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DDx > Common and life threats from QuickEM > Flashcards

Common and life threats from QuickEM Flashcards

1
Q

Diffuse abdominal pain

A 
BOWEL:
Early appendicitis
Bowel obstruction
Hernia (umbilical, incisional)
Gastroenteritis
Volvulus
VASCULAR:
METABOLIC/TOXICOLOGIC:
AAA
Mesenteric ischemia
Aortic dissection
DKA
Opiate withdrawal
Familial Mediterranean fever
Heavy metal poisoning
Addisonian crisis
INFECTIOUS, NOS:
Herpes zoster
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2
Q

Epigastric pain

A 
PANCREATIC:
Pancreatitis
GASTRIC:
Gastritis
PUD
BILIARY:
Cholecystitis
Choledocholithiasis
Biliary colic
Ascending cholangitis
Referred thoracic pain:
-PE
-ACS
-PNA
INFECTIOUS, NOS:
Shingles
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3
Q

RUQ pain

A 
PANCREATIC:
Pancreatitis
GASTRIC:
Gastritis
PUD
BILIARY:
Cholecystitis
Choledocholithiasis
Biliary colic
Ascending cholangitis
LIVER:
Hepatic abscess
Fitz-Hugh-Curtis (female)
Referred thoracic pain:
-PE
-ACS
-PNA
INFECTIOUS, NOS:
Shingles
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4
Q

LUQ pain

A 
PANCREATIC:
Pancreatitis
GASTRIC:
Gastritis
PUD
Thoracic pain, referred:
-PE
-ACS
-PNA
INFECTIOUS, NOS:
Shingles
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5
Q

RLQ and LLQ pain

A 
GI:
Appendicitis
Diverticulitis (cecal)
Crohn's
Ureterolithiasis
Bowel obstruction
Bowel perforation
Hernia (inguinal, femoral)
Epiploic appendagitis
Mesenteric adenitis
Constipation
Meckel's diverticulum
VASCULAR:
Mesenteric ischemia (>50 yo)
Ischemic colitis (>50 yo)
Gonadal vein thrombosis
RENAL/URINARY:
Pyelonephritis
UTI
Shingles
Psoas abscess
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6
Q

RLQ and LLQ pain- female

A 
NONPREGNANT:
PID
Ovarian torsion
TOA
Ovarian cyst (ruptured)
Hemorrhagic ovarian cyst
Endometriosis
MIttelschmerz
Uterine fibroid (>40 yo)
FIRST TRIMESTER: 
Ectopic pregnancy
Ovarian hyperstimulation syndrome
Threatened abortion
SECOND/THIRD TRIMESTER:
Placenta previa
Placental abruption
Round ligament pain
POSTPARTUM:
Septic pelvic thrombophlebitis
Endometritis
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7
Q

RLQ and LLQ pain-male

A

Testicular torsion

Epididymitis

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8
Q

AMS

A

Alcohol
Electrolytes (hyponatremia, hypocalcemia), Endocrine (myxedema coma, thyroid storm), Encephalopathy (hepatic, hypertensive, heat stroke)
Infection (encephalitis, systemic infection)
Overdose (drugs, also withdrawal from drugs or deficiency of thiamine, niacin, or B12), Oxygen (hypoxia, methemoglobinemia, carbon monoxide poisoning)
Uremia
Trauma (i.e., hemorrhagic shock, severe TBI, etc), Temperature (hypothermia)
Insulin (i.e., hypoglycemia)
Psychogenic (i.e., pseudoseizures, severe depression, psychosis)
Stroke, Seizure, Subarachnoid hemorrhage, Space-occupying lesion
MC in elderly: hypoglycemia, sepsis, stroke
MC in other age groups: EtOH, drugs, hypoglycemia

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9
Q

HA

A 
Infectious:
Meningitis
Encephalitis
Herpes (shingles, ophthalmicus, oticus)
Sinusitis
Vascular: 
SAH
Hemorrhagic stroke
Venous sinus thrombosis
Cervical artery dissection
Pituitary apoplexy
Other life-threats and maimers:
Idiopathic intracranial HTN
Carbon monoxide poisoning
Acute angle closure glaucoma
Giant cell arteritis (>50 yo)
Neoplasm
Others:
Migraine
Tension HA
Trigeminal neuralgia
TMJ pain
Post-LP (within 48 hrs of LP)
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10
Q

Head injury

A 
Intracranial hemorrhage/hematoma:
SAH
Subdural hematoma
Epidural hematoma
Intraparenchymal hemorrhage
Everything else:
Cervical artery dissection
TBI (concussion)
Diffuse axonal injury
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11
Q

