Top 100 Facts Flashcards
the number one cause of preventable morbidity and mortality (e.g., atherosclerosis, cancer, chronic obstructive pulmonary disease) in the US
smoking
number two cause of preventable morbidity and mortality in the US
alcohol
What is the classic ratio of AST to ALT in alcoholic hepatitis?
AST:ALT ≥ 1:1, although both may be elevated
Give _____ to reproductive age women before pregnancy to prevent _____
What should you keep an eye out for and how should this be managed if it does present?
Folate, Neural tube defects
watch out for pernicious anemia (loss of gastric parietal cells/loss of IF production); treat with B12 to prevent permanent neurological deficits
what medication can cause B6/pyridoxine deficiency?
isoniazid
what should you treat alcoholic patients with and why?
Thiamine
prevent Korsakoff dementia
most common cause of anemia
IDA
which vitamin is a known teratogen?
in whom would you commonly see this vitamin used for?
A
reprodcutive-age women who is treating acne with vitamin A analog, isotretinoin
What are some complications of atherosclerosis?
What are the risk factors?
MI, heart failure, stroke, gangrene
age/sex, family history, smoking, HTN, DM, high LDL, and low HDL
Complications of DM? 6
DM leads to
- atherosclerosis and its complications
- retinopathy (a leading cause of blindness)
- nephropathy (a leading cause of end-stage renal failure)
- peripheral vascular disease (a leading cause of limb amputation)
- peripheral neuropathy (sensory and autonomic)
- increased incidence of infections
complications of severe HTN
hypertensive emergency:
headaches, dizziness, blurry vision, papilledema, cerebral edema, altered mental status, seizures, intracerebral hemorrhage (classically in the basal ganglia), renal failure/azotemia, angina, MI, and/or heart failure.
lifestyle modifications (diet, exercise, weightloss, cessation of alcohol/tobacco use) may be able to treat which disorders without the use of medications? 7
HTN, hyperlipidemia, DM, GERD, insomnia, obesity, and sleep apnea.
What does an ABG tell you?
pH = 1˚ event (acidosis vs alkalosis)
CO/HCO3 = cause (same direction as pH) and any compenstatory effect (opposite of pH)
exogenous causes of hyponatremia
narcotics
oxytocin
diuretics
IV fluids (excess)
anti-epileptic medications
NO-DIE
ECG findings in hyperkalemia
peaked T waves
ECG changes in hypokalemia
T-wave flattening and U waves
ECG changes in hypocalcemia
Qt prolongation
ECG changes in hypercalcemia
Qt shortening
Initial management of a patient in shock
O2
start IV line
set up pulse ox, ECG, vitals
give fluid bolus if patient does not have CHF
Virchow’s triad of DVTs
1) endothelial damange
2) venous stasis
3) hypercoagulable state
3 mainstay therapies for CHF
1) diuretics
2) ACEi
3) ß blockers
what is cor pulmonale?
Right-sided heart enlargement, hypertrophy, or failure caused by primary lung disease (usually COPD)
w/u for a patient with a-fib
assess for underlying etiology:
TSH
Electrolytes
ECHO
complications of a-fib
- ventricular rate and ischemia (if needed, slow the rate with medications)
- atrial clot formation/embolic disease (consider anticoagulation with warfarin)
management of v-fib or pulseless v-tach
immediate defibrillation followed by amiodarone, lidocaine, vasopressin, & epinephrine (ALiVE)
management of v-tach with a pulse
amiodarone and synchronized cardioversion
management of pulseless v-tach vs v-tach with a pulse
pulseless v-tach - immediate defibrillation followed by amiodarone, lidocaine, vasopressin, & epinephrine (ALiVE)
v-tach with a pulse - amiodarone and synchronized cardioversion
most important parameter on pulmonary function testing to distinguish between obstructive vs. restrictive lung disease
FEV1/FEV ratio
obstructive = FEV1/FEV ratio is less than normal
restrictive = FEV1/FEV ratio is often normal
most common type and cause of esophageal cancer
adenocarcinoma occurring as a result of long- standing reflux disease and the development of Barrett esophagus.
second most common type and cause of squamous cell carcinoma
smoking and alcohol abuse
patient presents with a gastric ulcer. what is the next best step in management?
