Random Flashcards
What is the gold standard investigation for diagnosing a pulmonary embolism?
CT pulmonary angiography
What is the gold standard investigation for diagnosing CAD?
Coronary angiography
What is the gold standard investigation for diagnosing DM1?
C-peptide levels
(usually low in DM1, high in DM2)
What is the gold standard investigation for diagnosing celiac disease?
Small bowel biopsy
What is the gold standard investigation for diagnosing GERD?
24-hour pH monitoring
What is the gold standard investigation for diagnosing DVT?
Venography
Give DDX forpatients with “leg aching”
Evening symptoms, urge to move legs when lying, and involuntary movements without cramping? Think Restless Leg Syndrome
Evening symptoms, painful muscle contractions, relieved by forceful stretching? Think Nocturnal Muscle Cramps
After walking a predictable distance, and resolves with rest? Think Vascular Claudication
» Management Tip: Exercise is a proven treatment for this, but be sure to recommend a supervised exercise program (even if this isn’t available in your community, it’s still important to mention on the exam.)
Daytime symptoms, tingling/shock-like pain? Think Peripheral Neuropathy
Weakness, proximal muscle pain? Think Myopathy (ask about statin use)
No tightening or pain, but difficulty with sleeping and positive polysomnography? Think Periodic Limb Movement Disorder, a diagnosis of exclusion
give 2 treatments for each
State the FRS criterias
Age
Sex
Smoker
Total cholesterol
HDL cholesterol
Systolic BP
Blood pressure being treated with medicines
State the Wells DVT criteria
Active cancer/tx/palliation within 6 months
Bedridden recently >3 days or major surgery within 12 weeks
Calf swelling >3 cm compared to the other leg
Collateral (nonvaricose) superficial veins present
Entire leg swollen
Localized tenderness along the deep venous system
Pitting edema, confined to symptomatic leg
Paralysis, paresis, or recent plaster immobilization of the lower extremity
Previously documented DVT
Alternative diagnosis to DVT as likely or more likely
State the Wells PE criteria
Clinical signs and symptoms of DVT
PE is #1 diagnosis OR equally likely
Heart rate > 100
Immobilization at least 3 days OR surgery in the previous 4 weeks
Previous, objectively diagnosed PE or DVT
Hemoptysis
Malignancy w/ treatment within 6 months or palliative
State the PERC criteria
Age ≥50
HR ≥100
O₂ sat on room air <95%
Unilateral leg swelling
Hemoptysis
Recent surgery or trauma
Prior PE or DVT
Hormone use
List the Ottawa SAH rule.
Age ≥40
Neck pain or stiffness
Witnessed loss of consciousness
Onset during exertion
Thunderclap headache (instantly peaking pain)
Limited neck flexion on examination