Syncope

A 
CARDIAC, CONDUCTION:
Long QT
WPW
Brugada
Heart block
Tachydysrhythmia
Short QT
Arrhythmogenic RV dysplasia
CARDIAC, PUMP:
Aortic stenosis
HCM
ACS
VASCULAR:
PE
Severe carotid stenosis
Vertebrobasilar insufficiency
AAA, ruptured
Orthostatic hypotension
METABOLIC:
Hypoglycemia
Hyperkalemia
Anemia
NEURO:
Intracranial hemorrhage
Seizure
Vasovagal
Hyperventilation
Carotid sinus sensitivity
PULM:
Pneumothorax
OB/GYN
Ectopic pregnancy 
Vaginal bleeding
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12
Q

Tests for cardiac conduction causes of syncope

A

EKG

Monitor

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13
Q

Tests for cardiac pump causes of syncope

A

Auscultation
EKG
+/- troponin

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14
Q

Tests for vascular causes of syncope

A

Ausculatation

+/- AAA u/s

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15
Q

Tests for metabolic causes of syncope

A

D stick
+/-BMP
+/- CBC
+/- hemoccult

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16
Q

Tests for neuro causes of syncope

A

+/- CT head

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17
Q

Tests for pulm causes of syncope

A

+/- CXR

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18
Q

Tests for ob/gyn causes of syncope

A

Beta-hCG

+/- pelvic u/s

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19
Q

Dizziness

A 
Central vertigo:
-Cerebellar stroke
-Vertebral basilar artery insufficiency
-Vertebral artery dissection
-Subclavian steal
-Brain tumor
-Infection (meningitis, encephalitis, abscess)
-Vertebral basilar migraine
-MS
Peripheral vertigo:
-Vestibular neuronitis
-BPPV
-Labyrinthitis
-Meniere disease
-Ramsay Hunt syndrome
Lightheadedness:
-Anemia
-Decreased cardiac output
-Bradycardia
-Dehydration
-Orthostatic hypotension
-Hyperviscosity syndrome
Ataxia:
-Ethanol
-Hyponatremia
-Normal pressure hydrocephalus
-Medications:
--BZDs/barbiturates
--Antieleptic toxicity (phenytoin, carbamazepine, valproic acid)
--Aminoglycoside toxicity
--Loop diuretic toxicity
-Posterior column degeneration
-Peripheral neuropathy
-B12 deficiency
-Neurosyphilis
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20
Q

Weakness/fatigue

A 
MCCs in elderly: stroke, urosepsis, hypoglycemia, anemia/GI bleed, hyperkalemia, or cardiac
INFECTIOUS:
Sepsis (most commonly UTI, PNA)
Epidural abscess
Encephalitis/meningitis
Lyme dz
Rabies
Botulism
Tick paralysis
CARDIAC:
Arrhythmia
ACS
Bradycardia
CHF
METABOLIC/ENDO
Hypoglycemia
Hyperkalemia
Hyponatremia
Hypothyroidism
Malnutrition
Hypokalemic/thyrotoxic periodic paralysis
Acute intermittent porphyria
NEURO:
Stroke
Subdural hemorrhage
Myasthenia gravis
Lambert-Eaten
Guillain Barre
Transverse myelitis
MS
Polymalgia rheumatica
MUSCULOSKELETAL
Muscular dystrophy
Polymyositis/dermatomyositis
HEME-ONC
Anemia
Leukemia/lymphoma
Hyperviscosity syndrome
TOX
Organophosphate poisoning
Ciguatera
Drugs (CCBs, BBs, etc)
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21
Q

Tests for infectious causes of weakness/fatigue

A

UA
CBC
+/-LP

22
Q

Tests for cardiac causes of weakness/fatigue

A

Monitor
EKG
+/- Troponin
+/- Pads

23
Q

Tests for metabolic/endo causes of weakness/fatigue

A 
D stick (blood glucose)
BMP
Mg
Ca
\+/- TSH/FT4
24
Q

Tests for neuro causes of weakness/fatigue

A

+/- CT head
+/- MRI brain/spine
+/- LP

25
Q

Tests for musculoskeletal causes of weakness/fatigue

A

+/- ESR/CRP

26
Q

Tests for heme/onc causes of weakness/fatigue

A

CBC

+/- hemoccult

27
Q

Red eye

A 
Painful:
-Ruptured globe
-Corneal ulcer
-Corneal abrasion
-Acute angle closure glaucoma
-Iritis
-HSV keratitis
-Episcleritis
-Scleritis
-Endophthalmitis
-Chemical burn
-UV keratitis
-Foreign body
Painless:
-Conjunctivitis
-Subconjunctival hemorrhage
-Hyphema
-Epidemic keratoconjunctivitis
-Inflamed pingueculum
-Inflamed pterygium
EXTRA-OCULAR:
Blepharitis
Hordeolum
Orbital/periorbital cellulitis
Cavernous sinus thrombosis
Cluster HA
28
Q

