Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE step 2CS > Minicases > Flashcards

Minicases Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Headache: History

A
  • OPQRST
  • unilateral vs bilateral
  • dull vs stabbing
  • intensity
  • disturb sleep
  • neurological sxs (paresthesia, weakness, numbness, ataxia, stiffness)
  • n/v
  • exacerbating factors: fatigue, menses, food, exercise
  • alleviating: rest, medication
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Headache: PE

A 
Vitals
Inspect & palpate head
ENT
Neuro exam
Fundoscopic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Headache DDX

A 
Migraine
Tension headache
Cluster headache
Psuedotumor cerebri
Trigeminal neuralgia
CNS vasculitis
Neoplasm
Meningitis
Sinusitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Headache: Workup

A 
CBC
ESR
CT-head
MRI-brain
LP
XR- Sinus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Confusion: History

A 
History from family members
Time course: acute vs chronic
Associated sxs: constitutiaonl, ataxia, hypothyroid, depression
Screen for delirium: waxing/waning
Falls
Medications

PMH: stroke, vascular disease, syphillis, HIV, alcohol, vitamin B deficiency

FH: Alzheimer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Confusion PE

A 
Vitals
Neuro Exam
MMSE
Gait
ENT, Heart Lung, abdomen, Ext
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Confusion DDx

A 
Vascular dementia
Alzheimer disease
NPH
Chronic subdural hematoma
Intracranial tumor
Depression
B12 deficiency
Hypothyroidism
Creutzfeldt-Jakob
Hypoglycemia
Wernicke encephalopathy
Delirium
SIADH
TIA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Confusion Workup

A 
CBC
VRDL/RPR
B12
TSH
MRI-Brain
CT-Head
LP
EEG
Glucose
Electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Depressed mood: History

A 
Onset
Duration
Sleep patterns
Appetite
Weight change
Drug and alcohol use
Life stresses
Guit
Suicidality
Social function
Decreased interest
Energy
Concentration
Suicidality
Agitation
Retardation

FH: Mood disorders
PMH: prior episodes
Meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Depressed Mood PE

A

Vitals
HEENT
Neuro
MSE (behavior, speech, mood, affect, thought process, content, cognition, insight, judgement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Depressed Mood DDx

A 
Bereavement
adjustment disorder with depressed mood
Schizoaffective disorder
depressive disorder
MDD
Bipolar I Disorder
Substance-induced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Depressed Mood Workup

A 
Physical Exam
MSE
TSH
CBC
Urine Toxicology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Psychosis History

A

Positive sxs: Hallucinations, Delusions, Disorganized thoughts, catatonic behavior
Negative sxs: blunted affect, social withdrawal, decreased motivation, decreased speech, thought patterns

PMH: age at first sxs, hospitalizations
Social hx: alcohol/ substance use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Psychosis PE

A

Vitals

MSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Psychosis DDx

A 
Schizophrenia
Schizoid or schizotypal personality DO
Schizophreniform
Psychotic DO d/t medication
Depression with psychotic features
Substance induced psychosis
Schizoaffective DO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dizziness History

A 
Lightheadedness
vertigo
auditory (hearing loss, tinnitis)
duration
positioning
head trauma
Associated sxs: visual disturbance, URI, nausea, neck pain

Meds
PMH: atherosclerotic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dizziness PE

A 
Vitals
Neuro exam
Romberg
Nystagmus
Dix-Hallpike
Gait
Hearing
Weber/Rinne
ENT
CV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Psychosis Workup

A 
MSE
Urine Toxicology
TSH
CBC
Electrolytes
AST/ALT
Beck Depression Inventory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dizziness DDx

A 
Meniere disease
vestibular neuronitis
labyrinthitis
BPPV
Acoustic neuroma
Orthostatic hypotention
Vertebrobasilar insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Dizziness Workup

A 
Vitals
Orthostatic vitals
CBC
Electrolytes
MRI-brain
Dix-Hallpike
Audiogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Loss of Consciousness History

