Cardinal Presentations Flashcards
This deck covers Chapters 9-32 in Rosens, compromising all of the cardinal presentations.
List 2 outpatient and 2 inpatient antibiotic regimens for PID
Outpatient
- Doxycycline + Ceftriaxone + Flagyl
- Levofloxacin + Flagyl
Inpatient
- Clindamycin + Gentamycin
- Cefoxitin + Doxycycline
List 4 risk factors for C. difficile
- Recent hospitalization
- Recent antibiotics
- LTC facility
- Antacid use
List 5 reasons why you may not be able to visualize the optic fundus on fundoscopy
- Hyphemia
- Cornea scar
- Cataract
- Miotic pupil
- Vitreous hemorrhage
- Retinal detachment
What is the definition of massive hemoptysis? What is the usual source?
>500 cc/24h or >100 cc/hr
- Bronchial artery (90%)
- Pulmonary artery
List 6 risk factors for renal colic
- Male
- FHx
- Previous stone
- Dehydrated
- Hot climates
- Metabolic disturbance
List 8 causes of neuromuscular weakness that are life-threatening
- Stroke
- GBS
- MG
- LES
- Tick
- Botulism
- Tetanus
- Organophosphates
- ALS
- Pufferfish
- SEH
- SEA
- Transverse myelitis
What enzyme reduces met-HgB?
NADH MetHgB reductase
List 5 risk factors for serious abdominal pathology
- Age >60
- Previous OR
- Recent OR
- Fever/Rigors
- IBD
- Cancer
- Chemotherapy
- Immunocompromised
- Child-bearing age
- Recent immigrants
- Language barrier
List 5 causes of cervical motion tenderness
- PID
- Ovarian torsion
- Ovarian cyst
- TOA
- Ectopic
- Endometriosis
- Appendicitis
- Peritonitis
List 3 BPPV variants and their provocative and curative maneuver
-
Posterior (MCC)
* Dx: Dix-Hallpike
* Tx: Epley -
Horizontal
* Dx: Supine roll
* Tx: BBQ roll -
Anterior
* Dx: Dix-Hallpike
* Tx: Deep Head Hanging
List 5 risk factors for PUD/Gastritis
- H. pylori
- NSAIDs
- Alcohol
- Steroids
- Smoking
- Critical Illness
List 6 complications of vomiting
- UGIB (Mallory-Weiss)
- Aspiration
- Esophageal perforation (Boerhaave’s)
- Electrolyte abnormalities (HypoCl-/K+)
- Metabolic Alkalosis
- Dehdyration
List the 5 common causes of any ocular nerve palsy
- Aneurysm
- Diabetes
- CVST
- Tumour
- Trauma
- MS = CN3
- MG = CN4 (longest/thinnest and most prone to trauma)
- ICP = CN6
Describe 6 classic findings when performing the Dix-Hallpike maneuver in someone with posterior canal BPPV
- Symptomatic when head down
- Latency of nystagmus
- Geotropic nystagmus (up/rotatory ground)
- Nystagmus resolves within 30s
- Fatiguable on repeated testing
- Direction-changing when sitting up
List 10 causes of hemoptysis
Airway
- FB
- Bronchitis
- Bronchiectasis
- Cancer
- Trauma
Parenchymal
- Pneumonia
- TB
- Cancer
Vascular
- PE
- AVM
- Pulmonary HTN
- Vasculitis
Hematologic
- OAC
- Coagulopathy
- DIC
- Thrombocytopenia
Cardiac
- Endocarditis
- Valvular heart disease
- CHD
Miscellaneous
- Cocaine
- SLE
- Tracheal-arterial fistula (trach)
- Post-procedural
List 5 red flags with headache
- Sudden onset
- Syncope
- Focal deficits
- Trauma
- Fever
- Immunocompromised
- Weight loss
- Cancer history
- Elderly
- No history of headaches
List 6 causes of methemoglobinemia
- Nitrites
- Nitrates
- Topical anesthetics (lidocaine, benzocaine)
- Antibiotics (dapsone, sulfa)
- Anti-malarials (quinones)
- Antineoplastics (cyclophosphamide)
- NADH Met-HgB reductase deficiency
- G6PD deficiency
- Mothballs
Give 6 categories for causes of central cyanosis
- Shunt
- V/Q mismatch
- Diffusion
- Low FiO2
- Hypoventilation
- Hemoglobinopathy
Define orthostatic hypotension
5 min supine, stand, measure BP within 2-5 min
>20 mmHg drop in sBP
>10 mmHg drop in dBP
List 3 antibiotics that are 1st line for GAS sore throat and 2 if PCN-allergic.