get a biopsy OR follow it to resolution to exclude malignancy
best way to differentiate between upper vs lower GI bleed
test a nasogastric tube aspirate for blood
(although bright red blood via mouth or anus is a fairly reliable sign of a nearby bleeding source)
most common cause of GI complaints
IBS
(usually diagnosis of exclusion)
how does IBS classically present?
young woman with a history of chronic alternating constipation and diarrhea
type of pathology found on Crohns vs UC
Crohns = transmural inflammation
UC = mucosal/submucosal inflammation
bowel habit changes in Crohns vs UC
Crohns = obstruction, abdominal pain
classic lesions of Crohns vs UC
Crohns = fistulas, abscesses, cobblestoning, string sign on barium xray
UC = pseudopolyps, lead pipe colon on barium xray, toxic megacolon
which forms of hepatitis are transmitted parenterally and can lead to chronic infection, cirrhosis, and hepatocellular carcinoma?
BCD
most common known genetic disease in white people
how do they normally present?
how do you screen these patients?
how should these patients be managed?
Hereditary hemochromatosis
fatigue, impotence, hepatomeagly
transferrin saturation (serum iron/TIBC) and ferritin level
phlebotomy
sequelae of liver failure (many)
Coagulopathy that cannot be fixed with vitamin K
jaundice/ hyperbilirubinemia
hypoalbuminemia
ascites
portal hypertension
hyperammonemia/ encephalopathy
hypoglycemia
DIC
what is pancreatitis usually caused by?
management?
complications?
gallstones or alcohol
supportive treatment and pain control
pseudocyst formation, infection/abscess, ARDS (results from a systemic net pro-inflammatory response that causes endothelial and epithelial injury)
how do you determine if jaundice/hyperbilirubinemia is physiologic vs pathologic?
jaundice in neonates = physiologic
jaundice present at brith = pathologic
∆ between 1˚ and 2˚ endocrine disturbances
1˚ = gland malfunctions but the pituitary and another gland and the CNS responds appropriately
2˚ = gland is doing what it is told to do by other controlling forces (e.g., pituitary gland, hypothalamus, tumor, disease)
side effects of excess steroids
Weight gain, easy bruising, acne, hirsutism, emotional lability, depression, psychosis, menstrual changes, sexual dysfunction, insomnia, memory loss, buffalo hump, truncal/central obesity with wasting of extremities, moon facies, purplish striae, weakness (especially of the proximal muscles), HTN, peripheral edema, poor wound healing, glucose intolerance or diabetes, osteoporosis, and hypokalemic metabolic alkalosis (resulting from mineralocorticoid effects of certain corticosteroids). Growth can also be stunted in children.
most common cause of arthritis (≥75% of cases)
osteoarthritis
Sequelae of lung cancer 7
Hemoptysis
Horner syndrome
SVC syndrome
Phrenic nerve involvement/diaphragmatic paralysis
Recurrent laryngeal nerve involvement (hoarseness)
Hypercalcemia (PTHrP)
Paraneoplastic syndromes (Cushing syndrome, SIADH, hypercalcemia, Eaton-Lambert syndrome)
cause(s) of bitemporal hemianopsia
best diagnostic study?
pituitary tumor
get CT or MRI of brain
characteristics of a mole that should make you suspicious of a malignant transformation
management of such moles or if a mole starts to itch or bleed
- Asymmetry
- Borders (irregular)
- Color (change in color or multiple colors)
- Diameter (the bigger the lesion, the more likely it is malignant)
- Evolving over time
Do an excisional biopsy
Potential risks/ADR of estrogen therapy
hepatic adenoma
glucose intolerance/diabetes
DVT/strokes
gallstones
fibroids/fibroadenomas
migraines/epilepsy
This type of birth control increases risk of CAD and breast cancer
combined estrogen + progesterone therapy
Children in these age groups are at risk of this particular illness
0-18 mo
1-2 yr
2-5 yr
common causes?
