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Step 2 cs > DDX support > Flashcards

DDX support Flashcards

1
Q

myocardial infarction

A

hx:
pressure like substernal chest pain
pain radiates to left arm, upper back, neck
pain awakens pt at night

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2
Q

cocaine induced MI

A

hx:
pressure like substernal chest pain
h/o cocaine
last used cocaine yesterday

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3
Q

GERD

A

pain in mid chest
previous pain relieved by antacids
previous pain occured after heavy meals

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4
Q

aortic dissection

A

sudden tearing chest pain radiates to back
PHYS:
peripheral pulses/blood pressure diminished or unequal
aortic regurgitation murmur

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5
Q

bladder cancer

A 
hematuria
straining on urination
weak urinary stream and dribbling
painter
h/o smoking
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6
Q

urolithiasis\

A 
hx:
hematuria
straining on urination
physical:
CVAT
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7
Q

BPH

A

polyuria, nocturia
weak urinary stream and dribbling
straining on urination

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8
Q

disk herniation

A

low back pain
s/p lifting heavy boxes
radiated to left thigh and foot
worsens with movement, better when lying still

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9
Q

lumbar spinal stenosis

A

h/o intermittent LBP and leg pain with ambulation
pain resolves with sitting
PHYS
walks with back slightly bent forward

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10
Q

metastatic prostate cancer

A

difficulty urinating
incomplete emptying of bladder
low back pain

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11
Q

pneumothorax

A 
HX:
left sided chest pain s/p MVA
pain exacerbated by movement and deep breaths
dyspnea
PHYSICAL
decr breath sounds over left lung field 
RR = 22 br/min
bruising and tenderness over left chest
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12
Q

hemothorax

A 
HX:
left sided chest pain s/p MVA
dyspnea
cough
PHYS:
decr breath sounds over left lung field
RR 22 br/min
bruising and tenderness over left chest
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13
Q

pneumonia

A 
HX
unilateral chest pain
productive cough
low grade fever
PHYSICAL
temp 100F
RR 22 br/min
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14
Q

T1DM

A

polyuria
polydipsia
recent weight loss
hyperglycemia

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15
Q

T2DM

A

polyuria
polydypsia
obesity
hyperglycemia

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16
Q

insulin induced hypoglycemia

A

episodes of palpitations and diaphoresis that resolves with orange juice
tight glycemic control

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17
Q

diabetic peripheral neuropathy

A 
HX:
h/o DM
constant numbness and tingling in feet
PHYSICAL:
absent ankle jerk
diminished pinprick sensation on plantar surfaces bilaterally
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18
Q

organic ED

A

loss of erection x 2 years with absence of early morning erection
h/o DM
h/o etoh
lovastatin and atenolol

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19
Q

DVT

A 
HX
recent 15 hour airplane flight
gained 15 lbs over 3 years
OCPs x 2 years
FH DVT
PHYSICAL
homan's sign
pitting edema
swollen, tender, red warm right calf
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20
Q

cellulitis

A 
HX
cute to leg 2/2 fall
low grade fever
PHYSICAL
swollen, tender, red, warm right calf
temp 99.9 F
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21
Q

baker cyst rupture

A

HX
spasmodic calf pain
PHYS
swollen, tender, warm right calf

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22
Q

laryngeal cancer

A 
HX
cervical lymphadenopathy
worsenign hoarseness x3 months
weight loss, decr appetiti, low grade fever
h/o cigarrette smoking and alcohol use
advanced age
PHYSICAL
temp 99.9
right cervical lymphadenopathy
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23
Q

laryngitis

A 
HX
h/o flu in recent past
low grade fever
GERD
h/o cigarette smoking
PHYSICAL
temp 99.9
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24
Q

vocal cord polyp/nodule

A

vocal overuse

hoarseness x 3 months

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25
Q

spinal disk herniation

A 
HX
neck pain increases with movement
radiculopathy (left arm pain and numbness)
PHYSICAL
loss of pinprick sensation 
neck tenderness, spasm, decr ROM
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26
Q

cervical fracture

A 
HX
rapid rotation of neck before painm
pain increases with movement
osteopenia @ last DEXA
PHYSICAL
tenderness over spinous process
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27
Q

neck muscle strain

A 
HX
rapid rotation of neck before pain
PHYSICAL
tenderness ober spinous process
decreased ROM
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28
Q

biliary colic/cholecystitis

A 
HX
pain exacerbated by heavy, fatty foods
assoc with N/V
FFFF
PHYSICAL
epigastric tenderness
[positive murphy sign
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29
Q

peptic ulcer disease

A

HX
h/o heavy NSAID use
burning epigastic pain 2 to 3 hours after meals
pain exacerbated by hunger and fatty foods
relieved by antacids
PHYSICAL
epigastic tenderness

