presentation- ddx Flashcards by Molly Thayer

21 yo female with visual aura, throbbing HA, sensory weakness/ numbness

*****migraine with aura
tension HA
psuedotumor cerebri
neoplasm
thromboembolic event (birth control?)
CNS vasculitis
partial seizure

w/u: MRI, LP w/ CSF, ESR

How well did you know this?

Not at all

Perfectly

26 yo male with sharp HA, same time every day, with IPSILATERAL rhinorrea, tearing, eye redness, temporal pain that lasts SECONDS

*****cluster
migraine
tension
pseudo tumor
neoplasm

w/u: cbc, esr, MRI brain, CT head, LP csf

How well did you know this?

Not at all

Perfectly

65 yo female, FEBRILE, unilateral temporal head ache with jaw claudication and ipsilateral blurred vision

TEMPORAL ARTERITIS
migraine
meningities
carotid dissection
trigeminal neuralgia
TMJ

w/u-temp artery bx, esr, crp
(carotid us with doppler, MRI, CT)

How well did you know this?

Not at all

Perfectly

30 yo female with FEVER, frontal ha, nasal dc, maxillary sinus pain

bacterial sinusitus**
migraine
meningitis

xray sinus, ct sinus, LP

How well did you know this?

Not at all

Perfectly

35 yo male with SUDDEN severe HA, left sided hemiplegia, nuchal rigidity, n/v

SAH****
IC bleed
meningitis/encephalitis
intracranial neoplasm
acute hypertension

w/u: NON CON CT, lp-csf, pt/ptt/inr, utox

How well did you know this?

Not at all

Perfectly

21 yo obese female with pulsatile ha, v/m, blurred vision

PSUEDOTUMOR
migraine
intracranial venous thrombosis

w/u: CSF with opening pressure, urine Hcg

How well did you know this?

Not at all

Perfectly

ddx/wu for trigeminal neuralgia

TMJ
cluster headache
migraine
tumor

MRI, ESR, cbc

How well did you know this?

Not at all

Perfectly

81 yo with chronic memory loss, stepwise after strokes, hx of HTN

VASCULAR DEMENTIA
B12 deficiency
alzheimers
thyroid
NPH

w/u: B12, VDRL/PRP, TSH, CBC, Lytes, MRI brain

How well did you know this?

Not at all

Perfectly

81 yo with memory loss, incontinence, disturbed gait over the last 6 months

NPH
alzheimers
vascular dementia
intracranial neoplasm
depression
B12 deficiency
depression

CT brain, VRDL/PRP, B12, TSH, LP w/ opening pressures

How well did you know this?

Not at all

Perfectly

creutzfeld jacob

rapidly progressive dementia over a few months with STARTLE myoclonus

dx with EEG and CSF

How well did you know this?

Not at all

Perfectly

random things to include on a confusion differential in an old person

chronic subdural hematoma
depression
b12
delirium
neurosyphylis

How well did you know this?

Not at all

Perfectly

73 yo male with sudden loss of vision in R eye, palpitations, SOB. Hx of afib

no HA, weakness, numbness, photophobia, redness, discharge

Retinal artery occlusion
retinal vain occlusion
acute angle glauc (would be painful)
retinal detachment
Temporal arteritis

Carotid US,

How well did you know this?

Not at all

Perfectly

central retinal artery occlusion

acute, painless, unilateral vision loss

cherry red spot on macula

How well did you know this?

Not at all

Perfectly

acute angle closure glaumcoma

opthalamic emergency –> red, painful, frontal headache, fixed, dilated pupil

How well did you know this?

Not at all

Perfectly

differential for erectile dysfunction

drug side effects
medical d/o
psychological

How well did you know this?

Not at all

Perfectly

PTSD vs Acute stress

1 month

How well did you know this?

Not at all

Perfectly

normal grief can last up to…..

6 months

How well did you know this?

Not at all

Perfectly

crying, sleeping, poor hygeine after death of loved one 2 months ago while seeing them in public places

Normal grief
Major depression with psychotic features
adjustment d/o with depressed mood

do physical exam, utox, tsh, cbc

How well did you know this?

Not at all

Perfectly

dx of MDD

5/9 SIGECAPS, or SI

if alchol– > think substance induced depression

> 2 years, mild= dysthymia

How well did you know this?

Not at all

Perfectly

bipolar 1 vs 2

1: manic +/- hypomanic phase
2: hypomanic, depressive phase

w/u: physical, mini mental, utox

How well did you know this?

Not at all

Perfectly

MS differential and w/u

DDX: CNS vasculitis, conversion disorder, TIA, b12, tumor neurosyph

w/u: LP w/ CSF, MRI brain+spine, ESR, ANA, VRDL/RPR, CBC/lytes, b12

How well did you know this?

Not at all

Perfectly

30yo male, imigrants, with night swests, cough, swollen glands for one month

TB
acute HIV
lymphoma
leukemia
hyperthyroid

w/u: PPD/quantiferon, CXR, HIV antibody, sputum gram stain acid fast, CBC

How well did you know this?

