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CS cases Flashcards

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1
Q

five DDs for patient with migraine sx (focal neuro signs)

A

migraine, tension HA, cluster HA, pseudotumor, seizure

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2
Q

workup for patient with migraine sx (+ focal neuro signs) (4)

A

CBC
CT head
MRI brain
LP

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3
Q

5 DDs for patient with cluster HA sx

A 
cluster HA
 migraine HA
 tension HA
 trigeminal neuralgia
 sinusitis
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4
Q

workup for patient with cluster HA sx (4)

A

CBC
ESR
CT head
MRI brain

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5
Q

5 DDs for patient with:
intermittent vision loss
jaw claudication
u/l HA

A 
GCA
 migraine HA
 tension HA
 meningitis
 carotid dissection
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6
Q

5 workups for patient with:
intermittent vision loss
jaw claudication
u/l HA

A 
CBC
 ESR
 temporal a. bx
 carotid doppler US
 MRI brain
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7
Q

4 DDs for patient with sinusitis sx (+ fever)

A

sinusitis
tension HA
migraine HA
meningitis

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8
Q

4 workups for patient with sinusitis sx (+ fever)

A

CBC
XR sinus
CT sinus
LP

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9
Q

4 DDs for patient with tension HA sx

A

tension HA
migraine HA
depression
caffeine withdrawal

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10
Q

2 workups for patient with tension HA sx

A

CBC

CT head

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11
Q

5 DDs for patient with SAH sx (+ nuchal rigidity, focal neuro sx)

A 
SAH
 other intracranial hemorrhage
 meningitis
 migraine HA
 sinus vein thrombosis
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12
Q

5 workups for patient with SAH sx (+ nuchal rigidity, focal neuro sx)

A 
CBC
 PT/PTT
 CT head- no contrast
 LP
 MRI brain
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13
Q

4 DDs for patient with meningitis sx

A

meningitis
SAH
migraine HA
intracranial or epidural abscess

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14
Q

3 workups for patient with meningitis sx

A

CBC
CT head
LP

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15
Q

5 DDs for patient with pseudotumor sx

A 
pseudotumor cerebri
 migraine HA
 meningitis
 sinus vein thrombosis
 intracranial neoplasm
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16
Q

4 workups for patient with pseudotumor cerebri sx

A

CBC
CT head
LP
MRI brain

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17
Q

5 DDs for patient with trigeminal neuralgia sx

A 
trigeminal neuralgia
 tension HA
 migraine HA
 TMJ dysfunction
 intracranial neoplasm
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18
Q

3 workups for patient with trigeminal neuralgia sx

A

CBC
ESR
MRI brain

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19
Q

5 DDs for patient with vascular dementia sx (+ falls)

A 
vascular dementia
 Alzheimer's
 NPH
 SDH
 neurosyphilis/B12 deficiency
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20
Q

4 workups for patient with vascular dementia sx (+ falls)

A

CBC
B12
VDRL/RPR
CT head

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21
Q

5 DDs for patient with Alzheimer’s sx

A 
Alzheimer's
 hypothyroidism
 B12 deficiency
 depression
 neurosyphilis
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22
Q

5 workups for patient with Alzheimer’s sx

A 
CBC
 TSH
 B12
 MRI brain
 VDRL/RPR
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23
Q

5 DDs for patient with NPH sx

A 
NPH
 chronic SDH
 Alzheimer's
 Vascular dementia
 intracranial neoplasm
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24
Q

2 workups for patient with NPH sx

A

CT head

LP

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25
5 DDs for patient with CJD sx
``` CJD vascular dementia Lewy body dementia Wernicke encephalopathy intracranial neoplasm ```
26
4 workups for patient with CJD sx
MRI brain EEG LP brain bx
27
4 DDs for elderly patient with insulin-induced hypoglycemia sx
insulin-induced hypoglycemia delirium TIA cardiac arrhythmia
28
5 workups for elderly patient with insulin-induced hypoglycemia sx
``` CBC, electrolytes, glucose EKG carotid doppler cardiac echo CT head ```
29
4 DDs for patient with chronic SDH sx
chronic SDH SIADH intracranial neoplasm CJD
30
4 workups for patient with chronic SDH sx
CBC electrolytes CT head MRI brain
31
4 DDs for low mood after death of spouse
normal bereavement adjustment disorder major depression schizoaffective disorder
32
5 workups for low mood after death of spouse
``` physical exam mental status exam TSH CBC urine tox ```
33
3 DDs for low mood + fatigue, insomnia
major depression substance-induced mood disorder dysthymia
34
5 workups for low mood + fatigue, insomnia
``` physical exam mental status exam TSH CBC urine tox + blood EtOH ```
35
4 DDs for low mood + manic episode 6 months ago
bipolar I bipolar II cyclothymia schizoaffective disorder
36
3 workups for low mood + manic episode 6 months ago
physical exam mental status exam urine tox
37
5 DDs for psychosis
``` schizophreniform disorder schizophrenia schizoid/schizotypal PD depression with psychotic feature substance induced psychosis ```
38
5 workups for psychosis
``` mental status exam urine tox TSH CBC electrolytes ```
39
3 DDs for substance-induced psychosis
substance-induced psychosis brief psychotic disorder schizophreniform disorder
40
workups for substance-induced psychosis
urine tox
41
5 DDs for schizoaffective disorder
``` schizoaffective disorder mood disorder with psychotic features schizophrenia schizophreniform disorder psychotic disorder due to general medical condition ```
42
5 workups for schizoaffective disorder
``` mental status exam beck depression inventory TSH CBC electrolytes ```
43
5 DDs for intermittent vertigo + tinnitus
``` Meniere's disease labyrinthitis acoustic neuroma vestibular neuritis BPPV ```
44
3 workups for intermittent vertigo + tinnitus
CBC VDRL MRI brain
45
3 DDs for dizziness + volume depletion
orthostatic hypotension 2/2 dehydration vertebrobasilar insufficiency cerebellar SOL
46
5 workups for dizziness + volume depletion
``` orthostatic BP measurement/tilt test CBC, electrolytes if 2/2 diarrhea: stool exam for blood, electrolytes MRA brain MRI brain ```
47
4 DDs for BPPV sx
BPPV vestibular neuritis labyrinthitis Meniere disease
48
workups for BPPV sx
MRI brain electronystagmography audiogram
49
4 DDs for hours-long dizziness + hearing loss
labyrinthitis meniere's disease acoustic neuroma vertebrobasilar insufficiency
50
4 workups for hours-long dizziness + hearing loss
audiogram electronystagmography MRI brain MRA brain
51
5 DDs for hours-long dizziness without hearing loss
``` vestibular neuritis BPPV vertebrobasilar insufficiency labyrinthitis meniere's disease ```
52
5 workups for hours-long dizziness without hearing loss
``` CBC electrolytes electronystagmography MRI brain MRA brain ```
53
5 DDs for GTC sx
``` GTC seizure convulsive syncope substance abuse malingering hypoglycemia ```
54
5 workups for GTC sx
``` CBC, electrolytes, Glc urine tox EEG CT head EKG ```
55
4 DDs for LOC without prodrome (but + palpitations)
``` syncope 2/2 cardiac arrythmia syncope 2/2 aortic stenosis syncope NOS seizure hypoglycemia ```
56
5 workups for LOC without prodrome (but + palpitations)
``` EKG holter monitoring cardiac echo CT head CBC, electrolytes, glucose ```
57
3 DDs for transient hemiparesis + hemisensory deficit + dysarthria
TIA seizure hypoglycemia
58
5 workups for transient hemiparesis + hemisensory deficit + dysarthria
``` CBC, Glc, electrolytes CT head MRI brain carotid doppler cardiac echo ```
59
5 DDs for persistent hemiparesis + stroke RFs
``` stroke TIA seizure intracranial SOL SDH ```
60
5 workups for persistent hemiparesis + stroke RFs
``` CBC, electrolytes CT head MRI brain carotid doppler cardiac echo ```
61
5 DDs for symmetric ascending weaknes over 2 weeks
``` GBS MS polymyositis MG spinal SOL ```
62
5 workups for symmetric ascending weaknes over 2 weeks
``` LP MRI spine EMG/NCS tensilon test CPK ```
63
5 DDs for MS sx
``` MS stroke malingering CNS SOL CNS vasculitis ```
64
5 workups for MS sx
``` CBC ESR MRI brain LP retinal evoked potentials ```
65
4 DDs for diabetic neuropathy sx + alcoholism hx
diabetic neuropathy alcoholic neuropathy B12 deficiency hypocalcemia
66
3 workups for diabetic neuropathy sx + alcoholism hx
HbA1c calcium serum B12
67
5 DDs for MG sx
``` MG MS horner's syndrome intracranial SOL ALS ```
68
5 workups for MG sx
``` tensilon test, anti-AChR serology CXR CT chest MRI brain EMG ```
69
4 DDs for fatigue + low mood
depression adjustment disorder hypothyroidism anemia
70
2 workups for fatigue + low mood
CBC | TSH
71
5 DDs for fatigue + hx of trauma 1 yr ago
``` PTSD depression GAD hypothyroidism substance abuse ```
72
4 workups for fatigue + hx of trauma 1 yr ago
CBC TSH Ca2+ urine tox
73
4 DDs for fatigue + constipation
CRC hypothyroidism hypercalcemia renal failure
74
4 workups for fatigue + constipation
rectal exam, stool guiac CBC, electrolytes, Ca2+ colonoscopy BUN/Cr
75
4 DDs for hypothyroidism sx
hypothyroidism depression DM anemia
76
3 workups for hypothyroidism sx
TSH, FT3, FT4 CBC Glc, HbA1c
77
4 DDs for OSA sx
OSA hypothyroidism chronic fatigue syndrome narcolepsy
78
4 workups for OSA sx
CBC TSH polysomnography nocturnal pulse oximetry
79
4 DDs for fatigue + incresed urination
DM DI 1' polydipsia atypical depression
80
5 workups for fatigue + increased urination
``` CBC, electrolytes, Glc OGTT HbA1c UA BUN/Cr ```
81
4 DDs for fatigue + change in work shift
sleep deprivation circadian rhythm sleep disorder depression anemia
82
1 workup for fatigue + change in work shift
CBC
83
5 DDs for night sweats + lymphadenopathy
``` TB acute HIV Ly leukemia hyperthyroidism ```
84
5 workups for night sweats + lymphadenopathy
``` PPD, sputum gram stain, acid fast stain + culture CBC CXR HIV antibodies TSH ```
85
5 DDs for insomnia
``` stress caffeine circadian rhythm sleep disorder depression OSA ```
86
4 workups for insomnia
CBC TSH polysomnography mental status (if depressed)
87
4 DDs for sore throat + abd pain
infectious mono hepatitis pharyngitis (viral or bacterial) acute HIV
88
5 workups for sore throat + abd pain
``` CBC monospot (heterophile Abs) throat culture AST, ALT, ALP, bilirubin HIV Abs ```
89
4 DDs for sore throat + fever, rash, weight loss
acute HIV (acute retroviral syndrome) infectous mono viral pharyngitis strep tonsillitis
90
4 workups for sore throat + fever, rash, weight loss
CBC HIV Abs, viral load, CD4 count monospot test throat culture
91
4 DDs for sore throat + fever
pharyngitis (viral or bacterial) Mycoplasma pneumonia infectious mono acute HIV
92
5 workups for sore throat + fever
``` throat culture rapid strep test monospot test CBC HIV Abs ```
93
5 DDs for cough + wheezing
``` asthma GERD bronchitis pneumonitis foreign body aspiration ```
94
4 workups for cough + wheezing
CBC CXR PFTs methacholine challenge test
95
4 DDs for productive cough over last 2 years
chronic brochitis bronchiectasis lung Ca TB
96
5 workups for productive cough over last 2 years
CBC PPD, sputum gram stain, acid fast stain, culture CXR CT chest
97
5 DDs for productive cough + fever, chest pain
``` pneumonia bronchitis lung abscess lung Ca TB ```
98
5 workups for productive cough + fever, chest pain
CBC PPD, sputum gram stain, acid fast stain, culture CXR CT chest
99
3 DDs for nonproductive cough 2 weeks after URI
atypical pneumonia postnasal drip GERD
100
5 workups for nonproductive cough after URI
``` CBC sputum gram stain, culture CXR Mycoplasma IgM urine Legionella Ag ```
101
4 DDs for hemoptysis for 6 months
lung Ca TB lung abscess COPD
102
5 workups for hemoptysis for 6 months
``` CBC PPD, sputum Gram stain, acid fast stain, culture CXR CT chest bronchoscopy ```
103
5 DDs for productive cough + dyspnea in COPDer
``` COPD exacerbation pneumonia URI lung Ca CHF ```
104
5 workups for productive cough + dyspnea in COPDer
``` CBC CXR CT chest PFTs sputum Gram stain, culture ```
105
5 DDs for cough + night sweats + TB exposure
``` TB Ly pneumonia lung abscess other Ca ```
106
5 workups for cough + night sweats + TB exposure
``` CBC PPD, sputum Gram stain, acid fast stain, culture CXR CT chest bronchoscopy ```
107
5 DDs for cough + dyspnea + AIDS RFs + TB exposure
``` TB pneumonia (e.g. PCP) bronchitis acute HIV asthma ```
108
4 workups for cough + dyspnea + AIDS RFs + TB exposure
CBC PPD, sputum gram stain, acid fast stain, silver stain, culture CXR HIV Abs
109
3 DDs for cough + orthopnea
CHF cardiac valvular disease GERD
110
5 workups for cough + orthopnea
``` CBC BNP cardiac echo EKG esophageal pH monitoring ```
111
5 DDs for typical chest pain
``` ACS stable angina aortic dissection PTX GERD ```
112
5 workups for typical chest pain
``` EKG CK-MB, Tn cardiac echo cardiac cath CBC, electrolytes ```
113
4 DDs for chest pain in young African American
``` acute chest syndrome (HbS disease pulmonary infarction) pneumonia PE PTX ACS ```
114
5 workups for chest pain in young African American
``` CBC, reticulocytes, peripheral smear ABG CXR EKG CT chest + contrast ```
115
5 DDs for GERD-like chest pain
``` GERD esophagitis PUD esophageal spasm ACS ```
116
4 workups for GERD-like chest pain
EKG EGD esophageal pH monitoring barium swallow
117
3 DDs for stable angina sx
stable angina esophageal spasm esophagitis
118
5 workups for stable angina sx
``` EKG CK-MB, Tn cardiac cath EGD esophageal pH monitoring ```
119
5 DDs for atypical chest pain worse on inspiration
``` pericarditis costochondritis GERD esophageal rupture ACS ```
120
5 workups for atypical chest pain worse on inspiration
``` CBC EKG CK-MB, Tn cardiac echo EGD ```
121
3 DDs for atypical chest pain + dyspnea
PE pneumonia costochondritis
122
5 workups for atypical chest pain + dyspnea
``` CBC EKG CT chest + contrast doppler US legs CXR ```
123
5 DDs for palpitations in diabetic
``` hypoglycemia hyperthyroidism cardiac arrhythmia panic attack pheochromocytoma ```
124
4 workups for palpitations in diabetic
CBC, electrolytes, glucose TSH EKG holter monitor
125
4 DDs for unintentional weight loss
hyperthyroidism Ca malabsorption HIV
126
4 workups for unintentional weight loss
TSH, FT4 HIV Abs anti TTG, anti-gliadin serology colonscopy + bx
127
5 DDs for unintentional weight gain
``` hypothyroidism cushing's syndrome DM smoking cessation drug side effect ```
128
4 workups for unintentional weight gain
CBC, electrolytes, glucose TSH 24h urine free cortisol dexamethasone suppression test
129
5 DDs for dysphagia in smoker
``` esophageal Ca achalasia esophagitis systemic sclerosis ALS ```
130
5 workups for dysphagia in smoker
``` CBC CXR CT neck + chest EGD barium swallow ```
131
4 DDs for RUQ or LUQ pain + flank tenderness
nephrolithiasis RCC pyelonephritis appendicitis
132
5 workups for RUQ or LUQ pain + flank tenderness
``` rectal exam UA, urine culture + sensitivity Bun/Cr CT abdomen US renal ```
133
4 DDs for epigastric pain + weight loss + acholic stool
pancreatic ca acute hepatitis cholecystitis/choledocholithiasis PUD
134
5 workups for epigastric pain + weight loss + acholic stool
``` rectal exam CBC, electrolytes amylase, lipase AST, ALT, ALP, bilirubin CT abdomen ```
135
5 DDs for epigastric pain + vomiting in alcoholic
``` acute pancreatitis PUD cholecystitis/choledocholithiasis gastritis alchoholic hepatitis ```
136
5 workups for epigastric pain + vomiting in alcoholic
``` amylase, lipase EGD AST, ALT, ALP, bilirubin US abdomen CT abdomen ```
137
5 DDs for RUQ pain + fever
``` cholecystitis acending cholangitis (esp. if jaundice present) other GB disease PUD acute hepatitis ```
138
5 workups for RUQ pain + fever
``` rectal exam CBC AST, ALT, ALP, bilirubin EGD US abdomen ```
139
4 DDs for postprandial epigastric pain
PUD gastritis GERD cholecystitis
140
4 workups for postprandial epigastric pain
rectal exam amylase, lipase EGD AST, ALT, ALP, bilirubin
141
5 DDs for intestinal obstruction sx
``` intestinal obstruction intestinal cancer volvulus ileus hernia ```
142
5 DDs for intestinal obstruction sx
``` rectal exam AXR CXR CT abdomen CBC, electrolytes ```
143
4 DDs for crampy abdominal pain in patient with AF
bowel ischemia/infarction ACS diverticulitis PUD
144
5 workups for crampy abdominal pain in patient with AF
``` rectal exam CBC, amylase, lipase, lactate mesenteric angio CT abdomen EKG ```
145
5 DDs for RLQ pain + vomiting in woman
``` ovarian torsion (if no peritoneal sx) appendicitis (if peritoneal sx, fever) ruptured ectopic ruptured ovarian cyst nephrolithiasis ```
146
5 workups for RLQ pain + vomiting in woman
``` rectal exam pelvic exam bhCG doppler US pelvis CT abdomen ```
147
4 DDs for LLQ pain + alternating diarrhea/constipation
diverticulitis Crohn's UC IBS (if no N/V or weight loss)
148
5 workups for LLQ pain + alternating diarrhea/constipation
``` rectal exam AXR CXR CBC, electrolytes CT abdomen ```
149
4 DDs for appendicitis sx
appendicitis Crohn's nephrolithiasis volvulus
150
5 workups for appendicitis sx
``` rectal exam CBC, electrolytes AXR CT abdomen US abdomen ```
151
5 DDs for b/l lower abdominal pain in woman associated with menstruation
``` PID (if sexual hx supports) endometriosis dysmenorrhea vaginitis cystitis ```
152
5 workups for b/l lower abdominal pain in woman associated with menstruation
``` rectal exam pelvic exam US pelvis UA, urine culture, cervical cultures urine hCG ```
153
5 DDs for alternating constipation + diarrhea, + weight loss
``` CRC IBS diverticulosis IBD parasite ```
154
5 workups for alternating constipation + diarriea, + weight loss
``` rectal exam CBC colonoscopy barium enema CT abdomen ```
155
5 DDs for constipation
``` low fiber diet IBS substance abuse (esp. heroin) depression hypothyroidism ```
156
4 workups for constipation
rectal exam CBC, electrolytes TSH urine tox
157
3 DDs for infectious diarrhea sx
infectious diarrhea food poisoning IBD
158
5 workups for infectious diarrhea sx
``` rectal exam, stool for occult blood stool leukocytes + culture CBC, electrolytes CT abdomen CT pelvis ```
159
5 DDs for diarrhea + diffuse abdominal pain (without vomiting or fever)
``` Crohn's UC Celiac gastroenteritis hyperthyroidism ```
160
5 workups for diarrhea + diffuse abdominal pain (without vomiting or fever)
``` rectal exam stool exam, culture CBC, electrolytes colonoscopy CT abdomen ```
161
5 DDs for coffee ground emesis
``` PUD gastritis (esp if taking NSAIDs chronically) gastric cancer esophageal varices Mallory-Weiss tear ```
162
4 workups for coffee ground emesis
rectal exam CBC EGD AST, ALT, ALP, bilirubin
163
5 DDs for blood in stool in older person
``` anal fissure hemorrhoids CRC diverticulosis bowel ischemia ```
164
5 workups for blood in stool in older person
``` rectal exam CBC, PT/PTT CEA, AST, ALT, ALP, bilirubin colonoscopy CT abdomen, pelvis ```
165
5 DDs for blood in stool in younger person
``` UC Crohn's proctitis hemorrhoids dysentery ```
166
5 workups for blood in stool in younger person
``` rectal exam CBC, PT/PTT colonoscopy AXR CT abdomen, pelvis ```
167
5 DDs for painless hematuria
``` TCC RCC acute GN bleeding disorder ADPKD (esp if FHx) ```
168
5 workups for painless hematuria
``` genitourinary exam UA, urine cytology cystoscopy CBC, PT/PTT CT abdomen, pelvis ```
169
4 DDs for dysuria + fever + flank tenderness
acute pyeplonephritis nephrolithiasis RCC lower UTI
170
4 workups for dysuria + fever + flank tenderness
UA, culture, sensitivity CBC, BUN/Cr US renal CT abdomen
171
5 DDs for amenorrhea in non-elderly
``` pregnancy anovulatory cycle thyroid hyper-PRL PCOS ```
172
5 workups for amenorrhea in non-elderly
``` pelvic exam urine hCG CBC, electrolytes US pelvis PRL, TSH, LH, FSH ```
173
6 DDs for non-traumatic vaginal bleeding in young person
``` DUB bleeding disorder thyroid DM Cx cancer abnormal/aborting pregnancy ```
174
5 workups for non-traumatic vaginal bleeding in young person
``` pelvic exam urine bhCG Cx cultures, Pap smear TSH CBC, PT/PTT, glucose ```
175
5 DDs for vaginal bleeding in older person
``` endometrial ca cervical ca endometrial hyperplasia atrophic endometrium atrophic vaginitis ```
176
5 workups for vaginal bleeding in older person
``` pelvic exam pap smear endometrial bx US pelvis colposcopy ```
177
5 DDs for dyspareunia in young person
``` endometriosis cervicitis/PID vulvodynia/vaginismus abuse depression ```
178
5 DDs for MCP/PIP/DIP joint pain
``` SLE RA OA gonococcal arthritis psoriatic arthritis ```
179
5 workupss for MCP/PIP/DIP joint pain
``` CBC, ESR ANA, RF serology X-ray hands synovial fluid aspiration, analysis + culture UA ```
180
4 DDs for hip pain
hip fx hip dislocation trochanteric bursitis avascular necrosis (LCP in Peds/HbS in AfAm)
181
patients with hip fx hold leg ___ly | patients with hip dislocation hold leg ___ly
in external rotation | in internal rotation
182
patients with hip joint problem have pain on ___patients with trochanteric bursitis have pain on ___
internal rotation | external rotation
183
4 workups for hip pain
XR hip MRI hip serum Ca2+, Vit D DEXA scan
184
5 DDs for red, hot, painful knee
``` septic arthritis gonococcal arthritis gout/pseudogout Lyme arthritis rheumatic fever ```
185
5 workups for red, hot, painful knee
synovial fluid aspiration, analysis + culture XR knee CBC ESR
186
3 DDs for foot pain
plantar fasciitis stress fx foot sprain
187
3 workups for foot pain
XR foot bone scan foot MRI foot
188
2 PhEx tests for tennis elbow
point tenderness on lateral epicondyle | pain on resisted wrist dorsiflexion with elbow extended
189
5 DDs for thigh pain on exertion
``` PVD Leriche's syndrome lumbar spinal stenosis OA statin myopathy ```
190
4 workups for thigh pain on exertion
ABI doppler US legs angio MRI L spine
191
5 DDs for calf pain
``` DVT Baker's cyst rupture myositis/statin myopathy cellulitis superficial venous thrombosis ```
192
5 workups for calf pain
``` Doppler US leg CBC CPK d-dimer PT/PTT ```
193
5 DDs for L shoulder pain on exertion
``` angina OA tendonitis dislocation rotator cuff injury ```
194
5 workups for L shoulder pain on exertion
``` EKG CK-MB, Tn cardiac echo XR shoulder MRI shoulder ```
195
4 DDs for baby with fever + lethargy
neonatal sepsis meningitis pneumonia UTI
196
5 workups for baby with fever + lethargy, no rash
``` physical exam CBC, electrolytes UA, urine culture Blood culture LP ```
197
5 DDs for baby with diarrhea + vomiting
``` gastroenteritis food poisoning UTI URI intususception ```
198
5 workups for baby with diarrhea + vomiting
``` physical exam CBC, electrolytes UA, urine culture stool exam + culture AXR ```

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