Final-Differential Diagnosis Phys Di 1/2 Flashcards
(106 cards)
1
Q
Adult with recurrent substernal heartburn post heating
- worse lying down at night
- endoscopic exam to confirm
A
GERD
2
Q
What sign is positive in chronic cholecystitis
A
Murphy’s
3
Q
Low substernal chest pain that radiates through to back. Worse when stomach is empty. Food/antacids relieve pain. Dark, bloody, tarry stools due to long term use to NSAIDS>
A
Peptic ulcer
4
Q
When must toxin assay be done?
A
Clostridium difficile colitis
5
Q
Sudden onset, persistent fever, muscle aches (myalgia) with positive serologic tests-clinical differentiation may be possible
A
Influenza
6
Q
Info on IBS
A
Late adolescence/early adulthood
under 50
7
Q
Better sitting up and leaning forward
A
Pericarditis
8
Q
Least common hernia
A
Femoral hernia
9
Q
X-ray: barrel chest, increased retrosternal airspace, horizontal ribs, narrowed heart shadow, dark lung fields
A
Emphysema
10
Q
Central vision loss, blurred vision (MC). Hazy appearance on cornea. No pain
A
Corneal scar
11
Q
MC virus for pink eye
A
Adenoids virus
12
Q
Insidious tunnel vision over many years. 40+.
A
Chronic Glaucoma
13
Q
Pertussis aka
A
Whooping cough
14
Q
Photophobia in ONE EYE. Pupillary responses sluggish in that eye. Secondary to trauma, AS** and infection
A
Acute iritis/anterior uveitis
15
Q
Post trauma flashes and floaters, central vision preserved if macula intact. Flashes of light. Progressive curtain
A
Retinal detachment
16
Q
MC hernia
A
Indirect inguinal hernia
17
Q
Low substernal RUQ chest pain following fatty meals and may radiate to right scapula. Positive Murphy’s sign. X-ray comfirms. MC due to obstruction of what?
A
C. Cholecystitis
MC due to cystic duct obstruction from gallstones
18
Q
MC cause of a. Gastroenteritis
A
Rotavirus in infants/children
Norovirus in adults
19
Q
Lesion in geniculocalcarine tract
A
Homonymous contralateral hemianopia with macular sparing
20
Q
Colon ca
A
Pencil thin stools/change in bowel habits
Obese males 50+
Colicky abdominal pain
21
Q
Abdominal pain and vomiting, jaundice, tea colored/dark urine with gray/clay colored stools. AST, ALT and alkaline phosphates levels high
A
Hepatitis
22
Q
Triphasic friction rub
A
Pericarditis
23
Q
Redness, intense burning itching persistent or seasonal episodes.
A
Allergic conjunctivitis
24
Q
50+ cigarette smoke or pollution. Weight loss with persistent cough and blood.
A
Bronchogenic neoplasm
25
Chronic dilation of bronchi or bronchioles with large amounts of sputum. Due to repeate infections. 50% = cystic fibrosis
Bronchiectasis
26
Burning, gnawing pain
| Epigastric pain 2-3 hours after eating spicy, or fatty foods or alcohol
Duodenal ulcer
27
Positive markle, rovsing, Blumberg, psoas, obturator signs
Appendicitis
28
40+ slow central vision loss in one or both eyes. Central opacity of shadow in red reflex. Age, DM, tobacco, alcohol, steroid risks
Central cataract
29
Pain, swelling, redness in Canal. Hearing MC normal. Irritate canal my excessively cleaning or water.
Ottis externa/swimmers ear
30
Ulcerative colitis
20-30 bloody,pus stools per day
| Young
31
MC men 40+ with vague pain that’s worse when coughing, sneezing.straining near groin
Direct inguinal hernia
32
Ear pain and clutching ear. Feeling of fullness, fever, fluid drainage. Red and bulging eardrum, with purulent discharge MC in preschoolers.
Suppurations otitis media
33
Genetic disorder causing breakdown and loss of cells in retina. Rods affected first. Night blindness, loss of acuity, insidious tunnel vision. Black bone-spicule pigmentation
Retinitis pigmentosa
34
Rusty sputum and bronchophony (spoken sounds transmitted better through consolidation). Increased fremitus and dull percussion. Affects one.