A 
Preceding Sxs (nausea, diaphoresis, palpitations, pallor, lightheadedness)
Postural
Exertional
Traumatic
Stressful
Painful
Claustraphobic
Dehydration
Tongue biting
Incontinence
Tonic-clonic movementes
prolonged confusion
dyspnea

PMH: PE risk factors, Heart disease, arrhythmia, HTN, DM
Social: alcohol/ drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

LOC PE

A 
Vitals
orthostatics
Neuro
Carotid and cardiac exam
Lung exam
LE exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

LOC DDx

A 
Tonic Clonic seizures
Drug induced orthostatic hypotension
Cardiac arrhythmia
SYncope
Stroke
MI
PE
Malingering
Hypoglycemia
Seizure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

LOC Workup

A 
CBC
electrolytes
Urine toxicology
MRI-brain
CT-brain
LP
EKG
EEG
Holter monitoring
Glucose
Substance-induced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Numbness History

A 
Distribution
Unilateral vs bilateral
duration
progression
pain
constitutional signs

PMH: diabetes, alcoholism, atherosclerotic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Numbness PE

A

Vitals
Neuro
MSK
vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Numbness DDx

A 
TIA
Hypoglycemia
Seizure
Stroke
Intracranial neoplasm
Guillain Barre
Myasthenia
peripheral neuropathy
Conversion D/O
Neurosyphyllis
CNS vasculitis
Syringomyelia
Hypocalcemia
Hyperventilation
AML
Todd paralysis
Malingering
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Numbness Workup

A 
CBC
Glucose
electrolytes
EKG
CT-head
MRI-brain
Doppler carotids
Echnocardiogram
EEG
PT/PTT/INR
LP
B12
Tensilon Test
HbA1c
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Fatigue History

A 
Duration
Sleep
Snoring
Waking up choking/ gasping
Witnessed apnea
overexertion
stress
depression
emotional programs
Lifestyle changes
Shift changes
Diet
Weight changes
Thyroid

PMH: anemia, bleeding
Meds
Social: alcohol/ drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fatigue PE

A 
Vitals
ENT (conjunctival pallor, oropharynx/palate, lymphadenopathy, thyroid)
CV
Lung
Neuro
Extremity
Consider rectal, FOBT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Fatigue DDx

A 
Depression
Adjustment DO
Hypothyroidism
Anemia
PTSD
Psychotic DO
Colon cancer
OSA
DM
Sleep deprivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Fatigue Workup

A 
CBC
TSH
HIV/STD
FOBT
Urine Toxicology
HbA1c
Polysomnography
UA
BUN/Cr
Urine Toxicology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Night Sweats History

A 
Onset
duration
severity
frequency
timing
Recent URI
Cough, hemoptysis, lymphadenoathy, fever, rash, weightloss, diarrhea, n/v, early satiety, sexual exposure, sick contacts
High risk: prisoner, homeless

Menstrual history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Night sweat PE

A 
Vitals
HEENT
throat inspection
Heart/ Lungs
Skin
MSK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Night Sweats DDX

A 
TB
Acute HIV
Lymphoma
Leukemia
Hyperthyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Night Sweats workup

A 
PPD
CBC
CXR
Sputum gram stain
HIV antibody
TSH, FT4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Insomnia history

A 
Duration
trouble falling asleep
multiple awakenings
early morning wakenings
daytime sleepiness
snorning
nightmares
depression
caffeine
sleep hygiene

PMH: other medical problems– arthritis, DM
Social: work, recreation, lifestyle, stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Insomnia PE

A

Vitals

MSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Insomnia DDx

A 
Stress induced
caffeine induced
Circadian rhythm sleep disorder
MDD
OSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Insomnia Workup

A

CBC
TSH
Polysomnography
EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sore throat History

A 
Duration
Fever
ENT (early pain, nasal or sinus congestion)
Odynphagia
Swollen glands
Cough
Rash
Sick contacts

