Mnemonics/DDs Flashcards

Question

Complications of ulcerative colitis

Answer 1

F-5O-P- BTCON Fulminant colitis: severe inflammation of gut with high fever and tummy pain 5 Organs:(BELS-J): the same inflammation that triggers flares in your intestines can have an impact on other parts of the body — including your skin Bile duct (primary sclerosing cholangitis): The bile ducts are a series of thin tubes that go from the liver to the small intestine. In primary sclerosing cholangitis, inflammation causes scars within the bile ducts. These scars make the ducts hard and narrow and gradually cause serious liver damage. Eye (episcleritis, uveitis): Can colitis cause vision loss? Approximately 10% of people with inflammatory bowel disease (IBD) experience eye problems. However, most of these are treatable and do not pose any significant threat to loss of vision. Liver Skin (erythema nodosum, pyoderma gangrenosum) Joint Perforation: hole in gut Bleeding Toxic megacolon: occurs when swelling and inflammation spread into the deeper layers of your colon. As a result, the colon stops working and widens. In severe cases, the colon may rupture. CA Osteoporosis (because of steroids) Nutritional deficiency

Answer 2

MCAAT 1.Muscle disease 2.Celiac disease 3. Addison d. (Adrenal insufficiency: can be rel to abrupt steroid withdrawal: low BP), [OPP: Conn (Hyperaldosteronism): increased BP)] 4.Anorexia nervosa 5:Thyroid disease

Answer 3

M3IC HAD 2B 2P Mesenteric ischemia Ischemic colitis IBD Infection CA Hemorrhoids Anal fissure Diverticular disease Bleeding disorder Blood thinner Polyp Peptic Ulcer

Answer 4

2H3EM3I FA2DOC Hemochromatosis, Hepatitis Endocrine: DM, Thyroid, Addisons Malignancy Infection, infective endocarditis, Atypical pneumonia Fibromyalgia Anemia Depression, Drug (Steroid Withdrawal) Obstructive sleep apnea Celiac Dx

Answer 5

Mother: 5P+1 Polyhydramnios Pre-Eclampsia (Before time) Preterm labor PROM Placental abruption & Induction/ C section Baby: 3+3+3 (Baby size(3), Defects(3), After delivery(3)) Before birth: Macrosomia IUGR FDIU/IUD: Fetal death-in-utero Defects: NTD (Neural tube defect) Vertebral Heart After birth: RDS Hypoglycemia Jaundice (C&C Congenital Rubella syn.=Vision, Hearing, Limbs, Mental, Heart)

Answer 6

Causes:-(M3I2C H2AD) 1.Medications (reduced prod, inc destruction) 2.Infection (post-viral: red prod, virus: inc destruction, Hep/HIV/ParvoV) 3.Cancer (Leukemia, Myelofibrosis) 4.Hypersplenism 5.Anaemia (Fanconi, Aplastic) 6.Diet [Fanconi: reduced absorption of substances in kidney so they leave body Aplastic: Bone marrow doesn't makes adequate RBC Leukemia: Blood CA with increased WBC production Myelofibrosis: Bone marrow CA with scarring] 1.Decreased production: Hereditary (Fanconi anaemia) Post viral (Parvovirus B19, HIV, Hepatitis) Drugs Leukaemia Aplastic anaemia 2.Increased destruction: Hypersplenism Myelofibrosis (Bone marrow CA) Infections

Answer 7

2(SO) A 2(P DIM F) -C Sciatica Spinal Stenosis Osteoporosis OA Ankylosing Spondylitis Paget PMR (C&C Shoulder) Discopathy Disc Prolapse Infection: EPIDURAL ABSCESS, SA/ OM Malignancy (Multiple Myeloma, Prostate CA) Mechanical back pain Fracture Fibromyalgia Cauda Equina Syndrome MCS+4Image+2P+3CA MCS: 1.Mechanical back pain 2.Cauda equina 3.Sciatica (L5-S1 Radiculopathy) [Imaging findings:(4) 5.Fracture of vertebral body 6.Spinal canal stenosis 7.Ankylosing spondylitis 8.Abscess 8.PMR 9.Paget‘s disease 10.Multiple myeloma 11.Prostate cancer 12.Malignancy]

Answer 8

G L 3E AMPS 1.Genetic cause 2.Life style (junk food, sedentary) Endocrine: 3.Diabetes (Both T1 & 2 are associated with health complications that can lead to weight gain.) 4.Thyroid-Hypothyroidism 5.Cushing‘s syndrome 6.Alcohol 7.Medication (3)- Quetiapine(antipsy), Lithium, Steroid 8. PCOS (in female) 9.Smoking CESSATION

Answer 9

CII SEE U Chromosomal abnormalities Immune and blood clotting problems(3): APAS, SLE, Thrombophilia Infections(3): TORCH, STI, Hepatitis B&C SAD Endocrine: thyroid & DM Epidemiological: advanced age, prev H Uterine abnormalities AE2IU-C Advanced age Endocrine: DM, Thy Infec:(3): TORCH STI Hepatitis B&C Inflammation:3 SLE APAS Thrombophilia Uterine & CERVICAL abnormalities Chromosomal abnormalities

Answer 10

Intake/Nutritional deficiency: 1.Poor intake of meats and dairy products in the elderly population (aged 65 and above) 2.Strict vegan diets 3. Alcoholism Increased requirement: 4.Pregnancy and lactation Absorption: 5.Autoantibodies against the intrinsic factor (pernicious anemia) deficiency 6.Impaired absorption 7.Atrophic gastritis 8.Gastrectomy

Answer 11

HI 3T GO 4A P 1.Hearing and vision 2. Infections 3. Trauma 4.Temper tantrum 5.Tourette 6.Gender dysphoria 7.ODD 8.Absence seizures 9. Anemia 10.Autism Spectrum Disorder 11.ADHD 12.Psychological/Stress

Answer 12

VIA- TC- 2S 1. Vocal abuse- Occupation 2. Infection 3. Asthma 4.Thyroid 5.Cancer 6.Stroke 7. Surgery

Answer 13

3H 2E LV CT Hydrocele Hernia Hematocele Epididimo orchitis Epididymal cyst Lipoma Varicocele CA Trauma

