Pertinent positives Flashcards
(35 cards)
migraine
F>M unilateral, sharp/stabbing headache \+/- aura, nausea, vomiting, photophobia \+/- family history lack of neuro findings
tension headache
bilateral, squeezing headache
associated with stress/sleep deprivation
hrs-days long
worsens as day progresses
intracranial mass lesion
possible presenting symptom (1/3 patients)
similar to migraine
+/- weight loss, neuro findings
pseudotumor cerebri
diplopia or other visual changes
papilledema or normal if within first few days
cluster headache
M>F unilateral periorbital pain \+/- ipsilateral nasal congestion, rhinorrhea, lacrimation, redness of eye, +/- horners syndrome daily pain episodes occur in clusters pain can awaken patient at night
sinusitis
pain upon palpation of forehead
typical pneumonia
abrupt onset fevers, chills pleuritic chest pain (worse with inspiration) productive cough dyspnea increased tactile fremitus (airspace consolidation) \+/- bronchial BS \+/- crackles/rales **exam findings absent in up to 2/3 pts
URI-associated cough
persists for 1-2 weeks or up to 6-8 wks in patients with underlying asthma
PCP pneumonia
dry cough
dyspnea
TB
constitutional symptoms: fever, night sweats, unintentional weight loss hemoptysis recent exposure to active TB ** place in respiratory isolation! ** need PPD skin test
Lung cancer
long-time smoker
constitutional symptoms: fever, night sweats, unintentional weight loss
hemoptysis
clubbing - COPD patient with underlying malignancy
Lung abscess
gradual onset (wks-mos) of fatigue, fever, night sweats, cough foul-smelling expectoration
atypical pneumonia - mycoplasma pneumoniae, chlamydia pneumoniae, legionella
gradual onset fever, fatigue, headache, myalgia, sore throat, hoarseness, chest pain non-productive cough \+/- blood-streaked sputum legionella: GI symptoms mycoplasma: severe ear pain
exacerbation of chronic bronchitis (COPD exacerbation)
increased sputum production
increased wheezing
increased dyspnea
generalized anxiety disorder
fatigue
sleep disturbances - insomnia
tension, fears, irritable, difficulty concentrating
tachycardia, sweating, hyperventilation, palpitations, tremor
find source of anxiety
caffeine induced insomnia
most common pharm cause of insomnia
intake of caffeine
increased latency to sleep onset, more frequent arousals, reduction in total sleep time - several hrs after ingestion
hyperthyroidism
fatigue unintentional weight loss heat intolerance anxiety, tremor, palpitations, sweating frequent BMs menstrual irregularities
depression
Sleeping - sleep onset insomnia, sleep maintenance insomnia, early-morning wakefulness Interest - lost interest in activities used to enjoy Guilty Energy - lost Concentration difficulty Appetite changed Psychomotor agitation or lethargy Suicidal/homicidal ideation
insomnia 2/2 adjustment disorder
symptoms occur within three months of stressful event and end six months after stressor (change in job, lost love one, illness, exam)
significant impairment to one’s life
mood/behavior changes
insomnia: increased sleep latency, frequent awakenings, and/or early-morning awakenings
illicit drug use
cocaine, amphetamines - increased sympathetic activity
insomnia
OSA
insomnia: difficulty initiating and maintaining sleep, early-morning awakenings snore loudly wake up feeling tired obese large tonsils
pneumothorax/hemothorax
unilateral loss of BS
hyperresonance
shifting of trachea AWAY from affected side
JVD
cholecystitis
female, fat, forty
RUQ pain - constant, follows fatty meals
N/V
+ Murphy’s sign
biliary colic
intermittent RUQ pain
