Term
| *HEENT* (ALSO SEE DYSPHAGIA) |
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Definition
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Term
SORE THROAT
(also Hoarseness, Dysphagia, Dry Cough)
Key Qs;
1-fever
2-cough
3-abd pain |
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Definition
*w fever
Viral Pharyngitis
Bacterial Pharyngitis
Strept Pharyngitis
Scarlet Fever (rash)
*w/ risky sex
Acute HIV
2' Syphilis
ESOPHAGIAL CANDIDIASIS
*w/ dry cough
Mycoplasma Pneumonia
PCP Pneumonia
*w/ abd pain
IMN (LLQ) (sense of lump/cervical LAD!!) |
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Term
HOARSENESS/DYSPHONIA
(also Sore Throat, Dysphagia, Dry Cough)
Key Qs;
1-duration (>3wks), timing (AM/PM)
2-trigger (overuse, environmental)
3-assocpain(dysphagia/odynophagia/otalgia)
4-URI/constitutional/neurologic symptoms |
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Definition
*acute (<3wks)
Laryngitis (URI symptoms)
Vocal Abuse (shouting, screaming etc)
*chronic (>3wks) ---> Laryngoscopy
Laryngeal Cancer (old pt)(smoker/alcohol)
(otalgia/odynophagia)(sense of lump)
VC polyp (overuse; teacher, singer etc)
(sense of lump)(otalgia)
Reflux Laryngitis (worse at start of day)
Allergic Laryngitis (sinusitis)(PN drip)
Hypothyroidism
Medications (asthma, psychosis, allergies)
Parkisonism (tremble voice)(gait)(writing)
Essential Tremor (tremble voice)
CVA (Stroke/TIA; CN9,10)(dysphagia)
MG (worse at end of day)
MS (scanning speech)(dysphagia) |
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Term
NAUSEA/VOMITING
Key Qs:
1-fatigue
2-GI; hematemesis, abd pain
3-GU; polyuria
4-CNS; dizziness, headache/confusion |
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Definition
*w fatigue
Pregnancy
Gastritis (anemia)
Depression
HIV
*w polyuria
UTI
DM
DI
HyperCa++
*w headache/confusion (see Neuro) ICP
*w dizziness (see Neuro)
*w hematemesis (see GI) Upper Bleed
*w abd pain (see GI) |
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Term
NECK MASS
Key Q:
1-fever, fatigue, wt loss |
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Definition
*w constitutional symptoms
Hodgkin
NHL
CA Gastric (virchow)
TB
*w/o constitutional symptoms
Thyroid Nodule |
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Term
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Definition
*constant, w wt loss
TB
HIV
Lymphoma
Hyperthyroidism
*constant, w/out wt loss
Menopause
*intermittent
Pheochromocytoma
Carcinoid (liver) |
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Term
WT LOSS
1-assoc symptoms
2-lifestyle |
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Definition
Hyperthyroidism
Cancer
HIV
Diet/drugs
Anorexia
Malabsorption |
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Term
OBESE/WT GAIN
1-assoc symptoms
2-lifestyle |
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Definition
*endocrinal
Hypothyroidism
Cushing
PCOS
DM
Reactive Postprandial Hypoglycemia
Insulinoma
*other
Smoking Cessation
Atypical Depression
Drug Side Effect |
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Term
| *RS/CV* (ALSO SEE NIGHT SWEATS) |
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Definition
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Term
SORE THROAT
Key Qs:
1-fever
2-cough
3-abd pain |
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Definition
*w fever only
Viral Pharyngitis
Bacterial Pharyngitis
Strept Pharyngitis
Scarlet Fever (rash)
Acute HIV
2' Syphilis
*w cough
Mycoplasma Pneumonia
PCP Pneumonia
*w abd pain
IMN (LLQ)
Hepatitis A/B/C (RLQ) |
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Term
COUGH (1)
(also Sore Throat, Hoarseness & Dysphagia)
Key Qs:
1-vital signs?
2-expectoration? blood tinged?
3-ill contact? immunization? meds?
4-chest pain? (pleuritic = lower resp) |
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Definition
*dry
URI assoc cough (viral; pleurutic pain)
Reactive Airway
Laryngitis (hoarseness)
Atypical Pneumonia (fever)(fatigue)
GERD (chronic)(early AM cough & hoarseness & wheezing)(assoc dyspepsia)
Meds- ACEI |
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Term
COUGH (2)
Key Qs:
1-vital signs?
2-expectoration? blood tinged?
3-ill contact? immunization?