Epistaxis

A 
LOCAL ETIOLOGIES:
Digital trauma
Facial trauma
Irritants
SYSTEMIC ETIOLOGIES:
Anticoagulants
Liver failure
Blood dyscrasias:
-Leukemia/lymphoma
-ITP
-Polycythemia vera
-Hemophilia
29
Q

Hemoptysis

A 
AIRWAY DZ:
Bronchitis/bronchiectasis
Neoplasm
Trauma
Foreign body
INFECTIOUS:
TB
PNA
Fungal infection
VASCULAR DZ:
PE
AV malformation
Pulmonary HTN
Vasculitis (SLE, Wegener's, Goodpasture's)
OTHER:
Coagulopathy
Valvular heart disease (incl endocarditis)
Cocaine
30
Q

Dental pain

A 
ODONTOGENIC:
Cary
Pericoronitis
Periradicular periodontitis
Post-extraction pain
Alveolar osteitis (dry socket)
PERIODONTAL:
Periapical abscess
Peridontal abscess
Acute necrotizing ulcerative gingivitis
Ludwig's angina
TRAUMATIC:
Fracture
Subluxation
Avulsion
31
Q

Sore throat

A 
INFECTIOUS:
PTA/abscess
Retropharyngeal/parapharyngeal abscess
Epiglottitis
Strep pharyngitis
Mono
Viral pharyngitis
Gonococcal pharyngitis
Ludwig's angina
Diphtheria
Acute retroviral syndrome
NONINFECTIOUS:
Caustic ingestion
Foreign body
Lymphoma
32
Q

CP

A 
CARDIOVASCULAR:
ACS
Aortic dissection
Pericarditis
PULM:
PE
Pneumothorax
PNA
GI: 
Boerhaave's syndrome
Pneumomediastinum
GERD
THORACIC WALL:
Costochondritis
Rib contusion/fx
Shingles
OTHER:
Panic attack
Referred pain (from intraabdominal pathology)
33
Q

SOB

A 
PULM:
PE
Anaphylaxis
Asthma
COPD exacerbation
Pleural effusion
Noncardiogenic edema
Pneumothorax
PNA
Airway obstruction
CARDIAC:
CHF exacerbation
Pericardial effusion/cardiac tamponade
ACS
Arrhythmia
Valvular dysfunction
OTHER:
Anemia
Panic attack
Trauma (pulmonary contusion, flail chest)
DKA
Toxins (ingestion, CO poisoning, organophosphates)
34
Q

Back pain

A 
Life-threatening causes mneumonic:
Compression (cauda equina, conus medullaris, epidural hematoma)
Renal stone
AAA
Fracture
Tumor
Infection/inflammatory
RARE:
Pancreatitis
PUD
Ectopic pregnancy
PID
NON-LIFE-THREATENING CAUSES:
Mechanical LBP
Sciatica/radiculopathy
Ankylosing spondylitis
Spinal stenosis
35
Q

Diarrhea

A 
BACTERIAL:
Pseudomembranous colitis (C. difficile)
Dysentery
-Campylobacter
-Shigella
-Salmonela
-E. coli O157:H7
C. botulinum
VIRAL:
HIV
Enteroviruses
PARASITIC:
Entamoeba histolytica
Giardia lambia
OTHER:
IBD
Diverticulitis
Meds
Alcoholism
36
Q

GI bleed

A 
UGIB:
Gastric varices
Boerhaave's syndrome
PUD
Dieulafoy lesion
Gastritis
Mallory-Weiss tear
Lower-GI bleed, painless:
-CA
-Diverticulosis
-Angiodysplasia
Lower GI bleed, painful
-Crohn's
-UC
-Diverticulitis
-Aortoenteric fistula
-Ischemic colitis
-Mesenteric ischemia
-Hemorrhoids
37
Q

Testicular/penile pain

A 
Testicular torsion
Epididymitis
Torsion of testicular appendix
Orchitis
Testicular hematoma
Testicular fx/rupture
Scrotal abscess
Fournier's gangrene
Hydrocele
Inguinal hernia
Kidney stone
AAA
38
Q

Hematuria

A 
UTI
CA
Coagulopathy
Kidney stone
Nephropathy/nephritis
Foreign body
Sickle cell disease
BPH
39
Q