0-18 mo = bronchiolitis = RSV, parainfluenza, influenza (RIP)
1-2 yr = croup = parainfluenza, influenza
2-5 yr = epiglottitis = h. influenza, staph aureus, strep pneumo
X-ray findings of
bronchiolitis
croup (laryngotracheitis)
Epiglottitis
bronchiolitis = hyperinflation of lungs
croup (laryngotracheitis) = steeple sign (subglottic tracheal narrowing on frontal xray)
Epiglottitis = thumb sign (swollen epiglottis on lateral neck xray)
Treatment of
bronchiolitis
croup (laryngotracheitis)
Epiglottitis
bronchiolitis = humidified O2, bronchodilators, ribavirin (for RSV)
croup (laryngotracheitis) = dexamethasone, nebulized epinephrine, humidified O2
Epiglottitis = third gen cephalosporin + vanc or clindamycin (for MRSA), establish airway
Sequelae of streptococcal infection 3
which of thse can be prevented by antibiotics
Scarlet fever
Rheumatic fever (complication of scarlet fever)
Poststreptococcal glomerulonephritis.
Only the first two can be prevented by treatment with antibiotics
3 best diagnostic tests for multiple sclerosis
of these, which are the most sensitive?
- MRI = Most sensitive
- Lumbar Puncture (elevated IgG bands + MBP, mildly elevated lymphocytes and protein)
- Evoked potentials (slowed conduction in areas with myelin damage)
Top 3 ddx of an unconscious or delirious patient presenting to the ED with no history or evidence of trauma. How should these be managed?
hypoglycemia -> give glucose
opioid OD -> give naloxone
thiamine deficiency -> give thiamine, then glucose
∆ between delirium and dementia in terms of
onset
attention span
arousal level
delirium = acute onset, poor attention, fluctuating arousal
dementia = slow onset, unaffected attention, normal arousal
What should you consider in women between the ages of 15-50 before prescribing therapies or tests?
pregnancy
Initial management of patients with anaphylaxis
secure airway (intubation or cricothyroidotomy)
subcu or IV heparin
Colorectal screening recommendations
starting at age 50, but the frequency is determined by the type of procedure used
colonoscopy = q 10y if negative
flexible sigmoidoscopy = q 5y
FOBT = q 1y
prostate cancer screening recommendations
DRE = starting at age 40, annually
PSA = starting at age 50, annually *controversial*
Cervical cancer screening recommendations
Pap smear = start at age 21
- if Pap only, then annual screening; after 3 consecutive negative, then test every 3 years
- if Pap + HPV, then test every 3 years if both are negative
Pelvic exam screening recommendations
Pelvic exam = start at age 21, and perform annually; after 3 consecutive negative, then perform every 2-3 years. If after 65, perform annually
Breast cancer screening recommendations
- physical exam by MD - begin at 20, perform every 3 years until the age of 40, then perform annually
- mammogram - begin at 40, then perform annually
lung cancer screening recommendations
sputum/CXR testing is NOT recommended for asymptomatic individuals, even if they are at high risk
Annual CT is controversial, but may be indicated for smokers/former smokers aged 55-74 who have at least a 30PY
what type of error does the p-value reflect?
the likelihood of making a type I error (claiming there is an effect or difference when none existed)
What are 6 ADRs of anti-psychotics and how are some of them managed?
- Acute dystonia –> anti-histamines or anticholinergics
- akathisia –> ß blocker
- tardive dyskinesia –> switch to a new agent
- parkinsonism –> anti-histamine or anticholinergics
- hyperprolactinemia
- autonomic nervous system-related effects
T/F asking about depression and/or suicidal ideation will cause patients to commit suicide
FALSE!
3 recreational drugs that can have fatal withdrawal effects
alcohol
barbituates
benzodiazepines
all incr. action of GABA/inhitory action
note that alcohol can inhibit NMDA receptor and result in release of other inhibitors (ie dopamine and serotonin), which can activate the reward centers
most common preventable cause of infertility in the US
Pelvic inflammatory disease (PID)
women who are heavy, amenorrheic and have hair on face, chest, abdomen, and lower back
how are these patients treated?
think PCOS - most common cause of dysfunctional uterine bleeding. Remember these folks have a dysfunctional HPO circuit, where desuppression occurs with too many GnRH pulses frequency and amplitude, resulting in an absent feedback mechanism to endogenous hormones; results in elevated LH (–> theca cells produce androgens) and slightly decreased FSH (recruit follicles + estrogen production)
lack of feedback system
- long periods of unopposed estrogen
- persistent endometrial proliferation
- thick and unstable endometrium (not stabilized by progesterone) begins to outgrow vascular supply and breaks down into bits and pieces
- dysfunctional uterine bleeding
treatment:
- progesterone for endometrial protection
- OCPs for hirsutism and acne
- clomiphene for infertility
- metformin to increase insulin insensitivity
women with PCOS are at risk of this malignancy
what should you give these patients to prevent this?
endometrial cancer due to unopposed estrogen
treat with cyclical progesterone
Fetal/neonatal macrosomia is caused by
how to prevent this?
maternal diabetes until proven otherwise
prevent wiht diet and insulin
when should maternal serum alpha-fetoprotein be measured?
