important history per CC

Question 1

memory issue

Answer 1

acute or chronic?
waxing and waning?
drug effect
falls
ataxia
hypothyroid sx
depression

Question 2

tests to think about for memory issue

Answer 2

lytes
B12
HIV
meds
neurosyph

Question 3

headache

Answer 3

OPRST
jaw claudication
meds
trauma
menses

Question 4

loss of vision

Answer 4

associated sx: pain, redness, discharge, head ache, weakness, numbness

cardiac history, autoimmune history, diabetes?

Question 5

depressed mood

Answer 5

mini mental status exam

DOCUMENT mental status exam:
- appearance, behavior, speech, mood, affect, thought process, thought content, cognition, insight, judgement

Question 6

psychosis

Answer 6

positive vs negative sx
cognitive sx (thought process, content, paranoia)

Question 7

psychotic d/o timeline

Answer 7

<1 mo= brief psychotic do
1mo-6mo= schizophreniform do
>6 mo= schizophrenia

schizoaffective is schizophrenia+ mood d/o

Question 8

w/u for psychosis

Answer 8

utox
lytes
TSH
mse
cbc

Question 9

things to think about in sore throat

Answer 9

HIV risk, lymphoma, mono

Question 10

Rinne, weber

Answer 10

r: air conduction > bone = normal
w: no lateralization

Question 11

presbycusis

Answer 11

normal hearing loss of age
tinittus
normal weber/rinne

Question 12

VESTIBULAR causes of dizziness (4)

Answer 12

meniere
acoustic neuroma
labrynthitis (post URI)
benign paroxysmal POSITIONAL vertigo

Question 13

Dizziness (non vestibular)

Answer 13

hypovolemia (diarrhea, vomiting, antihypertensives)
vetebrobasilar insufficiency
orthostatic
arrhythmia
AS

Question 14

physical exam confirmation of plantar fasciitis and/or achilles tendonitis

Answer 14

pain with toe dorsiflexion

Question 15

pediatric fever WITH RASH

Answer 15

varicella
meningococcal meningitis (petechial rash)
fifths disease
scarlet fever

Question 16

child with noisy breathing

Answer 16

foreign body aspiration –> (bronch, direct laryngyscopy, ABG, chest xray, NECK XRAY)
croup
epiglotitis
retropharyngeal abcess

Question 17

cause of dysmenorrhea, dyspaurenia, heavy bleeding

Answer 17

endometriosis

Question 18

how to “test” for PID

Answer 18

cervical cultures for gc/ct

Question 19

mini mental status exam (quick in the room)

Answer 19

• orientation to person, place, date
• name three objects
• spell world backwards
• no ifs, ands, butts
• fold piece of paper, pick up

“alert and oriented x4, spells backward but can’t recall 3 items”

Question 20

psychosis after drug ingestion

Answer 20

PCP –> hypertension, tachy, rage, visual hallucinations, auditory non command
Substance induced psychosis

***cannot diagnose brief psychotic disorder if recently ingested substance

Question 21

ddx for enuresis in a child

Answer 21

primary nocturnal enuresis
UTI
secondary (life trauma)
functional

test with genital exam/ua/ucx

Question 22

ddx for seizure in <1 yr

Answer 22

febrile seizure
meningitis
hyponatremia