Lobar pneumonia
35
Lesion of optic tract
Homonymous contralateral hemianopia
Loss of opposite side field in both eyes. Lesion right. Loss of left field in both eyes.
36
Normal or yellow or dark TM with air bubbles/fluid line. Weber lateralizes to and rinne negative. Fullness, pressure, popping with swallowing
Serious otitis media/ otitis media with effusion
37
Poor sanitation and water purification leading to vomit/diarrhea watery stool. Fatal within 24 hours due to dehydration and hypovolemic shock
Cholera
38
Occlusion of pulmonary A. Prolonged sitting or rest. MC due to clots in legs that travel to lungs. Continuous chest pain. Crackles/wheezes
PE
39
Elderly who complain that people mumble. rinne AC>BC less than 2:1. Both early equally. High frequency are first to go
Presbycusis
40
Sudden epigastric pain with FEVER AND VOMITING. Fetal position may help.
Pancreatitis
41
Glandular autodigestion
Pancreatitis
42
Inflammation of large airways often secondary to an URI
Presents with crackles, wheezes, rhonchi
NORMAL FREMITUS/PERCUSSION
A. Bronchitis
43
Worse when stomach is empty and antacids/food help
Peptic ulcer
44
Altered color/configuration of macula. Central vision loss. Positive ampler grid. Druses bodies. Leading cause of vision loss.
Macular degeneration
45
Seen with blunt or penetrating trauma. Decreased breath sounds and decreased fremitis. Hyperresonance with percussion. Tracheal deviation AWAY from involved side.
Tension pneumothorax
46
Presents as cold at first then high fever and lop like spots and maculopapular rash
Measles/rubeola
47
Aka swimmers ear
Otitis externa
48
Pleurisy aka
Pleuritis
49
Pain, hearing difficulties, feeling of fullness, tinnitus, allergies and common cold MC cause. retracted TM. Secondary to URI, swollen adenoids, NO inflammation. MC children (smaller shorter more horizontal)
Eustacian tube blockage
50
Older adults with watery diarrhea 3x/day 2+ days MC after antibiotic use
Clostridium difficile colitis
51
4x M. Result of atherosclerosis, tobacco, HTN, may be present with LBP, severe tearing/ripping pain
Dissection aneurysm
52
Blurred vision, halo, nausea, vomiting. 90% open-angle. Large cup to disc ratio. Peripherally displaces vessels, pale white disc and pigment surrounding disc.
A. Glaucoma
53
Drinking while lying down causes in infants
Suppurations otitis media
54
Pulsation tinnitus
Sound matches heartbeats
55
Female with pain in femoral triangle. MC on right. Coughing and sneezing etc. aggregates
Femoral hernia
56
Prolonged expiration and wheezing
Asthma
57
Vomiting and unexpected weight loss. Unresponsive to antacids.
Gastric CA
58
Recurrent indigestion and flatulence a few hours after eating
C. Cholecystitis
59
Occurs at rest and unexpected. Lasts longer and may not disappear with rest. Due to plaques/clots that reduce flow. 911
Unstable angina
60
Asthma aka
Reactive airways disease
61
Leading cause of vision loss and + amsler grid
Macular degeneration
62
Adult smoker over 50 with history of heart disease, HTN or high cholesterol. Presents with persistent cough and orthopnea. Find cardiomegaly, crackles and added heart beats
Left-sided congestive heart failure
63
50+ smoker, COPD/CAD with fatigue, dyspnea, swollen ankles and ascites. Cardiomegaly, JVD, loud s2 possible s3. Left parasternal heave (feel), retractions
Right sided heart failure-cor pulmonale
64
Clostridium difficile colitis
Recurrent bouts of diarrhea 3+/day for 2+ days that are watery
MC older adults post antibiotic use
Need to do toxin assay to detect toxin the bacteria produces
65
Hyperresonant percussion, decreased fremitus, decreased breath sounds usually history of smoking
Emphysema
66
50+ with history of cigarette smoking or exposure. Crackles, productive cough. Spirometry
C. Bronchitis
67
MC secondary to URI with swollen adenoids. No inflammation with some hearing loss. MC in children
Eustachian tube blockage
68
Middle aged, overweight, smoker with diabetes, HTN, high LDL, claudication, atherosclerosis. Continuous substernal pain radiation not relieved by rest. S4 present. Paine
