Mar19 A1-Differential diagnosis

Question 1

causes of cough in smokers vs non smokers

Answer 1

same causes.

Question 2

4 causes of fever

Answer 2

1. infection
2. inflammation
3. cancer
4. injury

Question 3

sore throat different meanings

Answer 3

• hurts when swallow is not sore throat

- sore throat

Question 4

URTI, fever, sore throat, headache: most likely causes

Answer 4

• strep throat
• infectious mono
• bronchitis (UNLIKELY to cause fever)
• flu (sore throat bc congested)
• autoinflammatory syndromes
• ate something that got stuck in the throat and injured it (ex. fish bone)

Question 5

3 first steps of ddx

Answer 5

1. generate problem list
2. generate ddx
3. rank ddx

Question 6

3 year old with fever and a rash most likely dx

Answer 6

virus

Question 7

(imp?) 80 yr old, cough for 3 days most important thing to check and why

Answer 7

respiratory rate. only thing positively correlated with getting a CXR (change of having lung pathology only increases with higher RR)

Question 8

80 yr old: thing in history that becomes irrelevant

Answer 8

family history

Question 9

most common cause of cough in 2 yr old vs 80 yr old

Answer 9

virus

Question 10

45 yr old. 2 days of cough + short of breath + pleuritic pain: 2 things not to miss and that could kill the patient

Answer 10

• PE

- pneumothorax

Question 11

important question to ask in chest pain (cardiac or resp)

Answer 11

exercise intolerance (to check if cardiac)

Question 12

question to ask in pneumothorax (thing that might increases its probability in the ddx)

Answer 12

smoking weed
(increases chance of pneumothorax in general)

Question 13

mnemonic to structure a ddx

Answer 13

VITAMINSABCDE
Vascular. Infectious. Trauma. Autoimmune or Allergy. Metabolic. Idiopathic or Iatrogenic. Neoplastic. Social. Alcohol. Behavioral or psychosomatic. Congenital. Degenerative. Endocrine.

Question 14

11 month old with fever and irritability for 2 days: TWO most likely dx

Answer 14

1. acute viral illness

2. bacterial infection (can hide in lung, ear or urinary tract)

Question 15

11 month old with fever and irritability for 2 days: important disease not to miss and how to check

Answer 15

meningitis. (age, fever, irritability)
* **ask if stiff baby and doesn’t like to bend forward (is stiff or bent backwards): bc meninges is sack around spine and brain. inflammed = pain when stretched

Question 16

most common cause of fever in infants

Answer 16

rosiola. (can verify by checking for rash when fever resolves)

Question 17

common course of rosiola infection

Answer 17

• in infant between 2 months and 3 yrs of age
• high fever for a few days and then resolves
• rash develops

Question 18

important question in 27 yr old female with new onset abdominal pain

Answer 18

last menstrual period

Question 19

27 yr old female with new onset abdominal pain: main things on ddx

Answer 19

#1 ovarian torsion
#2 ectopic pregnancy (important bc can kill the patient*****)
#3 STIs
#4 kidney stone
#5 food poisoning
#6 volvulus and hernia
cancer is far down

Question 20

80 yr old female with new onset abd pain how differential changes

Answer 20

ectopic pregnancy impossible but rest of differential remains

Question 21

16 year old with difficult to control nosebleed for 1 week + headaches getting worse. FIRST thing on ddx

Answer 21

he picks his nose (can give nasal gel) (digital irritation in a dry environment)

Question 22

16 year old with difficult to control nosebleed for 1 week + headaches getting worse. what can not be missed and how to check

Answer 22

cranial malignancy

-ask if headache is worse in the morning bc positive = increased intracranial pressure

Question 23

16 year old with difficult to control nosebleed for 1 week + headaches getting worse. DDX

Answer 23

• cranial malignancy
• picks his nose
• medication induced platelet problem
• seizures (epilepsy)
• cocaine
• ITP

Question 24

20 yr old man brought to the ER having passed out in the metro + fatigue for last 2 months: DDX of syncope

Answer 24

1. malnutrition
2. anemia (Fe deficiency)
3. hypothyroidism
4. dehydration
5. type 1 DM
6. anxiety

Question 25

45 yr old. root canal. 10 minutes into procedure, short of breath. DDX

Answer 25

1. allergic rx (to local anesthetic) 2. anxiety attack 3. asthma 4. because of the pain 5. OSA 6. atypical angina 7. heart failure

Question 26

20 yr old comes to dentist for filling. persistent bleeding. number 1 cause + DDX

Answer 26

#1 periodontitis - trauma (iatrogenic) - liver disease (clotting factors) - vWF disease - scurvy

Question 27

basic pathophysiology principle in general, especially in hematology

Answer 27

not enough of a cell type = - not made (aplastic anemia, marrow malignancy) - being used (autoimmune or infectious) - destroyed (spleen or autoimmune)

Question 28

ddx of polydipsia

Answer 28

- central problem - solutes problem (hyperNa, hyperglycemia, ..) - excreting too much water (sweating, peeing, feces, etc.)

Question 29

coagulopathy def

Answer 29

problem of production of proteins needed for coagulation cascade (liver problem or immune problem)