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STEP 2 CS CASES > Pertanent Positives > Flashcards

Pertanent Positives Flashcards

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1
Q

Laryngeal cancer

A 
Cervical LAD
Worsening horseness over past 3 months
Weight loss, decreased appetite, and low grade fever.
History of smoking and/or ETOH use
Advance age
PE:  Fever
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2
Q

Laryngitis

A 
Recent viral infection such as flu 4 weeks ago.
History of smoking
Polluted air
Low grade fever
GERD
PE: Low grade fever
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3
Q

Laryngeal polyps

A

Over use such as teacher/singer

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4
Q

Laryngeal cancer, Laryngitis, Laryngeal polyps

Tests

A

Laryngoscopy
ESR
US neck
CT chest/neck

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5
Q

Disk Herniation

A

Neck pain that increases with movement.
Radiculopathy (numbness left arm)
PE: Loss of pinprick sensation to dorsum of left hand hand and posterior left forearm.

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6
Q

Cervical fracture

A

Rapid rotation neck preceded pain.
Pain increases with movement.
Osteopenia on DEXA scan.

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7
Q

Neck muscle spasm

A

Rapid rotation of neck preceded pain

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8
Q

Disk Herniation, Cervical fracture, Neck spasm

Tests

A

XR-C-spine
MRI-C-spine
Nerve conduction study

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9
Q

Cholecystitis

A 
Pain is exacerbated by heavy fatty foods
Associated with nausea and vomiting
Female gender, age in 40's
PE: Epigastric tenderness
positive Murphey's sign
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10
Q

Peptic Ulcer Disease

A

History of NSAID use
Epigastric pain 2-3 hours after meals
Pain is exacerbated by hunger and fatty foods and is relieved by antacids
PE: Epigastric tenderness

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11
Q

Gastritis

A

History of NSAID use
Epigastric pain associated with food
Nausea and vomiting
PE: Epigastric tenderness

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12
Q

Cholecystitis, Peptic Ulcer Disease, Gastritis

A

Rectal exam, stool for occult blood
US abdomen
Upper endoscopy
H. Pylori antibody testing

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13
Q

Migraine

A

Unilateral, sharp headache
Associated with nausea and vomiting
Photophobia
PE: Severe sharp pain with lack of neurologic findings

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14
Q

Tension headache

A

Chronic headaches
Associated with stress at work
Improves with sleep
PE: Severe sharp pain with lack of neurologic findings

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15
Q

Itracranial mass lesion

A

Headaches associated with nausea and vomiting

Family history of brain tumor

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16
Q

Migraine, Tension headache, Itracranial mass lesion

Tests

A

CBC
CT head or MRI brain
LP
CT sinus

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17
Q

Pregnancy

A

Change in menstrual cycle
Regular sexual activity
Previous successful pregnancy

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18
Q

Hyperprolactinomia

A

Galactorrhea

Oligomenorrhea

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19
Q

Polycystic ovary syndrome

A

Weight gain
Hirsutism
Oligomenorrhea

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20
Q

Pregnancy, Hyperprolactinomia, Polycystic ovary syndrome

Tests

A

Urine hCG
Pelvic and breast exam
Prolactin, TSH
LH, FSH

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21
Q

Vulvovaginitis

A

White vaginal discharge
Fishy odor of discharge
Vaginal pruritus

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22
Q

Cervicitus

A

White vaginal discharge
Dyspareunia
Sexual activity without barrier contraception

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23
Q

Endometriosis

A

Dysmenorrhea

Dyspareunia

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24
Q

Vulvovaginitis, Cervicitus, Endometriosis

Tests

A

Pelvic exam
Wet mount, KOH prep, “whiff test”
Cervical cultures (chlamydia and gonorrhea DNA probes)
Laprascopy