Answer 14

BY SITE: Plantar:(5) 1. Plantar fascitis 2. Heel spur 3.Heel pad syndrome 4. Nerve entrapment 5.Calcaneal stress fracture Posterior: 1.Achilles tendinopathy Midfoot (medial)(4) 1.Posterior tibialis tendinopathy 2.Flexor digitorum longus tendinopathy 3.Flexor hallucis longus tendinopathy 4.Tarsal tunnel syndrome Midfoot (lateral)(2) 1.Peroneal tendinopathy 2.Sinus tarsi syndrome 3PANTS 2F2HC=12 Plantar Fascitis Posterior tibialis tendinopathy Peroneal tendinopathy Achilles tendinopathy Nerve entrapment Tarsal tunnel syndrome Sinus tarsi syndrome Flexor digitorum longus tendinopathy Flexor hallucis longus tendinopathy Heel spur Heel pad syndrome Calcaneal stress fracture

Answer 15

VBT HAD HT ---Meningitis: Viral Bacterial TB Hemorrhage Abscess Drug overdose Hypoglycemia Tumor (coz Trauma same as hemorrhage)

Answer 16

2HES CT MMRV ID --Caused by sexual contact:(2HES): HIV, Hep, EBV, Syphilis(congenital), --Splenomegaly+Rash:(CT) CMV, TOXO --Rash Ddx:(MMRV ID) MMRV Dengue ITP Inv:- 1.FBE, UEC, ESR/CRP, LFTs, 2.Urine MCS, 3.HIV serology. -CD4 count as a baseline, -ELISA antibody testing. Take consent after Pre-test counselling for HIV. 4.Hepatitis A,B&C, 5.Monospot test for EBV (Epstein-Barr serology) 6.Syphilis If indicated 7.Urethral and anal swab for culture. 8.TORCH serology (nothing for MMRV, ID) Review: For HIV:-If negative -repeat in 6w -3m

Answer 17

Heartburn Qs: how long? Did you taste sour or bitter taste in your mouth? (Any water brash?), did you try anything? How often did it happen? Are you having your meals regularly? Relates to any food or drinks? Anything make it better or worse? Associated symptoms -Pain – epigastrium, Vomiting? Any blood in vomiting? Any blood color stool? Any weight changes? Loss of appetite? Any problem with swallowing of food? Cause Qs: 1.Chronic cough 2.Constipation 3.Heavy weight lifting, exercise 4.BMI 5.Diet- coffee, spicy food 6-Smoking 7.Aspirin 8.Advance age 9.Prev surgeries/injury 10.Congenital Cond: – draw a picture, it is when part of your stomach bulges up into your chest through an opening in your diaphragm, the muscle that separates the two areas. The opening is called the hiatus. But we don’t see any ulcerations, no Barret’s oesophagus which is the cell changes in lower part of the gullet due to reflux and no H.pylori infection which is a bug causing ulcers in food bag. So this is good thing. Normally, that hiatus is just a small opening just wide enough for your food pipe to pass through. Causes>becomes wide Sx of Barretts (not Hiatal Hernia): Frequent heartburn Difficulty swallowing food Chest pain (less common

Answer 18

GOLD 4PTAS GAD OCD Lifestyle stress Depression Pheochromocytoma Panic attack/disorder PTSD: Acute, chronic, delayed. Phobias Thyroid Adjustment syn? Social anxiety

Answer 19

FORMAT: 4B&B 2P (Polyp, Prolapse), MF (M, F causes) STI, CA & Trauma PM/SHx, Meds GENERAL DDx: 1.Polyp 2.STI eg.HSV 3.Pelvic organ prolapse- Cystocele, rectocele Bladder Outlet obstruction: 4.UTI(severe) 5.Stone: (KUB) Kidney, Ureter, Bladder 6.Stricture/scar tissue at bladder neck, 7.Malignancy of genitourinary tract 8.Constipation, Faecal impaction 10.Medications (anticholinergics, antipsychotics) 11.Medical conditions:- stroke/MS. 12.Pelvic surgery eg Hernia 13.Trauma 14.Tight pelvic floor muscle MALE causes:(3):Prostate 1.BPH 2.Prostatitis 3.Prostate cancer FEMALE(3) 1.Pregnancy 2.Fibroid 3.Ovarian CA

Answer 20

LAT-VANS(NI2CE) Lymph Arthritis Trauma Vein: DVT Artery: PVD Nerves: neuropathic pain/lumbar radiculopathy Skin:NI2CE: Necrotizing Fascitis Insect bite Contact Dermatitis Cellulitis Erythema Multiforme (infec, Bull's Eye)

Answer 21

(2E+2S+M+2T)+2(Electrolyte&Alc)+5CNS+2(Liv,Thy)+4F(CVS,HypoT,VV,Preg)+2Psy=22 1.Another episode of epilepsy attack 2.Side effects of anti-epileptics as extra pyramidal SE 3.Simple focal seizure 4.Myoclonic seizures 5.Conversion disorder (different from factitious: sympathy) 6.Malingering 7.Benign essential tremors 8.Intentional tremors 9.Electrolyte imbalance 10.Alcohol withdrawal (Delirium Tremens) CNS:(5) 11.Infections 12.ICSOL 13.Stroke 14.Tumour 15.Trauma 16.Thyroid problems 17.Liver problems Fainting Ddx?(4) 18.CVS-(MI, Arrhythmia, AS, HOCM) 19.Postural hypotension 20.Vasovagal syncope 21.Pregnancy (coz: weakness?) 22.Panic attack 23.Any anxiety disorder

Answer 22

Local: 1.Allergy- NSAIDs 2.Insect Bite 3.Cellulitis 4.Trauma 5.Child abuse 6.Malnutrition Systemic: 7.Kidney problem 8.Heart problem 9.Liver failure 10.Hypothyroidism Cushing?