Social: HIV risk fators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Sore throat PE

A 
Vitals
ENT exam (thrush, tonsillar exudate, lymphadenopathy)
Lung
Abdominal
Skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Sore throat DDx

A 
infectious Mononucleosis
Hepatitis
Pharyngitis
Acute HIV
Syphilis
Streptococcal tonsillitis
Scarlet fever
Mycoplasma pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Sore throat workup

A 
CBC with peripheral smear
Monospot test
throat culture
AST/ALT
HIV antibody
VDRL/RPR
CD4
Throat swab for culture and rapid streptococcal antigen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Cough/SOB history

A 
acute vs chronic
frequency
Sputum
constitutional
URI
post-nasal drip
dyspnea
wheezing
chest pain
heartburn
Timing
exposures

SocHx: smoking hx
PMH: lung disease
Allergies
Medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Cough PE

A 
Vitals
pulse oximetry
nasal mucosa
Heart
Lung, lymph nodes
extremities
clubbing, cyanosis, edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Cough DDx

A 
asthma
GERD
Bronchitis
Pneumonitis
Foreign body
COPD
Bronchiectasis
Lung cancer
TB
Pneumonia
Lung abscess
pericarditis
URI associated cough (post-infectious)
Post-nasal drip
CHF
TB
Sarcoidosis
Cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Cough Workup

A 
CBC
sputum gram stain
CXR
CT Chest
PPD
IgM mycoplasma, Urine legionella
HIV
EKG
Echo
PFTs
BNP
Bronchoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Chest Pain history

A 
Location
Quality
severity
radiation
duration
context
associated sxs: sweating, nausea, dyspnea, palpitation, sense of doom
Exacerbating, alleviating
PE: DVT, coagulopathy, malignancy, recent immbilization

PMH: HTN, hyperlipidemia
Social: Smoking
Family hx: early MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Chest pain PE

A 
Vitals
BP in both arms
JVD
PMI
Chest wall tenderness, heart sounds, ,pulses
lung
abdominal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Chest pain DDx

A 
MI
GERD
Angina
Costochondritis
Aortic dissection
pericarditis
pneumothorax
Esophagitis
esophageal spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Chest pain workup

A 
EKG
CK-MB, troponin
CXR
echocardiogram
CTA
Upper endoscopy
cardiac carth
amylase, lipiase
TEE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Palpitations History

A

gradual vs acute
onset/ offset
context (exertion, caffeine anexiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Palpitations PE

A

vitals
endocrine
thyroid (exopthalmos, lid retraction, lid lag, gland size, bruit)
CV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Palpitations DDx

A 
Hypoglycemia
Panic attack
Social phobia
cardiac arrhythmia
angina
Hyperthyroidism
GAD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Palpitations workup

A 
CBC
glucose
electrolytes
TSH
EKG
Holter
Echnocardiograph
MSE
Urine toxicology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Weight loss History

A 
amount
suration
intention
diet
body image
anxiety
deprssion
palpation
tremor
diarrhea
blood in stool or urine

Fam Hx: thyroid, cancers
Social: HIV, tobacco, alcohol, drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Weight loss PE

A

Vitals

Physical

59
Q

Weight loss ddx

A 
Hyperthyroidism
cancern
HIV infection
Dieting
Diet drugs
Anorexia
Malabsorption
60
Q

Weight gain History

A 
amount
duration
timing
smoking
depression
diet history
hypothyroid: Fatigue, Constipation, skin/hair/nail changes
menstrual irregularity

Social: alcohol/drug use

61
Q

Weight gain PE

A 
Vitals
Cushings (HTN, central obesity, Moon facies, buffalo hump, supraclavicular fat pads, purple abdominal striae)
62
Q

Weight gain DDX

A 
Smoking cessation
Drug side effect
hypothyroidism
Cushing
PCOS
DM
Atypical depression
63
Q

