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Primary Care > week 2: differential dx > Flashcards

week 2: differential dx Flashcards

1
Q

which systems have an inconsistent symptom pattern?

A

psychologic
endocrine
neurologic
rheumatic disorders
adverse drug reactions

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2
Q

what does a pain description of throbbing, pounding, and pulsating indicate?

A

vascular disorders
(ex: AAA, PVD)

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3
Q

what does a pain description of sharp, lancinating, shocking, and burning indicate?

A

neurological disorders

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4
Q

what does a pain description of aching, squeezing, gnawing, burning, and cramping indicate?

A

visceral disorders

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5
Q

suspected diff dx:
constant back pain not affected by mvmt
back pain worse at night
unexplained weight loss
failure of conservative treatment

A

back-related tumor

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6
Q

suspected diff dx:
spine rigidity
deep constant pain, increased with WB
fever, malaise, swelling

A

back-related infection (ex: spinal osteomyelitis)

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7
Q

suspected diff dx:
hx spinal stenosis
hx of DDD
urinary retention or incontinence
saddle anesthesia
global or progressive weakness in LEs

A

cauda equina syndrome

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8
Q

suspected diff dx:
exquisitely tender w/ palpation over site
local edema
increased back pain with WB
hx of trauma
long-term steroid use
over 70 yo

A

spinal fx

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9
Q

suspected diff dx:
back, abdominal, or groin pain
PVD or CAD
symptoms not related to mvmt
bruit in epigastric area

A

abdominal aneurysm

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10
Q

suspected diff dx:
pain unchanged by position or mvmt
age >50
unexplained weight loss
bowel disturbances

A

colon cancer

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11
Q

what are the most common places for metastasis of colon cancer?

A

liver, lung, bone, brain

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12
Q

suspected diff dx:
older female >70
hip, groin, or thigh pain
hx of fall from standing
severe, constant pain
shortened and ER’d LE

A

pathological fx in femoral neck

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13
Q

which pelvis region disease is for younger kids? older?

A

younger: Legg-Calve-Perthes disease
older: SCFE

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14
Q

suspected diff dx:
stiff hip joint
hx of long-term corticosteroid use
trauma
gradual onset of hip pain that worsens with WB

A

osteonecrosis of femoral head

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15
Q

suspected diff dx:
5-8 yo boy
groin/thigh pain
antalgic gait
pain with hip abd & IR

A

Legg-Calve-Perthes disease

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16
Q

suspected diff dx:
overweight adolescent (esp male)
recent growth spurt or trauma
aching in groin worse with WB
leg in ER
ROM limited in IR

A

SCFE

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17
Q

suspected diff dx:
>60
hx of T2DM &/or ischemic heart disease
sedentary, smoker
intermittent claudication
cool extremity

A

peripheral arterial occlusive disease

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18
Q

DVT has ____ symptoms, while compartment syndrome has ____ symptoms (intermediate/constant)

A

DVT: intermittent
compartment syndrome: constant

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19
Q

suspected diff dx:
recent surgery, malignancy, pregnancy, trauma, or leg immobilization
calf pain, edema, tenderness, warmth
pallor, loss of dorsalis pedis pulse

A

DVT

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20
Q

suspected diff dx:
blunt trauma, crush injury
severe, persistent leg pain
swelling, severe leg pain

A

compartment syndrome

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21
Q

suspected diff dx:
hx of recent infection, surgery, or injection
immunosuppressant disorder
constant aching or throbbing in joint
elevated body temperature

A

septic arthritis

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22
Q

suspected diff dx:
hx of recent skin ulceration or abrasion
hx of venous insufficiency, CHF, cirrhosis
pain, skin swelling, warmth
advancing irregular margin of erythema/reddish streak

A

cellulitis

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23
Q

suspected diff dx:
men >40, women >50 yo
chest pain, palpitations
pallor, sweating, dyspnea, nausea
hx of CAD, HTN, smoking, DM, elevated cholesterol

A

myocardial infarction

24
Q

suspected diff dx:
hx of CAD
chest pain outside of predictable pattern
unresponsive to nitroglycerin

A

unstable angina pectoris

25
Q

suspected diff dx:
>65 yo
hx of CAD
chest pain that occurs with predictable level of exertion
sx alleviated with nitroglycerin

A

stable angina pectoris

26
Q

suspected diff dx:
autoimmune disease
sharp, stabbing chest pain
increased chest pain with side lying
chest pain relived with forward sitting

A

pericarditis

27
Q

suspected diff dx:
immobility, trauma, &/or cancer
chest, shoulder, upper abdominal pain
dyspnea, tachycardia, tachypnea

