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Cases Flashcards

1
Q

What is the DDx for ABD pain in the ER?

A 
Cholecystitis 
R/o biliary duct obstruction
Doubt gastroenteritis 
Doubt gastric ulceration
Doubt duodenal ulceration
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3
Q

What is the PLAN for cough w/muscle pains?

A 
Acetaminophen 650 mg q4-6 hours prn fever, no more than 3 g/day
Increased fluids, rest
Nasal swab, CBC, CK
Return to clinic 1 week
Call if gets worse
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4
Q

What OMT can you do for uri or otitis media?

A

Periauricular drainage

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5
Q

PLAN for woman w/suspected hypothyroidism?

A

TSH, glucose, BUN/Cr, Na, K, Cl, BNP
U/A
Consider synthroid
Return to clinic 2 weeks after labs

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7
Q

What OMT can you do for TMJ dysfunction?

A

Galbreath technique

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9
Q

What is the DDx for ED outpt clinic?

A

Med SE
R/o venous steal syndrome
R/o testosterone def
R/o atherosclerotic disease

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10
Q

What OMT can you do for upper back pain?

Lower back pain?

A

MFR perpendicular stretch

ME

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11
Q

What is the DDx for neck pain with fever in the ER?

A 
Meningitis - viral
R/o bacterial meningitis
R/o aseptic meningitis 
Doubt brain abscess
Doubt SAH
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12
Q

What plan for ABD pain in ER?

A 
IV ABx, Pain control
CBC, AST, ALT, bilirubin, chem studies
Pregnancy test
CT scan ABD
Surgery CONSULT
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13
Q

What is the DDx for missed period for 3 months?

A 
Secondary amenorrhea - suspect HPA suppression
Low BMI
Calorie deficit 
R/O pregnancy
Doubt Pituitary adenoma
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15
Q

What is the plan for pt w/suspected meningitis in the ED?

A 
IV access, NS at 125 mL/hr
IV Abx
CT scan head
Consult Neuro, LP
Call family, admit to hospital
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16
Q

What test should you do for increasing forgetfullness in an old person?

A

Neuro exam
Check thyroid, carotid bruits
return to clinic for MMSE

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19
Q

What is the DDx for HA in FM clinic?

A 
Migraine HA
Sleep deprivation
Drug reaction/caffeine induced cephalgia 
Cranial SD
Doubt muscle tension HA
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20
Q

What is the PLAN for a sports physical?

A

No restrictions to participation
Pt education on warning sx
Bring father for genital exam
RTC for annual

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21
Q

What is the DDx for blood in the urine in the ED?

A 
Nephrolithiasis 
Vit C excess
R/O dehydration
R/O UTI
Doubt pyelonephritis 
Doubt Bladder cancer
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22
Q

What is the DDx for a skin lesion on a man?

A 
Neoplasm R post shoulder, likely seborrheic keratosis
r/o BCC
R/o SCC
R/o actinic keratosis 
Doubt melanoma
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23
Q

PLAN for old man w/stomach pain and fever in the ED?

A 
NPO, get IV for IVF and Abx
CT scan ABD
CBC w/Diff, BUN/Cr, Na, K, Cl
Consult surgery
Admit to hospital
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25
Q

What OMT can you do for sciatica?

A

ME anterior torsion for sacrum

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26
Q

What is the DDx for depression in FM clinic?

A 
Acute grief reaction
Depression
Anxiety
Adjustment disorder
R/O STI
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32
Q

What is the DDx for stomach pain in the ED, old man w/fever?

A

Acute diverticulitis w/peritonitis
R/o ischemic bowel
R/o bowel obstruction
Doubt CRC

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33
Q

What is the DDx for sports physical?

A

Healthy adolescent
Drug avoidance counseling
Hx of ____

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34
Q

What is the DDx for ankle pain?

A 
Ankle sprain
SD ankle
Contusion
Doubt ankle sprain
Doubt fracture
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35
Q

What is the Plan for blood in the urine in the ED?

A 
NPO, place IV, pain med
NS at 200 mL/hr
CT Scan kidney and ureters 
CBC, pregnancy test, BUN/Cr, Na, K, Cl
Consider consult to urology
37
Q

What OMT can you do for headache?

A

CV4

38
Q

What is the DDx for pain in the hands at wrist?

A

CTS
Doubt cervical radiculopathy
Doubt R.A.
Ligament sprain

39
Q

What is the PLAN for depression?