Weight gain workup

A 
CBC
electrolytes
glucose
TSH
Dexamethasone suppression
64
Q

Weight loss workup

A 
TSH
CBC
electrolytes
HIV antibody
Urine toxicology
65
Q

Dysphagia History

A 
Solids/ liquids
Progression
Constitutional ( weight loss)
Drooling
Regurgitation
odynophagia
GERD
Medications

Social: HIV, smoking
PMH: raynauds

66
Q

Dysphagia PE

A

Vitals
HEENT
Heart, lung, abdomen
Skin

67
Q

Dysphagia DDx

A 
Esophagela cancer
Achalasia
Esophagitis
Systemic sclerosis
Esophageal stricture
Mitral valve stenosis
Zenker Diverticulum
68
Q

Dysphagia Workup

A 
CBC
CXR
Endoscopy with biopsy
Barium swallow
HIV antibody
CD4
CT chest
69
Q

Nausea/ Vomiting History

A 
Acuity
onset
abdominal pain
relation to meals
sick contacts
possible food poisoning
possible pregnancy
neuro sxs
associated GI sxs
alleviating factors
70
Q

Nausea/Vomiting PE

A 
Vitals
ENT
Fundoscopic exam
complete abdominal exam
heart
lungs
rectal
71
Q

Nausea/Vomiting DDx

A 
Pregnancy
gastritis
hypercalcemia
DM
UTI
Depression
72
Q

Nausea/vomiting Workup

A 
Urine B-HCG
Pelvic exam
U/S pelvis
CBC
electrolytes
calcium
glucose
UA
Urine cx
Baseline pap
cervical cx
rubella
Hep B
VDRL
73
Q

Abdominal Pain History

A 
Location
quality
intensity
duration
radiation
timing ( timing to meals)
associated sxs (constitutional, GI, cardic, pulmonary, renal)
Exacerbating and alleviating factors

Past surgical hx
PMH: gallstones, atherosclerosis, vascular disease
Meds
Social Hx: alcohol and drug use, drug violence

74
Q

Abdominal Pain DDx

A 
Nephrolithiasis
RCC
Pyelonephritis
appendicitis
pancreatic cancer
acute viral hepatitis
chronic pancreatitis
cholecystitis
AAA
PUD
Gastritis
Mallory-Weiss tear
Hepatitis
Ascending cholangitis
mesenteric ischemia
Splenic rupture
Intestinal obstruciton
volvulus
Gastroenteritis
Ileus
Hernia
Ruptured ovarian cyst
Crohns
ulcerative colitis
abscess
ectopic pregnancy
75
Q

Constipation/ Diarrhea History

A 
Frequency and volume of stools
duration of change in bowel habits
associate sys ( constituational, abdominal pain, bloating)
thyroid
diet (fiber, fluid)
medications
sick contacts
travel
camping
HIV

Past surgical hx
PMH: DM, pancreatitis
Social hx: alcohol and drug use
Family hx: colon cancer

76
Q

Constipation/ Diarrhea PE

A 
vitals
thyroid/endocrine
abdominal
rectal exam
female pelvic exam
77
Q

Constipation/ Diarrhea DDX

A 
colorectal cancer
IBS
Diverticulosis
GI parasitic infection
Low fiber diet
Celiac disease
Gastroenteritis
Lactose intolerance
C.diff
Giardiasis
Hyperthyroidism
78
Q

Abdominal Pain workup

A 
Rectal exam
Pelvic exam
Urine HCG
CBC
Electrolytes Colonscopy
CT- abdoment/ pelvis
Stool for ova and parasites
UA
CXR
79
Q

Constipation workup

A 
rectal exam
stool for occult blood
CBC
electrolytes
CT abdomen/pelvis
C.diff toxin in stool
AST/ALT/ALk phos
Stool leukocytes, culture, giardia, entamoeba
Hydrogen breath test
Small bowel series
80
Q

Upper GI Bleeding History

A 
Amount
Duration
context (severe vomiting, alcohol ingestion, nosebleed)
Associated sxs ( N/V/abd pain)
easy bleeding