4-chest pain? (pleuritic = lower resp) |
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Definition
*productive
(amount/consistency/color/odor)
Postnasal Drip (chr rhinitis/sinusitis)
(repeated attempts to clear throat)
Asthma (episodic)(allergen)(wheezes)
Bact Pneumonia(fever)(postURI!)(pleuritic)
Chronic Bronchitis (longterm smoker)
Brchiectasis (foul,copious)(+/-sinusitis)
Lung Abcess |
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Term
COUGH (3)
Key Qs:
1-vital signs?
2-expectoration? blood tinged?
3-ill contact? immunization?
4-chest pain? (pleuritic = lower resp) |
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Definition
*hemoptysis
(bright red, pink frothy, mixed w mucous)
-w constitutional symptoms (pulmonary)
CA Lung (longterm smoker)
TB (fever, night sweats, fatigue ,wt loss)
Pneumonia (HIV)
COPD (Chr Bronchitis, Abcess, Emphysema, Bronchiectasis)
Lung Abcess (foul)(bad teeth)(prior LOC)
-vitally unstable (cardiac)
P Embolism (prev DVT)(chest pain)(anxiety)
CHF (MS w P Edema)(w DOE, PD, orthopnea)
-w hematuria
Vasculitis (w/autoimmune symptoms)
Wegner (sinusitis)
GoodPasture (LL edema)
-misc
Cocaine
Trauma |
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Term
SOB/DIFFICULTY BREATHING (1)
Key Qs:
1-vitals? (RR +/- HR & Temp)
2-onset? (abrupt/insiduous)
3-at rest/on exertion? (abrupt/insiduous)
4-assoc symptoms? (cardiac/pulmonary) |
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Definition
*abrupt onset; at rest
-pulmonary
Pulmonary Embolism(hx immobility/clotting)
Pneumothorax (trauma)
Asthma/exacerbation (environm)(wheezes)
Airway Obstruction (stridor)
-cardiac
MI (ischemic chest pain >20min)
CHF decompensation/Pulmonary Edema
(PND, orthopnea)(frothy pink sputum)
-other
Hyperventillation Syndrome(yng pt(anxiety) |
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Term
SOB/DIFFICULTY BREATHING (2)
Key Qs:
1-vitals? (RR +/- HR & Temp)
2-onset? (abrupt/insiduous)
3-at rest/on exertion? (abrupt/insiduous)
4-assoc symptoms? (cardiac/pulmonary) |
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Definition
*insiduous onset; on exertion
-pulmonary
Pneumonia (fever)(pleuritic chest pain)
COPD/exacerbation (smoker)
Interstitial Lung Disease (occup/exposure)
Pleural Effusion
-cardiac
Angina/CAD (ischemic chest pain <20min)
CHF compensated (PND, orthopnea)
Pericardial Effusion |
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Term
PALPITATIONS/ANXIETY
Key Qs:
1-lightheaded?
2-anxiety? timeline/trigger |
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Definition
*lightheaded/syncope
Arrythmia
MVP
Anemia
Hypoglycemia
Hyperventilation
*no lightheadedness (sympathetic)
Hyperthyroidism
Pheochromocytoma
Carcinoid (liver)
Caffeine induced
Substance induced
Anxiety (see below)
*psychologic (timeline, trigger)
-no trigger
Social Phobia
Avoidant Personality
Acute Stress Disorder (<6mo)
GAD (>6mo)
-identified trigger
Specific Phobia
Panic Attack
PTSD |
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Term
ANXIETY
Key Qs:
1-trigger?
2-timeline? |
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Definition
*no trigger identified
Social Phobia
Avoidant Personality
Acute Stress Disorder (<6mo)
GAD (>6mo)
*trigger identified
Specific Phobia
Panic Attack
PTSD |
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Term
CHEST PAIN
Key Qs:
1-vitals? (unstable;CV/RS)(stable;GI/MSK)
2-duration? course?