Causes of low maternal serum alpha-fetoprotein?
Causes of high maternal serum alpha-fetoprotein?
between 16 - 20 weeks gestation.
LOW: Down syndrome, inaccurate dates (most common), and fetal demise.
HIGH: Neural tube defects, ventral wall defects (e.g., omphalocele, gastroschisis), inaccurate dates (most common), and multiple gestation.
pregnant woman presents with HTN and proteinuria
pre-eclampsia until proven otherwise
management of a woman who presents with a positive pregnancy test + vaginal bleeding + abdominal pain
ectopic pregnancy until proven otherwise
get a pelvic US
∆ between early, variable, and late decelerations
how should they be managed?
- early - normal, caused by head compression
-
variable - caused by cord compression
- turn mother on side, give O2 and fluids, stop oxytocin
-
late - caused by uteroplacental insufficiency
- turn mother on side, give O2 and fluids, stop oxytocin, measure fetal O2 saturation or scalp pH, prepare for prompt delivery
how should a third trimester bleeding be managed
pelvic US BEFORE pelvic exam (in case placenta previa is present)
most common cause of postpartum bleeding
common etiologies?
uterine atony
etiologies: uterine overdistention (twins, polyhydramnios), prolonged labor, and/or oxytocin usage.
acute abdomen pathology localized by physical exam
RUQ
LUQ
RLQ
LLQ
Epigastric area
- RUQ - Gallbladder/biliary (cholecystitis, cholangitis) or liver (abscess)
- LUQ - Spleen (rupture with blunt trauma)
- RLQ - Appendix (appendicitis), PID
- LLQ - Sigmoid colon (diverticulitis), PID
- Epigastric area - Stomach (peptic ulcer) or pancreas (pancreatitis)
Causes of post-op fever
- water = UTI
- wind = atelectasis, pneumonia
- walk = DVT
- wound = surgical wound infection
- “wawa” = breast (post-partum)
- weird drugs
what should you consider in a patient with daily fever spikes that do not respond to antibiotics? what test should you order to confirm?
postsurgical abscess
Order a CT scan to locate, then drain the abscess if one is present.
What are the ABCDEs of trauma?
airway, breathing, circulation, disability (either coma or convulsion), and exposure.
6 thoracic injuries that must be recognized and treated immediately
- Airway obstruction (establish airway).
- Open pneumothorax (intubate and close defect on three sides).
- Tension pneumothorax (perform needle thoracentesis followed by chest tube).
- Cardiac tamponade (perform pericardiocentesis).
- Massive hemothorax (place chest tube to drain; thoracotomy if bleeding does not stop).
- Flail chest (occurs when rib is broken in two palces; consider intubation and positive pressure ventilation if oxygenation is inadequate).
3 causes of neonatal conjunctivitis
when do they normall present?
chemical reaaction - first 12-24 hours of giving drops for prophylaxis
gonorrhea - 2-5 days after birth
chlamydial infection - 5-14 days after birth
∆ between open angle and closed angle glaucoma?
-
open angle = painless, irreversible
- usually due to optic disc atrophy with cupping, usually with increased IOP and progressive peripheral visual field loss
-
closed angle = painful, sudden vision loss with halos around eyes, frontal HA with rock-hard eye
- if chronic, then it is often asymptomatic with damage to optic nerve and peripheral vision
- usually due to enlargement or movement of lens against central iris
how does uveitis present?
in what diseases do you commonly find them in?
remember, it is inflammation of the middle layer of tissue in the eye wall (uvea)
presents with photophobia, blurry vision, and eye pain
usually a marker for systemic conditions: juvenile rheumatoid arthritis, sarcoidosis, IBD, ankylosing spondylitis, reactive arthritis, MS, psoriasis, lupus
3 causes of bilateral (although often asymmetric) painless gradual loss of vision
cataracts, macular degeneration, or glaucoma
6 features of compartment syndrome
- Pain with passive movements, usually out of proportion to the injury
- Paresthesias (numbness, tingling, decreased sensation)
- Pallor (or cyanosis)
- Pressure (firm feeling muscle compartment, elevated pressure reading)
- Paralysis (late, ominous sign)
- Pulselessness (very late, ominous sign; treat with fasciotomy to relieve compartment pressure to prevent permanent neurologic damage)
Name this nerve:
wrist extension
provides sensory to back of forearm, back of hand (first 3 digits)
clinical scenario usually is a humeral facture
radial n.
