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Approach General Flashcards

(33 cards)

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1
Q

Fever

A

Acute <2 wk
Chronic >3wk

Local

  • head meningitis encep
  • Ear otitis media
  • node sinusitis
  • throat Tonsilitis
  • Lung bronchitis pneumonia
  • Abdomen Biliarry AGE
  • Urinary pyelonephritis
  • joint Arthritis
  • Skin Abscess cellulitis
  • Gyne PID
Systemic
Bacteria- rickettsial(ลุยสวน ลุยน้ำ)
Enteric typhoid (ผื่น ไข้ตอนเช้า rosespot)
Lepto
Melioidosis

Virus
Dengue
EBV

Parasite
Malaria

Chronic >3wk
- abscess diverticulitis TOA osteomyelitis Endocarditis Aspergilosis Histoplasmosis
####- HIV SLE RA Lymphoma Hyperthyroid
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2
Q

Fatigue

A

Psy
Physiologic

Organic

  1. Infection- TB HIV
  2. inflammation- HF, Cirrhosis, CKD, COPD, DM
  3. Autoimmune- SLE, RA
  4. Tumor- Hemato …
  5. Endocrine- Anemia, Hyper/hypothyroid, Aldosterone insuff
  6. Drug- Antithyroid, Diuretic, Chemo
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3
Q

Wt loss
5% 6 mo
10% 3 mo

A

กินได้- DM, Thyroid, Pheochromocytoma

กินไม่ได้ เหมือน อ่อนแรงอะ

  1. infection - TB HIV
  2. Inflammation - HF Cirrhosis CKD
  3. Auto immune- SLE RA
  4. Tumor Solid Hemato
  5. Endocrine - Aldosterone
  6. Malabsorption- Colectomy
  7. Drug -Amphet, Thyroid, Chemo, Laxative, Diuretic
  8. Psy- Depression, Anorexia, Bulimia
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4
Q

Wt gain

A

กินเยอะ

Endocrine- Cushing, Hypothyroid, PCOS
Thyroid enlarge, Brady, Hoarse, Slow relaxation $$$

Drug- Steroid, NSAID, Antithyroid, Antiepileptic, Antipsychotic

Water retention- HF, cirrhosis, CKD, Nephrotic, nephritis

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5
Q

Bleeding

A

Local- epistaxis, Hemoptysis, Hematemesis, Melena, Hatatochezia, Hematuria, Vaginal bleeding

Systemic
Primary- Skin mucosa Membrane–> vWF, Platelet - dengue, platelet dys, Aspirin, NSAID./ Fibrinogen
Secondary-
Intrinsic , Extrinsic

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6
Q

Epistaxis

A

which site how long until stop
Trauma, ตอนกลางคือเปิดแอร แคะแกะสั่ง
Infection fever face pain
warfarin hepatin painmed

Secondary
family hx
food green veg

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7
Q

Hemoptysis
200ml/day 1 episode
600 ml/ day massive

A

Airway

  1. Bronchitis
  2. Bronchiectasis
  3. Bronchogenic CA

Parenchymal

  1. TB
  2. Pneumonia
  3. ABscess
  4. SLE
  5. CA
  6. CHF

Vascular
1. Emboli ( sudden, asymm expansion, Dec breathsound)

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8
Q

Hematemesis

A

Local

  1. Esophagus - esophagitis, Ca, Mallory weiss, Varices
  2. Stomach- Ca, ulcer, Varies, Dieularoy lesion
  3. Duodenal- Ulcar, Ca, Dieulafoy
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9
Q

Hematochezia

A

Local

  1. Diverticulitis
  2. Ca
  3. INtussuseotion

Colon

  1. Infection
  2. Radiation
  3. Crohn, UC
  4. Ischemic emboli Afib
  5. Fiverticular hemorrhage
  6. Polyp CA

Anorectal

  1. Ext hemorrhoid
  2. Int Hemorrhoid
  3. Anal fissure
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10
Q

Hematuria

A

Local
1. Renal
Glomerular - Nephritis ( PSGN,IgA, SLE), Nephrotic
Non-Glomerular- ATN, Interstitial

  1. Ureter stone, CA
  2. Bladder cystitis, Stone, CA, Chemo
  3. Urethra- Urethritis, BPH, Ca
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11
Q

Vaginal Bleeding

A
  1. r/o pregnancy
  2. think ectopic, abortion, molar
  3. Local
    > ovary - DUB (excercise, wt loss, stress), Axis, Ca, Endometriosis, Endometrioma
    > Uterus - PID, Polyps, Fibroid, Adenomyosis, Endometrial Ca
    > Cervix- Polyps Ca( pap?)
    > Vaginal atrophy
  4. Systemic
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12
Q