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30
Q

gastritis

A 
HX
h/o heavy NSAID use
epigastic pain assoc with food
N/V
PHYSICAL 
epigastirc tenderness
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31
Q

migraine

A 
HX
unilateral, sharp ha
assoc with N/V
photophobia
PHYSICAL
severe pain with lack of neuro findings
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32
Q

tension headache

A 
HX
chronic headache
assoc  with stress at work
improve with sleep
PHYSICAL
severe pain with lack of neuro findings
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33
Q

intracranial mass lesion

A

HA assoc with N/V

FH brain tumor

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34
Q

hyperprolactinemia

A

galactorrhea

oligomenorrhea

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35
Q

PCOS

A

weight gain
hirsuitism
oligomenorrhea

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36
Q

pregnancy

A

change in menstrual cycles
regular sexual activity
previous successful pregnancy

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37
Q

vulvovaginitis

A

white vaginal discharge
fishy odor of discharge
vaginal pruritis

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38
Q

cervicitis

A

white vaginal discharge
dysparenia
sex without protection

39
Q

endometriosis

A

dysmenorrhea

dysparenia

40
Q

presbycusis

A 
HX
bilateral, progressive hearing loss
advanced age
HTN
PHYSICAL
normal rinne 
lack of lateralization on weber test
41
Q

cochlear nerve damage

A 
HX
exposure to loud noises
bilateral hearing loss
PHYSICAL
normal rinne
lack of lateralization on weber
42
Q

otosclerosis

A 
HX
bilateral, progressive hearing loss
advanced age
PHYSICAL
lack of lateralization on Weber
43
Q

physiologic jaundice

A

HX
infant in first WOL
no changes in feeding, urination, activity level, BM

44
Q

viral URI

A 
fever
rhinorrhea
sibling with URI
day care
increased breathing rate
45
Q

pneumonia

A 
HX
persistent cough
low grade fever
PHYSICAL
increased tactile fremitus
decr breath sounds
temperature
46
Q

URI associated cought (postinfectious cough)

A 
HX
recent URI
low grade fecer
persistent cough
PHYSICAL
temperature
47
Q

acute bronchitis

A 
HX
white sputum production
PHYSICAL
increased tactile fremitus
temperature
48
Q

extrahepatic biliary obstruction

ex: pancreatic cancer, cholangiocarcinoma, sphincter of oddi dysfunction

A 
HX
light stools
dark urine
pruritis
father with pancreatic cancer
PHYSICAL
jaundice 
sceleral icterus
RUQ tenderness
49
Q

viral hepatitis

A 
HX
history of blood transfusion
recent travel to mexico 
PHYSICAL
jaundice 
scleral icterus
RUQ tenderness
50
Q

acetaminophen toxicity

A 
HX
recent acetaminophen use
concomiant alcohol use
PHSYCIAL 
jaundice
scleral icterus
RUQ tenderness
51
Q

primary biliary cirrhosis

A

female age 40-60
pruritis
other autoimmune disease (i.e hypothyroid)

52
Q

meniere disease

A 
HX
senseation of spinning room
episodic one sided hearing loss
PHYSICAL 
decr hearing one side
normal rinne
53
Q

benign paroxysmal positional vertigo

A

sensation of room spinning
onset with positional changes
duration 20-30 mins

54
Q

orthostatic hypotension causing dizziness

A

h/o diarrhea

on antihypertensives

55
Q

gout

A 
HX
monoarticular joint pain and tenderness
h/o swollen toe 
occasional alcohol use
PHYSICAL
joint tenderness and stiffness
swelling at left knee
56
Q

rheumatoid arthritis

A 
HX
morning joint stiffness
FH of RA
systemic sx - anorexia, weight loss, fatigue, fever)
multiple joint involvement
duration > 6 weeks
PHSYCIAL
joint tenderness and stiffness
temp 99.9
57
Q

systemic lupus erythematosis

A 
HX
systemic symptoms (anorexia, wt loss, fatigue)
h/o multiple oral ulcers
h/o 2 spontaneous abortions
raynauds
PHYSICAL
joint stiffness and tenderness
58
Q

plantar fasciitis

A 
HX
training for marathon
gradual pain
worse with first few morning stepss
PHYSICAL
tender medial calcaneal tuberosity
pain with toe dorsiflexion
59
Q

calcaneal stress fracture

A 
HX
training for marathon
diffuse pain over heel
refractory to conservative management
PHYSICAL
tenderness over plantar heel and arch
60
Q

achilles tendiniities

A

HX
training for marathon
PHSYCIAL
pain with toe dorsiflexion

61
Q

acute otitis media

A 
HX
fever
pulling at right ear
fatigued, not playing with toys
h/o otitis media
62
Q

meningococal meningitis

A

maculopapular facial rash spread to chest, back, abdomen
fever
difficulty sleeping x 2 days
recent episode of vomitting`