Meds (wafarin, NSAIDS)
PMH: peptic ulcer, liver disease, AAA

81
Q

Upper GI Bleeding PE

A 
Vitals
Orthostasis
ENT
Heart
Lung
abdominal pain
rectal exam
82
Q

Upper GI Bleed DDX

A 
Peptic ulcer
Gastritis
Gastric cancer
Esophageal varices
Mallory Weiss
83
Q

Upper GI Bleed Workup

A 
Rectal exam
CBC, electrolytes
ASL/ALT
Bilirubin
Endoscopy
Barium swallow
84
Q

Blood in stool history

A

Melena vs. bright red blood
amount duration
associated sxs ( constitutional, abdominal or rectal pain, tenesmus, constipation)
trauma

Medications (warfarin)
PMH: easy bleeding, vascular dz

85
Q

Blood in stool PE

A

Vitals
Orthostatic
abdominal
rectal exam

86
Q

Blood in stool Workup

A 
rectal exam
cbc
PT/PTT
AST/ALT/ bilirubin/alk phos
CEA
Colonoscopy
CT abdomen/pelvis
Barium enema
CT-abdomen/ pelvis
AXR
87
Q

Blood in stool DDx

A 
UC
Crohn
Hemorrhoids
Diverticulosis
Dysentery
Angiodysplasia
anal dissure
ischemic bowel disease
Upper Gi bleeding
IBD
Colorectal cancer
88
Q

Hematuria history

A 
amount
duration
clots
associated (constitutional, renal colic, dysuria, irritative or voiding sxs)
vigorous exercise

Meds
PMH: cancer, easy bleeding, stones
social: alcohol/drugs

89
Q

Hematuria PE

A 
Vitals
Lymph nodes
abdominal exam
GU
Rectal exam
extremities
90
Q

Hematuria DDx

A 
Bladder cancer
RCC
Nephrolithiasis
Acute GN
prostate cancer
Coagulation DO
PKD
UTI
91
Q

Hematuria Workup

A 
GU exam
UA
Urine Cytology
BUN/Cr
PSA
CBC
PT/PTT
US-renal/blasser
CT-abd/pelvis
IVP
UA
rectal exam
92
Q

Other urinary sxs

A

Duration
obstructive (hesitancy, diminished stream, sense of incomplete emptying, straining, post void dribbling)
irritative sxs (urgency, frequency, nocturia)
Constitutional (bone pain(

Medications
PMH: Uti, stones, DM
Social: Alcoholism

93
Q

Other urinary sxs PE

A 
vitals
abdominal exam (suprapubic)
genital exam
rectal exam
Focused neuro exam
94
Q

Urinary Sxs DDX

A 
Urethritis
cystitis
prostatitis
acute pylonephritis
Nephrolithiasis
RCC
Lower UTI
Stress incontinence
Urge incontinence
Overflow incontinence
DM
95
Q

Urinary Sxs Workup

A 
genital exam
rectal exam
urine culture
gram stain/ culture
Chlamydia and gonorrhea PCR
US -renal
CT-abdomen
Bun/Cr
IVP
cystourethroscopy
96
Q

Erectile Dysfunction History

A 
Duration
Severity
nocturnal erections
libido
stress or depression
trauma

Medications
PMH: HTN, DM, high cholesterol, atherosclerotic vascular disease

social: smoking, alcohol and drug

97
Q

Erectile Dysfunction PE

A

Vitals
CV
Genital and rectal exam

98
Q

Erectile Dysfunction DDX

A 
Drug related ED
HTN
DM
Psychogenic
peyronie
99
Q

Erectile dysfunction Workup

A

GU exam
Rectal exam
Glucose
CBC

100
Q

Amenorrhea History

A

Primary vs secondary
duration
pregnancy
associated sxs (Headache, decreased peripheral vision, galactorrhea, hirsutism, hot flashes, vaginal dryness, thyroid)