Amenorrhea

6 month or 3 consecutive mon

A
  1. Preg, lactation, Menopause
    2.Primative - uterus
  2. Secondary
    Pituitary- stress, excercise, prolactin, sheehan, anorexia, hyperthyroid
    Ovary- PCOS, Ovarian failure, OCP
    UTerus - Asherman
    Cervix-
    Vagina- Imperforated hymen
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13
Q

Anemia

A

find source trauma, hematuria, melena

Vitamin def- eat less meat, iron b12 def
Chronic HF,CKD,COPD
Genetic- Family History , Drug G6PD

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14
Q

Hemolysis

A

Intravascular- hemoglobinuria cocacola++
G6PD, PNH, MAHA»>DIC, HUS, TTP, Eclap, HELLP, Malignant HT, Prosthetic valve

Extravascular- concentrated Urine
AIHA, Hereditary Spherocytosis, Thalassemia

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15
Q

Dysphagia

A

Oropharyngeal
Mechanical- Tumor CA
Functional- CNS,PNS(GBS,MS), NMJ(MG,Botulinum), Muscle (Polyomyositis)

Esophageal
Mechanical- Stricture, Ca(Progressive)
Functional- Achalasia, Scleroderma, Diffuse esophageal spasm
Sensational- GERD( globus)

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16
Q

Chest pain

Study These Flashcards
A

Skin - herpes
MSK- chosto, fracture
Lung- Pneumothorax, empyema, Pneumonia, Embolism
GI- Esophagitis, GERD, Mallory Weiss, Dyspepsia, Ca
Vascular- Dissection

Heart
Ischemic- ACS, Angina, Prinzmetal
non-ischemic- Pericarditis, Myositis, Hypertrophy, AS

17
Q

Palpitation

Study These Flashcards
A

Cardiac
Arrhythmia- tachy (SVT,VT), Brady (Av block), Irregular
Non arrhythmia- ASD,VSD, AR, AS, CHF

Metabolic- Physiologic(stress, excercise, volume depletion)
Pathologic (Fever, Hypogly, Thryotoxicosis, Pheochromocytoma)

Drug- coffee, alcohol, smoking, amphetamine

Psy- Anxiety, panic, hyperven

18
Q

Syncope

Dx Seizure, TIA, Hypogly

Study These Flashcards
A

Cardiac

  • Vascular-Pulmo embolism, Aortic dissection
  • Cardiac -Arrhythmia - block
  • Cardiac structural- Tamponade, Hypertrophy, MI, AS

Orthostatic

  • Hypovolemic- vomit, Diarrhea, Bleeding, Diuretic, Vasodilator
  • ANS- Aging, DM, URemia, Cord injury

Reflex

  • Emotional
  • Situational- sneeze defecation, urination
  • Carotid sinus- Massage, Tight shirt
19
Q

Cough

Study These Flashcards
A

Lung

  • Upper - Sinusitis, Common cold, Post infection, FB
  • Lower- Bronchitis, Bronchiolitis, Pneumonia, TB, Asthma, COPD, Irritant, Cancer

Heart
- LV failure

GI
- GERD

Drug
- ACEi

20
Q

Dyspnea

Study These Flashcards
A

Respi

  • Airway- FB, CROUP, Bronchiolitis, Anaphylaxis, Asthma, COPD
  • Parenchymal- Pneumonia, Intersitial lung(fibrosis, COPD, Occupational), Tumor CA
  • Vascular - embolism
  • Pleural - pneumothorax, hemothroax, chylothorax, pleural effusion

Neuromascular
Upper - Brain stem c spine
Lower- GBS, MG, Kyphosis

Heart
CHF

Metabolic
Anemia, Acidosis, DKA, Uremia, Thyrotoxicosis

Psychiatric
Anxiety, panic, Hyperventilation

21
Q

Edema

Study These Flashcards
A

Localized
infection- cellulitis, erysipelas, parasite
Venous obstruction- DVT
Lymph obstruction- Radiation, Surgery, Dissection, Tumor Ca

Generalized
Heart - CHF
Liver - Cirrhosis
Kidney- Nephrotic, Glomerulonephritis, AKI/CKD
Hypoalbumin- malnutrition
Metabolic- hypothyroid
Drug- amlo, NSAID, Estrogen
22
Q

