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Differentials Flashcards

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1
Q

Abdominal/Pelvic Mass

A

Adult:
1. Tumor (cholangiocarcinoma, pancreatic adenocarcinoma, fallopian tube tumor, etc)
2. Gallstones
3. Hepatitis
4. Infections
5. AAA

Child:
1. Intussusception
2. Kidney (50% are renal in origin)
3. Fecal impaction
4. Hepatomegaly/splenomegaly
5. Tumor (Wilm’s, renal cell carcinoma)*

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2
Q

Abdominal Distention

A

Adult:
1. Infection (H. pylori, toxic megacolon)
2. Bowel obstruction
3. Ascites (cirrhosis)
4. Ectopic pregnancy
5. Irritable bowel syndrome
6. Misplaced endotracheal tube

Child:
1. Trauma
2. Allergic/dietary
3. Neoplastic mass
4. Volvulus*
5. Bowel obstruction

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3
Q

Abdominal Pain

A

Adults:
1. Tumor/neoplasm
2. Hernia
3. Infection
4. Pancreatitis
5. Gall stones

Children:
1. Tumor
2. Trauma/abuse
3. Dietary (colic)
4. Appendicitis
5. Gastroenteritis

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4
Q

Abnormal Heart Sounds & Murmurs

A

Aortic
Pulmonic
Mitral
Tricuspid

S1
S2
S3
S4
Splitting

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5
Q

S3 Differential

A
  • Volume overload in the ventricle
  • Best hear in left lateral decubitus
  1. Normal under age 40
  2. Normal in third trimester
  3. Mitral regurgitation
  4. Tricuspid regurgitation
  5. Congestive heart failure
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6
Q

S4 Differential

A
  • Represents rapid active ventricular filling
  1. Normal in athletes and elderly
  2. Stiff left ventricle
    a. HTN
    b. Coronary artery disease
    c. Aortic stenosis
    d. Cardiomyopathy
    e. Ventricular hypertrophy
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7
Q

Abnormal Liver Function Tests

A

AST: multiple sources (esp muscle)
ALT: more specific to liver

Adult:
1. Cirrhosis
2. Hepatitis
3. Infectious
4. Gallstones
5. Pregnancy

Children:
1. Medication
2. Virus
3. Celiac
4. Non alcoholic fatty liver disease
5. Immune (primary sclerosing cholangitis, autoimmune hepatitis, etc)

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8
Q

Abnormal Serum Lipids

A

Adults:
1. Hypercholesterolemia
2. Obesity
3. Drugs (steroids, estrogen)
4. Diabetes
5. Alcohol

Children:
1. Familial hypercholesterolemia
2. Medications
3. Nephrotic syndrome*
4. Diabetes
5. Obesity

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9
Q

Acid Base Abnormality

A

Adult:
1. Diabetic ketoacidosis
2. Kidney injury
3. Vomiting
4. Drugs
5. Hypoventilation

Child:
1. Renal disorder
2. Pneumonia
3. Drugs
4. Diarrhea
5. Vomiting

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10
Q

Allergic Reactions

A
  1. Drugs
  2. Food allergens
  3. Insect bites
  4. Physical stress
  5. Dust/pollen
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11
Q

Anxiety

A
  1. Generalized anxiety disorder
  2. Panic disorder
  3. Medication induced
  4. Separation anxiety
  5. Social anxiety
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12
Q

Ataxia

A

Adult:
1. Neuromuscular disorder (MS)
2. Alcohol induced
3. Stroke
4. Tumor
5. Degenerative (Parkinson’s)

Child:
1. Tumor
2. Developmental delay
3. Medication
4. Traumatic bleed
5. Hereditary

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13
Q

Upper Gastrointestinal Bleed

A

Adult:
1. Vomiting (Mallory Weiss tear)
2. Infection
3. Ulcer
4. Cancer
5. Varices

Child:
1. Gastritis
2. Stress ulcer
3. MW tear
4. Esophagitis
5. Varices

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14
Q

Lower Gastrointestinal Bleed

A

Adult:
1. Anorectal disease
2. Diverticulosis
3. Colorectal cancer
4. Rectal trauma
5. Enterocolitis*

Child:
1. Infection (bacteria, parasite)
2. C dif.
3. Hirschsprung disease*
4. Allergy
5. Anal fissure

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15
Q

Hypertension

A

Adult:
1. Anxiety
2. Diet
3. Catecholamines
4. Renal disorder
5. Vascular disorder (heart attack, etc)

Child:
1. Pheochromocytoma
2. Renal artery stenosis
3. Coarctation of aorta
4. Anxiety
5. Congenital renal disease

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16
Q

Hypotension

A

Adult:
1. Hemorrhage
2. Heart failure/myopathy/ischemia
3. Pneumothorax
4. Aortic dissection
5. Substance abuse

Child:
1. Hemorrhage
2. Anaphylaxis
3. Drugs
4. Addison’s
5. Sepsis

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17
Q

Blood in Sputum (Hemoptysis)

A

Adult:
1. Alcohol (Mallory Weiss)
2. Infection
3. Inflammatory
4 Pulmonary embolism
5. Neoplasm

Child:
1. Infection (bacteria, viral)
2. Foreign body
3. Neoplasm
4. Bleeding disorder
5. AV malformation

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18
Q

Blood in Urine (Hematuria)

A

Adult:
1. Kidney stones
2. Neoplasm
3. STI
4. Autoimmune (SLE)
5. Medications/food

Child:
1. Food
2. Abuse
3. Renal tumor or stone
4. Coagulopathy*
5. Renal vein thrombosis

