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Step 2 CS > Minicases > Flashcards

Minicases Flashcards

1
Q

Headache key history

A

OPQRSTAA neuro sx N/V jaw claudication trauma dental sinusitis pmh/fhx

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2
Q

headache PEx

A

vitals HEENT fundoscopic neuro

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3
Q
A
  • migraine (complicated)
  • tension
  • cluster
  • pseudotumor cerebri
  • CNS vaxulitis
  • partial seizure
  • intracanial neoplasm
  • CBC
  • ESR
  • CT-head
  • MRI-brain
  • LP-CSF analysis
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4
Q
A
  • cluster
  • migraine
  • tension
  • intracranial tumor
  • pseudotumor cerebri

​​

  • CBC
  • CT-head
  • MRI-brain
  • LP-CSF
  • ESR
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5
Q
A
  • temporal arteritis
  • migraine
  • cluster
  • tension
  • meningitis
  • carotic artery dissection
  • pseudotumor cerebri
  • trigeminal neuraglia
  • intracranial neoplasm
  • TMJ
  • ESR
  • CBC
  • CRP
  • temporal artery biopsy
  • Doppler US-carotids
  • MRI-brain
  • LP-CSF
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6
Q
A
  • sinusitis
  • migraine
  • tension
  • meningitis
  • IC tumor​
  • CBC
  • XR-sinus
  • CT-sinus
  • LP-CSF
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7
Q
A
  • tension
  • migraine
  • depression
  • caffeine or analgesi withdrawal
  • HTN
  • cluster
  • pseudotumor cerebri
  • IC tumor

​​

  • CBC
  • electrolytes
  • ESR
  • CT-head
  • LP-CSF analysis
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8
Q
A
  • subarachnoid hemorrhage
  • migraine
  • meningitis/encephalitis
  • IC hemorrhage
  • Vertebral artery dissection
  • IC venous thrombosis
  • acute HTN
  • IC tumor
  • noncontrast CT-head
  • LP-CSF
  • CBC
  • PT/PTT/INT
  • Urine toxicology
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9
Q
A
  • meningitis
  • migraine
  • SAH
  • sinusitis/encephalitis
  • IC or epidural abscess

​​

  • CBC
  • CT-head
  • MRI-brain
  • LP-CSF
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10
Q
A
  • pseudotumor cerebri
  • tension
  • migraine
  • cluster
  • meningitis
  • IC venous thrombosis
  • IC tumor
  • Urine BhCG
  • CBC
  • CT-head
  • LP-opening pressure and CSF analysis
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11
Q
A
  • trigeminal neuralgia
  • tension
  • migraine
  • cluster
  • TMJ
  • IC tumor
  • CBC
  • ESR
  • MRI-brain
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12
Q

confusion/memory loss key history

A
  • must include hx from family members/caregivers when available
  • time course
  • assoc sx
  • delirium
  • falls
  • meds
  • hx stroke
  • hx ASCVD, spyhilis, HIV, EtOH, B12 def
  • FHX
  • other neuro dz
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13
Q

confusion/memory loss PEx

A
  • vitals
  • neuro
  • MMSE
  • gait
  • general
    • ENT
    • Heart
    • Lungs
    • ABD
    • Ext
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14
Q
A
  • vascular dementia
  • alzheimer dz
  • NPH
  • chronic SHD
  • IC tumor
  • depression
  • B12 def
  • neurosyphilis
  • hypoTHY
  • CBC
  • VDRL/RPR
  • SerumB12
  • TSH
  • MRI-brain
  • CT-head
  • LP-CSF
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15
Q
A
  • alzheimer’s dz
  • vascular dementia
  • depression
  • hypoTHY
  • cSDH
  • NPH
  • IC tumor
  • B12 def
  • Neurosyphilis
  • CBC
  • VDRL/RPR
  • sB12
  • TSH
  • MRI-brain
  • CT-head
  • LP-CSF
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16
Q
A
  • NPH
  • Alz dz
  • vascular dementia
  • cSDH
  • IC tumor
  • Depression
  • B12 def
  • neurosyphilis
  • hypoTHY
  • CT-head
  • BRI-brain
  • LP-opening P and CSF
  • sB12
  • VDRL/RPR
  • TSH
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17
Q
A
  • CJD
  • vascular
  • lewy body dementia
  • Wernicke’s encephalopathy
  • NPH
  • cSDH
  • IC tumor
  • depression
  • delirium
  • B12 def
  • neurosyphilis
  • CBC
  • electrolyties, calcium
  • sB12
  • BDRL/RPR
  • MRI-brain (preferred)
  • CT-head
  • EEG
  • LP-CSF
  • brain biopsy
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18
Q
A
  • hypoglycemia
  • TIA
  • arrhythmia
  • delirium
  • angina
  • glucose
  • CBC
  • electrolyties
  • CPK-MB, troponin
  • ECHO
  • ECG
  • MRI-brain
  • Doppler US-carotid
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19
Q
A
  • SDH
  • SIADH
  • CJD
  • IC tumor
  • CT-head
  • CBC
  • electrolytes
  • MRI-brain
  • LP-CSF
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20
Q