Jaundice

23
Q

NV

Study These Flashcards
A

Head

  • Brain - hydroceph, EDH, SDH, ICH, Menintitis, Enceph, Tumor Ca
  • Eye- glaucoma
  • Ear- Labyrinitis, Motion sickness

Non-head
GI- biliary, hep, panc
Stomach colon- AGE, Dyspepsia, Gastricoutlet obstruction, Diverticulitis, obstruction
GU- Pyelonephrotis, PID, Stone, Pregnancy
Metabolic- Uremia, DKA, Hyponat, Adrenal insuff
Drug- Morphine

24
Q

Diarrhea

Study These Flashcards
A

Acute
WATERY
+ vomiting- Vomiting(poisoning)
+Diarrhea dominant- Bacteria ETEC, Vibro, Camphylo, C diff, Rota, Novo virus

BLOODY
Bacteria - EHEC, EIEC, Shiga, samonella, C diff, V parahemolyticus
Virus - CMV
PRotozoa- E Histolytica

Chronic
+ lactose def, Thyroitoxicosis, TB, Amebic, IBD, Radiation, Ca, C Philippinesis, Giardia, Cirrhosis, Bile duct obstruction, LAxative, Colchicine, Amoxyclav

25
Abdominal PAin
Biliary - Hepatitis, abscess, Colic, Cholecystitis, Cholangitis, Pancreatitis Stomach- GERD, Esophagitis, Dyspepsia, CA Small Bowel- Dyspepsia Large bowel- AGE, Appendicitis, Diverticulitis, Obstruction, Infraction, Intussusception, Volvulus Renal- Pyelonephritis, stone OBGYN- PID, Ovarian Cyst, Ectopic preg, Endometriosis, Eterine fibroid, Cystitis Aorta- dissection, aneurysm
26
Pelvic Pain
OB- ectopic, Abortion, Molar 3rd trim- Placenta previa, arubtion, uterine rupture GYNE- Ovary- PID, Cyst, Ectopic, Endometriosis Tube- PID, Ectopic Uterine- Adenomyosis, Myoma Cervix- PID
27
Leukorrhea
Physiologic PAthologic Infection= PID- Gonorrhea, chlamydia Vaginitis= Gardnerella, Trichomonas, Candida Non-infection- FB, IUD, Atrophic vaginitis
28
HEad ache
Primary - Tension - Cluster - Migraine - Trigerminal neuralgia ``` Secondary - infection- enceph, meningitis, subdural empyema, abscess - trauma- concussion, hemorrhage - Tumor- Ca brain -Vascular - Stroke, SAH CSF- Hydrocephalus, post lumbar puncture ``` Red flag - fever, wt loss , HIV, Preg - Neuro seizure, weakness, diplopia, vision loss - 50 yo plus - Progressive
29
Alteration of consciousness
Intracranial - infect trauma tumor pressure stroke Infection- enceph, meningitis, Abscess, Subdual empyema Trauma- Hemorrhage Tumor- CA Vascular- stroke, malformation Other- Status epilepticus, Hydrocephalus Extracranial Infection - sepsis Endocrine- hypogly, DKA/HHS, Hypo/per thyroid, Adrenal crisis Metabolic - Uremia encep, hepatic encep, hypoxemia, hypercapnea Electrolyte- hyperhypo Na hyper Cal Drug- morphine, Alcohol, Sedative Other- shock, hypohyperthermia, HTN enceph, Eclampsia
30
Seizure
``` Intracranial Infection-Enceph,meningoenceph, abscess,subdural empyema, cysticercosis Trauma- Brain, hemorrhage Tumor Vascular- Stroke , SAH, Malformation Other- Hydrocephalous ``` ``` Extracranial Infection- sepsis, fever Endocrine- hypogly Metabolic- uremia Electrolyte- hyponat, hypocal Drug/toxin- alcohol intox,withdrawal, BZD withdraw Medication- ```
31
Vertigo
Central - Brain stem, cerebellar, Migrain Peripheral - With HL = Meniere, Lybrinthitis, Vesticular shwannoma - with out HL= BPPV, Vestibular neuritis, Perilymph fistula
32
Tremor
Resting - parkinson, antipsychotic Intentional- Brain stem, cerebellar Postural - Essential tremor, Thyrotoxicosis, Alcohol withdrawal, Anxiety, Fear, coffee
33
Weakness
Cortex Brainstem- Abscess, Trauma, Stroke Spinal cord- Abscess, Demyelination, infract, trauma, tumor Anterior horn- poliomyositis, Trauma PNS- GBS, DM NJM- Myasthenia gravis, Botulinum Muscle- Myositis, muscle dystrophy, Electrolyte

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