A

Refer to psychologist
Offer meds
Return to clinic in 1 week

40
Q

What OMT can you do for asthma or post op ileus?

A

Rib raising: MFR

43
Q

Plan for constipation and abd pain in old person presenting to the office?

A

Refer to ER
CT scan ABD
CBC, CEA, BUN/Cr, electrolytes
Colonoscopy

44
Q

What is the DDx for unintentional weight gain in a female?

A 
Hyopthyroidism
Weight gain
R/O Heart failure
Doubt Cushing’s
Doubt DM
45
Q

What is the DDx for shoulder pain in old male, FP clinic?

A

Adhesive capsulitis
Possible impingement syndrome
R/o rotator cuff tendinopathy
Doubt bursitis

47
Q

What is the PLAN for ED?

A

Sildenafil 50mg once a day
Lipid panel, testosterone level
Daily exercise, improve diet
Return to clinic 2 weeks, genital exam

48
Q

What OMT can you do for frozen shoulder?

Steps?

A

Spencer

Extension
Flexion
Circumduction
Circumduction w/traction

Abduction
IR
Traction

49
Q

What is the DDx for pain on the bottom of your foot?

A 
Plantar fasciitis 
Plantar SD
R/O tendinitis 
R/O fracture
Doubt rupture of plantar fascia
51
Q

What OMT can you do for elbow pain?

A

Effleurage - lateral and cephalad

52
Q

What is the DDx for hand burn at an urgent care center?

A

Localized 1st degree burn
Doubt secondary burn
Doubt secondary infection

54
Q

What is the DDx for smoking cessation?

A

Tobacco use disorder
Hx of something else
If BP is elevated, say it is w/out diagnosis

55
Q

What is the DDx for cough?

A 
Bacterial bronchitis
Consider viral bronchitis
R/O PNA
Doubt Influenza 
Doubt GERD
56
Q

What is the DDx for cough with muscle aches at FP clinic?

A

Influenza
Consider viral uri
Consider bronchitis
Doubt PNA

57
Q

What OMT can you do for ankle sprain?

A

Functional technique or ME for posterior fibular head

60
Q

What is the DDx for sore throat in FM Clinic?

A 
Mono
Consider viral pharyngitis
R/O streptococcal pharyngitis 
Doubt environmental allergies
Anticipatory guidance in teen
62
Q

What medication has a SE of erectile dysfunction?

A

Chlorathalidone - thiazide diuretic

63
Q

What is the DDx for constipation and ABD pain in outpt geriatric clinic?

A

Partial bowel obstruction - r/o colorectal cancer
Hemorrhoids
R/o mesenteric ischemia
Doubt diverticulitis

68
Q

What is the DDx for knee pain?

A

Knee sprain
Consider meniscal tear
Doubt MCL tear
Doubt ACL tear

70
Q

What is the DDx for chest pain in 26 y/o female FP Clinic?

A 
GERD
Slight dysphagia 
R/O hiatal hernia
R/O peptic ulcer disease
R/O BArrett’s
R/O esophageal webs, Schatzki ring
72
Q

What is the DDx for forgetfullness?

A 
Mild anxiety 
FH of dementia
R/O Hyperlipidemia 
R/O UTI
Doubt thyroid disorder
Doubt depression
73
Q

What OMT can you do for gluteal/upper leg pain?

A

ME - piriformis hypertonicity

75
Q

What is the plan for chest pain in the ED?

A 
ACS protocol: O2, ASA, BB, Morphine, Nitro
CBC, INR, trops, BUN/Cr, Na, K, Cl
Start IV
12 lead ECG, portable CXR
Admit to hospital
76
Q

What OMT can be done for cough?

A

Rib raising

79
Q

What is the DDx for pain in both hands, old woman?

A

OA
Doubt RA
R/O osteopenia
If they have HTN

80
Q

What OMT can you do for knee injury?

A

Lymphatic effleurage

84
Q

What OMT can you do for sinuses?

A

frontal and maxillary efflurage

85
Q

What is the DDx for chest pain in the ED?

A 
Dissection
AAA
CHF
ACS
Angina
89
Q

What is the DDx for cold in the nose?

A

Allergic rhinitis
Environmental rhinitis
Doubt URI

98
Q

What OMT can you do for Neck pain?

A

Counterstrain Post TP w/FPR

102
Q

FED TACOS = what?

A 
Food
Exercise
Drugs
Tobacco
Alcohol
Caffeine
Occupation
Sexual - LMP

PE Cases (1 decks)

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