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19
Q

Breast Discharge

A

Adult:
1. Prolactinoma
2. Breast cancer
3. PCOS
4. Medication
5. Pituitary tumors

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20
Q

Breast Mass

A

Adult:
1. Breast cancer
2. Medication
3. Benign mass
4. Infection
5. Lactation

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21
Q

Burns

A
  1. Assess severity and degree
  2. Treatment modalities and wound care
  3. Critical lab values
  4. Pain control
  5. Psychosocial effects
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22
Q

Calcium Disorder

A

Adult:
1. Autoimmune
2. Malignancy
3. Thyroid disorder
4. Parathyroid disorder
5. Vitamin D

Child:
1. Malabsorption
2. Malignancy
3. Vitamin D
4. Medications
5. Kidney disorder

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23
Q

Cardiac Arrest

A
  1. Conduction abnormality
  2. Coronary artery disease
  3. Myocardial infarction
  4. Trauma
  5. Pulmonary embolism
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24
Q

Cerebrovascular Accident and Transient Ischemic Attack (stroke)

A

Ischemia vs hemorrhagic

Adult:
1. Uncontrolled hypertension
2. Trauma
3. Medication
4. Seizure
5. Atrial fibrillation

Child:
1. Seizure
2. Meningitis
3. Trauma
4. Tumor
5. Embolism

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25
Chest Pain
Adult: 1. Myocardial infarction 2. Breathing abnormality (mechanical obstruction? trauma?) 3. Anxiety 4. Malignancy 5. Peptic ulcer disease Child: 1. Breathing abnormalities (asthma) 2. Mechanical obstruction 3. Tumor 4. Vascular (MI?) 5. Anxiety and stress
26
Clinical Infomatics
1. Importance of longitudinal, efficient and concise patient records 2. EMR 3. Telehealth modalities 4. Security of information (HIPPA) 5. Risks and benefits
27
Coagulation Abnormalities
Adult: 1. Coagulopathy 2. Medication 3. Cancer 4. Traumatic (abrasion, laceration) 5. Platelet disorders Child: 1. Mechanical (epistaxis) 2. Traumatic 3. Cancer 4. Medication 5. Genetic conditions
28
Constipation
Adult: 1. Dietary/allergy 2. Colorectal cancer 3. Drugs and medication 4. Pregnancy 5. Obstruction Child: 1. Dietary 2. Hirschsprung 3. Cystic fibrosis 4. Bowel obstruction 5. Psychological
29
Contraception
1. Hormone 2. Barrier 3. IUD 4. Abstinence 5. Sterilization (male vs female)
30
Cough
Adult: 1. Pneumonia 2. Asthma or COPD 3. Irritant (toxicity, exposure) 4. Medication 5. Reflux Child: 1. Allergy 2. Environmental/exposure to irritant 3. Asthma 4. Obstruction 5. Infection
31
Cyanosis
Adult: 1. ARDS* 2. Cystic fibrosis* 3. Pulmonary embolism 4. Restrictive lung disease 5. High altitude Child: 1. Tetralogy of Fallot and other congenital heart diseases 2. Hypothermia 3. Airway obstruction 4. Seizure 5. Sepsis
32
Developmental Delay
Adult: 1. Trisomy 21 2. Autism 3. CNS infection (meningitis?) 4. Malnourished (vitamin deficiencies?) Child: 1. Autism 2. Fetal alcohol syndrome 3. Brain injury
33
Diarrhea
Adult: 1. Dietary (celiac) 2. IBS 3. Food poisoning 4. Infection (C. dif, viral, bacterial) 5. Drugs/toxins 6. Carcinoid tumor Child: 1. Malabsorption 2. Drugs 3. Laxatives 4. Diet related intolerance 5. Intussusception 6. Infections
34
Diplopia
Adult: 1. Intracranial mass 2. Stroke 3. Trauma (fracture of orbital floor?) 4. Glaucoma 5. Hypertension Child: 1. Strabismus 2. Anxiety and stress 3. Intracranial mass 4. Hyperthyroid
35
Dizziness (vertigo)
Adult: 1 Drugs 2. Meniere's 3. Presyncope 4. Peripheral neuropathy 5. Multiple sclerosis Child: 1. Ear infection 2. Seizures 3. Poor mobility 4. Anxiety or panic disorder
36
Dying Patients
1. Palliative Care 2. Communication 3. Pronouncing death 4. End of life directives and substitute decision maker
37
Dysphagia (difficulty swallowing)
Adult: 1. Structural abnormality (Zenker, tumor, pharyngitis, strictures) 2. Neuromuscular (stroke) 3. Achalasia 4. Trauma 5. Reflux Child: 1. Esophageal structures or mass 2. GERD 3. Neuromuscular (myasthenia gravis) 4. Cleft lip or palate 5. Swallowing disorders
38
Dyspnea (Shortness of breath)
Adult: 1. Heart failure 2. Asthma or other respiratory problem 3. Pneumonia 4. Anxiety 5. Anaphylaxis Child: 1. Mechanical obstruction 2. Congenital condition 3. Valvular disease 4. Arrhythmia 5. Pneumonia
39
Ear Pain
Adults: 1. Sinusitits 2. Otitis externa/media 3. Trauma (frost bite, piercing) 4. Trigeminal neuralgia 5. TMJ Children: 1. Trauma (perforation, foreign body) 2. Otitis externa/media 3. Auricular cellulitis 4. Abscess 5. Cerumen impaction
40
Early Pregnancy Loss/Spontaneous Abortion
