common presentations Flashcards

Question

Liver cirrhosis

Answer 1

Alcohol Viral - B and C NASHimmune - primary sclerosing cholangitis, autoimmune hepatitis (ANA, ASMA, SLA, ALK, MI, ALC) Biliary - primary biliary cirrhosis, CF, secondary biliary cirrhosis Genetic - haemochromatosis, OC, Wilson's Chronic venous outflow obstruction

Answer 2

``` Mechanical - MSK, discogenic, posterior ligament, facetogenic dysfunction Degenerative Fracture Malignancy - breast, bronchus, prostate, melanoma, thyroid, kidney Multiple myeloma Osteoporosis Spinal stenosis Hypercalcaemia Pagets Spondylothesis Scheuermann's disease Psoriatic Reactive IBD related Epidural abscess Osteomyelitis Diabetes Meningioma Mets Glioma Syrynx Pancreatitis, PUD, Depression, Hypercalcaemia ```

Answer 3

Alcoholic hepatitis/cirrhosisDrugs - OCA, amytryptiline, chlorpromazine, gold Biliary cirrhos Viiral hepatitis Cancers and mets ``` Extrahepatic: Bile duct cancer Pancreatic cancer Other cancer mets Cholangitis PSC Gallstones in common bile duct Pancreatitis Post surgery stricture/oedema ``` Charcot triad - fever upper abdominal pain + jaundice, acute cholecystitis

Answer 4

``` Acute pancreatitis Gastritis/duodenitis PUDBiliary colic Acute cholecystitis Basal pneumonia Oesophagitis AAA rupture Ascending cholangitis MI Mesenteric ischaemia Acute hepatitis Non ulcer dyspepsia Bowel obstruction Gastric cancer Pancreatic cancer Boerhaave perforation ```

Answer 5

Hyper cholesterol: Hypothyroid Cholestasis Nephrotic Drugs - thiazide, cyclosporin, carbamazepine ``` Hypertryglycerides: obesity, DM Cushing Alcohol renal failure ``` Drugs - oanzapine, steroids, oestrogen, SSRIPrimary familial hyperchoelsterolaemia Anorexia - increased LDL HCC - increased LDL Hepatitis - increased VLDL

Answer 6

``` GORD Oesophageal spasm Candidia HSV CMV Pill induced Cancer Achalasia ```

Answer 7

Acute: Primary - splenectomy, cirrhosis, nephrotic syndrome Secondary - Perforation - gallbladder, appendix, ulcer, diverticular, Crohn's Infection - appendix, abscess, pyosalpinx Ischaemia - volvulus, mesenteric, ischaemia, strangulated hernia Chemical - blood, bile Chronic - infection (TB and candida), carcinomatosis, chemical (talc powder on gloves)

Answer 8

``` Biliary colic Cholecystitis Duodenal ulcer Pancreatitis Basal pneumonia Ascending cholangitis Gastric ulcer Small bowel obstruction Appendix Hepatitis Pyelonephritis Ovarian pathology ```

Answer 9

``` Orientation Registration Attention and calculation Recall Language ```

Answer 10

Fever haemorrhage Low platelet Leaky capillary - ascites, pleural effusion, low haematocrit 70%, low albumin Tests - FBC, leukopenia, platelets, LFT (increased AST, ALT, low albumin), UEC

Answer 11

Parkinsons CUD Drugs - antipsychotics, metoclopramide, lithium, sodium valproate, manganese, tetraberazine Neurodegenerative - levy body dementia, progressive supra nuclear palsy, impaired up and down gaze, cognitive impairment, bulbar symptoms MSA - parkinsons, cerebellar, autonomicCorticobasilar degeneration - dystonia, myoclonus, alien limb + parkinsons Anoxic, genetic, Fragile X, Huntington, Wilsons

Answer 12