A

PE

28
Q

suspected diff dx:
hx of recurrent respiratory disorder
severe, sharp pain with inspiration
dyspnea, decreased chest wall excursion

A

pleurisy

29
Q

suspected diff dx:
recent bout of coughing or strenuous ex
pleuritic pain
fever, chills, HA, malaise, nausea

A

pneumothorax

30
Q

suspected diff dx:
hx of infection
pleuritic pain
fever, chills, malaise, HA, nausea

A

pneumonia

31
Q

suspected diff dx:
sx worsen with ingestion of fatty foods
middle aged woman
colicky pain in R upper quadrant
R scapular pain

A

cholecystitis

32
Q

suspected diff dx:
sx relieved with ingestion of food
pain in epigastrium, midback, or supraclavicular regions
tenderness at R epigastrium
tarry stool

A

peptic ulcer

33
Q

suspected diff dx:
recent or current UTI &/or kidney stone
enlarged prostate
tenderness over costovertebral angle

A

pyelonephritis

34
Q

where are the most common levels of spinal fx?

A

T11-L1

35
Q

suspected diff dx:
sudden severe back or flank pain
renal colic
symptoms of UTI
fever, malaise, nausea, vomiting

A

nephrolithiasis (kidney stone)

36
Q

suspected diff dx:
hx of fall, MVA, osteoporosis
long-term steroid use
age >70
midline tenderness
LE neuro signs
increased thoracic kyphosis

A

spinal fx

37
Q

suspected diff dx:
hx of infection, skull fracture
+ slump sign
HA, fever, nausea, vomiting
photophobia, confusion
seizures, sleepiness

A

meningitis

38
Q

suspected diff dx:
age 24-64 yo
HA, altered mental status
ataxia, speech deficits
sensory abnormalities
visual changes, seizures

A

primary brain tumor

39
Q

suspected diff dx:
hx of smoking, HTN, alcohol abuse
sudden onset HA
bries LOC
brain tumor signs
meningeal irritation signs

A

subarachnoid hemorrhage

40
Q

suspected diff dx:
major trauma
hx RA or AS
oral contraceptive use
+ Babinski sign
dizziness, nystagmus, vertigo, clonus

A

cervical ligamentous instability with possible cord compromise

41
Q

suspected diff dx:
paresthesias
retrograde distribution of pain
UE muscle tender to palpation

A

cervical & shoulder girdle entrapment neuropathies

42
Q

suspected diff dx:
men >50 w/ smoking hx
nagging pain in shoulder & scapula
nagging pain –> burning in ulnar n. distr.

A

Pancoast’s tumor
(superior sulcus long tumor)

43
Q

suspected diff dx:
asymmetry of neck line
inability to shrug shoulder
lack scapular stabilizers
weak shoulder abduction

A

spinal accessory nerve disorder

44
Q

suspected diff dx:
>40 with shoulder dislocation
weak shoulder abduction & flexion
lack sensation in lateral aspect of up arm

A

axillary nerve disorder

45
Q

suspected diff dx:
serratus anterior weakness
loss of scapulohumeral rhythm

A

long thoracic nerve disorder

46
Q

suspected diff dx:
deep, poorly localized pain
weak shoulder abduction and ER
hx of scapula fracture

A

suprascapular nerve disorder

47
Q

suspected diff dx:
FOOSH with forearm supinated
elbow held at side

A

radial head fx

48
Q

suspected diff dx:
FOOSH w/ forceful wrist extension
>40

A

distal radius fx (Colles’)
(most common)

49
Q

suspected diff dx:
pain in anatomical snuff box

A

scaphoid fx

50
Q

suspected diff dx:
FOOSH
diffuse synovitis

A

lunate fx or dislocation

51
Q

suspected diff dx:
FOOSH w/ forearm pronated
ulnar-sided wrist pain

A

TFCC tear

52
Q

suspected diff dx:
recent skin puncture, insect bite
presence of abcess
purulent tenosynovitis
signs of o=inflammation

A

space infection of hand

53
Q

suspected diff dx:
hx RA, trauma, corticosteroid use
hand/wrist tenderness, swelling, muscle spasms, hematoma

A

long flexor tendon rupture

54
Q

suspected diff dx:
hx RA, smoking, beta blocker use
hands or feet blanch & turn red when exposed to cold or emotional stress

A

Raynaud’s disease

55
Q

suspected diff dx:
hypersensitivity
pain doesn’t respond to analgesics
swelling (pitting edema), warm
aching, stinging, cutting, burning pain
pain not typical to injury

A

complex regional pain syndrome

Primary Care (7 decks)

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