1. Drug toxicity 2. Chromosomal abnormality 3. PCOS (endocrine) 4. Uterine anomalies (ruptured ectopic) 5. Prothrombotic factors
41
Edema (Generalized)
Adults: 1. Heart failure 2. Renal abnormality 3. Alcoholic cirrhosis 4 Endocrine abnormality 5. Pregnancy Children 1. Nephrotic syndrome (protein loss) 2. Allergic reaction 3. Malnutrition 4. Medication 5. Cardiac
42
Edema (Localized)
Adults: 1. DVT (Well's criteria)* 2. Injury 3. Infection 4. Venous insufficiency 5. Lymphedema Children: 1. Injury/trauma 2. Infection 3. Inflammation
43
Erectile Dysfunction
1. Psychiatric (depression, anxiety) 2. Medication 3. Alcohol/medication 4. Hormonal 5. Neurologic (diabetes)
44
Eye Redness
Adult: 1. EKC 2. Uveitis 3. Alcoholic 4. Dry eye 5. Medication Child: 1. Traumatic injury 2. EKC 3. Keratitis 4. Blepharitis 5. Allergic reaction
45
Frailty in the Elderly
1. Medication 2. Social (isolation, poverty, elder abuse) 3. Disease 4. Malnutrition 5. Psychiatric 6. Visual or auditory changes 7. Mobility
46
Failure to Thrive (infant)
1. Malnutrition 2. Child abuse/neglect/poverty 3. Maternal use of medication or drugs 4. Sucking/swallowing difficulty (cleft palate) 5. Metabolic disorder
47
Falls
1. Medical condition (vertigo, syncope) 2. Socioeconomic factors (malnutrition) 3. Decreased vision 4. Choice of footwear 5. Medication
48
Fatigue
Adult 1. Depression or other psychiatric disorder 2. Medication 3. Vitamin insufficiency 4. Heart failure/cardiac instability 5. Cancer Child: 1. Malnourished 2. Child abuse 3. Anxiety/depression 4. Metabolic disorder 5. Medication
49
Fatigue
Adult 1. Depression or other psychiatric disorder 2. Medication 3. Vitamin insufficiency 4. Heart failure/cardiac instability 5. Cancer Child: 1. Malnourished 2. Child abuse 3. Anxiety/depression 4. Metabolic disorder 5. Medication
50
Genetic Concerns
1. Chromosomal 2. Prenatal exposure to disease or toxins 3. Neural tube defect 4. Autosomal dominant/recessive 5. Malnutrition
51
Congenital Anomalies (Dysmorphic Features)
1. Fetal alcohol 2. Trisomy 21 3. Fragile X 4. Mechanical 5. Hypothyroidism
52
Glucose Abnormality
1. Diabetes 2. Malnutrition 3. Medication 4. Endocrine disorder (adrenal insufficiency) 5. Obesity
53
Diabetes Mellitus
Type 1: 1. Autoimmune 2. Idiopathic Type 2: 1. Obesity 2. Genetic predisposition 3. Medication Gestational
54
Headache
Adult: 1. Brain hemorrhage 2. Migraine 3. Medication overuse 4. Intracranial infection 5. Carbon monoxide Child: 1. Viral infection 2. Sinusitis 3. Hypertension 4. Brain tumor 5. Migraine
55
Health and the Climate Crisis
1. Heat 2. Malnutrition 3. Infectious disease 4. Refugees and immigrants 5. Physical/social consequences
56
Health of Special Populations
1. Homeless 2. Disabled 3. Immigrants 4. Poverty 5. Other
57
Hearing Loss
Adult: 1. Aging 2. Infection 3. Tumor or mass 4. Trauma (perforation) 5. Horner's Child: 1. Infection 2. Foreign body 3. Congenital (Alport's) 4. Cerumen build up 5. Noise induced hearing loss
58
Hemoglobin Abnormality (Anemia)
1. Excessive bleeding 2. Decreased red cell production (marrow) 3. Increased destruction (sickle) 4. Hemoglobinopathies 5. Vitamin B12/folate deficient
59
Hemoglobin Abnormality (Elevated)
1. Polycythemia vera 2. Secondary erythrocytosis 3. Decreased plasma volume
60
Hypothermia
1. Severity 2. Precipitating events 3. Life saving measures 4. Long term treatment plan 5. Active vs passive rewarming 6. Need for specialized care
61
Incontinence (urine)
Adult: 1. Infection 2. Polyuria 3. Medication 4. Prostate enlargement 5. Mobility issues Child: 1. Abuse 2. Anxiety 3. UTI 4. Vesicoureteral reflux
62
Incontinence (fecal)
1. Neurological 2. Impaction 3. Infection 4. Dietary
63
Indigenous Health
1. Demonstrate awareness of root cause of inequitable health care and outcomes experienced by Indigenous Peoples 2. Provide anti-racist and culturally appropriate care 3. Describe health services delivered to IP 4. Four key themes of United Nations Declaration on the Rights of Indigenous people (right to self-determination; right to cultural identity; right to free, prior and informed consent; and the right to be free from discrimination)
64
Immunization
1. Assess immunization status 2. Recommend appropriate schedule 3. Counselling 4. Contraindications 5. Special at risk groups
65
Jaundice (elevated bilirubin and evidence of scleral icterus)
Adult: 1. Alcoholic cirrhosis 2. Congestive heart failure 3. Drugs 4. Sepsis 5. Fatty liver Neonatal: 1. Hemolytic (Coombs) 2. Gilbert syndrome 3. Hypothyroid 4. Infection 5. Biliary atresia
66
Joint Pain - Back pain and related symptoms