``` Dry: GORD Postnatal drip Lung cancer COPD Drugs Interstitial lung disease Pulmonary oedema -CCF Pleurisy - RA/SLE Fibrosing alveoli's, penumoconious, sarcoid ``` ``` Productive: Bronchiectasis TB COPD Lung cancer Congenital - CF, Kartagener Lung abscess Foreign body - late Extrinsic alveolitis ``` ASTHMA in both

Answer 13

``` Acute asthma Anaphylaxis Laryngeal oedema PE Pneumothorax AMI, mitral regurg Flash P oedema Croup Foreign body Epiglottitis Angina A stenosis Arrhythmia in HF Acidosis Uraemia ```

Answer 14

``` COPD Chronic asthma Heart failure Pulmonary fibrosis Pneumoconisis, sarcoid, allergic alveolitis Anaemia Bronchiectasis Decondition Pleural effusions Pul HTN Mesothelium Pulmonary TB Kyphoscoliosis MND Ankylosing Spondlyitis ```

Answer 15

Fluent - input or receptive and comprehension Wernickes - fluent, poor comprehension, poor repitiion Conduction - good comp, poor repitition Transcortical sensory - poor comprehension, good repetition Non fluent - good comprehension, difficult articulation Broca - good comp, poor reputation Transcortical motor - good comprehension, good reputation GLOBAL

Answer 16

``` Common: Pneumonia TB Pulmonary infarct Pluerisy, empyema Malignancy CCF Subphrenic abscess, pancreatitis ``` ``` Uncommon: Lowered protein - nephrotic, liver failure --> lymphoma SLE, RA ARF Post MI syndrome Megs Asbestos Myxoedema Uraemia - failure kidney ```

Answer 17

``` Rotator cuff tendinopathy Frozen shoulder Subacromial bursitis Bicepital tendinitis Glenoid labral tears OA Polymalgia rheymatiuca Posterior dislocation Recurrent subluxation Neoplasia - pancoast and bone Referred - diaphragm, gallbladder Axillary vein thrombosis Gout/psuedo - rare Winged scapula Cervical spine Avascular necrosis and post fracture ``` Clipping bra/touching shoulder blade - internal rotation Combing hair - external rotation - frozen shoulder Pain at night - capsule or cuff

Answer 18

``` Depression/anxietyViral or post viral OSA Cardiac failure PUD Anaemia HIV/AIDSMalignancy Hypo/hyperthyroid Addison's DM Kidney failure Liver cirrhosis Respiratory - COPD/ashtma Neuro - Parkinsons, MS, Myasthenia Met - hypokalemia, magnesium, haemochormatosis Nutrient - coeliac Cushing SLE/RA Post infectious RRV Barmah ```

Answer 19

Reflex - vasovagal, carotid sinus sensitivity, situational (urination, defaecation, cough) Cardiac - Arrhythmia, outflow obstruction, aortic stenosis, HOCM, massive PE, AAA Orthostatic - Dehydration, drugs, baroreceptor, anaemia dysfunction, Addison's, Parkinson's, Autonomic neuropathy Cerebrovascular - vertebrobasilar insufficiency, subclavian steal Non syncope - Head trauma, hypoglycaemia, Epilepsy, alcohol

Answer 20

Light headed - presyncope, hypoglycaemia, post concussive, anxiety, hyperventilation, addison's Loss of balance - ataxia, weakness, loss of joint sense, gait apraxia, visual Movement and vertigo - see vertigo card + ear wax

Answer 21

``` Pulmonary - PE, COPD, pneumonia Idiopathic/ischaemia RHF Alcohol Thyrotoxicosis Endocarditis/cardiomyopathy Sick sinus HTN Ischaemic Valve disease ```

Answer 22

``` Steroid Hyperthyroid, hyperplasia, hypercalcaemia Alcohol and tobacco Thin <22 Testosterone low - antiandorgens Early menopause Renal/liver failure Erosion bone disorder - RA, myeloma Dietary ca low, Diabetes ``` Fx Heparin

Answer 23