No allergies
- Pen G IM
- Pen V PO
- Amoxicillin PO
PCN Allergic
- Azithromycin
- Clindamycin
Give a DDx of 8 items that cause hyperthermia (not fever)
- Stroke
- Seizure
- DVT
- CHF
- MI
- Pulmonary edema
- Pancreatitis
- Crohn’s/UC
- Gout
- Cancer
- Hyperthyroidism
- SS/NMS/MH
- Transfusion reaction
- Drugs
List 4 admission criteria for PID
- Unable to tolerate PO antibiotics
- Failure of PO antibiotics
- Pregnant
- Toxic
- TOA
List 5 critical diagnoses that cause pelvic pain in women
- Ovarian torsion
- PID
- Ectopic pregnancy
- Placental abruption
- Uterine rupture
- TOA
List 7 critical diagnoses that present with vomiting
- ICH/Stroke
- ACS
- Boerhaave’s
- Bowel Ischemia
- Ovarian/Testicular torsion
- DKA
- Sepsis
- Pregnancy
- Organophosphate
Define weakness
Lacking physical strength, energy, or vigor (feeble)
List 4 things that shift the oxy-HgB curve to the left
(higher affinity for oxygen)
- Decreased temp
- Decreased H+
- Decreased 2,3-DPG
- Carboxy-HgB
- Met-HgB
- Fetal-HgB
List 8 causes of binocular diplopia
Orbital
- Grave’s, Hematoma, Abscess, Entrapment
Oculomotor
- CN3/4/6 palsy
Neuro-muscular
- GBS, Tick, LES, MG
Brain
- MS, Migraine, Tumour
Vascular
- Aneurysm, Dissection, CVST
List the 4 components of the MacIsaac-Centor score
- Fever
- Exudative tonsils
- No cough
- Anterior lymphadenopathy
- Age
What are 6 requirements for the use of methotrexate for therapeutic abortion?
- Small (<3.5cm)
- BhCG <5000
- No fetal heart beat
- Hemodynamically stable
- Not ruptured
- Good follow-up
After what week in pregnancy is a pelvic exam contraindicated without an ultrasound to rule out previa?
20 weeks
List 6 factors that increase mortality in LGIB
- Age >70
- Male
- Transfused
- Intestinal ischemia
- OAC use
- Comorbid
What are the three main categories for causes of jaundice? Give a DDx for 5 for each.
Overproduction
- Hemolysis
- Hemoglobinopathy
- Membranopathy
- Enzymopathy
- Sepsis
- ABO incompatibility
- Breast milk jaundice
- Breastfeeding jaundice
- HEELP syndrome
Hepatocellular
- Infectious (Hepatitis)
- Ischemic
- Drugs (Tylenol, EtOH, etc.)
- Autoimmune
- Metabolic (Gilbert, Wilson)
- Budd-Chiari
Obstructive
- Cholangitis
- Choledocholithiasis
- Choledochal cyst
- Biliary atresia
- Biliary stricture
- Cancer
- CF
- Sepsis
List 4 treatment options for stable abnormal uterine bleeding
- OCP
- Progestin-only OCP
- Estrogen IV
- NSAIDs
- TXA
- Lupron
How much do HR and RR increase with fever?
HR = 10 bpm/degree
RR = 5 bpm/degree
List 6 ‘can’t miss’ diagnoses for sore throat
- PTA w/ airway compromise
- RPA w/ airway compromise
- Epiglottitis w/ airway compromise
- Croup w/ stridor at rest
- Lemierre’s
- Ludwig’s
- Angioedema
- Anaphylaxis
- ACS with referred pain
Give a DDx of 8 for altered mental status
DIMES
- Drugs (BZD, opiates, sedatives, EtOH, toxin)
- Infection (sepsis, CNS infection)
- Metabolic (hypoglycemia, hypoxia, hepatic/renal failure)
- Endocrine (adrenal insufficiency, hypo/hyperthyroid)
- Structural (mass, bleed, stroke)
List 5 critical causes of hemoptysis
- PE
- Tracheoinominate fistula
- Aortotracheal fistula
- DIC
- Post-procedural
List 4 inclusion criteria for the Ottawa SAH Rule.
Inclusion
- Age >15
- Max intensity with 1hr
- Non-traumatic
- GCS 15
Rule:
ANT LEaF
- Age >40
- Neck stiffness
- Thunderclap
- LOC
- Exertional
- Flexion limited
List 5 categories of Type 1 and Type 2 respiratory failure
Type 1 (Hypoxemic)
- V/Q mismatch
- Shunt
- Low FiO2
- Diffusion
- Hypoventilation
- Hemoglobinopathy
Type 2 (Hypercarbic)
- Hypoventilation
- Neuromuscular
- Obstructive
- Chest wall disorder
- Decreased gas exchange area
List 4 indications for OR with a GI bleed
- Hemorrhage despite endoscopic therapy
- 4 units pRBCs within 1 hr
- Indication for surgery as the cause of bleed (perf)
- Life-threatening hemorrhage despite resuscitation
List 5 indications to get a CT scan after a seizure
- First seizure
- Age >65
- >15 minutes
- Focal neuro deficits
- Persistently altered
- Immunocompromised
- Trauma history
- Cancer history