Name this nerve:
finger abduction
provides sensory to front and back of last 2 digits
clinical scenario usually is an elbow dislocation
ulnar n.
Name this nerve:
pronation, thumb opposition
provides sensory to palmar surface of hand (first 3 digits)
clinical scenario usually is carpal tunnel syndrome or humeral fracture
median n.
Name this nerve:
abduction, lateral rotation
provides sensory lateral shoulder
clinical scenario upper humeral dislocation or fracture
axillary n.
Name this nerve:
dorsiflexion, eversion
provides sensory to dorsal foot and lateral leg
clinical scenario usually is knee dislocation
peroneal (common fibular nerve)
Which pediatric hip disorder is associated with female, firstborn, or breech delivery?
When does it first present?
What are some signs/symptoms associated with it?
What is the main treatment?
Congenital hip dysplasia
at birth
barlow and ortolani signs
harness
Which pediatric hip disorder is associated with short male wiht delayed bone age?
When does it first present?
What are some signs/symptoms associated with it?
What is the main treatment?
Legg-Calvé-Perthes disease
4-10 years
knee, thigh, groin pain, limp
orthoses
Which pediatric hip disorder is associated with overweight male adolescent?
When does it first present?
What are some signs/symptoms associated with it?
What is the main treatment?
slipped capital femoral epiphysis
9-13 years
knee, thigh, groin pain, limp
surgical pinning
Why should you avoid lumbar puncture in a patient with head trauma or signs of increased intracranial pressure? What is an alternative option?
risk of herniation
Perform CT scan without contrast instead.
how do neck masses differ in children than do adults?
In children, 75% of neck masses are benign (lymphadenitis, thyroglossal duct cyst)
in adults, 75% of neck masses malignant (e.g., squamous cell carcinoma and/or metastases, lymphoma).
Management of symptomatic carotid artery stenosis
depends on % occlusion
- if occluded 70-99% –> carotid endarterectomy
- if occluded 50-69% –> assess patient specific factors to determine appropriateness
- if occluded <50% –> medical management with anti-hypertensive agents, statins, and antiplatelet therapy and addressing atherosclerotic risk factors
Pulsatile abdominal mass + hypotension =
management?
ruptured AAA
ex-lap
what are some conditions that are similar to angina? 3
TIA
claudication
chronic mesenteric ischemia (commonly due to atherosclerosis or a presence of a stenosis/occlusion of the mesenteric vessels; characterized by postprandial abdominal pain)
main identifiable risk factor for testicular cancer
management?
Cryptorchidism
surgical retrieval and orchiopexy vs orchiectomy
T/F BPH can present as acute renal failure
T
Patients have a distended bladder and bilateral hydronephrosis on ultrasound (neither is present with “medical” renal disease). Drain the bladder first (catheterize), then perform TURP
Causes of Impotence?
physical (e.g., vascular, nervous system, drugs)
psychogenic (patients have normal nocturnal erections and a history of dysfunction only in certain settings).
Which is more important in terms of assessing the development of a child: overall growth pattern or any one measurement?
overall growth pattern - a stable pattern is less worrisome and less likely to be correctable than a sudden change in previously stable growth
what are some examples of suspicious findings for child abuse? 7
- failure to thrive
- multiple injuries in different stages of healing
- retinal hemorrhages plus subdural hematomas (shaken baby syndrome)
- sexually transmitted diseases
- a caretaker story that does not fit the child’s injury or complaint
- childhood behavioral or emotional problems
- multiple personality disorder as an adult
What is the APGAR score? When is it usually performed?
Appearance
Pulse
Grimace
Activity
Respiration
performed at 1 and 5 minutes after birth
common cause of metabolic derangements
some examples of each?
diuretics
thiazide - hyperCa, hyperglycemia, hyperuricemia, hyperlipidemia, hyponatremia, hypokalemic metabolic alkalosis, hypovolemia
loop diuretics - hypokalemic metabolic alkalosis, hypovolemia (more potent than thiazides), ototoxicity, and calcium excretion
carbonic anhydrase inhibitors - metabolic acidosis, and potassium-sparing diuretics (e.g., spironolactone) may cause hyperkalemia.