Answer 23

PTI -H 3E 2C- 5M 4(D) 2S: 1.Psychogenic- stress 2.Trauma 3.Infections- Mumps 4.Heart- BP 5.PVD Endocrine (3) 6.DM 7.Thyroid 8.Prolactinoma CNS (2) 9.Stroke 10.MS 11&12.PM/SHx:- -previous surgery/Prostatectomy -Radiation/ EBR (External Beam Radiation) -previous history of : Kidney disease Heart disease, HF, Uncontrolled Bp/ BSL, Lipid/cholesterol level Stroke Spinal cord lesion 13.(9=5+4): Medications + SADMA Meds:(5) Beta-blocker Thiazide H2 Antagonist antiDepressant, antiPsychotic SAD:(4) Smoking Alcohol Cocaine Marijuana Ix: 1)FBC, UEC, LFT 2)Lipid profile 3)HBA1c/FBS 4)TFT 5)Prolactin level 6)FSH, LH 7)Testosterone 8)ECG (imp b4 Sildenafil?) 9)Penile Tumescence Test (3-5 spontaneous is N) Mx:(9) 1)Psychologist 2)Family therapy 3)Relaxation techniques 4)Address and Modify RFx a.LSM b.DM c.BP- Stop BB, Cardiologist 5)Meds: Sildenafil SE-Side effects: (6)(F3H-NP) a.flushed skin b.hypotension c.headache d.heartburn e.nasal congestion f.priapism *CI (3): Angina, IHD, Nitroglycerin 6)Penile injection: Papaverine, Phentolamine, Prostaglandin E1: Alprostadil 7)Pump A vacuum 8)ITestosterone, taking this hormone will help if LOW 9)Surgery: Penis Implant /Prosthesis (last resort)

Answer 24

TRAM HAD 2I3C: 1Thyroid 2.Reduced intake/increased exercise 3.Anorexia 4.Malnutrition 5.Hypopituiatrism 6.Anemia 7.Depression 8.Infection 9.IBD 10.Celiac 11.Cystic Fibrosis 12.CA

Answer 25

13= 1.Normal change in puberty and obesity 2.True & Pseudo-gynecomastia 3.Chronic Liver insufficiency Endo(3) 4.Thyroid 5.Cushing’s 6.Prolactinoma 7.Medications:(3) Steroids, Spirinolactone(Diuretic), Ramipril(ACEI) 8.Breast cyst 9.Cancer:(3) Breast, Testicular, Adrenal

Answer 26

2+1+1+2=6 Anything that over distends the uterus:(2) 1.Polyhydramnios 2.Multiple pregnancy 3.Cervical incompetence 4.Maternal infections Maternal conditions :(2) 5.GDM 6.Pre-Eclampsia. Complication-(2) CC 1.Infection (Chorioamnionitis) 2.Cord prolapse

Answer 27

HE2G 2C2T LESS 1.Hepatitis A/E 2.Escherichia coli Diarrhea 3.Gastroenteritis 4.Giardiasis 5.Campylobacteriosis 6.Cryptosporidiosis 7.Typhoid Fever/ Paratyphoid 8.Leptospirosis 9.Encephalitis 10.Salmonellosis 11.Shigellosis

Answer 28

4V 3C 5U- 1O 1B [VCU-OB] Superficial penetration(4) 1)Vulv-itis 2)Atrophic vaginitis 3)Vaginal infection 4)Vagin-ismus: (psychosocial problem, vagina spasms. Can't ask in hx. On exam on touching vagina will spasm.) Deep penetration- CERVIX: 1)Cervic-itis 2)Cervical Ectropion: (Sx: excessive mucosal discharge) 3)Cervical CA UTERUS:(5) Endometriosis PID Fibroid Endometrial CA Displaced IUCD Ovarian Cyst BLADDER: Cystitis VAGINISMUS: DDx: Dyspareunia Psychological (e.g. performance anxiety) Mx: Diagnosis confirmed if vaginal muscles contract involuntarily with pelvic exam Gradual vaginal dilators Physical therapy to relax the tight muscles Counseling

Answer 29

(MMRV DR HIKE-2S HIMAL V) MMRV DR HIKES: MENINGOCOCCAL MENINGITIS Measles Rubella Varicella Drug reaction Roseola infantum *HFM (Hand Foot Mouth) Infectious Mononucleosis Kawasaki ERYTHEMA INFECTIOSUM Scarlet fever Septicemia non-Blanchable: HIMAL-V (HER) *HSP ITP Meningococcemia Allergic rash Leukemia Viral:(HER) Hemophilus influenza, EBV, Rubella SKERV(MMV)-A: Blanchable Scarlet Kawasaki Erythema Infectiousum Roseola Infantum 3)Virus: (MMV:) Measles, Mumps, Varicella Allergic Rash

Answer 30

Hx structure: 1)BEFORE: AR+TORCH : ABO, RH, maternal fever: immunization & meds 2)DURING: Trauma: cephalohematoma 3)AFTER: P+2H+2B+3L+2F+S a)Physiological b)Heel-prick: Galactosemia(cataract), Hypothyroidism c)Feeding: Breastfeed & Breastmilk (after 14 D) d)Liver(obstructive jaundice): (3) Neonatal Hepatitis Biliary atresia Choledochal cyst e)FHx: G6PD def, Hereditary Spherocytosis, blood dyscrasia f)Sepsis UNCONJUGATED: (8) 1.Physio 2.ABO, 3.Rh 4.TORCH 5.Breast milk 6.Breast feeding 7.Herediary Spherocytosis 8.G6PD def. CONJUGATED:(6):ie 2Heel-prick + 3Liver + SEPSIS 1.Galactosemia 2.Hypothyroidism 3.Neonatal Hepatitis 4.Choledochal Cyst 5.Biliary Atresia 6.Sepsis

Answer 31

6+5(-itis)=11 VC-ESKA-TQPLA: 1.Viral URTI 2.Covid 19 3.EBV 4.Scarlet fever 5.Kawasaki disease 6.Allergy -ITIS(5): 1.Tonsillitis 2.Quinsy 3.Pharyngitis 4.Laryngitis 5.Allergic rhinitis

Answer 32

4Birth, 4 CNS, + 3: Child Abuse, Metabolic, GDD, Familial delay =12 Genetic or hereditary:(4) 1)Downs syndrome 2)Cerebral palsy (Hyertonia(spastic), Athetoid(hypotonic)Dx after 2Yrs 3)Spina bifida 4)Congenital hypothyroidism Sx: 4 (Lethargy, Hoarse cry, Feeding problems, Constipation) PEx:6 (GA(2): dry skin, prolonged Jaundice, V=Hypothermia, Macroglossia, Umbilical hernia, Hypotonia)  CNS:(4) Trauma Tumor Infections Epilepsy Child abuse  Metabolic disease  GDD: (Global Developmental Delay) Familial Delay

Answer 33

2Q D2A6IG: GLEAMBIC GLEAM (med cond) B(breast infec) I(infec:BB) C(Cleft l&p) (Intake, Quality, Quantity, Deformity, Absorption, Increased Usage, Genetic) INTAKE: QUALITY: junk, no solid food QUANTITY: Inadequate(malnutrition/neglect), Breast feed (supply, infec) DEFORMITY: Cleft lip or Palate ABSORPTION: Celiac, Cystic fibrosis, Lactose intolerance, Cows milk protein intolerance INCREASED USAGE: (6 in 3 Categ) Infection:(B&B) diarrhea, UTI Endo: DM, hyperthyroidism Chronic illness: (CVS &Resp) Chronic respiratory, CHD (congenital heart disease) GIT:, GERD, Pyloric stenosis, IBD Genetic

Answer 34

GUTS ATE M-2H: GE UTI Testicular Torsion Strangulated Hernia Appendicitis Trauma Encopresis Mesenteric Adenitis (swollen LN in tummy, better wt/out Tx, common<16Yrs) HSP (Henoch Schonlein Purpura HUS (Hemolytic Uremic Syndrome) [Deserves acute tummy pain after eating my house)

Answer 35

T-testicular torsion R-renal stone U-UTI S-strangulated hernia T-trauma A-Appendicitis E-Epididymo-orchitis I-Intestinal obstruction

Answer 36

4C3IL 4C: digestion rel & Psy: Cows milk Celiac Constipation Childhood Migraine, Non-Specific pain 3 I: IBS, IBD, Intestinal(parasites) L: Lactose intolerance

Answer 37

HIIFAT: HUS Infections: Meningitis, OM, Pneumonia, UTI, AGE, Intussusception Food allergy Travel (C&C vomit and acute Diarrhea: all infec)

Answer 38

3C-3IL GF2T (Girl Friend: Giardiasis, Food Allergy): 1.Cow Milk Protein Allergy 2.Cystic Fibrosis 3.Celiac 4.IBD 5.IBS 6.Intestinal Parasite 7.Lactose Intolerance 8.Giardiasis 9.Food Allergy 10.Toddlers Diarrhea 11.Travel Investigations: (6) FBE, ESR/CRP,UEC Stool microscopy and culture + for Reducing Sugar (lactose intolerance) Celiac disease serology if all other Ix normal (C&C Galactosemia: Reducing substance)

Answer 39

HOST LMNOP C H-3O-2S-2T HSP OM, OA, JRA SA, SCFE Trauma, TTN Ligament inj, Malignancy Neonatal: DDH Os-good Schlatter Perthes Child abuse PERTHES: PEx: +Roll test: rotation invokes Guarding or Spasm, esp. with Internal Rotation. Mx: Inv: Xray, CT/MRI/Bone scan Perthes: Orthopedic support for 2Yrs, Physio: strengthen Thigh muscles Complications: (2) 1.OA 2.shortening of leg/permanent deformity and disfigurement Irritable hip: Aspiration for infection. Ix: FBE/ ESR/ X-ray or USG: Hip joint.  Once infection is R/O: Mx.-Painkillers, Rest, Crutches Repeat X ray in 4-6 weeks: To R/O Perthe’s OM/Septic arthritis: Ix: FBC, ESR/CRP, Blood Culture Aspiration of joint IV Antibx until improvement fol/by Oral 3-6 Weeks May need Plaster, traction or Splint (immobilization) Joint wash out to drain infection (if req) HSP: Ix: FBC, ESR/CRP, Urine Analysis Monitor urine for Output & proteins (:May req Steroids). F/U for 6 Months to monitor Kidney involvement SCFE: Inv: some x rays (AP and frog lateral Pelvis X Rays of both hips ) Mx: -shouldn’t bear weight and be on strict bed rest. -urgent referral to the Orthopedic specialist to review his condition. -Crutches if needed. -The specialist might consider surgery to prevent further slipping and can do Pinning to Stabilize the bone and almost all cases require Surgery -Advise him to lose Weight in the future. This may help in Preventing recurrence. The outcome is usually good with treatment. I will be in contact with the specialist and follow him up in the future. Complications:(3) 1.OA 2.Recurrence 3.Avascular necrosis (C&C Hip pain Ddx: Avascular necrosis)

Answer 40

PAPPA-GCC-FISH: POST VIRAL COUGH ASTHMA PERTUSSIS PSYCHOGENIC COUGH ALLERGIC RHINITIS GERD CONGENITAL HEART DISEASE CYSTIC FIBROSIS Foreign body Irritant-induced: like parental smoking Sinusitis Habit cough/Tics FHx: (HEAA-HC) Hay fever, eczema, asthma, allergy Heart disease, Cystic fibrosis Asthma triggers: 2C2PDS+EU: carpet, cold air pet, pollen dust smoke exercise URTI

Answer 41

3A2B3C2D EFU 3P: Asthma, Anaphylaxis/Angioedema BRONCHIOLITIS Bacterial Tracheitis(toxic child wt high fever, bacterial, steeple) CROUP CHF (Congestive heart failure) Covid-19 Developmental abn: a)laryngomalacia: Birth defect of larynx causing inspiratory stridor b)vascular ring EPIGLOTTITIS Foreign body URTI PNEUMONIA PERITONSILLAR ABSCESS/Quinsy Panic attack

Answer 42

RARE-FNC: 1.Recurrent viral infection/URTI 2.Allergic Rhinitis 3.Rhino Sinusitis 4.Enlarged Adenoid 5.FB 6.Nasal Polyp 7.CF PEx: GA : active /irritable/ drowsy? Any Adenoid Facies? Any Mouth-breathing? PICKLED Vitals and GC ! ENT: -EAR : any Discharge from the ear? Any Tympanic membrane changes? -Nose: Any nasal crease? Is the nasal Mucosa pale and Congested? Boggy in appearance? Any Polyp, FB or Ulcers? Any Hypertrophy of Nasal Turbinate? -Throat: Any bad ODOR from the Mouth? Any throat Congestion or exudate? Any Tonsillar or Adenoid Hypertrophy? Mallampati score 1-4 Finish off wt: Respiratory & CVS.

Answer 43

3PIES FAT B PID PCOS POLYP IUCD (Intra-Uterine Contraceptive Device) Endometriosis * Endometrial Hyperplasia (Cystic or Complex) Submucous Myoma * Fibroids/ Leiomyoma (Uterine Myomata) * Diffuse adenomyosis (is characterized by endometrial tissue scattered diffusely within the myometrium.) * Complex adenomatous hyperplasia OTHER: * Chronic PID * Blood dyscrasia * Hypothyroidism * Neoplasia (imp) (Three layers of uterus: endometrium myometrium perimetrium: also k/n as serosa)

Answer 44

DIIMS: 1.Diet: Green leafy diet like grape, grape juice and spinach 2.Infection: diarrhea like salmonella, E. Coli 3.immune: IBS diarrhea 4.Med: Antibiotic use 5.Surg: Removal of Gall bladder (recent)

Answer 45

3PAR2T3S WH 1.Pilonidal abscess/cyst/sinus (one opening) 2.Perianal abscess 3.Perianal fistula (small tunnel) 4.Anal fissure 5.Rectal prolapse 6.Tumor (Sacrococcygeal Teratoma?) 7.Trauma 8.Sebaceous cyst 9.Skin tag 10.Syphilis Chancre 11.Warts (Genital) 12.HSV ulcer

Answer 46

1.PRIMARY Tumour 2.METASTASIS: a.Head b.Neck c.Melanoma d.Lung e.Breast f.Genitourinary 3.Glioma 4.ABSCESS: a.OM b.Sinusitis c.HIV (C&C AIDS in ABI) d.immune deficiency state e.Toxo (ring enhancing lesion) 5.Haematoma Subdural, Epidural 6.Intracranial Bleed

Answer 47

O-DIGFAST Disinhibition/Distractibility Increased Energy Grandiosity Flight of Ideas Agitation Sex/Sleep- deceased Talkativeness Over-Sexual Over-Spending/ Gambling Over-Speeding ??Mania: min. 7D, Delusions/ Hallucinations, Bipolar 1 Hypomania: min. 4D, no Delusions, no Hallucinations, Bipolar 2

Answer 48

2C3AS2T LMN 1.Cervical Spondylosis 2.Cervical Disc prolapse 3.AS,RA,OA 4.Stroke 5.Trauma 6.Tumor: Pancoast 7.Metastasis 8.Lymphedema 9.Nerve damage because of radiation Inv:- 1.FBC, LFT, RFT 2.Tumor markers 3.Mammogram if breast tissue present 4.Imaging X-ray and MRI of the spine 5.CXR 6.PET scan

Answer 49

JOINT PATHO: 4 1.Gout 2.Pseudogout 3.Septic arthritis, OA/RA LOCAL CAUSES: 4 4.Trauma 5.Stress fracture 6.Cellulitis 7.Insect bite DEFORMITIES: 2 8.Hallux valgus bunion 9.Ingrown toe nail

Answer 50

MEDs: 1.Atenolol 2.Thiazides 3.Aspirin (High dose) DIET: 4.Purine containing foods like fish and meat 5-10: ABCDF Frequently associated with: ABCDF Alcohol BP,BMI (high) Cholesterol (high) DM, Diet (purine) FHx

Answer 51

Ddx: L-H-2(INT) Loosening of hip implant Hernia- Inguinal Infection- cellulitis, sepsis Inflammation- OA,SA,Osteomyelitis Nerve- low back nerve irritation Necrosis- avascular necrosis Tendons- iliopsoas tendinitis, adductor tendinitis Trauma- pelvic fracture Complications: HIS PM -Hip Dislocations -Increased incidence in Falls. -Stroke -Pseudotumor -Metal toxicity due to wear particles

Answer 52

5(UGIT)+2(Uterine)+2(Cyst)+3(CA)+D UGIT:(5) 1.Cholecystitis 2.Hepatitis 3.Cirrhosis (liver) 4.Gastritis 5.PUD FEMALE CAUSES:(2) Uterine: -Fibroid -Endometriosis OVARIAN Cysts:(2) Ovarian cyst Functional ovarian cyst CA:(3) -Benign ovarian tumor -Primary ovarian cancer -Metastasis -Drug Induced Signs and symptoms of ovarian cancer may include:(8) Abdominal bloating or swelling. Discomfort in the pelvic area. Back pain. Weight loss. Early satiety. Fatigue. B&B: Changes in Bowel habits, such as constipation. A frequent need to urinate PEFE:- 1.Shifting dullness 2.Adnexal mass on lower abdomen, non tender 3.orange shaped mass pushing the uterus from behind 4.PR exam: Mass in pouch of Douglas Inv:- FBC, UEC, CRP LFT, RFT TFT CA 125 TVS CT Abd PET scan Genetic testing (BRCA1,2 & Lynch/HNPCC) Mx:- 3.MDT 4.Surgery 5.Chemo/Radio

Answer 53

5: Intake, Absorption, Increased Req., GI/non-GI Blood loss Decreased Iron Intake: 1.Low socioeconomic status, 2.Vegetarian or vegan diets, 3.Lack of balanced diet 4.Poor oral intake Diminished Iron Absorption: (med, medical, surgical) -Malabsorption 1.Medications that decrease gastric acidity or bind iron 2.Coeliac disease 3.Chronic Gastritis 4.Chronic Renal failure (Healthy kidneys produce a hormone called erythropoietin or EPO, which stimulates the bone marrow to make red blood cells needed to carry oxygen (O2) throughout the body) 5.Gastrectomy 6.Intestinal bypass Increased Iron Requirement: (child, mum) 1.Growth (infants, children, adolescents), 2.Pregnancy, Lactation, Multiparity Gastrointestinal blood loss: 1.Medication related (e.g. aspirin, NSAIDs) 2.Malignancy e.g. colon, PUD 3.Infection: Parasites 4.Angiodysplasia (: a small vascular malformation of the gut. It is a common cause of otherwise unexplained GIT bleeding and anemia. Lesions are often multiple, and Frequently involve the cecum or ascending colon, although they can occur at other places) Non-Gastrointestinal blood loss: 1.Menorrhagia 2.Iatrogenic: a-repeated Phlebotomy, b-Post op patients with significant blood loss, c-Haematuria, d-intravascular Haemolysis e-extreme physical Exercise (C&C Absorption prob: Vit B12, CF, lack of Wt gain)

Answer 54

I CAN'T REST (TESTIN-C) T- TIME 6 months E- ENERGY decreased S- SLEEP impaired T- TENSION in muscles I- irritability, A- anxiety, nervousness, worry R- restless N- NO control over worry C- CONCENTRATION impaired

Answer 55

Most common type C VACTERL vertebral defects(defects in backbone?) anal atresia (passed meconium?), cardiac defects, tracheo esophageal fistula, renal anomalies, limb abnormalities (any limb anomalies?) VACTERL should be 3 of them positive COMPLICATIONS Choking Aspiration pneumonia Post-Operative: Reflux Esophageal Stricture Vomiting Hx Qs: tell more about it, when start, CCVO Forceful/not, related to feed/food DDx: VJDHE2MS Obstruction due to hernia/lump or bump in tummy Infection: fever, rash? TE fistula: cough? Turning blue while feeding? (aspiration) Well-Baby: general condition? Floppy? Appetite? Pee and poo? BINDS BEFORE: Any sickness/med/complication during pregnancy DURING: AT TERM? AFTER: PASS STOOL YET/DELAYED PASSAGE/RESUS REQUIRED/

Answer 56

FAB 2H3C Febrile convulsion Absence seizure Breath holding attack Hypoxia Hypo/Hyperglycemia SOL/Tumour Trauma Epilepsy Commonality: 1 in 25 Cause & Association: high temp, absence of disease in brain, immature brain Course: 4-6 yrs Complication: (recurrence) Cure:self-limiting Ix BSL, C X-Ray,urine Tx: Panadol tepid sponging remove Tight clothing, sharp objects Do not: Restrain Put anything in mouth. Note the time. Consult doc next day Red flags : Prolonged fits more than 5 mins Focal neurological deficit after fits, drowsy after fits, (Epilepsy) high fever, rash, neck stiffness (Meningitis)

Answer 57

Common causes of Peds HA: SMA TEST ▪Sinusitis (most common in GP) ▪Migraine ▪Analgesic-induced headache ▪Toothache ▪Ear pain ▪Trauma ▪SOL Causes of Papilledema: 3T3I 3BI(4)D ▪Brain Tumor ▪Spinal cord tumor ▪Trauma /head injury ▪Infection: a.(Encephalitis, Meningitis) b.Brain Abscess ▪Uncontrolled , life threatening high BP ▪Bleeding in brain ▪Blood clot or a problem within certain vein ▪IIH: Idiopathic intracranial hypertension ▪Drugs (Corticosteroid, isotretinoin, lithium, tetracycline)

Answer 58

VJ-DHE-2M-S Volvulus: Volvulus occurs when a loop of intestine twists around itself and the mesentery that supplies it, causing a bowel obstruction. Symptoms include abdominal distension, pain, vomiting, constipation, and bloody stools. The onset of symptoms may be insidious or sudden. Jejunal obstruction (small bowel obstruction elsewhere Duodenal Atresia (in Downs):Malrotation is a birth defect link that occurs when the intestines do not correctly or completely rotate into their normal final position during development. Treatment: nasogastric suction, surgery (duodenoduodenostomy) Hirchsprung (in Downs): A condition of the large intestine (colon) that causes difficulty passing stool. Hirschsprung's disease involves missing nerve cells in the muscles of part or all of the large intestine (colon). Present at birth, it causes difficulty passing stool. The main symptom is a newborn's failure to have a bowel movement within 48 hours after birth. Other symptoms include a swollen stomach and vomiting. Surgery is required to bypass the affected part of the colon or remove it entirely. Esophageal Atresia/Tracho-esophageal fistula Meconium ileus: Meconium ileus (pronounced meh-COE-nee-um ILL-ee-us) means that a baby's first stool (feces), called meconium, is blocking the last part of the baby's small intestine (ileum). This can happen when the meconium is thicker and stickier than normal. Malrotation: Malrotation is a birth defect link that occurs when the intestines do not correctly or completely rotate into their normal final position during development. Sepsis/Infection -Malrotation: is an abnormality of the bowel, which happens while the baby is developing in the womb. -Volvulus: is a complication of malrotation and occurs when the bowel twists so the blood supply to that part of the bowel is cut off.

Answer 59

Differential diagnosis: Unprovoked seizure (Ddx: young: breath holding attacks, teen: Drug) Provoked seizure causes are: 1.Trauma 2.Tumor 3.Infection 4.Electrolyte imbalance (Na, Ca) 5.Hypo or Hyperglycemia 6.Alcohol, Drugs, Medications, toxins Cond: most likely unprovoked seizure, which could be precipitated by many Factors like: (5) sleep deprivation hunger stress Infection Bright flashing light. Ix: Blood tests (FBE, ESR, CRP) (UCE, LFT, TFT, BSL) Urine MCS if UDT + X-Ray chest +/-CT decided by specialist Drug screen with consent of parents. Referred to Neurologist. referred to 1st Seizure Clinic they might do EEG General measures in case if happen again. Need to know what to do: Do not allow him to Swim alone, no baths, no sea diving, Heights to prevent injury. Stay away from fires.

Answer 60

10= CD AN2T F: HLK FAILURES: 1.Heart 2.Liver 3.Kidney Wt Loss Rel: 4.Thyroid problems (Pretibial myxedema) 5.Tumors in pelvis and tummy 6.Nutritional oedema, 7.Amlodipine induced edema, 8.DVT 9&10. Cellulitis and trauma unlikely Most likely – heart failure – as the heart is not working properly, there is increased fluid Congestion backwards in the vessels we call Veins, Instead of moving forward, blood is congested in the Legs, and also other Organs like lungs resulting in Swelling of the legs and Dyspnea.

Answer 61

(7 Trauma+3 Arthritis +Neuro) FB- GP - SIN 1. Fracture 2. Buckle 3.Greenstick (leg?) 4. Pulled elbow 6. Sprain (wrist) 7. Infection a. SA b. OM c. Post Viral Arthritis 8.Neuro Lesion 4.Toddler fracture (leg?9M-3Y, walking boot)

Answer 62

GLEM (no A&S for Alcohol/smoking) LSM: Diet & exercise & Screen time Endo: hypothyroidism Cushing Med: Steroid COMPLICATIONS: MEDICAL: 5 1.DM 2.Heart dx 3.Liver dx, 4.breathing problem 5.joint problems. PSYCHOLOGICAL: 3 1.Low self-esteem 2.Bullying 3.Obesity in adulthood Mx: Refer to Weight Mx Clinic Healthy Diet Use small Plates to make portion size looks bigger Give home-made Lunch box. Exercise: * Increased physical activity (1-5 yrs – 3 hrs active play, > 5yrs – 1 hr) * Reduce screen time (<2 – 0, 2-5 years- 1 hr, 5-12 yrs – 2 hrs)

Answer 63

Differential Diagnosis : CUF TTV *Child abuse *UTI *Foreign body *Threadworms *Trauma *Vulvovaginitis Risk factors: COSST DP 1. Cancer 2. obesity 3. soaps/bubble baths 4. swimming 5. tight clothing 6.DM 7.products-change in cosmetics- allergy

Answer 64

Spontaneous bacterial peritonitis: can occur when bacteria that normally live in the intestine enter the abdominal cavity and the ascites becomes infected. This happens in advanced liver disease because the immune system response weakens and the bacterial environment in the gut changes DDx: 1.Viral hepatitis (A,B,C,D,E) 2.Alcoholic hepatitis 3.Drug induced hepatitis (toxin, acetaminophen) Other:- jaundice 4.Cirrhosis 5.Pancreatitis 6.Pancreatic cancer 7.Gall stones 8.Ischemic hepatitis 9.Autoimmune hepatitis 10.Budd-Chiari syndrome 11.HELLP ( hemolysis , elevated liver enzymes, low platelets) syndrome 12.Acute fatty liver of pregnancy 13.Wilson disease 14.Alpha -1 antitrypsin deficiency 15.Nonalcoholic fatty liver disease (steatohepatitis) Hx: fever? abdominal pain? Jaundice questions (ABP FIT NO SEX)? Swelling Qs: SOB? Leg swelling? Abdominal swelling? R/O Hepatic encephalopathy: Confusion? (Fever as?)Muscle or joint pain? Tummy pain Qs: Bowel & bladder Qs Wt changes? (LOW/LOA) (ascites, cachexia?) TMAC SADMA Stress? Physical Examination General appearance: jaundice, dehydration, BMI VS: stable Skin: needle marks ENT: sclera or under the tongue Chest and Heart Abdomen: mass, pulsations, liver span, tenderness, organomegaly Leg edema? Bruit over liver? (feature of severe alcoholic hepatitis) decreased grip strength? Investigations (AST>ALT alcoholic hepatitis rather than viral or drug induced) PEFE card: (+)Fever, (+)jaundice, (+) ascites (+) hepatomegaly (+)parotid enlargement Cx:- Alcoholic hepatitis Cause(2): Heavy: binge drinking or long-term drinking Commonality: 40-50yr CFx: RUQ pain+ jaundice+fever hepatic encephalopathy proximal muscle wasting Mx:- R/o other causes of fever if present:- 1.Spontaneous bacterial peritonitis 2.Pneumonia 3.UTI 4.Other hepatitis Inv:- 1.Hepatitis serology 2.Septic screen (C-Xray, UMCS, Blood culture) 3.LFTs (AST/ALT => 2 will be found) 4.Transabdominal USS with doppler (Biliary obstruction or Budd Chiari syndrome) High: serum bilirubin, serum GGT, neutrophils, INR Low: albumin and pre albumin Tx:- Stop (OCP/ offending drug/)Alcohol Paracentesis under USS guidance (If fluid: antibiotics can be discontinued after 48 hours if ascitic fluid, Blood, and urine cultures demonstrate no bacterial growth and the ascitic fluid PMN count is <250/mm3(per cubic mm.)

Answer 65

Ddx: CO-MAIL  Celiac disease  Oral thrush candida (NOTE wt O not C)  Milk residue  Antibiotics S/E  Immune suppressive condition  Lactose intolerance Mx: Investigation: FBE, ESR CRP, immunoglobulins IgA, IgG, IgM, Swab of thrush MCS, stool MCS, celiac screening Refer to pediatrician Antifungal Miconazole gel for 10 days Advice to wash nipples and sterilize objects in contact with thrush.

Answer 66

❑ Implication of Pertussis: CAPE DISH ▪ Cessation of respiration/ Apnoea Atelectasis (collapse of lung or part of lung: lobe when tiny air sacs :alveoli lose air) ▪ Pneumonia ▪ Emphysema (permanent enlargement of lung air spaces) ▪ Dehydration intracranial haem. ▪ Seizure, fits, ▪ Hypoxic encephalopathy Implications of URTI: SOD SEL Acute/Chronic Sinusitis Otitis media Dental prob Overbite) d/t mouth breathing Sleep disturbance /Apnea Excessive daytime fatigue/ poor school performance Learning impairment.

Answer 67

*Dental pathology *Eye disorders *EAR infection *Nose: Rhinitis, sinusitis *Mouth: Ulcer/ Cancer/ Tonsillitis *TMJ dysfuction *Erysipelas *Herpes zoster *Trigeminal neuralgia (tic douloureux *Glossopharyngeal neuralgia *Migrainous neuralgia (cluster headache Parotid gland: Infection Temporal Arteritis Chronic paroxysmal hemicrania Cervical spinal dysfunction

Answer 68

T2AME4D GL Thyroid Adjustment D Anniversary Grief Menopause Empty Nest Depression Dysthymia Dementia (early) Drugs Grief Life stress: Sickness Seasonal affective disorder

Answer 69

CASE PI=LN Cervical (includes submental, post auricular) Axillary Supraclavicular, Infraclavicular Epitrochlear Paraaortic Inguinal

Answer 70

Physical exam: Scrotal exam then need to specifically ask for perineum and DRE: a picture of a sinus at the perineum will be given Ddx: 3S2I3P HAC Syphilic Chancre STI (no skin tag) Solitary rectal ulcer syn Incontinence Impaction Perianal fistula Pilinoidal cyst Pilonidal sinus HSV ulcer Anal: Fistula (not fissure) CA of margin

Answer 71

Differential Diagnosis: 3P 2T M  Preterm labor False Labor/Braxton Hicks contractions  Pre-Eclampsia Placental Abruption  Trauma  TORSION of Ovarian Cyst  MEDICATION causes: UTI, Appendicitis, Cholecystitis, Pancreatitis

Answer 72

BET Parkinson Drug induced: Risperidone Thyroid Liver Lung: CO2 retention/COPD Cerebellar disease Post-stroke Brain abscess MS Peripheral Neuropathy (Q: RA) Tea/coffee Alcoholic withdrawal/ Delerium tremens Anxiety disorders: GAD

Answer 73

Differential diagnosis for Chest pain: -Cardiac MI -Pulmonary embolism -Aortic dissection -Pericarditis -Tension pneumothorax -Esophageal rupture ( Boerhaave’s syndrome)

Answer 74

AEOU: Arthritis Erythema Nodosum Oral ulcers Uveitis

Answer 75

Causes of excessive thirst – ▪ Diabetes mellitus - Do you have those symptoms like tiredness? Extreme hunger? Blurred vision? Slow healing wounds? Skin infections? ▪ Diabetes insipidus –Causes of diabetes insipidus - any head injury? Previous surgery? Headache? Nausea? Vomiting? (brain tumor) ▪ Loss (dehydration) – any diarrhoea or excessive vomiting? Any profuse sweating? Or strenuous exercises ▪ Loss of body fluids into tissue - Any history of recent infections with high fever, heart, liver or kidney disease? Any recent injury or burn? ▪ Psychogenic – any mental illness before? ▪ Any medications you are taking? (lithium, diuretics and antipsychotics?) Are you taking any supplements? (Vit D and calcium? )(key q) ▪ Do you eat a lot of spices or salty foods? ▪ Calcium or vit D intake + , symptoms of hypercalcemia – constipation? Tummy pain? Headaches? Muscle cramps? Or weakness? Any disturbance in thinking process? Dx – There are many causes leading to this increased thirst but most likely in your case is hypercalcemia which is the increased calcium level in the blood as you have a history of excessive Vit D/calcium intake. Too much calcium in the blood means that kidneys have to work harder leading to increased urination and excessive thirst. ▪ Other causes can be Diabetes mellitus which is increased blood sugar, increased sweating, any heart, liver or kidney diseases, Diabetes insipidus which is a abnormality levels of hormone called ADH or spicy and salty foods but less likely according to your history. DDx: DM Diabetes Insipidus: abnormality levels of hormone called ADH Vit Ca/ D intake: Too much calcium in the blood means that kidneys have to work harder leading to increased urination and excessive thirst. (DM DI D(dehydration) injure&burn Mental Failure , medication, supplement, spicy alcohol Spicy and salty foods but less likely according to your history. Heart Liver Kidney (

Answer 76

16 IN 6 CATEGORIES =5+ 3+ [2X4] CVS: 1.Angina 2.MI 3.Pericarditis 4.Aortic dissection 5.Aortic stenosis LUNG: 1.Pneumonia 2.Pulmonary embolism 3.Pneumothorax GIT: 1.GERD 2.PUD MSK: 1.Costochondritis 2.Rib Fx NEURO: 1.Prolapsed disc 2.Herpes Zoster PSYCHOLOGICAL: 1.Anxiety rel. 2.Panic attack ACUTE LIFE THREATENENING: 5 CVS: Aortic Dissection MI Pericarditis RESPIRATORY: PneumoThorax PE NON-LIFE THREATENING: 8 CVS: Heart Failure Aortic stenosis RESPIRATORY: Pneumonia Lung CA MSK: Shingles Costochondritis GI: Biliary Colic PUD

Answer 77

HD HOPC-SOB Associated-FEVER(if +:neck stiffness, fits),RASH,VOMITING COUGH(SOCRATES-onset,type,pattern,any relationship to feeding) Does he turn blue/stops breathing for few secs?(Cyanosis/Apnea) Wheeze (if +: at rest or with activity) stridor(if +: while breathing in or out) Any recent URTI? Asthma: (Able to complete a sentence) Epiglottitis-any drooling of saliva?Any particular posture that child prefers? FB-Any choking episode? Anytime he is unsupervised? WELL-B & B habit? Diarrhoea or reduction of wet nappies, LOW/LOA TMAC(if + asthma Hx: 2CPDS-EU BINDS-SMA=Social-any stress, Smoking PMH/FHx of Allergies or Known heart or lung condition from birth?

Answer 78

Thyroid Qs: Hypercalcemia Qs: Abdominal groans: Hows bowel habit? Any abdominal pain?Any constipation or diarrhea? Any vomiting? Stones: How is your waterworks? Any pain or difficulty passing urine? Any PMHx of stones? Any bone pain? How's your mood? What about your sleep and appetite? Any tiredness? Hypercalcemia cause Q: Do you feel thirsty? Drink enough water? DDx: Addisons:Dizziness? Discoloration? Raynaud: Any bluish discoloration of hands on exposure to cold? TMAC: Any Hx of travel or contact with pets? Malignancy: Any LOW/A? Any bone pain or muscle aches? SADM(steroid, vit D)A PMHx: Kidney stones? Amyloidosis, Histoplasmosis, Sarcoidosis FHx of CA

Answer 79

BC-CCL Bleeding, Clotting CA: BOU (breast, ovarian, uterine) CVS: BMS: uncontrolled BP, MI, Stroke Liver disease

Answer 80

SOAP IM Salbutamol by MDI/inhaler O2 Aminophylline Prednisone oral/IV Methyprednisolone Ipratropium

Answer 81

PPO BCS-OIC MAT Position of mom Placental position Obesity Busy lifestyle Coffee Sleep Oligohydramnios IUGR Congenital anomalies Maternal infections Anemia Thyroid problems