, Turner, 46XY
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4
Q

secondary amenorrhea

A

+hCG: Preg, Ectopic preg

-hCG: Stress/overexercise/wt loss, PCOS, Pituitary adenoma, Hypothyroidism, Rxs like OCPs/antipsych/metoclopramide

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5
Q

anorexia

A

Psych: ED, Depression, Body dysmorphia
GI: PUD, Crohn’s/UC, Celiac, Malabsorption, Gallstones, Parasites, Chronic pancreatitis
Endocrine: Hyperthy, Addison, Hypopituitarism
CA
HIV
Amphetamines

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6
Q

anxiety

A

GAD/Panic disorder/Agoraphobia/Specific or social phobia
Withdrawal
Rxs like antichol/coke/amphetamines/caffeine/hallucinogens
ABNORMAL LABS: Anemia, Hyperthy, Cushing, Hypogly, HypoNa+, HypoCa2+
LABS WNL: Arrhythmia, Asthma, CTE, Partial complex seizure

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7
Q

cardiomegaly

A

Infection
Myocarditis (Neuromusc, Sarcoidosis, Amyloidosis, SLE, Thyrotoxicosis, Hemochromatosis, Fe2+ overload)
INC MUSCLE: Hypertrophic cardiomyopathy, HTN, Athlete, Aortic stenosis
DILATED CARDIOMYOPATHY: Ischemia s/p infarct, Autoimmune, Rxs like EtOH/coke/ZDV/doxorubicin/trastuzumab, IHSS(HOCM), Restrictive, rare Arrhythmogenic R ventr cardiomyopathy

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8
Q

carpal tunnel

A 
Overuse/OA
DM
Hypothy
Preg
Acromegaly
RA/SLE
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9
Q

cataracts

A 
Trauma
Congenital d/t maternal DM, fetal galactosemia, TORCH infec, Rx, familial
DM
Corticosteroids
Age
Myotonic dystrophy
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10
Q

recurrent chills

A

IF DRUG USER: HIV, Endocarditis, Opioid withdrawal
NAH: Pneumonia/Lung abscess/Hypersens pneumonitis, Endocarditis, TB, Brucellosis, Yellow fever, Malaria, Rocky Mountain Spotted Fever

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11
Q

cirrhosis

A 
EtOH HEP OR Rx! (MTX/amiodarone/INH/valproic acid)
Hep B/C
Hemochromatosis
Autoimmune hep
1o biliary cirrhosis
a1AT-def
Nonalc steatohep
1o sclerosing cholangitis (if UC Hx)
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12
Q

CHF

A

MI
ABNORMAL VALVES: Aortic stenosis/insufficiency, Mitral regurg
NORMAL VALVES: Ischemic cardiomyopathy, 2o cardiomyopathy d/t infec or Rx or HTN, DEC EF d/t AFib

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13
Q

cough

A 
ACEis
COPD
CHF
Pneumothorax
c WT LOSS: TB, Mediastinal mass
s WT LOSS: GERD, Sarcoid, s/p viral infec, Postnasal drip/allergies
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14
Q

Cushing

A

Long-term corticosteroid use!
Pituitary adenoma
Adrenal tumor/hyperplasia, Carcinoid tumor, Oat-Cell lung CA
PNP syndrome

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15
Q

delayed puberty

A

GET FSH/LH, THEN:
WNL or LOW: Anorexia/malnutrition, DM, Chronic infec, Pituitary adenoma, Hypothy
INC FSH/LH c DEC ESTRADIOL: Turner, Chemo/rad
INC FSH/LH c DEC TESTOSTERONE: Klinefelter, Anorchism, Chemo/rad

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16
Q

dementia

A

ABNORMAL LABS: Thyroid disorder, Syphilis, B12/Folate-def, Electrolyte imbalance, Uremia, Infec
WNL: Rxs, CHECK CT/MRI:
WNL: Alz, Parkinson, Lewy body, Chronic EtOH
ABNORMAL: Normal-pressure hydrocephalus, Multi-infarct dementia, Pick/frontotemporal dementia

17
Q

depression

A

ABNORMAL LABS: Thyroid disorder, Hyperparathy, Addison, Cushing, Chronic renal disease
ABNORMAL NEURO: CTE, Parkinson, Dementia, Tumor, MS
Rxs like EtOH/amphetamines/narcotics/BZDs/steroids
Recent MI, CABG, CA
Postpartum

