Mini Cases Presentation Flashcards by Hingle McCringleberry

throbbing unilateral temporal
flashes of light - auras
nausea/vomiting
family history
lasts 2-3 hours

Migraine

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severe unilateral temporal
ipsilateral rhinorrhea, eye tearing, redness
occurred same time every night lasts for 45 mins

Cluster

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severe intermittent right temporal headache
fever
ipsilateral blurred vision
pain in jaw when chewing

Temporal Arteritis

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frontal headache
fever
nasal discharge
TTP of frontal and maxillary sinus

Sinusitis

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bilateral squeezing headaches

stress, end of work day, dec caffiene intake

Tension Headache

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severe sudden headache
vomiting, confusion
hemiplegia
nuchal rigidity

Subarachnoid Hemorrhage

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severe headache
confusion
photophobia
nuchal rigidity

Meningitis

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pulsatile headache
Obese F with OCP use
vomiting
blurred vision

Pseudotumor cerebri

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right cheek, electric stabbing, with shaving

Trigeminal neuralgia

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progressive confusion, forgetfulness, clumsiness

stepwise decline in cognitive fxn

Vascular “multi-infarct” dementia

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memory loss
gait disturbance
urinary incontinence

Normal Pressure Hydrocephalus

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rapidly progressive change in mental status
inability to concentrate
memory impairment past 2 months
myoclonus, ataxia, startle response

Creutzfeld-Jakob disease

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insulin dependent - episodes of confusion, dizziness, palpitations, diaphoresis, weakness

Hypoglycemia

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gradual altered mental status and headache

history of head trauma

Subdural Hematoma

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acute loss of vision in L eye
palpitation, SOB
hx of a fib and cataracts in R eye
No eye pain, discharge, redness, photophobia

Retinal Artery Occlusion

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intermittent episodes of vertigo, tinnitus, nausea, hearing loss within past week

Meniere’s disease

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dizziness, faint
severe diarrhea
furosemide for HTN

Orthostatic hypotension 2/2 dehydration

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postural dizziness, unsteadyness
Started on new HTN medication recently
(can lose consciousness)

Drug-induced orthostatic hypotension

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dizziness on moving head to the left

tilt test - nystagmus and nausea

Benign positional vertigo

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dizziness with n/v
recent hx of URI
NO hearing loss

Vestibular neuronitis

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dizziness with some hearing loss

recent hx of URI

Labyrinthitis

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rhythmic motion of limbs

lost control of bladder

General Tonic Clonic

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loss of consciousness
no warning
recent hx of palpitations

Cardiac arrhythmia

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20 min episode of slurred speech, R facial drooping and numbness, R handed weakness
Resolved sx by the time he got to ER
hx of DM, HTN, smoking

TIA

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slurred speech, R facial drooping and numbness, R handed weakness. R Positive Babinski's

Stroke

ascending loss of strength in lower legs over past 2 weeks | 2 wk hx of URI

Guillian Barre

30 y/o F weakness, loss of sensation, tingling in L leg started this morning R eye pain, decreased vision, double vision electric shock feelings down her spine when she flexes her head

Multiple sclerosis

tingling and numbness in hands and feet hx DM HTN smoking dec soft touch, vibratory, and positional sense

Diabetic peripheral neuropathy

double vision with drooping eyelids at night | normal in the morning

Myasthenia gravis

hemiparesis after tonic clonic seizure

Todd's Paralysis

feeling tired worthless, hopeless, suicidal thoughts lost her job, fights husband about money

Depression

fatigue, insomonia, nightmares about a traumatic event

PTSD

fatigue, weight loss, constipation | FHx of colon cancer

Colon Cancer

fatigue, weight gain, sleepiness, cold intolerance, constipation, dry skin

Hypothyroidism

obese, fatigue, daytime sleepiness | snores heavily, 3-4 naps a day never feels refreshed

Obstructive sleep apnea

fatigue, thirst, increased appetite, polyuria

Diabetes mellitus

feeling tired, sleepy during day | recent hx of changing shifts

Shift work sleep disorder

night sweats, cough, swollen glands for 1 month | recent emigration from Africa

Tuberculosis

excessive sweating, unintentional weight loss, palpitations, diarrhea, SOB

Hyperthyroidism

3 week hx of difficulty sleeping sleeps 7 hours a night began college recently, trouble with boyfriend, drinks 3-4 cups of coffee a day

Stress-induced insomnia

3 weeks of fatigue, trouble sleeping falls asleep well, wakes up at 3AM- cannot return to sleep unintentional weight loss inability to enjoy things she used to