Adult: 1. Sciatica 2. Herniated disc 3. Ankylosing spondylitis or arthritis 4. Fracture 5. Neoplasm Child: 1. Neoplasm 2. Fracture 3. Infection 4. Spinal stenosis 5. Abuse
67
Joint Pain - Neck Pain
Adult: 1. Infection (meningitis, etc) 2. Neoplasm 3. Fracture 4. Nerve root entrapment 5. Thyroid/pharynx Child: 1. Trauma 2. Infection (mumps, etc) 3. Neoplasm 4. Cord compression 5. Arthritis
68
Joint Pain - Non Articular Musculoskeletal Pain (pain in the muscles but not the joints)
Adult: 1. Trauma 2. Fibromyalgia 3. Autoimmune 4. Infection 5. Vascular (sickle) Child: 1. Trauma 2. Neoplasm 3. Necrotizing fasciitis 4. Neuropathic 5. Infection
69
Joint Pain - Oligoarthralgia (pain in 1-4 joints)
Adult: 1. RA/OA 2. SLE 3. Fracture 4. Scleroderma 5. Gout Child: 1. Early RA 2. Lyme 3. Post viral 4. Rheumatic fever 5. Leukemia
70
Joint Pain - Polyarthralgia (pain in more than 4 joints)
Adult: 1. RA 2. OA 3. Fibromyalgia 4. Polymyalgia rheumatica 5. Neuropathy Child: 1. Juvenile polyarthritis 2. Sarcoidosis 3. Ankylosing spondylitis 4. Hypercalcemia 5. Infection/sepsis
71
Language and Speech Disorders
Adult: 1. Neurological (Parkinsons, etc) 2. Head injury 3. Head/neck neoplasm 4. Stroke 5. Autism Child: 1. Deafness 2. Autism 3. Neglect 4. Head injury 5. Cleft palate
72
Legal, Ethical and Organizational Aspects of Medicine - Confidentiality
1. Know what the exceptions are 2. Who to release information to 3. Mandatory disclosures 4. Limitations 5. Alternate decision makers
73
Legal, Ethical and Organizational Aspects of Medicine - Consent
1. How to obtain informed consent 2. Know steps to take for substitute decision makers 3. Implied consent 4. Issues with verbal/written consent 5. Identify information that must be provided
74
Legal, Ethical and Organizational Aspects of Medicine - Legal System
1. Federal vs provincial statutes 2. Regulatory bodies 3. Awareness of when consultation is important
75
Legal, Ethical and Organizational Aspects of Medicine - Negligence
1. Elements required to prove negligence 2. Differences in standard of care based on health care provider 3. Appropriate communication with patient 4. CMPA
76
Legal, Ethical and Organizational Aspects of Medicine - Truth Telling
1. Communicate effectively 2. Identify challenging situations and how to best address them 3. Ascertain personal/cultural context of patient or professional 4. Recognize when it is necessary to disclose personal beliefs or values that could be in conflict with patient choices
77
Limp in Children
1. Trauma/fracture/abuse 2. Bone deformity 3. Tumor 4. Growing pains 5. Referred
78
Lump/Mass (Musculoskeletal)
Adult 1. Neoplasm 2. Bone (cyst vs Ewing) 3. Rheumatoid nodule 4. Osteomyelitis Child 1. Traumatic hematoma 2. Cyst
79
Lymphadenopathy (submandibular, axillary or inguinal nodes that are abnormal in either size, consistency or number)
Localized: 1. Strep (look for tender cervical nodes, sore throat) 2. Mononucleosis (symmetric adenopathy, usually cervical but sometimes axillae or inguinal) 3. Skin and soft tissue infection (cat scratch, cellulitis, etc look for erythema and tenderness of isolated node) 4. TB (cough) 5. Kawasaki (tender cervical nodes in children) Generalized: 1. Idiopathic 2. Neoplastic (painless adenopathy, look for fever and weight loss) 3. HIV (look for fever, malaise, rash) 4. SLE (look or malar rash, arthritis) 5. Sarcoidosis (look for cough, muscle weakness, weight loss, could also be localized)
80
Mediastinal Mass
Adult: 1. Tumor (lymphoma, thymoma) 2. AAA 3. Sarcoidosis 4. Esophageal cancer 5. Hiatal hernia Child: 1. Foreign body 2. Lymphoma (non Hodgkin and Hodgkin) 3. Congenital anomaly 4. Teratoma 5. Cyst
81
Menopause (12 months of amenorrhea after the final menstrual period)
1. Physiological 2. Autoimmune disorder 3. Turner's Syndrome 4. Radiation 5. Chemotherapy
82
Menstrual Cycle - Amenorrhea (absence) and Oligomenorrhea (infrequent, fewer than 6-8 periods per year)
1. Pregnancy 2. Menopause 3. Hypothalamus/pituitary gland abnormalities 4. PCOS 5. Lifestyle changes (Low weight, nutritional deficiencies, strenuous exercise)
83
Menstrual Cycle - Dysmenorrhea (painful periods)
Primary: Secondary (clinically identifiable/underlying pathology): 1. Endometriosis (endometrial tissue that grows outside of the uterus and breaks down during menstruation causing bleeding in pelvis or abdominal cavity causing inflammation and scarring of the surrounding tissue) 2. Adenomyosis (endometrial tissue growing into the myometrium of the uterus) 3. Fibroids (growth of smooth muscle cells and fibrous connective tissue) 4. Imperforate hymen 5. IUD
84
Menstrual Cycle - Premenstrual Dysphoric Disorder and OMS
- PMDD is similar to PMS but causes more severe symptoms and impairment of functioning - Approach should include: 1. Symptom diary 2. Ruling out other disorders (depression, hypothyroidism, anemia, etc) 3. Assess their effect on ADLs 4. Creating a management plan 5. Counselling patient
85
Mental Status - Coma
Adult: 1. Stroke 2. Intoxication 3. Traumatic bleed 4. Hypertensive episode 5. Metabolic (uremia, hypercalcemia, hypoglycemia) Child: 1. Traumatic bleed (abuse): look for bruises 2. Infection: look for fever 3. Seizures 4. Metabolic (hypoglycemic): look for preceding somnolence 5. Neoplasm: look for ataxia, confusion or loss of milestones in recent weeks
86
Mental Status - Delirium
Adult: 1. Hypoxia 2. Stroke 3. Dementia 4. Infection 5. Withdrawal Child: 1. Intoxication (sedative, anticholinergic, drugs) 2. Metabolic (DKA?) 3. Trauma 4. Infection 5. Mental health
87
Mental Status - Neurocognitive Disorders and Dementia
Adult: 1. Alzheimer's (neurodegenerative disorder of uncertain cause and pathogenesis that primarily affects older adults with no cure) 2. Huntington 3. Intracranial masses 4. Infection (HIV, neurosyphilis) 5. Toxins (heavy metals) Child: 1. Down's 2. Brain trauma 3. Drugs 4. Nutritional disorders 5. Endocrine (hypothyroid, B12)
88
Mood Disorders - Depressed Mood
Adult: 1. Major depressive disorder 2. Bipolar 3. Grief 4. Substance abuse 5. PTSD Child: 1. Adjustment disorder 2. Bipolar 3. Anxiety 4. Sleep disturbances 5. Bullying/abuse
89
Mood Disorders - Mania/Hypomania
Adult: 1. Bipolar 2. Excessive steroid or HGH use 3. Stimulant intoxication (cocaine, amphetamine, PCP, nicotine) 4. Schizophrenia 5. Borderline personality disorder Child: 1. Bipolar 2. Substance abuse 3. Cyclothymic disorder (emotional ups and downs not as severe as bipolar) 4. OCD 5. Drugs
90
Movement Disorders - Involuntary or Tic Disorders
Adult: 1. Medication overuse 2. Drug overdose 3. Neurological (Huntington's, Parkinson's, Wilson's) 4. Essential tremor 5. Myoclonus Child: 1. Tourette's 2. Autism 3. Infection (encephalitis) 4. Multiple sclerosis 5. Drugs
91
Neck Mass - Goiter
1. Congenital (thyroglossal duct cyst) 2. Inflammatory (lymph nodes) 3. Neoplasms (lipoma) 4. Lymphoma 5. Thyroid cancers
92
Neonatal Distress
1. Premature 2. Meconium aspiration 3. Decreased respiratory drive 4. Cardiovascular disease 5. Infection
93
Numbness/Tingling
Adult: 1. Multiple sclerosis 2. Medication 3. Disc herniation 4. Neuropathy 5. Herpes zoster Child: 1. Trauma 2. Neuropathy 3. Panic attacks 4. Diabetes 5. Spine abnormalities/mass
94
Obsessive Compulsive Disorder
1. Abuse 2. Anxiety 3. Depression 4. Substance abuse 5. Infections
95
Oral Conditions
Adult: 1. Candida 2. Drugs (methamphetamines) 3. Xerostomia 4. Behcet's* 5. Malignancy Child: 1. Cleft palate 2. Poor hygiene 3. Trauma 4. Toxins 5. Infections
96
S3 Differential
- Volume overload in the ventricle - Best hear in left lateral decubitus 1. Normal under age 40 2. Normal in third trimester 3. Mitral regurgitation 4. Tricuspid regurgitation 5. Congestive heart failure
97
Pain - Central/Peripheral Neuropathic Pain
Adult: 1. Diabetic neuropathy 2. Herniated disc 3. Spine mass or mass impinging on spine 4. Trauma 5. Post herpetic neuralgia Child: 1. Spinal cord injury or abnormality 2. Neurotoxic drug 3. Brain injury 4. Multiple sclerosis 5. Cancer
98
Generalized Pain Disorders
Adult: 1. Fibromyalgia 2. Polymyalgia rheumatica 3. Depression 4. Rheumatoid arthritis 5. SLE Child: 1. Anxiety 2. Depression 3. Adjustment disorder 4. Trauma/abuse 5. Osteomalacia
99
Palpitations
Adult: 1. Shock 2. Cardiac (myocardial infarction, a fib, SVT) 3. Cocaine, caffeine 4. Metabolic (pheochromocytoma or carcinoid) 5. Pregnancy Child: 1. Drug use 2. Anxiety 3. Dehydration 4. WPW 5. Thyrotoxicosis
100
Pediatric - Crying Child
1. Hunger 2. Colic 3. Trauma 4. Infection 5. Sleep disturbances
101
Pediatric - Hypotonic Infant (decreased muscle tone)
1. Cerebral palsy 2. Down's 3. Marfan's 4. Prader-Willi* 5. Sepsis
102
Pelvic Pain
Adult 1. Pregnancy/ectopic 2. Menstruation 3. UTI 4. Hernia 5. Appendicitis Child: 1. UTI 2. Abuse 3. Irritable bowel 4. Depression 5. Endometriosis
103
Preventative Health - Immunizations
1. Contraindications 2. Proper communication and informed consent 3. Counselling those who refuse 4. Organizing a schedule 5. At risk populations 6. Vaccine storage and administration
104
Preventative Health - Newborn Assessment