loss of vision key history

A
  • acute/chronic
  • progression
  • ability to see light
  • assoc sx
    • eye pain, discharge, itching, tearing, photophobia, redness, HA, weakness, numbness, floaters, sparks
  • hx cardiac/rheum/thromb/ai/neuro dz
  • jaw claudication
  • rx
  • trauma
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21
Q

loss of vision PEx

A
  • vitals
  • CV
  • HEENT
  • fundoscopic
  • neuro
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22
Q
A
  • retinal artery occlusion
  • retinal vein occlusion
  • acute angle-closure glaucoma
  • retinal detachment
  • temporal arteritis
  • fluorescein angiogram
  • ECHO
  • doppler US-carotids
  • intraocular tonometry
  • ESR
  • temporal artery biopsy
  • CBC
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23
Q

depressed mood key history

A
  • onset
  • duration
  • Sleep
  • Interest change
  • Guilt
  • Energy level change
  • Concentration change
  • Appetite change
  • Psychomotor agitation or retardation
  • Suicidal ideation
  • life stress
  • social function
  • excessive etoh /drug use
  • fhx
  • prior epidosdes
  • Rx
    *
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24
Q

depressed mood PEx

A
  • vitals
  • head/neck
  • neuro
  • MSE
    • appearance
    • behavior
    • speech
    • mood
    • affect
    • thought process
    • thought content
    • cognition (30pt MMSE)
    • insight
    • judgment
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25
Q
A
  • Normal bereavement
  • djustement disorder with depressed mood
  • MDD with psychotic featuers
  • schizoaffective disorder
  • depressive disorder not otherwise specified
  • PEx
  • TSH
  • CBC
  • Utox
  • Beck Depression Inventory
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26
Q
A
  • MDD
  • substance-induced mood disorder
  • dysthymic disorder
  • PEx
  • MSE
  • Beck Depression Inventory
  • blood EtOH level
  • TSH
  • CBC
  • Utox
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27
Q
A
  • bipolar I disorder
  • bipolar II disorder
  • cyclothymic disorder
  • MDD
  • schizoaffective disorder
  • PEx
  • MSE
  • Utox
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28
Q
A
  • schizophrenia
  • schizoid or schizotypal personality disorder
  • schizophreniform disorder
  • psychotic disorder due to genearl medical condition
  • subtance-induced psychosis
  • depression with psychotic features
  • MSE
  • Utox
  • TSH
  • CBC
  • electrolytes
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29
Q

psychosis key history

A
  • positive sx
    • delusions, hallucinations, disorganized thoughts, disorganized catatonic behavior
  • negative sx
    • blunted affect, social w/d, dec motivation, dec speech/thought poverty/blocking
  • cognitive sx
    • disorganized speech, paranoia
  • age first sx
  • hospitalizations
  • hx psych meds
  • alcohol and drug use
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30
Q

psychosis key PEx

A
  • vitals
  • MSE
  • general appearance
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31
Q
A
  • substance-induced psychosis
  • brief psychotic disorder
  • schizophreniform disorder
  • schizophrenia
  • psychotic disorder to general medication condition
  • Utox
  • MSE
  • TSH
  • CBC
  • electrolytes, BUN/Cr
  • AST/ALT
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32
Q
A
  • schizoaffective disorder
  • mood disorder with psychotic features
  • schizophrenia
  • schizophreniform disorder
  • psychotic disorder from gen med condition
  • MSE
  • PHQ9
  • TSH
  • CBC
  • electrolytes
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33
Q

dizziness key history

A
  • lightheadedness vs. vertigo
  • auditory sx
    • tinnitus, hearing loss
  • duration
  • context
    • occurs with positioning, following head trauma
  • assoc sx
    • visual changes, URI, nausea
  • neck pain
  • trauma
  • meds
  • hx ASCVD
34
Q

dizziness key PEx

A
  • vitals
  • neuro
  • Romberg
  • gait
  • nystagmus
  • tilt test (Dix-Hallpike maneuver)
  • hearing
  • Weber and Rinne
  • ENT
  • CV
35
Q
A
  • Meniere’s disease
  • vestibular neuronitis
  • labyrinthitis
  • BPPV
  • acoustic neuroma
  • CBC
  • VDRL/RPR (syphilis is a cause of Meniere dz)
  • MRI-brain
  • Dix-Hallpike maneuver
36
Q
A
  • orthostatic hypotension due to dehydration (diarrhea, diuretic use)
  • vesituvar neuronitis
  • labyrinthitis
  • BPPV
  • vertebrobasilar insufficiency
  • orthostatic vital signs
  • CBC
  • electrolytes
  • rectal exam, stool for occult blood
  • stool leukocytes
37
Q
A
  • drug-induced orthostatic hypotension
  • vesitbular neuronitis
  • labyrinthitis
  • BPPV
  • brain stem or cerebellar tumor
  • ARF
  • orthostatic vitals
  • CBC
  • electrolytes
  • ECHO
  • MRI-brain
38
Q
A
  • BPPV
  • vestibular neuronitis
  • labyrinthitis
  • Meniere’s dz
  • Dix-Hallpike maneuver
  • MRI-brian
  • audiogram
39
Q
A
  • vestibular neuronitis
  • labyrinthitis
  • Meniere’s dz
  • BPPV
  • vertigo associated with cervical spine dz or injury
  • vertebrobasilar insufficiency
  • CBC
  • electrolytes
  • electronystagmography
  • MRI/MRA-brain
40
Q
A
  • labyrinthitis
  • vestibular neuronitis
  • Meniere’s dz
  • acoustic neuroma
  • vertebrobasilar insufficiency
  • audiogram
  • electronystagmography
  • MRI/MRA-brain
41
Q

loss of consciousness key history

A
  • prodrome
    • nausea, diaphoresis, palpitations, pallor, lightheadedness
  • context
    • exertional, postural, traumatic, stressful/painful, claustrophobic, dehydration
  • tongue biting/incontinence/tonic/clonic movements/prolonged confusion
  • SOB/PE risk factors
  • hx heart disease, arrhyth, HTN, DM
  • drug and alcohol use
42
Q

loss of consciousness key PEx

A
  • vitals
  • orthostatic vitals
  • neuro
  • carotid and CV exam
  • Resp
  • LE
43
Q
A
  • GTC seizure
  • convulsive episode
  • substance abuse/OD
  • malingering
  • hypoglycemia
  • CBC
  • electrolytes, glucose
  • Utox
  • EEG
  • MRI-brain
  • CT-head
  • LP-CSF
  • ECG
44
Q
A
  • drug-induced orthostatic hypotension (causing syncope)
  • hypoglycemia
  • cardiac arrhythmia
  • syncope (vasovagal, other)
  • stroke
  • MI
  • PE
  • orthostatic vitals
  • CBC
  • electrolytes, glucose
  • ECHO
  • Ct-head
  • ECG
  • V/Q scan
  • CTA-chest w/ IV contrast
  • D-dimer
45
Q
A
  • cardiac arrhythmia (causing syncope)
  • severe aortic stenosis
  • syncope (other causes)
  • seizures
  • PE
  • ECG
  • holter monitor
  • CBC
  • electrolytes, glucose
  • ECHO
  • CT-head
46
Q

numbness and tingling key history

A
  • distribution
    • unilaterlal, bilateral, prox/distal
  • duration
  • progression
  • pain
    • esp. HA, neck, back pain
  • constitutional sx
  • other neuro sx
  • hx DM, EtOH, ASCVD
47
Q

numbness and tingling key PEx

A
  • vitals
  • neuro
  • MSK
  • relevant vascular exam
48
Q
A
  • TIA
  • hypoglycemia
  • seizures
  • stroke
  • facial nerve palsy
  • CT-head
  • CBC
  • electrolytes, glucose
  • fasting lipid panel
  • ECG
  • MRI-brain
  • Doppler US-carotid
  • ECHO
  • EEG
49
Q
A
  • stroke
  • TIA
  • seizure
  • IC tumor
  • SDH/EDH
  • CT-head
  • CBC
  • electrolytes
  • PT/PTT/INF
  • fasting lipid panel
  • MRI-brain
  • Doppler US-carotid
  • ECHO
  • ECG
50
Q
A
  • GBS
  • MS
  • polymyositis
  • MG
  • peripheral neuropathy
  • tumor of vertebral canal
  • CBC
  • electrolytes
  • CPK
  • LP-CSF
  • MRI-spine
  • EMG
  • nerve conduction studies
  • Tensilon (edrophonium) test
  • sB12
51
Q
A
  • MS
  • stroke
  • conversion disorder
  • malingering
  • CNS tumor
  • neurosyphilis
  • syringomyelia
  • CNS vasculitis
  • CBC
  • ESR
  • BDRL/RPR
  • MRI-brain, spine
  • LP-CSF and oligoclonal bands
  • retinal evoked potentials
52
Q
A
  • diabetic peripheral neuropathy
  • alcoholic peripheral neuropathy
  • B12 def
  • hypocalcemia
  • hyperventilation
  • paraproteinemia/myeloma
  • HbA1c
  • ESR
  • calcium
  • sB12
  • UA
  • SPEP and UPEP
53
Q
A
  • MG
  • Horner’s syndrome
  • MS
  • IC tumor compressing CN II, IV, VI
  • amyotrophic lateral sclerosis
  • Tensilon (edrophonium) test
  • serum anti-AChR antibodies
  • CXR
  • CT-chest
  • MRI-brain
  • EMG
54
Q
A
  • Todd’s paralysis
  • TIA
  • stroke
  • complicated migraine
  • malingering
  • CBC
  • electrolytes
  • EEG
  • MRI-brain
  • Doppler US-carotid
55
Q
A
  • carpal tunnel 2/2 hypothyroidism
  • overuse injury of median nerve
  • medial epicondylitis
  • Phalen’s maneuver
  • Tinel’s sign
  • nerve conduction studies
  • TSH
  • CBC
56
Q

fatigue and sleepiness key history

A
  • duration
  • sleep hygiene
  • snoring, witnessed apnea, waking up choking/gasping
  • overexertion
  • stress, depression, emotional problems
  • lifestyles changes, shift changes
  • diet, weight changes
  • sx other
    • thyroid, bleeding, anemia
  • meds
  • alcohol
  • drugs
  • caffeine
57
Q

fatigue and sleepiness key PEx

A
  • vitals
  • ENT
    • conjunctival pallor, oropharynx/palate, lymphadenopathy, thyroid)
  • CV
  • pulm
  • ABD
  • neuro
  • LE
  • consider rectal exam and occult blood testing
58
Q
A
  • depression
  • adjustment disorder
  • hypothyroidism
  • anemia
  • CBC
  • TSH
  • HIV/STD testing
  • PHQ9
59
Q
A
  • PTSD
  • depression
  • GAD
  • psychotic or delusional disorder
  • hypoTHY
  • CBC
  • TSH
  • Utox
  • PHQ9
60
Q
A
  • colon cancer
  • hypothyroidism
  • renal failure
  • hypercalcemia
  • depression
  • rectal exam, stool for occult blood
  • CBC
  • electrolytes, BUN/Cr, calcium
  • AST/ALT
  • TSH
  • colonoscopy
  • barium enema
  • CT-abd/pelvis
61
Q
A
  • hypothyroidism
  • depression
  • diabetes
  • anemia
  • TSH, fT4, fT3
  • CBC
  • fasting glucose
  • HBA1c
62
Q
A
  • OSA
  • hypothyroidism
  • chronic fatigue syndrome
  • narcolepsy
  • CBC
  • TSH
  • nocturnal pulse ox
  • polysomnography
  • ECG
63
Q
A
  • diabetes mellitus
  • atypical depression
  • primary polydipsia
  • diabetes insipidus
  • GTT
  • HbA1c
  • UA
  • CBC
  • electrolytes, BUN/Cr, glucose
64
Q
A
  • shift work sleep disorder
  • sleep apnea
  • depression
  • anemia
  • CBC
  • nocturnal pulse ox
  • polysomnography
65
Q