Not at all

Perfectly

hyperthyroid like presentation including palpitations, weight loss, diarrhea

Study These Flashcards

hyperthyroid, pheo, carcinoid

TSH, FT3, T4
24 hr catecholamines
5HIAA

26 yo female with sore throat, fever, severe fatigue, LUQ discomfort, LAD, rash. Boyfriend with SAME sx

Study These Flashcards

MONO- monospot, anti-EBV ab
viral/bacterial pharyngitis- throat culture
acute HIV- HIV ab
syphilis

test to add to cough if: - hemoptysis - sputum - dypsnea

- bronch - sputum gram stain and culture - echo

45 yo F with retrosternal burning after heavy meals and lying down, relieved by antacids

GERD, pud, esophageal spasm, MI | EGD, pH monitoring, h pylori stool antigen, barium swallow EKG

things that could maybe look like very stable angina

esophageal spasm | esophagitis

w/u for stable angina

stress test, ekg, lytes, trop/ck-mb

ascending cholangitis test vs cholecystitis

MRCP/ERCP also do ast/alt/alk phos/bili

test to do when suspicious o peptic ulcer dz/perferated ulcer

rectal exam and stool for occult blood

work up for bowel obstruction

abdominla xray ct colonoscopy rectal exam

70yo female with crampy abdominal pain, dark bowel movement, history of afib

acute mesenteric ischemia- abdominal ct angiogram diverticulitis peptic ulcer disease gastroenteritis

work up for young female with RLQ pain

torsion, ruptured cyst, appendicitis, pid, ectopic pelvic, hcg, abdominal us, vaginal us

30yo female with 6 mnths of periumbilical pain that is relieved with pooping

IBS, chrons, celiac, GI parasitic infection hcg (if young enough), stool for ova parasite, colonoscopy,

watery diarrhea after travel

travelers diarrhea giardiasis amebiasis hepatitis A stool leuks, culture, viral hepatitis serologis cbc cmp

test for lactose intolerance

hydrogen breath test

something to test for in diarrhea!!

TSH

painless bright red blood per rectum

diverticulosis hemmorroids angiodysplasia

23yo female obese with 6 months ammenorrhea, facial hair

PCOS (test/DHEAS, FSH/LH, transvag US) hyperprolocatinemia thyroid disease ovarian/adrenal tumor bhcg, testosterone, DHEAS, FSH/LH, TSH, transvaginal US

18yo female who is skinny and exercises incessantly with no period

anorexia --> LTYES pregnancy- hcg hyperthyroid --> TSH, T4

teenager with xs vaginal bleeding irregularly for months

AUB coagulation d/o (hemophilia, vonwillebrand) molar preg pelvic, pap, CBC, Pt/ptt, hcg, cervical culture, TSH/LH/FSH

61 obese postmenopausal female with endometrial bleeding

endometrial cancer- endo bx, endo curettage endometrial hyperplasia adenomyosis

45yog5p5 with postcoital bleeding

cervical cancer cervical polyp trauma endometrial cancer HPV testing, colpo with bx

28 yo female at 8 weeks with lower abd pain, vaginal bleeding

spont abortion- hcg ectopic molar preg- quant hcg

vaginal discharge

vaginitis (candidal, trichimonal) bacterial vaginosis cervicitis (GC/CT) wet mount, KOH prep, cervical culture

carpal tunnel ddx

carpal tunnel median nerve compression root C6, C7 radiculopathy nerve conduction studies, EMG, US wrist, MRI cspine

CAGE

Cut down? Annoyed by questioning? Guilt? Eye opener?

28yo f with MCP tenderness, L knee pain, morning stifness for irst hour of waking

RA SLE disseminated gonoccocal arthritis IBD? RF, esr, ANA, anti ds DNA, cervical culture for GC/CT

hip facture and pelvic fracture can be different

XR hip/pelvis serum calcium and vit d dexa scan

things to think about in suspected abuse

substance abuse --> utox | osteogenesis imperfecta --> xray skeletal survey

45yo male with red, swollen knee and fever

``` septic arthritis gout lymes trauma reactive arthritis ``` arthrocentesis with synovial fluid analysis (count, gram stain, culture, crystals), ESR, lyme serologies, xray, uric acid levels, blood cx

plantar fascitis ddx

plantr facscitis heel fracture splinter/ foregin body xray, bone scan

60yo f with pain in both knees when walking, relieved by rest, with recent CABG

PVD (intermittent claudication) lumbar spinal stenosis leriche syndrome ABI, lower extremetiy doppler, angiography, MRI L spine

ddx of DVT with red swollen calf

don't forget cellulitis!! myositis - CPK do CBC, CPK, d dimer and le US with doppler

something for ddx of someone anxious/depressed, constipated

hypercalcemia

presentation- ddx Flashcards

(55 cards)