18
Q

chronic diarrhea

A 
C.Diff
Chronic laxative abuse
Sorbitol/fructose abuse
Parasitic infec
Bacterial infec
Colitis
CA
DM
Hyperthy
19
Q

dwarfism

A

s EXTREMITIES SHORT RELATIVE TO TRUNK: Turner, Down, Hypothy, Pituitary disorder, Idiopathic GH-def
c EXTREMITIES SHORT RELATIVE TO TRUNK: Achondroplasia, Diastrophic dysplasia, Spondyloepiphyseal dysplasia

20
Q

dyspareunia

A

Functional
Cystitis
IBD
Diverticulitis
Ovarian CA/cyst
SUPERFICIAL: Inadequate lube, Vulvodynia/atrophy/dermatitis, Vaginitis/ismus, Urethritis
DEEP: Vaginal dryness/atrophy, Endometriosis, PID, Retroverted uterus, Endometrial/cervical carcinoma, Adenomyosis

21
Q

dyspepsia

A 
PUD
Esoph/gastric carcinoma
Rxs like NSAIDs/alendronate/metronidazole/erythromycin
GERD
Biliary disease
Functional dyspepsia
22
Q

dysuria

A

+NITRITE: Acute bacterial cystitis

-NITRITE: Herpes, STD, Interstital cystitis for female, Reiter for male

23
Q

enuresis

A 
Functional
1o
Hypothy
Structural defect
Congenital spinal column defect
24
Q

esophageal regurg/dysphagia

A

+REGURG/CHOKING/COUGH: Rx, Rad, Candida, Cleft palate, Sjogren, Dermatomyositis, Scleroderma, Sarcoidosis, MS, ALS, Zenker diverticulum
FOOD “STUCK”: Spasm, Achalasia, Carcinoma, Stricture, Foreign body

25
Q

failure to thrive

A 
Neglect/abuse/poor feeding technique
Thyroid disease
Anemia
TB/HIV
UTI
CF
Malabsorption syndrome
Chronic systemic disease
26
Q

fatigue

A

Rxs like opioids/antidep/hypnotics/muscle relaxants
PSYCH: Substance abuse, Personality disorder, Abuse victim, Depression/Anxiety
Thyroid disorder
Infec/inflam
Anemia
Carcinoma

27
Q

genital ulcers

A 
HSV
Chancroid
Behcet
Syphilis
Granuloma inguinale
28
Q

gigantism

A 
Fragile X
Marfan
Pituitary gigantism
McCune-Albright
MEN-1
29
Q

amnesia

A 
Concussion
Drugs
Seizure
TIA
Migraine
30
Q

chronic HA

A 
Tension
Migraine
Depression/GAD
Epidural/subdural hematoma
Tumor
31
Q

heel pain

A 
Fx/Stress Fx
Contusion
Plantar fasciitis
Osteomyelitis
Foreign body
Sever disease
Calcaneal bursitis
Achilles tendinitis
32
Q

hemianopia

A 
CVA/TIA
Migraine
MS
Tumor
Optic nerve disorder
33
Q

persistent hiccups

A 
Concussion/Epidural hematoma/Subarachnoid hemorrhage
Hemopneumothorax
Ruptured spleen
EtOHic gastritis
Bromism
Salicylate toxicity
ARF/CRF
Encephalitis/Meningitis
Peritonitis/Cholecystitis/Ruptured viscus/Subdiaphragmatic abscess
Reflux esophagitis/Gastritis/Hiatal hernia/PUD/Esophageal carcinoma
Hodgkin disease/Mets
Mediastinitis
AAA
Idiopathic/Psychogenic
34
Q

Horner syndrome

A

Congenital
Rxs like scopolamine/botox/eye drops
TRAUMA: Brachial plexus injury, C-spine injury, Carotid dissection
Cluster HA/Migraine
Mets/Hodgkin/Bronchogenic carcinoma/Pancoast tumor

35
Q

hypothermia

A 
TRAUMA: Shock, Hemorrhage, Burns, Brain injury/bleeding, Sepsis
OD: Barbs/opiates/EtOH/Phenothiazines
Coma
CVA
Hypogly
Hypothy
Hypopituitarism
Adrenal insufficiency
Malnutrition (severe)/Dehydration
Metabolic/Infec encephalopathy
36
Q

infertility

A 
Congenital defects
PID/Cervicitis/Endometriosis/Cysts
PCOS
HyperPRL
Hypopituitarism
Acromegaly
1o hypogonadism
Hypogonadotrophic hypogonadism
Steroids
Short luteal phase
37
Q

chronic insomnia

A 
Rxs like theophylline/Bb/steroids/thyroxine/bronchodil
EtOH/substance withdrawal
Environmental
Angina/CHF
Psych (Depression/Anxiety/Schizo)
Central sleep apnea
RLS
GERD/PUD
COPD/Asthma

Clinical DDx (3 decks)

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