``` Forgot medications Arrhythmia/anaemia Ischaemia/infection Lifestyle - salt and fluid overload Upregulation of CO - pregnant, hyperthyroid, hypothyroid Renal failure Extras - PE/Endocarditis/Drugs (NSAIDs) ```

Answer 24

External ear - perichondritis, otitis externa (candida, aspergillus nigra, psuedomonas, staph aureus), furunculosis, trauma, neoplasia, zoster, viral myringitis, wax impacted Middle ear - Eustacian tube dysfunction, barotrauma, AOM, chronic cholesteatoma, acute mastoiditis Referred - Dental, TMJ, cervical spine, parotiditis, temporal arteritis, nodes Other referred - pharyngeal, tonsillitis Red flag - offensive discharge, downward displaced pinna, swelling behind hear, neuro (headache, drowsiness), older, unexplained, intractable ear pain, fever

Answer 25

``` Generalisation of focal - tumour, infection, abscess, trauma, cerebrovascular (infarct, haemorrhage, AV malformations, cavernous hemangioma) Genetic Trauma Hydrocephalus Cerebral anoxia Drugs - penicillin, isoniazid, chloroquine, lidocaine, TCA, lithium Alcohol withdrawal Organophosphate Metabolic - hypoglycaemia/calcemia/natremia/magnesimia Liver and renal failure Meningitis Alzheimer's DM SSLE Eclampsia Epilepsy Hyperthermia ```

Answer 26

``` Pseudo: Bilateral lacunar MND MS Vasculitis - cerebral High brainstem ``` Increased gag reflex or normal, spastic tongue, increased jaw jerk, speech is spastic dysarthria, labile emotions, Donald duck dysarthria involves V and VII ``` Bulbar: Kennedy Medullary MND, synringobulba Myasthenic GBS Polio Vasculitis Brainstem glioma Malignant Meningitis ``` Absent gag reflex, wasted and fasciculated tongue, absent or normal jaw jerk, normal emotion, limb fasciculation

Answer 27

Conduction: Cerumen, osteomata, otitis externa, Eustachian tube dysfunction, congenital mental atresia, chronic otitis media, glue ear, perforated TM, otosclerosis, Pagets, cholesteatoma Sensorineural: Trauma, viral infection, syphilis, TB, drugs, Menieres, congenital, cochlear otosclerosis Mixed: Acoustic neuroma, cerebellopontine angle tumours, zoster, central, vestibular neuritis Perilymph fistula --> after sapedcctomy + sudden onset deafness Glomus tumour --> tinnitus, hearing loss as it grows