Antidote for Benzodiazepine OD
flumazenil
Antidote for ß blocker OD
glucagon
Antidote for carbon monoxide OD
oxygen
Antidote for cholinesterase inhibitors OD
atropine or pralidoxime
Antidote for copper or gold OD
penicillamine
Antidote for digoxin OD
normalize K and other electrolytes
digoxin antibodies
Antidote for Iron OD
deferoxamine
Antidote for lead OD
EDTA (adults)
succimer (children)
Antidote for methanol/ethylene glycol OD
fomepizole, ethanol
Antidote for muscarinic blockers OD
physostigmine
Antidote for opioids OD
naloxone
Antidote for Quinidine or TCAs OD
Sodium bicarbonate (cardioprotective)
Is the platelet dysfunction reversible or irreversible with NSAID? Aspirin?
NSAID = reversible
Aspirin = irreversible
What type of renal damage would aspirin/NSAIDs cause?
interstitial nephritis, papillary necrosis
Why should you never give aspirin to a child with a cold?
risk of Reyes Syndrome - encephalopathy and/or liver failure
metabolic derangements with aspirin OD
metabolic acidosis and respiratory alkalosis
Central pontine myelinolysis can be caused by:
overly rapid correction of hypOnatremia
Low levels of this can make hypocalcemia and hypokalemia unresponsive to replacement therapy
HypoMg
What are examples of scenarios that can cause abnormal lab results? (4 major ones)
Hemolysis (hyperkalemia)
Pregnancy (elevated ESR and alkaline phosphatase)
hypoalbuminemia (hypocalcemia)
hyperglycemia (hyponatremia)
What are some ECG findings of MI?
flipped/flattened T waves
ST-elevation
Q waves in a patterned distribution (ie leads II, III, aVF for inferior infarct)
When would you institute interventions for cholesterol?
What are the differences between Type I and Type II DM in terms of:
age of onset
body habitus
development of ketoacidosis
levels of endogenous insulin
response to oral hypoglycemics
antibodies to insulin
How is HTN classified?
Rapid Associations: friction rub
pericarditis
Rapid Associations: Kussmaul breathing (deep rapid breathing)
DKA
Rapid Associations: Kayser-Fleischer ring in the eye
Wilson disease
Rapid Associations: Bitot spots
Vitamin A deficiency
Rapid Associations: Dendritic corneal ulcers on fluorescein stain of the eye
herpes keratitis
Rapid Associations:
Cherry-red spot on the macula without hepatosplenomegaly
Cherry-red spot on the macula with hepatosplenomegaly
W/O HSM: Tay-Sachs
W/ HSM: Niemann-Pick (niemann picks which organs)
Rapid Associations: Bronze skin plus diabetes
Hemochromatosis
Rapid Associations: Malar rash on the face
Systemic lupus erythematosus
Rapid Associations: Heliotrope rash (purplish rash on the eyelids)
Dermatomyositis
Rapid Associations: Clue cells
Gardnerella vaginalis infection
Rapid Associations: Meconium ileus
Cystic fibrosis
Rapid Associations: Rectal prolapse
Cystic fibrosis
Rapid Associations: Salty-tasting infant
Cystic fibrosis
Rapid Associations:
Café-au-lait spots with normal IQ
Café-au-lait spots with mental retardation
normal IQ: Neurofibromatosis
mental retardation: McCune-Albright syndrome or tuberous sclerosis
Rapid Associations: Worst headache of the patient’s life
Subarachnoid hemorrhage
Rapid Associations: Abdominal striae
Cushing syndrome or pregnancy
Rapid Associations: Honey ingestion
botulism
Rapid Associations: LLQ tenderness w/ rebound
Diverticulitis
Rapid Associations: Children who torture animals
conduct d/o
Rapid Associations: Currant jelly stools in children
Intussusception
Rapid Associations: Ambiguous genitalia and hypotension
21-Hydroxylase deficiency in girls
Rapid Associations: Catlike cry in an infant
Cri-du-chat syndrome
Rapid Associations: Infant weighing more than 10 lb
maternal diabetes
Rapid Associations: Anaphylaxis from immunoglobulin therapy
IgA deficiency
Rapid Associations: Postpartum fever unresponsive to broad-spectrum antibiotics
Septic pelvic thrombophlebitis
Rapid Associations: Increased hemoglobin A2 and anemia
thalassemia
Rapid Associations: Heavy young woman with papilledema and negative CT/ MR scan of head
how are these patients usually managed?