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25
Presbycusis
``` Bilateral, progressive hearing loss Advanced age Hypertension PE: Positive Rinne test Lack of lateralization on Weber test ```
26
Cochler nerve damage
Prior exposure to loud sounds Bilateral hearing loss PE: Positive Rinne test Lack of lateralization on Weber test
27
Otosclerosis
Bilateral, progressive hearing loss Advanced age PE: Lack of lateralization on Weber test
28
Presbycusis, Cochler nerve damage, Otosclerosis | Tests
Audiometry Tympanography Brain stem auditory evoked potentials
29
Physiologic jaundice
Infant in first week of life | No changes in feeding, urination, or bowel movements
30
ABO or Rh incompatibility
Infant in first week of life | Mother and father with different ABO types
31
Neonatal sepsis
History of maternal infection
32
Physiologic jaundice, ABO or Rh incompatibility, Neonatal sepsis Tests
Total and indirect bilirubin Blood typing Direct Coombs test CRP
33
Viral URI
``` Fever (101F) Rhinorrhea Sibling with URI Daycare attendance Increased breathing rate ```
34
Pneumonia
Fever (101F) Daycare attendance Sibling with URI Increased breathing rate
35
Otitis media
Fever (101F) Irritability Daycare attendence
36
Viral URI, Pneumonia, Otitis media | Tests
``` CBC with differential Blood culture UA and urine culture CXR Respiratory viral panel Pneumatic otoscopy ```
37
Pneumonia
``` Persistent cough Low grade fever PE: Increased tactile fremitus Decreased breath sounds right side Temperature 99.9F ```
38
URI-associated cough (post-infectious cough)
Recent URI Low grade fever White sputum production PE: Temperature 99.9F
39
Acute bronchitis
``` Low grade fever Persistent cough White sputum production PE: Increased tactile fremitus Temperature 99.9F ```
40
Pneumonia, URI-associated cough (post-infectious cough), Acute bronchitis Tests
CXR CBC with differential Sputum gram stain and culture
41
Extrahepatic biliary obstruction
``` Light colored stools, dark urine Pruritus Father with pancreatic cancer PE: Jaundice scleral icterus RUQ tenderness ```
42
Viral hepatitis
``` History of blood transfusion Recent travel to Mexico PE: Jaundice scleral icterus RUQ tenderness ```
43
Acetaminophen hepatotoxicity
``` Frequent acetaminophen use Concomitant alcohol use PE: Jaundice scleral icterus RUQ tenderness ```
44
Extrahepatic biliary obstruction, Viral hepatitis. Acetaminophen hepatotoxicity Tests
AST/ALT/bilirubin/alkaline phosphatase US RUQ abdomen Viral hepatitis serologies
45
Meniere's disease
``` Sensation of room spinning Left sided hearing loss tinnitus sensation of aural fullness PE: Decreased hearing acuity on the left Positive Rinne test ```
46
Benign paroxysmal positional vertigo
Sensation of room spinning Onset with positional changes Duration 20-30 minutes
47
Orthostatic hypotension causing dizziness
History of diarrhea | Taking antihypertensive medication
48
Meniere's disease, Benign paroxysmal positional vertigo, Orthostatic hypotension causing dizziness Tests
Dix-Hallpike maneuver Audiometry MRI brain
49
Gout
``` Monoarticular joint pain and tenderness History of swollen toe Occasional alcohol use PE: Joint tenderness and stiffness Swelling at left knee ```
50
Rheumatoid arthritis
``` Morning joint stiffness Family history of rheumatoid arthritis Systemic symptoms (anorexia, weight loss, fatigue, fever) PE: Joint tenderness and stiffness Temperature 99.9F ```
51
Systemic lupus erythematosus
``` Systemic symptoms (anorexia, weight loss, fatigue) History of multiple ulcers History of 2 spontaneous abortions Raynaud's phenomenon PE: Joint tenderness and stiffness ```
52
Gout, Rheumatoid arthritis, Systemic lupus erythematosus | tests
CBC with differential Immunologic testing (ANA, dsDNA, RF, CCP) Knee aspiration with Gram stain, culture, and inspection for crystals. XR left knee and both hands
53
Plantar fasciitis
Training for marathon Pain is gradual Pain is worse with first few steps in the morning and after prolonged sitting PE: Tenderness over medial calcaneal tuberosity Pain with toe dorsiflexion
54
Calcaneal stress fracture
Training for a marathon Diffuse pain over heel Refractory to conservative management PE: Tenderness over plantar heel and arch
55
Achilles tendinitis
Training for a marathon | PE: Pain with toe dorsiflexion
56
Plantar fasciitis, Calcaneal stress fracture, Achilles tendinitis Tests
XR right ankle/foot Bone scan MRI right ankle/foot
57
Acute otitis media
Fever 101F Pulling at the right ear; fatigued and not watching TV usual History of otitis media Runny nose and cough that have subsided
58
Meningococcal meningitis
Maculopapular facial rash that has spread to the chest, back, and abdomen Fever 101F Difficulty sleeping for 2 days Recent episode of vomiting
59
Scarlet fever
Maculopapular facial rash that has spread to the chest, back, and abdomen Fever 101F Difficulty swallowing for 2 days
60
Acute otitis media, Meningococcal meningitis, Scarlet fever | Tests
``` Pneumatic otoscopy LP CSF analysis CBC with differential Blood culture UA and urine culture Throat culture Platelets, PT/PTT, D-dimer, fibrin split products, fibrinogen ```
61
Pulmonary tuberculosis
Fever and night sweats with fatigue Worsening cough of 1 month's duration Close contact with patients with active TB Decreased appetite with unintentional weight loss of 6lbs over 2 months PE: Blood-tinged mucus
62
Lung cancer
Fever and night sweats with fatigue Decreased appetite with unintentional weight loss of 6lbs over 2 months History of heavy smoking and chronic bronchitis PE: Blood tinged mucus
63
Typical pneumonia
Fever Mucus production History of heavy smoking and chronic bronchitis PE: Sputum production
64
Pulmonary tuberculosis, Lung cancer, Typical pneumonia | Tests
``` PPD or Quantiferon Gold CBC Blood cultures Sputum Gram stain, AFB smear CXR PA and lateral CT chest Bronchoscopy Lung biopsy ```
65
Pancreatic cancer
History of smoking and eating foods that are high in fat content Unintentional weight loss of 8 lbs over past 6 months Foul smelling, greasy looking stools PE: Mild epigastric pain
66
Depression
Feelings of sadness Loss of interest in activities, early awakening, impaired concentration, low energy Decreased appetite, and unintentional weight loss
67
Chronic pancreatitis
History of alcohol use Worsening epigastric discomfort that radiates to the back Foul smelling, greasy looking stools PE: Mild epigastric pain
68
Pancreatic cancer, Depression, Chronic pancreatitis | Tests
``` CBC, stool for occult blood Glucose Fecal fat studies Amylase, lipase AST/ALT/bilirubin/alkaline phosphatase CT abdomen ```
69
Medication induced erectile dysfunction
Taking propanolol Onset of ED coincides with propranolol use No early morning or nocturnal tumescence
70
Erectile dysfunction secondary to vascular disease
History of hypertension History of hyperlipidemia Hair loss No early morning or nocturnal tumescence
71
Hypogonadism
Loss of libido and ED Hair loss No early morning or nocturnal tumescense
72
Medication induced erectile dysfunction Erectile dysfunction secondary to vascular disease Hypogonadism Tests
``` Genital and rectal exams Serum glucose Testosterone level Prolactin, TSH, LH/FSH Ferritin MRI brain Doppler US penis Dynamic cavernosography ```
73
Anxiety
Impaired concentration, irritability, difficulty sleeping, muscle tension, sweating, and palpitations Anxiety over academic achievement No history of substance use PE: Tachycardia (HR 102/minute)
74
Caffeine induced insominia
Drinks 4-5 cups of caffeine per day Spends 2 hours awake before falling asleep History of heart palpitations that are more pronounced after drinking caffeine PE: Tachycardia (HR 102/minute)
75
Hyperthyroidism
Anxiety History of unintentional weight loss, tremor, fatigue, sweating, palpitations, and increased bowel movements PE: Tachycardia (HR 102/minute)
76
Anxiety, Caffeine induced insomnia, Hyperthyroidism | Tests
TSH, FT3, FT4
77
Foreign body aspiration
Sudden onset while playing with toys | Noisy breathing
78
Croup
Noisy breathing Difficulty breathing Fever for the past week
79
Epiglottitis
Occasional voice hoarseness | Occasional muffling
80
Foreign body aspiration, Croup, Epiglottitis | Tests
``` ABG CXR PA and lateral XR neck, AP and lateral CBC with differential Bronchoscopy Direct laryngoscope ```
81
Appendicitis
``` Right lower abdominal pain Pain exacerbated by movement Nausea and vomiting Low grade fever PE: RLQ direct and rebound tenderness RLQ gaurding Temperature 100.5F Positive Rovsing's sign Positive Psoas sign ```
82
Pelvic inflammatory disease
``` STD 6 months ago with untreated partner Nausea and vomiting Spotting Unprotected sex with multiple partners Low grade fever PE: RLQ tenderness Temperature 100.5F ```
83
Ruptured ectopic pregnancy
``` Last menstrual period 5 weeks ago and spotting Crampy lower abdominal pain Pain is exacerbated by movement Nausea and vomiting Pain is of recent onset PE: RLQ rebound tenderness RLQ guarding ```
84
Appendicitis, Pelvic inflammatory disease, Ruptured ectopic pregnancy Tests
``` Urine hCG Pelvic exam Cervical cultures U/S abdomen and pelvis CT abdomen and pelvis CBC ```
85
Alzheimer's disease
``` Steady cognitive decline Memory impairment Impaired executive functioning Decline in activities of daily living PE: Failed 3 item recall ```
86
Vascular ("multi-infarct") dementia
``` Previous stroke History of coronary artery disease (MI) Hypertension Impaired executive functioning PE: Decreased strength in left upper extremity DTRs 3+ in left upper and lower extremities Positive Babinski bilaterally Failed 3 item recall ```
87
Dementia syndrome of depression
Dysphoria after husband's death impaired executive funtioning Memory impairment PE: Failed 3 item recall
88
Alzheimer's disease, Vascular ("multi-infarct") dementia, Dementia syndrome of depression Tests
``` CT head or MRI brain EEG or SPECT CBC Serum B12, TSH, RPR Electrolytes, calcium, glucose BUN/Cr ```
89
Major depressive disorder
``` Dysphoria, anhedonia Loss of appetite Passive suicidal ideation Decreased energy/fatigue Impaired concentration Early awakening ```
90
Hypothyrodism
Fatigue for 3 months Cold intolerance Hair loss Weight gain
91
Post traumatic stress disorder
Nightmares about the trauma Negative mood/anhedonia Decreased concentration Difficulty staying asleep
92
Major depressive disorder, Hypothyrodism, Post traumatic stress disorder
TSH CBC HIV antibody
93
Domestic violence
``` Admits to physical abuse Exhibits self blame Attempts to defend husband Episodes of abuse directed at child PE: Symmetrical bruises on extremities ```
94
Diabetes mellitus
Polyuria, polydipsia Obesity Family history of diabetes
95
Anemia
Fatigue/weakness Heavy menstrual flow PE: Conjunctival pallor
96
Domestic violence, Diabetes mellitus, Anemia | Tests
``` Serum glucose, HbA1c, CBC Serum iron, ferritin, TIBC, serum B12 UA Electrolytes ```
97
PCP intoxication
``` Drug use 1 day before presentation Visual hallucinations Noncommand auditory hallucinations Delusions Myalgias PE: Tachycardia (HR 110/minute) Hypertension (BP 140/80) Vertical gaze nystagmus ```
98
Substance induced psychosis
``` Drug use 1 day before presentation Visual hallucinations Noncommand auditory hallucinations Delusions No history of non-drug-related psychosis Does not associate drug use with presentation PE: Dilated pupils ```
99
PCP intoxication, Substance induced psychosis
``` Urine toxicology Electrolytes CPK Urine myoglobin Mental status exam ```
100
COPD/Chronic bronchitis
Chronic cough Sputum production History of smoking 1PPD x 10 years Worked as coal miner
101
Pneumoconiosis
Worked as coal miner | Chronic cough
102
Pulmonary tuberculosis
``` Recent emigration from Africa Chronic cough Weight loss Blood tinged sputum Dyspnea Chest pain TB exposure ```
103
COPD/Chronic bronchitis, Pneumoconiosis, Pulmonary tuberculosis Tests
CXR PA and lateral PPD or Quantiferon gold CBC
104
Colorectal cancer
Blood mixed with stool for 1 month Family history of colorectal cancer Unintentional weight loss of 10lbs Change in bowel habits
105
Hemorrhoids
History of hemorrhoids Hematochezia Fresh blood on toilet paper or in toilet bowel
106
C difficile colitis
Acute diarrhea | Recent antibiotic exposure
107
Colorectal cancer, Hemorrhoids, C difficile colitis | Tests
``` Rectal exam, stool for occult blood Colonoscopy Stool for C difficile PCR Fecal leukocytes CBC Anoscopy flexible proctosigmoidoscopy ```
108
Parkinson's disease
Resting tremor that is evident with the affected body part supported and completely at rest. Improves with voluntary movement PE: Low frequency tremor in upper extremity Bradykinetic gait Upper extremity rigidity
109
Essential tremor
``` Possible family history of tremor Action tremor PE: Tremor in distal upper extremity Tremor with arms out stretched Positive F/N ```
110
Physiologic tremor
Resting tremor | PE: Tremor in distal upper extremity
111
Parkinson's disease, Essential tremor, Physiologic tremor | Tests
MRI brain
112
Hypothyrodism
``` Oligomenorrhea and hypomenorrhea Chronic dry skin Chronic cold intolerance Weight gain Deepening of voice Constipation Depression Fatigue ```
113
Smoking cessation
Weight gain following smoking cessation normally 5 pounds
114
Lithium related weight gain
``` On going lithium therapy Cold intolerance Dry skin Confusion Dizziness Headache Lethargy Hair loss Fatigue ```
115
Hypothyrodism, Smoking cessation, Lithium related weight gain Tests
TSH Serum lithium level Fasting glucose, cholesterol, triglycerides
116
Viral gastroenteritis
Acute watery diarrhea Low grade fever 100.5F Day care attendance
117
Bacterial diarrhea
Acute diarrhea Day care attendance Low grade fever 100.5F
118
Malabsorption
Watery diarrhea Dry mouth Juice in babies of this age group
119
Viral gastroenteritis, Bacterial diarrhea, Malabsorption
Physical exam Rotavirus enzyme immunoassay/norovirus PCR Electrolytes Stool leukocytes, culture, ova and parasitology and pH
120
Intussusception
``` Abdominal pain Vomiting Bloody ("currant jelly") stools Recent viral illness Low grade temperature ```
121
Monosymptomatic primary nocturnal enuresis
Chronic nocturnal enuresis Family history of enuresis History of never being continent
122
Urinary tract infection
Enuresis | Possible dyduria
123
Secondary enuresis
Nocturnal enuresis Major trauma Life or environmental change (divorce, major illness, abuse)
124
Monosymptomatic primary nocturnal enuresis, Urinary tract infection, Secondary enuresis Tests
Genital exam UA Urine culture
125
Sleep apnea and Narcolepsy in children
Can cause enuresis
126
Functional bladder disorder
Void several times a day Hold urine until the last moment Wet small volumes almost every night Sometimes multiple times a night
127
Simple febrile seizure
Seizure duration
128
Meningitis
Tonic-clonic seizure Fever Tmax 102.9F Decreased appetite Decreased urine output
129
Hyponatremia
Seizure | Poor family waters down infant formula
130
Simple febrile seizure, Meningitis, Hyponatremia
LP CSF analysis CBC Elecrolytes
131
Infectious mononucleosis
``` Sore throat 2 weeks (exudative pharyngitis) LUQ pain Recent history of ill contact PE: LUQ tenderness Lymphadenopathy Splenomegaly ```
132
Acute HIV infection
Sore throat 2 weeks Two sexual partners over the past year, active with men and women Treated for gonorrhea 4 months ago
133
Streptococcal pharyngitis
Sore throat 2 weeks Low grade fever History of cigarette smoking PE: Lymphadenopathy
134
Infectious mononucleosis, Acute HIV infection, Streptococcal pharyngitis Tests
``` CBC with peripheral smear Monospot test Anti-EBV antibodies HIV antibody and viral load Throat culture ```
135
Convulsive syncope
Loss of consciousness for several minutes Arms and legs shaking for 30 seconds No subsequent confusion or weakness
136
Cardiac arrhythmia
Loss of consciousness preceded by palpitations and lightheadedness Taking a B-blocker (atenolol) No subsequent confusion or weakness History of MI
137
Seizure
``` Loss of consciousness lasting several minutes Arms and legs shaking for 30 seconds Sudden onset Tongue biting Incontinence Prolonged confusion Drowsiness postictally ```
138
Convulsive syncope, Cardiac arrhythmia, Seizure | Tests
``` CBC Electrolytes ECG and Holter or event monitor CT head or MRI brain EEG ```
139
Vasovagal sycnope
``` Nausea Sweating Tachycardia Pallor Feeling "Faint" ```
140
Myocardial ischemia or infarction
Pressure like substernal chest pain Pain radiates to left arm, upper back, and neck Pain awakens patient at nght
141
Cocaine induced myocardial ischemia
History of cocaine use Last used yesterday afternoon Pressure like substernal chest pain
142
GERD
Pain in midchest Previous pain relieved by antiacids Previous pain occurred after heavy meals
143
Myocardial ischemia or infarction, Cocaine induced myocardial ischemia, GERD Tests
``` ECG Cardiac enzymes (CPK, CPK-MB, troponins) Transthoracic echocardiography Upper endoscopy Urine toxicology ```
144
Bladder cancer
``` Hematuria Straining on urination Weak urinary stream and dribbling Work as painter (exposure to industrial solvents) History of smoking 1 PPD x 30 years ```
145
Urolithiasis
Hematuria Straining on urination PE: CVA tenderness
146
Benign prostatic hypertrophy
Polyuria, nocturia Weak urinary stream and dribbling Straining on urination
147
Bladder cancer, Urolithiasis, Benign prostatic hypertrophy | Tests
``` Genital exam Rectal exam Cystoscopy US renal UA CT abdomen/pelvis PSA ```
148
Disk herniation
``` Low back pain Pain started after lifting heavy boxes Pain radiates to left thigh and foot Pain worsens with movement and is relieved by lying still PE: Positive straight leg raise ```
149
Lumbar spinal stenosis
History of intermittent low back pain and leg pain with ambulation Pain resolves with sitting PE: Walks with back slightly bent forward
150
Metastatic prostate cancer
Difficulty urinating Incomplete emptying of bladder Low back pain
151
Disk herniation, Lumbar spinal stenosis, Metastatic prostate cancer Tests
XR L spine MRI L spine Rectal exam PSA
152
Pneumothorax
Left sided chest pain following an MVA Pain is exacerbated by movement and deep breaths Dyspnea JVD PE: Decreased breath sounds over left lung field RR 22/minute
153
Hemothorax
Left sided chest pain following an MVA Dyspnea Cough PE: Decreased breath sounds over left lung field RR 22/minute Hypovolemic shock
154
Pneumonia
``` Unilateral chest pain Productive cough Low grade fever PE: Temperature 100F RR: 22/minute ```
155
Pneumothorax, Hemothorax, Pneumonia | Tests
CXR | Sputum and blood Gram stain and culture
156
Normal pregnancy
Amenorrhea for 6 weeks Positive pregnancy test Bilateral breast engorgement Nausea and weight gain
157
Ectopic pregnancy
Amenorrhea 6 weeks | Positive pregnancy test
158
Molar pregnancy
Positive pregnancy test | Nausea
159
Normal pregnancy, Ectopic pregnancy, Molar pregnancy | Tests
Urine hCG US pelvis Breast/pelvic exams Blood type, Rh, antibody screen
160
Type 1 diabetes mellitus
Polyuria, polydipsia Recent weight gain Hyperglycemia
161
Type 2 diabetes mellitus
Polyuria, polydipsia Recent weight gain Hyperglycemia
162
Secondary cause of diabetes
Obesity
163
Type 1 diabetes mellitus, Type 2 diabetes mellitus, Secondary cause of diabetes Tests
``` Insulin and C peptide levels Islet cell antibodies HbA1c Electrolytes, glucose UA and urine microalbumin 24 hour urine free cortisol ```
164
Humeral fracture
Pain following fall on outstretched arm Pain increases with arm movement PE: Tenderness over upper and middle right arm Restricted range of motion
165
Shoulder dislocation
Pain following fall on outstretched arm Pain increases with arm movement PE: Right arm externally rotated and slightly abducted Pain and restricted range of motion on shoulder exam
166
Osteoporosis
Advanced age
167
Humeral fracture, Shoulder dislocation, Osteoporosis | Tests
XR right shoulder and arm MRI shoulder Bone density scan (DEXA)
168
Insulin induced hypoglycemia
Episodes of palpitations and diaphoresis that resolve with drinking orange juice Tight glycemic control
169
Diabetic peripheral neuropathy
History of diabetes mellitus Constant numbness and tingling in feet PE: Absent ankle jerk
170
Organic erectile dysfunction
Loss of erection for 2 years with absence of early morning erection History of diabetes mellitus History of alcohol use Taking lovastatin and atenolol
171
Insulin induced hypoglycemia, Diabetic peripheral neuropathy, Organic erectile dysfunction
``` Genital exam Serum glucose, HbA1c UA, urine microalbumin, Bun/Cr Doppler US penis Nerve conduction studies ```
172
Rib fracture
Physical assualt Right chest pain Pain is exacerbated by movement and deep breaths PE: Tenderness to palpation right chest wall
173
STD
Sexual assault by 2 men | No condoms use
174
Pregnancy
Unprotected vaginal intercourse with possible ejaculation No OCP use Last menstrual period 3 weeks ago
175
Rib fracture, STD, Pregnancy
``` Pelvic exam XR skeletal survey CXR Urine hCG Wet mount, KOH prep, cervical culture, gonorrhea and chlamydia tests HIV antibody, VDRL, HBV antigen ```
176
Deep venous thrombosis
Recent 15 hour plane flight Weight gain of 50lbs over the past 3 years Taking oral OCPs for 2 years Father with DVT (possible familial thrombophilia) PE: Homan's sign Pitting edema Swollen, tender, red, warm right calf
177
Cellulitus
Cuts to right leg secondary to fall Low grade fever PE: Swollen, tender, red, warm right calf Temperature 99.9F
178
Rupture of Baker's cyst
Spasmodic pain in right calf | PE: Swollen, tender right calf
179
Deep venous thrombosis, Cellulitus, Rupture of Baker's cyst | Tests
``` Doppler US legs D-dimer Hypercoagulability testing CBC with differential Wound and blood cultures ```

STEP 2 CS CASES (2 decks)

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