PMH: anorexia, dieting, exercise, pregnancy, uterine infections
PSH: D&C
Meds
SocHx: drug use

101
Q

Amenorrhea PE

A

Vitals
Breast exam
Pelvic exam

102
Q

Amenorrhea DDX

A 
pregnancy
anovulatory cycle
hyperprolactinemia
UTI
thyroid disease
PCOS
Ovarian or adrenal malignancy
premature ovarial failure
Prolactinoma
pituitary tumor
menopause
Sheehan syndrome
Asherman syndrome
Anorexia
103
Q

Amenorrhea Workup

A 
Pelvic exam
Urine hCG
US pelvis
CBC, electrolytes
UA
urine cx
prolactin
TSH
Pap
LH/FSH
prolactin
Testosterone
DHEAS
MRI-Brain
ACTH
Hysteroscopy
Urine Cortisol
104
Q

Vaginal Bleeding History

A 
Pre/post menopausal
duration
amount
menstrual history
relation to last period
associated ( diacharge, pain, Urinary sxs)
Trauma

Medication (wafarin, POC)
PMH: easy bleeding, abnormal pap

105
Q

Vaginal Bleeding PE

A

Vitals
Abdominal exam
Pelvic exam

106
Q

Vaginal Bleeding DDx

A 
Dysfunctional uterine bleeding
coagulation DO
cervical cancer
molar pregnancy
hypothyroidism
DM
Endometrial Ca
Cervical CA
atrophic endometrium
atrophic vaginitis
trauma
Spontaneous abortion
Ectopic
ovarian torsion
PID
107
Q

Vaginal Bleeding Workup

A 
Pelvic exam
Urine HCG
Cervical cultures
US pelvis
CBC
Pt/PTT
Prolactin
TSH
LH/FSH
108
Q

Vaginal Discharge History

A 
amount
color consistency
odor
duration
associated vaginal burning
pain
last menstrual period
use of contraceptives
tampons
douches

PMH: STD

109
Q

Vaginal Discharge PE

A

Vitals
abdominal pain
complete pelvic exam

110
Q

Vaginal discharge DDX

A

Bacterial vaginosis
Vaginitis-candida
Cervicitis (Gonorrhea, chlamydia)
Vaginitis-trichomonal

111
Q

Vaginal Discharge Workup

A 
Pelvic exam
Wet mount
cervical cx
KOH
pH
112
Q

Dyspareunia History

A 
Duration
timing
associated sxs (vaginal discharge, painful meses, GI sxs, hot flashes)
Sexual history
Trauma
Domestric violence
Endometriosis
PID

PSH: prior abd/GU surgeries

113
Q

Dyspareunia PE

A

VItals
Abdominal exam
pelvic exam

114
Q

Abuse history

A 
confidentiality
question about physical, sexual or emotional abuse
safety, backup plan
hx of accidents
mental illness

SocHx: drug use, firearms

115
Q

Abuse PE

A

vitals
complete exam
pelvic exam

116
Q

Abuse DDX

A

Rape
Domestic violence
Substance abuse

117
Q

Abuse workup

A 
pelvic exam
urine hcg
wet mount
KOH
x-ray ( skeletal survey)
CBC
HIV antibody
118
Q

Dyspareunia workup

A 
pelvic exam
wet mount
KOH
US pelvic
laparoscopy
119
Q

Joint/Limb History

A 
location
duration
intensity
quality
pattern
Constitutional ( red eye, genital ulcers, diarrhea, dysuria, rash, focal numbness, weakness)
exacerbating and alleviating factors
DVT risk

SocHx: alcohol and drug use
FamHx: rheumatic

120
Q

Joint/Limb PE

A

Vitals
HEENT
MSK
Neurovascular

121
Q

Joint/Limb DDx

A 
Domestic violence
Factitious D/O
Substance abuse
SLE
RA
Psoriatic
Hip fracture
Hip dislocation
Osteoarthritis
Septic arthritis
Gout
Trauma
Reiter
Sprain
epicondylitis
PVD
DVT
Shoulder dislocation
122
Q