1. Maternal and perinatal history 2. Psychosocial history 3. Screen for acute illness and congential malformations 4. Caregiver concerns 5. Specialized care
105
Preventative Health - Preoperative Medical Evaluation
1. Medical/social/family history 2. Relevant diagnoses (sleep apnea, malignant hyperthermia) 3. Special concerns in management (mobility, positioning, post op care) 4. Communication with health professionals 5. Management of stress
106
Preventative Health - Well Child
1. Growth 2. Development (milestones) 3. Motor skills 4. Communication and language 5. Cognitive abilities 6. Self care 7. Behavioral and emotional health
107
Personality Disorders
Cluster A (MAD): 1. Paranoid 2. Schizotypal 3. Schizoid Cluster B (BAD): 1. Borderline 2. Narcissistic 3. Antisocial Cluster C (SAD): 1. Avoidant 2. OCD 3. Dependent
108
Pleural Effusion
Adult: 1. PE 2. Congestive heart failure 3. Nephrotic syndrome 4. Cirrhosis 5. Neoplasm Child: 1. Infection 2. Trauma 3. Mesothelioma* 4. Nephrotic syndrome 5. PE?
109
Poisoning
1. Household cleaners 2. Environmental (plants, insecticides) 3. Drugs (cocaine, THC, etc) 4. Medications 5. Alcohol
110
Population Health and Its Determinants - Administration of Effective Health Programs at the Population Level
- Methods of regulation of health profressional and institutions - Regulated vs non regulated health care providers - Ethical issues - Adjustment of programs to fit population needs - What can be improved
111
Population Health and Its Determinants - Assessing and Measuring Health Status at the Population Level
- Collecting information - Critical evaluation - Assessing risk - Analyze populations - Interpret results
112
Population Health and Its Determinants - Concepts of Health and Its Determinants
Define and discuss the determinants/concepts of health, wellness, illness, disease and sickness
113
Population Health and Its Determinants - Disaster Preparedness
- How to determine when to announce emergency - Cause of disaster - Management of patients and peers - Collaboration - Mitigation - Participation in emergency response - Assist with emergency recovery
114
Population Health and Its Determinants - Environment
- Identify common environmental hazards - How to perform risk assessment - Regulatory agencies - Interventions - Communication to community
115
Population Health and Its Determinants - Health of Special Populations
- Health outcomes for special populations - Cultural perspectives - Countries of origin and their specific risks for illness - Provide culturally safe care - Public policy
116
Population Health and Its Determinants - Indigenous Health
- Connection between historical and current government policies - Disruption due to colonization - Availability of health services - Racism and cultural sensitivity - Four key themes of the United Nations Declaration on the Rights of Indigenous Peoples and how they link to health outcomes - Equal rights
117
Population Health and Its Determinants - Interventions at the Population Level
- Levels of prevention - Community needs - Understand role as physician - Public policy
118
Population Health and Its Determinants - Outbreak Management
- Characteristics and management of an outbreak - Risk factors - Communication skills - Preventing or reduce risk
119
Population Health and Its Determinants - Work Related Health Issues
1. Ergonomic hazards (e.g. awkward postures and movements, poor lighting) 2. Chemical hazards (e.g. organic solvents, metals, asbestos, toxic gases) 3. Physical hazards (e.g. noise, vibration, radiation) 4. Biological hazards (e.g. blood or other body fluids, animal and bird droppings) 5. Psychological and work organization hazards (e.g. workplace stressors, workplace bullying)
120
Potassium - Hyperkalemia*
- Mild moderate 5-7 with tall peaked T - Severe >7 with flattened P and wide QRS Adult: 1. Insulin deficiency 2. Rhabdomyolysis* 3. Kidney injury or missed dialysis 4. Medication (decreased secretion) 5. Transfusions Tx: Protect heart: calcium gluconate Shift K+ into cells: D50W + insulin, NaHC03, salbutamol Remove K+: fuids + furosemide, dialysis Child (>5.5): 1. Diet 2. Poisoning 3. Medication 4. Kidney disease 5. Addison's*
121
Potassium - Hypokalemia
- Mild 3-3.5 usually asymptomatic - Severe <3 Adult: 1. Decreased intake (dietary) 2. Increased loss (diarrhea, laxatives, vomiting) 3. DKA 4. Medications 5. Hyperaldosteronism
122
Pregnancy - Intrapartum and Postpartum Care
- History and physical - Emotional and psychosocial needs - Onset, stages and progression - Complications - Management plan
123
Pregnancy - Prenatal Care
- Informed decision making - Counselling (vitamins, smoking cessation, weight management) - Risks - Genetic counselling - Partner violence - Preterm labor
124
Prescribing Practices
- History - Contraindications - Writing a prescription clearly - Communicating with patient to ensure adherence - Care given their socioeconomic status
125
Preterm Labor
1. Placental abruption 2. Substance abuse 3. Infection or illness 4. Neonatal distress 5. Eclampsia*
126
Proteinuria*
1. Dehydration 2. Multiple myeloma* 3. Kidney abnormality 4. Amyloidosis 5. Autoimmune
127
Pruritis
Adult: 1. Psoriasis 2. Allergy 3. Biliary disease 4. Polycythemia vera* 5. Psychiatric disorder Child: 1. Allergy 2. Anxiety 3. Infection 4. Parasite 5. Carcinoid
128
Psychosis
Adult: 1. Substance abuse 2. Psychiatric disorder (bipolar, schizophrenia) 3. Traumatic brain injury 4. Brain tumor 5. Sepsis Child: 1. Psychiatric disorder 2. Medication 3. Dehydration/malnutrition 4. Seizure 5. Thyroid disorder
129
Acute Renal Failure (abrupt reduction in kidney function and is defined as an increasing serum creatinine level from baseline over a short period)
1. Pre - Renal hypoperfusion (RAS) - Systemic hypoperfusion (shock, hypovolemia) 2. Renal - TTP - HUS - Glomerulonephritis 3. Post - Calculi -Tumors
130
Acute Renal Failure (abrupt reduction in kidney function and is defined as an increasing serum creatinine level from baseline over a short period)
1. Pre - Renal hypoperfusion (RAS) - Systemic hypoperfusion (shock, hypovolemia) 2. Renal - TTP - HUS - Glomerulonephritis 3. Post - Calculi -Tumors
131
Chronic Renal Failure (persistently elevated serum creatinine)
1. Pre - Blood pressure 2. Renal - Diabetic nephropathy - Drug toxicity - Ischemia - Polycystic kidney disease - Dysplasia 3. Post - Obstruction
132
Scrotal Mass
Adult: 1. Tumor 2. Inguinal hernia 3. Hydrocele 4. Seminoma 5. Testicular torsion Child: 1. Varicocele 2. Orchitis (mumps) 3. Hematocele 4. Cyst 5. Tumor
133
Scrotal Pain
Adult: 1. Epididymitis 2. Hernia 3. STI 4. Testicular neoplasm 5. Cellulitis Child: 1. Torsion 2. Trauma 3. Orchitis 4. Henoch-Schönlein purpura 5. Kidney stone
134
Seizure/Epilepsy
Adult: 1. Withdrawal 2. Brain neoplasm 3. Hypoglycemia 4. Encephalitis 5. Meningitis Child: 1. Primary seizure disorder 2. Head trauma 3. Electrolyte imbalance 4. Toxicity (lead, drugs, etc) 5. Fever (febrile seizures)
135
Sexual Dysfunction
1. Erectile dysfunction (depression, diabetes, spinal cord injury, beta blocker, aging) 2. Genito-pelvic pain (menopause, endometriosis, PID) 3. Substance/medication induced 4. Gender dysphoria 5. Sexual disorders (arousal disorders, anorgasmia, paraphilic disorders)
136
Abnormal Pubertal Development
1. Exogenous androgens 2. Chromosomal abnormality 3. Malnutrition 4. Hypothalamic/pituitary dysfunction 5. Congenital adrenal hyperplasia
137
Skin Rash - Urticaria & Angioedema
Adult: 1. Allergic reaction 2. Opiates 3. Infection 4. Mastocytosis 5. Cold (Raynaud's?) Child: 1. Allergic reaction 2. Infection 3. Connective tissue disease 4. Autoimmune disorder 5. Scabies
138
Skin and Integument Conditions
Skin 1. Rash 2. Tumor 3. Ulcer Nail 1. Fungus 2. Clubbing Hair 1. Alopecia 2. Hirsutism 3. Hypertrichosis
139
Sleep Wake Disorders
Adult: 1. PTSD 2. Sleep apnea 3. Substance abuse 4. Anxiety 5. Psychiatric disorders Child: 1. Trauma 2. Poor environment 3. Stress and anxiety 4. Insomnia 5. Psychiatric
140
Sodium - Hypernatremia (>145 mmol/L)
1. Water depletion/dehydration 2. Increased loss (renal, diarrhea, exercise) 3. Increased gain (fluids) 4. Diabetes insipidus 5. Endocrine (Cushings?)
141
Sodium - Hyponatremia (<136 mmol/L)
1. Hyperglycemia 2. Kidney failure 3. SIADH 4. CHF 5. Hyperlipidemia
142
Somatic Symptoms
Adult: 1. Malingering 2. Fibromyalgia 3. Substance abuse 4. PTSD 5. Undiagnosed medical condition Child: 1. Physical abuse 2. Anxiety 3. Life change (move, parents separate, etc) 4. Factitious 5. Drugs
143
Sore Throat and Rhinorrhea
Adult 1. Infection 2. Allergy 3. Abscess 4. SJS? 5. Foreign body Child: 1. Physical obstruction 2. Infection 3. Polyp 4. Allergic 5. Epiglottitis
144
Short Stature
1. Down's 2. Turner's 3. Malnutition 4. Toxins 5. Low birth weight
145
Tall Stature
1. Marfan's 2. GH excess 3.
146
Strabismus and Amblyopia
1. Muscle disease/inflammation 2. CNS tumors 3. Congenital 4. Mechanical restriction (trauma?) 5. CN paralysis
147
Substance Use and Addictive Disorders
1. Childhood trauma 2. Family history 3. Mental illness 4. Chronic pain 5. Psychosocial (unemployed, social isolation, etc)
148
Sudden Infant Death Syndrone