MI
69
A. Bronchitis usually seen after?
URI
70
Radiates to right scapula
Cholecystitis
71
Adult with fever beyond 4-5 days. Cough with yellow or green mucus and crackles/wheezes. CBC—differentiation possible
Viral pneumonia —may lead to secondary bacterial pneumonia
72
Lesion of optic chiasm (heteronomymous bitemporal hemianopia)
Tunnel vision
73
Female, 40+ fat and flatulent and symptoms relieved with antacids
C. Cholecystitis
74
Lesion of optic N
Blindness in ipsilateral eye
75
Weber lateralized to and rinne is negative on affected side (negative means abnormal)
Suppurations otitis media
76
Exam for A. Bronchitis
Crackles, wheezes, Rhône
Normal fremitus and percussion
77
Diarrhea and constipation
Pain relieved by defecation
Lower fiber/overuse of laxatives
IBS
78
50+ sudden severe waves of abdominal pain with visible peristalsis, frequency high-pitched peristaltic sounds
Intestinal obstruction
79
S4 present
MI
80
1/3 of pneumonia cases
Viral
81
Otitis media with effusion aka
Serious otitismedia
82
Weight loss, night sweats, blood stained cough, lethargy. Fibrotic= bronchial breath and bronchophony, increased fremitus and dull percussion
Travel to Russia, africa, Latin America
Secondary TB
83
1-3 days of severe pain in LLQ. Altered bowel habits, rectal bleeding. Bed rest helps. Male or female over 40
Diverticulitis
84
RLQ pain migrated from umbilicus.
Appendicitis
85
Inflammation in bronchi MC by bacteria. Crackles, wheezes and diminished breath sounds
Broncopneumonia
86
Very contagious usually in kids post daycare. Crusting/gluing of eyelids during sleep=bacterial. Viral= adenoids virus. Usually little pain
Conjunctivitis/pink eye
87
Crohn’s disease
Young adults
Recurrent bouts of diarrhea
```
RLQ pain
Terminal ileum/prod. Colon
Perianal skin tags
Colonoscopy=cobblestone appearance
Vit b12 deficiency
```
88
Violent coughing attaching and have inspiration stridor.
Pertussis
89
Things that present with acute “surgical” abdomen
—sudden severe, persistent writhing abdominal pain—surgical intervention
- a. Cholecystitis
- appendicitis
- perforated peptic ulcer
- strangulated hernia
- sup. Mesenteric A. Thrombosis
- splenic rupture
90
Cor pulmonale due to(RSHF)
Lung disease
91
Hearing loss and retracted TM with no signs of inflammation.
Eustachian tube blockage
92
Adult, sudden sharp chest pain especially with breathing. Coughing aggrevates. Hear friction rub and decrease breath sounds. May lead to what?
Pleurisy/pleuritis
Lead to pleural effusion or get infected empyema.
93
+ Murphy’s sign
Cholecystitis
94
Rinne AC>BC but less than 2:1 ratio. Sensorineural hearing loss. Gradual or sudden.
Noise induced hearing loss
95
Pain, red eye, excessive tearing, “gritty” feeling. Photophobia, potentially decreased visual acuity
Corneal abrasion
96
Inflammation of pericardium. Sharp stabbing chest pain worse with deep breaths or coughing. Dry cough. Better sitting up and leaning forward. Triphsic friction rub heart with heartbeat
Pericarditis
97
Occurs at rest due to vasospasm of heart arteries with temp reduce flow. Due to smoking, stress, cocaine etc
Prinzmetal angina
98
Central blind spot
Scotoma
Migraine, MS
99
Pencil thin stools
Colon CA
100
Male, first occurs in infancy and extends into scrotum, worse coughing or sneezing
Indirect inguinal hernia
101
Maculopapular rash
Measles
102
Disease of bones of middle ear. They become fused. stapes MC affected. Dizziness, balance problems, tinnitus. Usually inherited. Hearing loss 10-30yeras old.
Otosclerosis
103
Morning sickness affects ____% of females
80
104
Partial hearing loss, feeling of fullness, earache, tinnitus. Insidious onset or Q-tip use. Dark wax occluding canal. Weber lateralizes. Rinne negative
Excessive ear wax-blockage
105
Virchow’s nodes present
Gastric CA
106
Predictable chest pain with activity, stress, cold. Etc. disappears with rest/medication
Stable angina