Joint/Limb Workup

A 
ANA
Anti-ds DNA
Xray
Arthrocentesis
RF, ESR
Uric acid
CT/MRI
DEXA
PT/PTT
Doppler
CPK
urine myoglobin
TSH
123
Q

Low Back pain History

A 
Location
quality
intensity
radiation
context (moving, bending, twisting)
timing
associated (constitutional, incontience)
URI

PMH: DM, renal stones
SocHx: IVDU, smoking

124
Q

Low Back pain PE

A 
Vitals
Neuro (L4-S1)
back palpation
ROM
hip exam
Rectal
125
Q

Low back DDX

A 
disk herniation
lumbar muscle strain
AAA
vertebral compression fractures
PVD
Malingering
Ankylosing spondylitis
126
Q

Low Back workup

A

Xray- Spine
MRI Spine
CT spine
ABI

127
Q

Child with Fever History

A 
Severity
Duration
localizing sxs
appetite
rash
sick contacts
day care
immunization
128
Q

Child with fever PE

A 
Vitals
HEENT
Neck
Heart
Lung
Abdominal
Skin exam
129
Q

Child with fever DDX

A 
sepsis
meningitis
pneumonia
UTI
Acute OM
Measles
Rubella
Roseola
Varicella
Gastroenteritis
UTI
URI
130
Q

Child with fever workup

A 
PE
CBC
electrolytes
UA
Urine culture
Blood cultures
CXR
LP- CSF analysis
UA
Throat swab
131
Q

Child with GI sxs history

A

Onset, location, quality, intensity, radiation
Associated sxs ( constitutional, GI, cardiac, pulm, renal pelvic)
Exacerbating and alleviating factors
day care
immunication
changes in weight

Medications

132
Q

Child with GI PE

A 
vitals
heart and lung
abdominal
rectal
pelvic
133
Q

Child with GI ddx

A 
pyloric stenosis
duodenal atresia
GERD
gastroenteritis
Hepatitis
UTI
Hypothyroidism
intussusception
appendicitis
Meckel Diverticulum
Volvulus
Gasteroenteritis
Malingering
IBS
lactose intolerance
Colic
lactose intolerance
testicular torsion
sepsis
134
Q

Child with GI sxs workup

A 
PE
CBC
Electrolytes
US-abd
barium swallow
Contrast enema
US abdomen
CT abdomen
Blood cx
Stool exam
amylase/ lipase
FOBT
135
Q

Child with Red eye History

A 
onset
location
duration
Discharge
Sick contacts
Immunication
Constitutional: GI, cardiac, pulmonary, renal)

Medications

136
Q

Child with red eye ddx

A 
Bacterial conjunctivitis
viral conjunctivitis
keratitis
sesonal allergies
uveitis
137
Q

Child with red eye workup

A 
PE
Opthalmoscopic exam
CBC
Electrolytes
Discharge
Slit lamp
138
Q

Child with short stature

A 
Prenatal and birth history
growth history
PMH
Medications
FamHx
Constitutional: GI, cardiac, pulm, renal, pelvis
139
Q

child with short stature PE

A 
Vitals
height
weight
HEENT
Heart, lung
Abdominal exam
neuro exam
140
Q

Child with short stature DDx

A 
Familial short stature
GH deficiency
Hypothyroid
Chronic renal insufficiency
Genetic
141
Q

Behavioral problems in childhood hisotyr

A

Onset, severity, duration, triggers
developmental history
changes in environment

142
Q

behavior problems PE

A

Vitals

neuro exam

143
Q

Behavior problems DDX

A 
ADHD
Adjustment DO
Substance abuse
age appropriate
Manic
ODD
Manic
Conduct DO
Oppositional Defiant DO
144
Q

Behavioral problems workup

A

Physical exam
MSE
Urine toxicology

USMLE step 2CS (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions