DDx Flashcards
How to dx a dz (51 cards)
Jaundice in pregnancy
-HELLP
Hemolysis, Elevated Liver enzymes, Low Platelet
Preeclampsia, RUQ pain, N/V
-Intrahepatic cholestasis of pregnancy
Very elevated AST/ALT, direct bilirubinemia
Pruritus and jaundice
-AFLP
Liver failure, DIC, mod elevated AST/ALT
RUQ pain, malaise, N/V
Erythema nodosum
Sarcodosis Group A strep TB Histoplasmosis IBD (always do a CXR)
Hemorrhagic vs ischemic stroke
If hemorrhagic rapidly worsening sx
N/V, headache, AMS
Risk factors: smoking, HTN
Dx with CT scan w/o contrast
Anemia of chronic dz
Low MCV
Low iron (if high and microcytic think thalassemia)
Low TIBC
High ferritin
Lumbar spinal stenosis
Worse with extension
Pain when standing and walking downhill
Neurological deficits
Dx with MRI
Spondylolisthesis/spondylolysis
Fracture of pars interarticularis
Stiffness that radiates to buttocks and back of thighs
Worsen with standing/walking
Improves with rest
Solitary lung nodule
Concerning if on CXR: >2cm size spiculated, scalloped then biopsy causes: primary cancer, metastasis, granuloma, benign neoplasm (lipoma, granuloma, hamartoma), vascular malformation
Laryngomalacia
chronic stridor
Peaks at 4-8 months
dx with laryngoscopy
worse when supine, better when prone
CVID
Low Ig in all classes
Recurrent resp infxn, sinusitis, GI infxn
Tx with immunoglobulin replacement
Lung cancer
Adenocarcinoma Squamous Small cell Large cell Carcinoid
Spherocytosis
Extravascular hemolysis, jaundice, splenomegaly
Hgb concentration elevated, ankyrin mutation
Spherocytes on smear
negative Coombs
Glycerol lysis test positive for fragility
eosin 5 maleimide binding test
B19 parvovirus -> aplastic crisis
Hypoparathyroidism
Post surgical or autoimmune High phos, low Ca Tetany spasms (Chvostek sign) Prolonged QT from hypocalcemia
Hyperparathyroidism
Low Phos, high Ca, due to adenoma, hyperplasia, carcinoma
Secondary from CKD -> high Phos, low Ca
Vit D def -> high Ca, low Phos
Bones, stones, groans, psych overtones
HUS
follows Shiga like E coli infection
MAHA (Coombs neg), thrombocytopenia, AKI
bruising, petechiae, edema
schistocytes on smear
Pernicious anemia
Abs against parietal cells producing intrinsic factor
Low B12 serum levels with glossitis, neuropathy, macrocytic anemia
Atrophic gastritis increases risk of gastric cancer, carcinoid
Primary sclerosing vs biliary cholangitis
Fatigue, pruritus, cholestasis mutlifocal narrowing with onion skin fibrosis PBC = middle aged women anti mt abs + PSC = young men with IBD pANCA abs + (nonspecific)
Epidural vs subdural
Epidural:
Does not cross suture lines
biconvex shape, fast growing, mass effect
Subdural:
Crosses suture lines
lentiform shape, slow growing, no mass effect
NPH
onset in 60 to 70s, M=F Early gait impairment with broad based shuffling Incontinence Late memory and cognitive impairment normal CSF opening pressure
PE
Elevated JVP, loud P2
Tachycardia, hypoxia, chest pain, syncope
Reduced EF, hypotension
on echo, R free wall hypokinesis with apical sparing
Bowing of septum into LV due to PHTN
Tx with LMWH then switch to warfarin
Thyroiditis
Hashimoto’s = chronic autoimmune, hypothyroid
nontender diffuse goitier, + TPO, variable iodine uptake
Painless = mild, transient, hyperthyroid
nontender small goitier, + TPO, low iodine uptake
De Quervain = subacute postviral, hyperthyroid
tender goitier, low iodine uptake
distinguish Graves from painless t. with uptake test
Muscular dystrophy
Becker = no dystrophin, early onset, XLR Duchenne = reduced dystrophin, early onset, XLR Myotonic = DMPK triplet expansion, late onset, dominant
Hepatorenal syndrome
precipitated by infxn, GI bleed, vomiting, diuresis, NSAID
Renal hypoperfusion with low FeNa, no tubular injury
no sediment, no improvement with IV fluids
Tx: splanchnic vasoconstriction with octeotride, midodrine, NE, address precipitating factors
Beckwith-Wiedemann syndrome
Hemihyperplasia macroglossia omphalocele abd U/S for Wilms tumour Monitor alpha fetoprotein
Wilms tumor
Hypertension, hematuria, abd mass associated with: Beckwith-Wiedemann neurofibromatosis WAGR syndrome