63
Q

scarlet fever

A

maculopapular facial rash
fever
difficult swallowing x 2 days

64
Q

pulmonary TB

A 
HX
fever and night sweats with fatigue
worsening cough x 1 month
close contact with active TB
decr appetitie
unintentional weight loss - down 6 lbs over 2 months
PHYSICAL
productive cough with blood tinged sputum
65
Q

malignant lung neoplasm

A 
HX
fever and night sweats with fatigue
decr appetitie
h/o heavy smoking and chronic broncitis
PHYSICAL
blood tinged sputum
66
Q

typical pneumonia

A 
HX
fever
mucus production
h/o heavy smoking and chronic bronchitis
PHSYCIAL
sputum production
67
Q

pancreatic cancer

A 
HX
h/o smoking
h/o eating fatty foods
unintentional weight loss 
foul smelling, greasy stools
PHYSICAL 
mild epigastic pain
68
Q

chronic pancreatitis

A 
HX
h/p alcohol use
worseing epigastic discomfort that radiates to back
foul smelling, greasy looking stools
PHYSICAL
mild epigastric tenderness
69
Q

ED 2/2 vascular disease

A

h/o htn
h/o hld
no early morning or nocturnal tumescence

70
Q

general anxiety disorder

A 
HX
imparied concentration, irritabilty, difficulty sleeping, muscle tension, sweating, palpitations
anxiety over academics
no h/o substance use
PHYSICAL
tachy: HR 102/min
71
Q

hyperthyroidism

A 
HX
anxiety
unintentional weight loss, fatigue, sweating, palpitations, incr B<
PHYSICAL
tachy: HR 102
brisk DTR
72
Q

foreign body aspiration

A

sudden onset while playing with toys
noisy breathing
muffled cough

73
Q

croup

A

noisy breathing
difficulty breathing
fever x 1 week

74
Q

epiglottitis

A

HX
occasional voice hoarseness
occasional muffling

75
Q

appendicitis

A 
HX
RLQ abd pain
worse with movement
N/V
low grade fever
PHYSICAL
RLQ direct and rebound tenderness
RLQ guarding
temp 100.5
positive rovsing
positive psoas
76
Q

pelvic inflammatory disease

A 
HX
std 6 months ago with untreated partner
N/V
spotting
unprotected sex with multiple partners
low grade fever
PHYSICAL
RLQ tenderness
temp 100.5
77
Q

ruptured ectopic pregnancy

A 
HX
LMP 5 weeks ago and spotting
crampy lower abdominal pain
pain worse with movement
N/V
pain recent
PHYSICAL
RLQ rebound tenderness
RLQ guarding
78
Q

alzheimers

A 
HX
steady cognitive decline
memory impairment
imparied EF
decline in ADLs
PHYSICAL
failed 3 item recall
79
Q

vasucular (multi-infarct) dementia

A 
HX
previous stroke
h/o coronary artery disease (MI)
HTN
impaired EF
PHYSICAL 
decreased strength in LUE
DTR 3+ in LUE and LLE
positive babinki bilaterally
failed 3 item recall
80
Q

hypothyroidism

A 
fatigue x 3 months
cold intolerance
hair loss
weight gain
chronic dry skin
oligomenorrhea
81
Q

COPD/chronic bronchitis

A 
HX
chronic cough
sputum production
smoking history
coal miner
82
Q

pneumoconiosis

A

coal miner

chronic cough

83
Q

colorectal cancer

A

bloody stool x 1 month
FH
unintentional weight loss

84
Q

hemorrhoids

A

history of hemorrhoids

hematochezia

85
Q

parkinson’s

A 
HX
resting tremor
PHYSICAL
low frequency resting tremor UE
bradykinetic gait
UE rigidity
86
Q

viral gastroenteritis

A

HX
acute watery diarrhea
low grade fever
day care

87
Q

simple febrile seizure

A

<15 mins
no prior history
fever

88
Q

meningitis

A

tonic clonic seizure
fever
decr appt
decr urine output

89
Q

infectious mononucleosis

A 
HX
sore throat x 2 weeks
LUQ pain
recent ill contacts
PHYSICAL
LUQ tenderness
lymphadenopathy
90
Q

acute HIV infection

A

sore throat x 2 weeks
two sexual partners over past year, male and female
treated for gonorrhea recently

91
Q

streptococcal pharyngitis

A 
HX
sore throat  x  2 weeks
low grade fever
h/o cigarette smoking
PHYSICAL
lymphadenopathy
92
Q

convulsive syncope

A

LOC x several minutes
arms and legs shaking x 30 secons
no subsequent confusion or weakness

93
Q

cardiac arrhythmia

A

LOC after palpatiations and lightheadedness
taking beta blocker (atenolol)
no confusion or weakness after
history of MI

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