Vaginal bleeding, pregnant

A 
FIRST TRIMESTER:
Ectopic pregnancy
Spontaneous miscarriage
Threatened abortion
Post-coital bleeding
SECOND/THIRD TRIMESTER:
Placental abruption
Placenta previa
Placenta accreta
40
Q

Vaginal bleeding, nonpregnant

A 
NONPREGNANT:
CA: endometrial/cervical
Uterine fibroids (leiomyomas)
Adenomyosis
Polyps
Breakthrough bleeding on oral contraceptives
Atrophic vaginitis
Foreign body
Menstruation with coagulopathy
POST-PARTUM HEMORRHAGE:
Uterine atony
Uterine inversion
Retained placenta
Uterine rupture
Vaginal/cervical lacerations
Coagulopathy
41
Q

Urinary retention

A 
MCCs: BPH, meds
PROSTATIC OBSTRUCTION:
BPH
Prostate CA
Prostatitis
Prostate trauma/avulsion
URETHRAL OBSTRUCTION:
Stricture
Foreign body
BLADDER:
CA
Clots 
Calculi
NEUROGENIC:
Meds:
-Anticholinergics
-Antihistamines
-Nifedipine
-Sympathomimetics
Diabetic neurogenic bladder
Cauda equina/cord compression
42
Q

Knee pain

A 
ORTHO/TRAUMA:
Fx
Knee dislocation
Ligamentous tear
Meniscal injury
Muscle strain/rupture
Hemarthrosis
Bursitis
Osteoarthritis
INFECTIOUS:
Septic joint
Reactive arthritis
Osteomyelitis
Septic bursitis
CRYSTALLINE:
Gout
Pseudogout
OTHER:
Tumor
DVT
Baker's cyst
43
Q

Hypothermia

A 
INCREASED HEAT LOSS:
Environmental
Immersion
Pharmacologic/toxicologic
Burns
DECREASED HEAT PRODUCTION:
Endocrine abnormalities: hypothyroidism, hypopituitar, adrenal insufficiency
IMPAIRED THERMAL REGULATION:
CNS dysfunction
44
Q

Fever/hyperthermia

A 
INFECTIOUS:
PNA
UTI
TOXICOLOGIC:
Anticholinergic
Sympathomimetic (cocaine, meth, PCP, LSD)
EtOH withdrawal
BZD withdrawal
Salicylate overdose
Serotonin syndrome
Neuroleptic malignant syndrome
ENDOCRINE:
Thyroid storm
Pheochromocytoma
DKA
NEUROLOGIC:
Hypothalamic hemorrhage/infarction
Stroke
Status epilepticus
ENVIRONMENTAL:
Heat exhaustion
Heat stroke
45
Q

Tachycardia

A 
NARROW COMPLEX
REGULAR:
Sinus tachy
AVRT/AvnRT
Atrial flutter
IRREGULAR:
AFib
Multifocal atrial tachycardia
Atrial flutter with variable block
WIDE COMPLEX:
VTach
Antidromic AVRT
Aberrancy
Accelerated idioventricular rhythm
46
Q

Bradycardia

A 
SINUS BRADYCARDIA:
Mneumonic:
Drugs
Ichemia/infarction
Electrolytes/endocrine: hyperkalemia, hypokalemia, hypomagnesemia, hypocalcemia, hypoglycemia, hypothyroidism
Sick sinus syndrome
COLD hypothermia
NON-SINUS BRADYCARDIA:
Mobitz II
3rd degree heart block
Ventricular/junctional escape
Nonconducted PACs
47
Q

Hypotension

A 
DISTRIBUTIVE:
Sepsis
Anaphylaxis
Neurogenic
Addisonian crisis
CARDIOGENIC:
CHF
MI
Arrhythmia
OBSTRUCTIVE:
Cardiac tamponade
Tension pneumo
PE
HYPOVOLEMIC:
Hemorrhage
Dehydration, severe
48
Q

HTN

A 
Hypertension emergency: evidence of end-organ damage
-Neuro: stroke, hypertensive encephalopathy, intracranial hemorrhage
-Cardiac: CHF, ACS, aortic dissection
-Pulmonary: pulmonary edema
-Renal: AKI
-Pregnancy-related: (pre-)eclampsia
-Sympathomimetic crisis
Asymptomatic HTN
Drugs: sympathomimetics
49
Q

Allergic reaction

A

Anaphylaxis
Mild/moderate allergic reaction
Angioedema
Scromboid poisoning

50
Q

Burn

A 
BURN:
Chemical
Thermal
Electrical
SKIN-SLOUGHING:
TEN
Staphylococcal toxic shock syndrome
Pemphigus vulgaris

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