Answer 28

``` Articular: Trauma (fracture, haemarthrosis, meniscus) Gout Pseudogout Septic Seronegative 1st presentation of RA or OA Sarcoid Vasculitis SLE Rheumatic fever ``` ``` Peri-articular Ligament Tendonitis Bursitis Fascitis Perioxtis ``` ``` Non-articular: Nerve entrapment Radiculopathy Osteomyelitis Malignancy Leukaemia ``` Viral arthritis --> RRV, polyarthritis

Answer 29

Anterior cerebral peduncle: 3rd nerve palsy, contralateral increased UMN, contralateral hemiplegia Claude: cerebral peduncle + red nucleus: ipsilateral 3rd contralateral cerebellar Parinaude: Dorsal-midbrain-tectum: Vertical gaze palsy, convergence disorder, convergence retraction nystagmus, pupillary + lid disorder Milard-Gubler: Pontomedullary junction --> ipsilateral 6th, ipsilateral 7th, contralateral hemiplegia Wallenber - lateral medulla, ipsilateral 5th, 9th, 10th, 11th, ipsilateral horner's, ipsilateral cerebellar, contralateral spinothalamic sensory loss, vestibular disturbance

Answer 30

Haemarthrosis - ACL, osteochondral fracture, dislocated subluxation of patella, capsule, peripheral medici Synovial fluid effusion - ligament, meniscus Bursitis Chronic - patellofemoral pain syndrome, osteochondritis dessicans, degenerative meniscal, arthritis Others: Osgood schlauer, patellar tendinopathy, anserine bursitis, prepatellar bursitis, infra patellar bursitis, quadriceps tendinopathy, ITB, hamstring knee, synovial plica syndrome / infra patellar fat pad

Answer 31

Cerebellar - slurred, sing song, impaired timing Bulbar - slurred, nasal, indistinct Myopathy - indistinct, poor articulation Myasthenic - indistinct with fatigue, dysphonia, fluctuating severity Dystonic - strained, high pitch Parkinson's - soft, rapid, indistinct Pseudobulbar - indistinct, mumbling, breathy

Answer 32

Peripheral: Labryinth - labyrinthitis, menderes, BPPV, Drugs, trauma, ear wax, perilymph fistula, cholesteatoma, otosclerosis 8th nerve - vestibular neuritis, acoustic neuroma, drugs Central: Demyelination, migraine, posterior fossa mass (4th ventricle cerebellum), vertebobasilar insufficiency, visual-vestibular mismatch, seizure (complex/partial), temporal lobe ischaemia

Answer 33

Upper GI, PUD, Acute gastritis, gallstones, oesophageal malignancy, oesophageal spasm, IBS, non ulcer dyspepsia Other: pancreatitis, colon cancer, chronic hepatitis, mets, acute loop, pancreatic cancer Systemic - Renal, hyperglycaemia + oesophagitis + hiatus hernia Drugs: NSAID, steroids, iron and potassium, digoxin Other - alcohol, depression Upper GIT malignancy - stomach, oesophagus, pancreas Giardia

Answer 34

Peripheral - bronchospasm, PE, pneumonia, tacheitis, pneumothorax, malignancy, TB, CTD MSK - OA, rib fracture, chostochondritis (TIetze's syndrome), intercostal muscle, endemic myalgia (Borholm) Neuro: Intervertebral disc, herpes zoster, thoracic outlet syndrome

Answer 35

Extrapyramidal Pyramidal - UMN (stroke, hemiplegia --> extend toe --> circumduct hip) Foot drop Myopathic - proximal weakness Ataxic - cerebellum, vestibular, proprioception + vermis ; broad based + vestibular - normal walk + vertigo +proprio - stamping Apraxic - bilateral hemisphere (frontal lobe, hydrocephalus) - feet stuck to ground Marche a petit pas - small vessel (LUD: show small steps + marked instability, lacks increased pace or freezing)

Answer 36

Primary: Tension, migraine, cluster, drugs --> medical overuse ``` Secondary - subdural, SAH, intracerebral Increased ICP: Tumour, idiopathic, intracranial HTN Infection - encephalitis, meningitis, brain abscess Inflammation - temporal arteritis, other vasculitis Central vein thrombosis Glaucoma TMJ, neck, sinusitis Eye strain Post trauma Dental Sleep apnoea Hypoglycaemia Cervical spondylosis ICE pick HTN Sex Exertion/cough Transformed migraine Anaemia ```

Answer 37

Cardiac - MI, angina, unstable angina, myocarditis, pericarditis, mitral valve prolapse, AS Oesophageal - oesophagi's, spasm, Mallory Weiss Massive PE Mediastinal - rachitis, malignancy AAA, dissection

Answer 38

EMBOLISM Existing DVT, malignancy, baby, oestrogen, Large, Immune diseases, Surgery, Mobilisation

Answer 39

``` Pneumonia Bronchitis Heart failure Pleural effusion Exacerbation of COPD Post operative atelectasis ARDS Lung collapse Myasthenia gravis GBS Hyperventilation DKA Pericardial tamponade Extrinsic allergic alveolitis ```

Answer 40

``` Dry: Asthma Rhinitis/sinusitis with post nasal drip URTI ACE Foriegn body Lung cancer obstructs main bronchus Pulmonary oedema - CCF Atypical pneumonia (viral and mycoplasma) Whooping cough GORD Pleurisy Infants - dust, smoke, sarcoid ``` ``` Productive: LRTI - bronchitis, pneumonia Bronchiectasis COPD + exacerbation TB Asthma Lung abscess ```

Answer 41

Infective - Abscess - diverticular, UTI, hepatobiliary, CNS, lungs, pelvic Viral - IM, HIV, hepatitis, Q fever, CMV Parasite - amoebasis, malaria, toxoplasmas, Other - IE, brucella, rate bite fever, listeria, Biliary, lyme disease, typhoid, osteomyeletis HIV - RJP, MAC, CMV, chronic septicaemia Nosocomial - Surgery, prosthesis More - Malaria, B psuedomallei, liver abscess, dengue --> imports Malignant - Hodgkins, Cancer kidney, pancreas, GIT, lung mets, atrial myxoma Inflammation - temporal arteritis, stills, SLE, RA, PAN, sarcoid, ARF Undetermined - MI, drugs, PE, CVA GIT - IBD, pancreatitis, hepatitis Endo - Thyrotoxicosis/Thyroiditis, adrenal insufficiency, increased triglycerides Haem - haemolytic anaemia, TTP, paroxysmal nocturnal haemoglobinurai, GV host ``` INVESTIGATIONS: FBC ESR Blood film LFT Urinanalysis MCS Blood culture CXR Abdo US Tubercillin test Serology - HIV, heterophilic ab, Q fever, CMV, hepatitis, ACE (sarcoid), EBV, Typhoid Collagen - ANA, RF, ANCA, Complement CT abdo chest Echocardiograpy Lower limb duplex Thyroid uptake BM aspirate, node biopsy, laparoscopy ```

Answer 42

Essential - 90-95% Secondary Kidney - GN, renal failure, kidney artery stenosis, other neuromuscular, DM, PCKD Endo - Conn syndrome, phaochromocytoma, thyroid, cushing's OCP, NSAIds Coarctation of aorta Immune - PAN Pregnant

Answer 43

Coeliac Tropical sprue Lactose deficiency Crohn's Whipples - 2 weeks ceftriaxone, 12 months cotrimoxazole/tetracycline Giardia + other parasites Lymphoma Seronegative arthropathy Pancreas - chronic pancreatitis, CF, tumour Associations - IDA< T1DM, pernicious anaemia, PBC, sub fertility, thyroid, osteoporosis, Downs

Answer 44

Muscular strain Referred from spina OA --> antalgic gait, quad wasting + fixed flexion and ER Mets - sarcoma, lymphoma, myeloma) Osteoma Septic arthritis Osteomyelitis Pelvic infections Avascular necrosis - steroid, SLE, sickle cell, alcoholic at risk Bursitis - greater trochanter, ischial, iliopsoas Neurogenic claudication Nerve entrapments - sciatic, obturator, lateral anterior nerve to thigh Polymyalgia rheumatica Fracture - stress fracture femoral neck, sacrum, [pubic rami, subcapital Labrum, CAM + Gauz lesion Sacroileitis / dysfunction Osteitis pubis Kids: DOG - acetabulum dysplasia, O-bm - Pavlic harness - transient synovitis Perthre - JIA Slipped femoral epiphysis - hip lies in external rotation

Answer 45

Psychiatric - anxiety, schizophrenia (delusions and hallucinations), drug and alcohol abuse, dementia Organic - malignancy (lung, pancreas), hypothyroid, hypoparathyroid, other endocrine (e.g. Cushing), anaemia (especially pernicious), past infections (EBM), CCF, SLE Drugs - antihypertensives, benzodiazepines, steroids, NSAIDs, OCP, cytotoxins, antiparkinsons Dysthymia MDE MDD

Answer 46

Chronic - PFP, degenerative knee + meniscus, osteochonritis desicans Locking - meniscus, loose body (retropatellar fragment) - osteochondritis desicans, ALL, articular cartilage, tibial spine, displaced patellar, synovial oesteochondromatosis Pseudolocking - patella femoral dislocation, 1st/2nd medial ligament tear, ACL sparain, gross effusion, spasm hamstring, catching --> locking + sublimed patellar + loose body Click - patellar/maltrack/sublux, loose body, meniscus Anterior pain: PFDS, OA, Patellar tendinopathy, osteonecrosis Medial pain: OA, medial meniscus, PFPS, MCL Lateral OA, lateral meniscus, PFPS, ITB, LCL

Answer 47

``` Bronchial carcinoma Solitary met Granuloma Hamartoma Bronchial adenoma AUM Hydatid GUR Haematoma ```

Answer 48

``` Non melanocytes: Pigmented/BCC Seborrhoiec keratosis Solar keratosis Dermatofibroma Pyogenic granuloma Foreign body granuloma Tinea nigra Becker navus ``` Melanocytic: Non melanoma - freckles, lengiines, naevi (congenital, acquired), melanoma Types of melanoma: Lentigo, superficial spreading, nodular, acrolentiginous, desmoplastic

Answer 49

``` Sepsis Shock Trauma Burns Multiple transfusion Drug overdose Obstetric Cx - eclampsia, AFE Pulmonmary aspiration Toxic gas Blast injury SARS pancreatitis ``` Expansion lowered, no heart failure, fine crackles, rib retraction, laboured breathing

Answer 50

Sarcoid - commonest Infection - strep, viral, TB, leprosy, chlamydia, infection, fungal IBD Drugs - sulphonurea, tetracycline, OCP, iodines Malignancy - lymphoma, leukaemia Pregnancy MUST DO FBC, CXR, ESR

Answer 51

Target lesion + mucosal ulcers HSV Mycoplasma Parapoxivirus, VZV, Adenovirus, hepatitis, HIV, CMV, Viral vaccine Drugs <10%

Answer 52

``` DM - drugs, insulin, sulphonurea Drugs - guanine, salicylates, pentamicheric Alcohol Fasting Tumours - insulinomas Addisons Hypopituitar Liver disease Post gastrectomy Gastric dumping disease Autoimmune - insulin, antibodies, receptor antibodies GH deficiency Epinephrine deficiency Post prandial ``` Critical illness - renal, liver, starvation, sepsis and organ failure

Answer 53

Psychological - stress, anxiety, anorexia, bulimia, dementia Serious: CCF Malignancy Chronic infection - HIV, TB, hidden abscess, IE, brucellosis Malabsorption - parasites, coeliac, IBD, others, malabsorption CKD, liver cirrhosis, gastric ulcer CTD, chronic vomiting + diarrhoea Addisons, hypopituitary, hyperthyroid DM

Answer 54

``` Maculopapular Measles Rubella Scarlet fever Viral exanthem Roxola infantum Priamry HIV Secondary syphilis Urticaria Erythema multiforme Drug RRV/Barmah ``` ``` Maculopapular vesicular Varicella Herpes zoster and simplex Eczema herpeticum Impetigo hand food and mouth Drug ``` Purpura Purpura Vasculitis - PAN, HSP

Answer 55

Sinus tachycardia - emotion (anxiety), stress, fever, exercise Atrial x ventricular ectopics - alcohol, caffeine, stress, smoking, thyroid Drugs - codeine, beta agonist PS VT - faster in onset and offset, higher rate than sinus achy AF - PIRATE SHIV see other flash card, atrial flutter Valve - aortic incompetence, mitral regurgitation, mitral stenosis (hyper dynamic state) ``` Rare: VT Sick sinus Anaemia Long QT Heart block Thyroid WPW Electrolyte - Hypokalaemia, hypermagnesaemia, hypoglycaemia Pregnancy Menopause Phaeochromocytoma ```

Answer 56

``` Malignant: Lymphoma - NHL, HL Leukemia - ALL (kids), AML Metastases - lungs, liver and GIT (supraclaviucular), breast, head and neck (anterior triangle) CT disease - SLE, RA Sarcoid Amyloid Phenytoin Infections: Viral - EBV, CMV, HIV, Rubella Bacterial - TB, syphilis, atypical TB, brucellosis, cat scratch protozoa - Toxoplasmosis ```

Answer 57

Febrile seizures Infantile spasms - generalised tonic with flexion of arms, forward flexion of trunk and extension of legs - give ACTH Lennox-Gastaut syndrome - triad - difficult to control seizure, mental retard, EEG Benign volandic epilepsy - strong FHx, simple partial motor Somatosensory --> occur during sleep --> gurgling mouth, males, unable to speak, rheumatoid contorsion Childhood absence Juvenile myoclonic epilepsy - head of myoclonic jerks tonic clonic absences, sodium valproate for treatment Medial temporal lobe epilepsy - post ictal confusion and speech dysfunction

Answer 58

``` Probability: URTI Post nasal drip Nonspecific irritative pharyngitis Vocal abuse Nodules of vocal cord Presbyphoria Acute tonsillitis GOR GOitre Physical trauma Fungus Allergy - laryngioedema Leukoplakia SLE Wegener's ``` Not to be missed: Ca, airway obstruction (epiglottis and croup), TB, diphtheria, foreign body, MND, myasthenia Kids - laryngomalacia, laryngeal stenosis, laryngeal paralysis, croup, tonsil, epligottis, pappiloedema

Answer 59

Viral pharyngitis - Severe (EBC, herpangina, HSV) milder (adeno, corona, entero, influenza, rhino, pincorna, varicella) Bacterial - GABHS, haemophilus, moraxella, gonococcal, diphtheria, staph, sphyilis, vincent angina syndrome Chronic sinusitis + post nasal drip Candida Neoplasic Other infection - mycoplasma + chlamydia Apthous ulcers Severe infection - epiglottitis, quinsy, pharyngeal abscess Blood dyscrasia - leukaemia, agranulocytosis Reflux - pharyngiolaryngitis, irritants - smoke Rare - scleroderma, becket's, sarcoid, TB, malignant, granuloma

Answer 60

Vascular inherited - HHT, Marfan's, Osler weber Acquired - infection, purport simplex, HSP, steroid purport, scurvy Coagulation Inherited - haemophilia A and B, VWMB Acquired - DIC, liver disease, vitamin K deficiency, warfarin and anticoags Thrombocytopenia: Inherited - Fanconi syndrome, anega karycyte thrombocytopaenia Immune acquired - ITP, drug induced, TTP/HUS, post transfusion purport + megaloblastic anaemia Functional platelet Inherited - Glanzmann, Bernard-soulier, storage pool defieicny Acquired - Drugs (NSAID, aspirin), uraemia, myeloproliferative, dysproteinaemias

Answer 61

``` Recent UTI treated Glucocorticoid Acute febrile episode Cyclophosphamide Pregnancy Renal transplant rejection Genitourinary tract trauma Prostatitis and cystourethritis - STD, etc. Renal TB Genitourinary tract malignancy Presence of urinary catheter or recent use Urinary tract stones Pelvic irradiation PCKD Renal vein thrombosis ITN or analgesic nephropathy Papillary necrosis Interstitial cystitis SLE or kawasaki ```

Answer 62

``` Polyps Adenomyosis Leiomyomata Malignant and hyperplasia Coags Ovulation Iatrogenic Endometriosis Not yet classified ```

Answer 63

``` Nipple discharge Change in appearance Cylcic pain./ pain SKin changes Redness Skin tethering and puckering Tenderness Change in density L:ump Lymphon nodes Bone pain ``` ``` DDX: Fibrocystic Fibroadenoma DCIS/LCIS Ductule/lobule cancers Abscess, mastitis, galactocele Papillary and Medullary ``` Ask about nulliparity, FmHx, early menarche, oestrogen/progesterone, radiation, personal history of cancer

Answer 64

``` Fibroids Adenomysis DUB Hypotyhyroidism PID Polyps Leukaemias ZBleeding disorders Prostalgandin excess Stress Liver and renal disease ```

Answer 65

``` Pregnancy Breast feeding Meno[pause Medications Stress, exercise, weight PCOS Thyroid Puituitary tumour uterine scarring Genital malformations Turner's Metabolic disturbance ```

Answer 66

``` Cervical cancer Endometrial hyperplasia Uterine body cancer Urethral curuncle Atrophic vaginitis Polyps ```

Answer 67

``` Birth - Hep B 2 months - Hep B-IPV, DTPA, 13vPCV, rotavirus 4 months same as above 6 months - same as above minus rotavirus 12 months - MMR + Men C - HIB 18 - MMRV + dtpa 4 years - dtpa and IPV year 7 - HPV, dTPA Year 10 - Men nonavalent ```

Answer 68

``` Primary: Infection Trauma + foreignbodies Impacted cerumen otological neoplasms ``` ``` Secondary: Dental TMJ Trigeminal Head and neck cancer Eagle's Temporal arteritis ``` ``` Red flags: Discharge Downward pinna Swelling Focal neuro Older Persistent fever ```

Answer 69

``` Blephiritis Conjunctivitisd Keratitis Iritis Epislceritis Acute glaucoma ```

Answer 70

``` Mehcanical Degenerative Fracture Malignancy Spinal Paget's Spondylothesis Scheumanns Psoriatric, reactive, IBD Epidural abscerss Osteomyelitis Depression Pancreatitis ```

Answer 71

``` Platelet disorders Leukaemia Anaemia Trauma Enlarged spleen liver failure Ethanol Toxins Sepsis ``` PLATETLS

Answer 72

``` Sepsis Trauma Obstetric Pancreatitis Malignancy Nephrotic snydromes Transfusion ``` STOP making new thrombi

Answer 73

``` Congerstive HF HTN Age above 75 DM Stroke Age 65-75 Sex female ```

Answer 74

``` HTN Abnormal renal and liver Stroke Bleeding Labile INR Elderly over 65 Drugs or alcohol ```

Answer 75

``` Bleeding Hiccups Bone pain/back ache Diarrhoea Hypercalcemia Itching SOB Flkuid overload Metallic taste in mouth Nausea and vomiting ```

Answer 76

``` BPH Cancers Stricture Stones Retroperitoneal fibrosis Bilateral renal infarction Conspitation LMH Cystocele, rectocele STI Cauda equina ```

Answer 77

``` Hernia Bowel obstruction Epieidymitis STI Endometriosis Ectopic Mittelschermz Rupture of ovarian cyst Femoral artery aneurysm torsion Cancer ```

Answer 78

``` Anemia Anxiety Dehydration Electrolyte imbalance (especially hypokalemia and hypomagnesemia) Fever/ sepsis Hyperthyroidism Hypoglycemia Ischemia Metabolic disorders Pain Poisoning and toxic exposure Pulmonary embolism Respiratory disease (e.g. pneumonia, pneumothroax) Shock Trauma Withdrawal syndromes ```

Answer 79

MGUS Multiple myeloma Waldenstrom Macroglobinemia

Answer 80

Long standing venous disease (post thrombotic syndrome) DVT Lymphoedema - Surgical excision of local lymph nodes - Radiotherapy to local lymph nodes - Tumour infiltrating the lymphatics - Trauma - Filiriasis - Lymphoedema artifacta: patient tying a tourniquet around the limb Extrinsic pressure (pregnancy, fibrosis, tumour) Lipoedema Klippel–Trénaunay syndrome Disuse/hysterical edema

Answer 81

``` Heart failure Liver failure/cirrhosis Renal failure Hypoproteinemia Hereditary angioedema ```

common presentations Flashcards

(105 cards)