Insomnia related to MDD

sore throat, fever, fatigue, loss of appetite epigastric + LUQ pain cervical lymphadenopathy and a rash boyfriend had similar symptoms

Infectious mononucleosis

sore throat, rash, fever, weight loss | hx of needle sharing and IV drug abuse

HIV, acute retroviral syndrome

fever and sorethroat

Pharyngitis

SOB, cough, wheezing worsens in cold air several episodes past 4 months

Asthma

SOB, productive cough which lasts for 3 month each year | Hx of Heavy smoking

COPD

1 week of pleuritic CP, fever, chills, cough with purulent yellow sputum. Hx of smoking and COPD

PNA

2 weeks of nonproductive cough | 3 weeks ago had sore throat and runny nose

Atypical PNA

worsening cough for past 6 months hemoptysis, dyspnea, weakness, weight loss Hx of heavy smoking

Lung Cancer

inc dyspnea and sputum production hx of COPD stopped using inhaler

COPD exacerbation (bronchitis)

worsening cough 6 weeks duration, weight loss, fatigue, night sweats, and fever hx of TB contacts at work

Tuberculosis

SOB and cough hx of unprotected sex recently exposed to pt with active TB

Tuberculosis

cough exacerbated by lying down at night improved by propping up with 3 pillows exertional dyspnea

CHF

dyspnea of 6 hours duration, cough with frothy pink sputum

Pulmonary edema

sudden onset of substernal CP lasts 30 mins, radiation to L arm dyspnea, diaphresis, nausea hx of HTN, HLD, Smoking

Myocardial infarction

acute onset of CP for few hours hx of sickle cell disease multiple hospitlizations for pain and anemia mangement

Sickle cell disease - acute chest syndrome

retrosternal burning sensation that occurs after heavy meals and after lying down symptoms are relieved by antacids

GERD

retrosternal squeezing pain occurs for 2 mins occurs with exercise relieved by rest and not related to food intact

Stable Angina

retrosternal stabbing chest pain improves leaning forward and worsesns with deep inspiration hx of URI 1 week ago

Pericarditis

stabbing chest pain worsening with deep inspiration and relieved by ASA Hx of URI 1 week ago Chest wall tenderness noted

Costochondritis

acute onset of SOB at rest and pleuritic CP tachycardic, hypotensive, tachypneic and mild fever Recent hx of THA

sudden onset of chest pain radiation to back | Hx of uncontrolled HTN

Aortic dissection

insulin dependent diabetic | episodes of palpitations and diaphoresis

Hypoglycemia

several episodes palpitations, sweating, rapid breathing unexpectedly episodes does not recall any triggers 4-5 episodes per month for several months episodes last 2-3 minutes

Panic Attack

``` episodic palpitations especially in front of class heart pounding, facial blushing, hand tremor, excessive sweating, rapid breathing ```

Social Phobia

episodic palpitations with lightheadedness and sharp atypical chest pain

Mitral valve prolpase

weight gain within 2 months quit smoking 3 months ago and on amitriptyline for depression cold intolerance and constipation

Smoking cessation

weight gain with tremor, palpitations, anxiety, hunger relieved by eating Exhibits proximal muscle weakness and easy bruising

Insulinoma

dysphagia started with solids and progressed to liquids Hx alcoholics and heavy smoker unintentional weight loss

Esophageal CA

dysphagia 2 weeks with mouth and throat pain, fatigue and a craving for ice and clay

Plummer-Vinson syndrome

dysphagia for both solids and liquids - slowly progressed in severity in past year associated with difficulty belching and regurgitation of undigested food esp at night lost weight in past 2 months

Achalasia

dysphagia and pain on swallowing solids more than liquids | oral thrush present

Esophagitis (CMV, HSV, HIV, pill-induced)

single 2 cm mass on R side of neck with night sweats, fever, weight loss, loss of appetite, early satiety Painless mass, mobile, not changed in size

Hodgkin's/non-Hodgkin's lymphoma

``` F with nausea/vomiting (in the morning) fatigue, polyuria LMP 6 weeks Breasts are full and tender occasional use of condoms ```

Preggos

sudden onset of colicky right sided flank pain radiation to testicles n/v, hematuria, CVA tenderness

Nephrolithiasis

dull epigastric pain that radiates to the back weight loss, dark urine, clay-colored stool heavy drinker, smoker jaundiced

Pancreatic cancer

midepigastric abdominal pain that radiates to back and improves when he leans forward anorexia, n/v alcoholic and spent the 3 days binge drinking

Acute pancreatitis

Mini Cases Presentation Flashcards

(77 cards)