night sweats key history

A
  • OPQRSTAA
  • assoc dz or sx
    • fever, recent URI, assoc cough, hemoptysis, pleuritic chest pain
  • lymphadenopathy
  • rash
  • malaise
  • wt loss
  • itching
  • diarrhea
  • n/v
  • early satiety
  • presence of sig RF
    • traveling to areas with endemic infections IVDU
  • Hx alcohol
  • sexual exposures
  • sick contacts
  • exposure to high-risk populations such as prisoners/homeless
  • menstrual history/menopausal status
  • travel history
66
Q

night sweats key PEx

A
  • vitals
  • HEENT
    • throat, LNs
  • CV
  • pulm
  • abd
    • hepatosplenomegaly
  • skin
  • MSK
    • joint pain
67
Q
A
  • tuberculosis
  • acute HIV infection
  • lymphoma
  • leukemia
  • hyperthyroidism
  • PPD/Quantiferon gold
  • CBC
  • CXR
  • sputum gram stain, acid-fast stain, cx
  • HIV antibody
  • TSH, fT4
68
Q
A
  • hyperthyroidism
  • pheochromocytoma
  • carcinoid syndrome
  • TB
  • TSH, fT4, fT3
  • 24-h urine catecholamines
  • urine 5-HIAA
  • CBC
  • PPD
69
Q

insomnia key history

A
  • primary/secondary
  • description
  • daytime sleepiness
  • other med problems
    • arthritis (pain)
    • diabetes (polyuria)
    • common sleep disorder (sleep apnea, RLS)
  • nightmares, depression
  • caffeine, alcohol, drugs, meds
  • work or lifestyles (jet lag or shift work)
  • stressors
  • sleep hygiene
  • psychiatric sx (mania sx)
70
Q

insomnia key PEx

A
  • vitals
  • thyroid
  • MSE
71
Q
A
  • stress-induced insomnia
  • caffeine-induced insomnia
  • insomnia with circadian rhythm sleep disorder
  • insomnia related to MDD
  • polysomnography
  • MSE
  • utox
  • CBC
  • TSH
72
Q
A
  • OSA
  • daytime fatigue in primary hypersomnia
  • insomnia with circadian rhythm sleep disorder
  • insomnia related to MDD
  • CBC
  • TSH
  • polysomnography
  • ECG
73
Q
A
  • insomnia related to MDD
  • primary hypersomnia
  • insomnia with circadian rhythm disorder
  • MSE
  • TSH
  • CBC
  • polysomnography
74
Q

sore throat key history

A
  • duration
  • fever
  • other ENT
  • odynophagia
  • swollen glands
  • cough
  • rash
  • sick contacts
  • HIV RF
75
Q

sore throat key PEx

A
  • vitals
  • HEENT
    • oral thrush
    • tonsillar exudate
    • lymphadenopathy
  • pulm
  • abd
    • splenomegaly
  • skin
76
Q
A
  • infectious mononucleosis
  • hepatitis
  • viral/bacterial pharyngitis
  • acute HIV infection
  • secondary syphilis
  • CBC w/ peripheral smear
  • monospot test
  • throat cx
  • AST/ALT/bili/ALP
  • HIV ab and viral load
  • anti-EBV ab
  • VDRL/RPR
77
Q
A
  • HIV, acute retroviral syndrome
  • infectious mononucleosis
  • hepatitis
  • viral pharyngitis
  • strep tonsillitis/scarlet fever
  • secondary syphilis
  • CBC with peripheral smear
  • HIV antibody and viral load
  • CD4 count
  • monospot test
  • VDRL/RPR
  • AST/ALT/bili/ALP
78
Q
A
  • pharyngitis (bact or viral)
  • mycoplasma PNA
  • acute HIV if
  • infectious mononucleosis
  • throat swab for cx and rapid strep antigen
  • CBC
  • monospot test
  • serologic test (cold agglutinin titer) for mycoplasma
  • HIV antibody and viral load
79
Q

cough/dyspnea key history

A
  • acute/chronic
  • freq, timing
  • sputum/hemoptysis
  • assoc sx
    • constitutional, URI, post nasal drip, dyspnea, eheez, chest pain, heartburn
  • exac/allevi
  • exposures
  • smoking?
  • hx lung disease
  • posttussive emesis
  • heart failure
  • allergies
  • meds
    • ACEi
80
Q

cough/shortness of breath key PEx

A
  • vitals
  • pulse ox
  • HEENT
    • nasal mucosa, oropharynx
  • LNs
  • pulm
  • CV
  • ABD
  • ext
    • clubbing, cyanosis, edema
81
Q
A

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Step 2 CS (1 decks)

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