1. Young maternal age 2. Smoking 3. Alcohol use 4. Poor perinatal care 5. Sleep position (prone, room sharing) 6. Sleep environment (swaddled, soft blankets)
149
Brief Resolved Unexplained Event (characterized by a non-specific, resolved and episodic presentation, including any of the following: cyanosis or pallor; absent, decreased or irregular breathing; marked change in tone - hypertonia or hypotonia; and/or altered responsiveness)
1. Misinterpretation 2. Infection 3. Sleep apnea 4. Neurological disease (epilepsy) 5. Child abuse 6. Metabolic
150
Suicidal Behavior
1. Psychiatric 2. Psychosocial 3. Substance 4. Serious chronic disease 5. Malingering
151
Syncope and Pre-Syncope
1. Cardiac arrhythmia 2. Hypovolemia 3. Shock 4. Hypoglycemia 5. Medication
152
Fever and Hyperthermia
1. Infection 2. Inflammation 3. Medication 4. Heat stroke 5. Drugs
153
Fever in Immunocompromised Individuals
1. Host deference (HIV, steroids, congenital) 2. Anatomic (surgery, burns) 3. Other (diabetes, splenectomy)
154
Hypothermia and Cold Related Injuries
1. Cold injury (exposure) 2. Hypothermia 3. Alcohol
155
Tinnitus
1. Ear infection 2. Trauma 3. Impacted cerumen 4. Acoustic neuroma 5. Venous hum?
156
Trauma - Abdominal Injury
1. Blunt trauma 2. Penetrating trauma
157
Trauma - Bone or Joint Injury
1. Abuse 2. Accidental falls 3. MVA (high energy trauma) 4. Osteoporosis
158
Trauma - Chest Injury
1. Blunt 2. Penetrating
159
Trauma - Drowning
1. Inability 2. Risk 3. Substance abuse 4. Trauma 5. Neglect
160
Trauma -Facial Injury
1. History 2. Evaluate airway and neuro status 3. Severity 4. Priority of treatment 5. Cosmesis and function
161
Trauma - Hand and Wrist Injuries
1. Tendons 2. Nerves 3. Joints 4. Bones
162
Trauma - Head Trauma and Transplant Donations
1. Skull fracture 2. Hemorrhage 3. Contusion 4. Edema
163
Trauma - Nerve Injury
1. Compression 2. Contusion 3. Laceration
164
Trauma - Skin Wounds
1. Laceration 2. Puncture 3. Crush 4. Abrasion
165
Trauma - Spinal Trauma
1. Trauma 2. Rupture
166
Trauma - Urinary Tract Injuries
1. Kidney 2. Bladder 3. Urethra (straddle injury, bike, monkey bars, pelvic fracture)
167
Trauma - Vascular Injury
1. Penetrating trauma 2. Blunt trauma
168
Polyuria (increased urination) Polydipsia (increased thirst)
Adult: 1. Diabetes (look for low urine specific gravity) 2. Renal failure 3. Increased intake 4. Pyelonephritis 5. Medications Child: 1. Diabetes 2. Conn's syndrome 3. Anorexia 4. Renal failure 5. Addison's
169
Cystitis (syndrome of dysuria, urinary frequency and urgency, which is sometimes associated with suprapubic pain, and often found in the presence of pyuria)
Adult: 1. Kidney stones 2. Urinary tract infection 3. STI 4. Bladder carcinoma 5. Urethral strictures Child: 1. UTI 2. Physical trauma 3. Psychological trauma 4. Vulvovaginitis 5. Urethritis
170
Urinary Tract Obstruction
Adult: 1. Infection 2. Stone 3. Diabetes 4. Medication 5. BPH Child: 1. Congenital 2. Ureterocele 3. Structural (narrowed/widened/misplaced urethra) 4. Stone 5. Inflammation???
171
Uterine Prolapse
Adult: 1. Pregnancy 2. Neurogenic dysfunction 3. Genetic predisposition 4. Connective tissue disorder 5. Prior surgery
172
Vaginal Bleeding
1. Miscarriage 2. Normal menstruation 3. Neoplasm 4. Trauma 5. Endometriosis 1. Trauma 2. Abuse 3. PCOS 4. Pregnancy 5. Benign growth
173
Vaginal Discharge
Adult: 1. STI 2. UTI 3. Yeast infection 4. Normal variant 5. Menopause Child: 1. Abuse 2. Yeast infection 3. Bacterial vaginosis 4. Contact vulvitis 5. HSV
174
Acute Visual Disturbance
Adult: 1. TIA 2. Multiple sclerosis 3. Glaucoma 4. Trauma 5. Retina detachment Child: 1. Traumatic retina detachment 2. Malingering 3. Uveitis 4. Corneal ulcer
175
Chronic Visual Disturbance
Adult: 1. Glaucoma 2. Diabetic retinopathy 3. Macular degeneration 4. Persistent corneal ulcer 5. Cataract Child: 1. Keratoconus 2. Strabismus 3. Corneal ulcer 4. Poor contact lens hygiene 5. Traumatic injury
176
Vomiting
Adult: 1. GI upset 2. Pregnancy 3. Increased intracranial pressure 4. Sepsis 5. Drugs Child: 1. Bowel obstruction 2. Appendicitis 3. Gall stones 4. Neoplastic 5. Food poisoning
177
Weakness
Adult: 1. Muscular dystrophy 2. Myasthenia gravis 3. Encephalitis 4. Vascular 5. Degenerative Child: 1. Infection 2. Traumatic 3. Drug toxicity 4. Allergic reaction 5. Hypoglycemic
178
Weight Gain
1. Diet 2. Hormones 3. Drugs/medications 4. Sedentary lifestyle 5. Psychological
179
Weight Loss
1. Neoplastic 2. Eating disorder 3. Drugs 4. Excessive physical exercise 5. Malabsorption

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