Pseudotumor cerebri (increased ICP without clear etiology)
managed with acetazolamide +/- lasix, migraines Rx, and weight loss
Rapid Associations: Low-grade fever in the first 24 hr after surgery
atelectasis
Rapid Associations: vietnam veteran
PTSD
Rapid Associations: Bilateral hilar adenopathy in an African American patient
Sarcoidosis
Rapid Associations: Sudden death in a young athlete
Hypertrophic obstructive cardiomyopathy
Rapid Associations: Fractures or bruises in different stages of healing in a child
child abuse
Rapid Associations: Absent breath sounds in a trauma patient
pneumothorax
Rapid Associations: Constant clearing of throat in a child or teenager
Tourette syndrome
Rapid Associations: Shopping sprees
mania
Rapid Associations: Intermittent bursts of swearing
Tourette syndrome
Rapid Associations: Koilocytosis
HPV or cytomegalovirus
Rapid Associations: Rash develops after administration of ampicillin or amoxicillin for sore throat
Epstein-Barr virus infection
Rapid Associations: Daytime sleepiness and occasional falling down (cataplexy)
Narcolepsy
Rapid Associations: Facial port wine stain and seizures
Sturge-Weber Syndrome
What is this sign? Babinski sign
What is it an indication of?
Stroking the bottom of the foot yields extension of the big toe and fanning of other toes (UMN lesion)
What is this sign? Beck triad
What is it an indication of?
Jugular venous distention, muffled heart sounds, and hypotension (cardiac tamponade)
What is this sign? Brudzinski sign
What is it an indication of?
Pain on neck flexion with meningeal irritation (meningitis)
What is this sign? Charcot triad
What is it an indication of?
Fever/chills, jaundice, and right upper quadrant pain (cholangitis)
What is this sign? Chvostek sign
What is it an indication of?
Tapping on the facial nerve elicits tetany (hypocalcemia)
What is this sign? Courvoisier sign
What is it an indication of?
Painless, palpable gallbladder plus jaundice (pancreatic cancer)
What is this sign? Cullen sign
What is it an indication of?
Bluish discoloration of periumbilical area (pancreatitis with retroperitoneal hemorrhage)
What is this sign? Cushing reflex
What is it an indication of?
Hypertension, bradycardia, and irregular respirations (high intracranial pressure)
What is this sign? Grey Turner sign
What is it an indication of?
Bluish discoloration of flank (pancreatitis with retroperitoneal hemorrhage)
What is this sign? Homans sign
What is it an indication of?
Calf pain on forced dorsiflexion of the foot (DVT)
What is this sign? Kehr sign
What is it an indication of?
Pain in the left shoulder (ruptured spleen)
What is this sign? Leriche syndrome
What is it an indication of?
Claudication and atrophy of the buttocks with impotence (aortoiliac occlusive disease)
What is this sign? McBurney sign
What is it an indication of?
Tenderness at McBurney point (appendicitis)
What is this sign? Murphy sign
What is it an indication of?
Arrest of inspiration during palpation under the rib cage on the right (cholecystitis)
What is this sign? Ortolani sign/test
What is it an indication of?
Abducting an infant’s flexed hips causes a palpable/audible click (congenital hip dysplasia)
What is this sign? Prehn sign
What is it an indication of?
Elevation of a painful testicle relieves pain (epididymitis vs. testicular torsion)
What is this sign? Rovsing sign
What is it an indication of?
Pushing on left lower quadrant then releasing your hand produces pain at McBurney point (appendicitis)
What is this sign? Tinel sign
What is it an indication of?
Tapping on the volar surface of the wrist elicits paresthesias (carpal tunnel syndrome)
What is this sign? Trousseau sign
What is it an indication of?
Pumping up a blood pressure cuff causes carpopedal spasm (tetany from hypocalcemia)
What is this sign? Virchow triad
What is it an indication of?
Stasis, endothelial damage, and hypercoagulability (risk factors for DVT)