3-radiation? (neck/shoulder/arm) |
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Definition
*w unstable VS (RS/CV)
Angina Pectoris (<20min)
Myocardial Infarction (>20min)
Pericarditis (relieved leaning forward)
Dissecting Aortic Aneurysm
Tracheobronchitis (assoc cough)
Pleurisy (sharp, knife like pain)
(Pulmonary Embolism,Pneumonia,Pnemothorax)
Cocaine Use
Anxiety (assoc stress) (may mimic angina)
*stable VS (GI/MSK)
Esophageal Spasm (assoc dysphagia)
GERD (assoc dysphagia, regurgitation)
PU
Costochondritis (local tenderness)
Muscle Strain
Acute Chest Syndrome (Sickle)
Herpes Zooster (dermatomal rash) |
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Term
*GI* (ALSO SEE NAUSEA/VOMITING, JAUNDICE)
ANY ABD PAIN
Key Qs:
1-character
(sharp=peritonal, dull=visceral)
2-onset
(seconds=perforation
minutes=inflammation
dys=obstruction)
3-location
(site of organs in abd quadrants)
4-progression
(non/progressing/constant) |
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Definition
(11)
Peritoneal (Parietal)
-sharp, severe, constant
-well localized
-"guarding" rigidity
-pt lying/sitting very still, increases with cough/sneeze/jarring/car ride
Visceral Pain
-dull, less severe, constant/intermittent
-not well localized
-"radiation" is common
-usu assoc w N/V, pallor, sweating |
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Term
DYSPHAGIA/ODYNOPHAGIA
Key Qs:
1-describe; difficulty with/out pain?
2-to solids/liquids or both?
3-cough/choke/gag or feeling food stuck?
4-systemic symptoms?
(NB: odynophagia = pain w swallowing) |
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Definition
**DYSPHAGIA
*solids 1st (structural; food stuck)
-Esophageal CA
-Stricture/Webs (Plummer Vinson - anemia)
-Scleroderma
-GERD
Mitral Stenosis
Goitre
Globus Hystericus
-Cancer Radiation
*solids & liquids (motility; choke/cough)
ALS, MS, Parkinson
Stroke, Head Trauma, SC Injury
Achalasia (Chaga - more to liquids)
Zenker Diverticulum
Radiation
**ODYNOPHAGIA
Esophagitis (HIV, HSV, CMV, pill)
Caustic ingestion
Cancer Radiation |
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Term
EPIG PAIN
Key Qs:
1-vitals?
2-related to food?
3-alcohol intake?
4-jaundice? |
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Definition
*related to food - recurring
Gastritis
PUD
GERD
Cholecystitis (severe)(related fatty food)
Mesenteric Ischemia(severe)(2hr after eat)
*related to alcohol - acute onset
Acute Pancreatitis
Alcoholic Hepatitis
*jaundice - radiation rt shoulder/back
Viral Hepatitis
Chronic Pancreatitis
Pancreatic CA
CholangioCA
Asc Cholangitis (hx gall stone)(f/c,shock)
*vitally unstable
MI
AAA (old male smoker)
Boerhave Syndrome
Perforated PUD |
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Term
RUQ PAIN (also see JAUNDICE)
Key Qs:
1-constant/intermittent?
2-jaundice? stool/urine? itchy/grade?
3-abd pain? |
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Definition
*w/o jaundice
PUD
Acute Cholecystitis (constant pain)
Calcular Cholecystitis (intermittent pain)
Nephrolithiasis (CVAT)
Costochondritis (localized tenderness)
*w jaundice
CONJUGATED; "pale stool & dark urine"
-Hepatic
Hepatocellular Disease..
((infectious))
Viral Hepatitis
((toxic))
Alcoholic Hepatitis
Acetaminophen Hepatotoxicity
-Nonhepatic
Extrahepatic Biliary Obstruction..
((constant))
Pancreatic CA
1aryBiliary Cirrhosis(F, itch, w/other AI)
((intermittent))
Choledocholithiasis (stone CBD)
Cholangio CA ("intense" itching)
Ascending Cholangitis (fever/chills,shock) |
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Term
|
Definition
*w trauma
Splenic Rupture (RF;IMN,Liver Dis,Bld CA)
Rib Fracture (localized tenderness)
*w/o trauma
Splenic Infarct
Pneumonia
Perforated PU
Nephrolithiasis (CVAT)
Costochondritis (localized tenderness) |
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Term
DIFFUSE LQ PAIN
Key Qs:
1-female? old pt?
2-cramps?
3-wt loss?
4-pass gas? |
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Definition
*crampy
GastroEnteritis
Food Poisoning
IBS (stress)
* w wt loss
Celiac Disease (gluten)
Chronic Pancreatitis
Parasitic (Ameobasis, Giardiasis)
*no flatulence
Intestinal Obstruction
Small Bowel CA
Colon CA
Volvulus
Ileus
Hernia
*old pt
Mesenteric Ischemia(severe)(2hr postmeal)
Mesenteric Infarction
DiverticulOSIS
*female pt (ALSO BACK PAIN)
PID
Endometriosis
Dysmenorrhea
Vaginitis
Cystitis
Spontaneous Abortion |
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Term
RLQ PAIN
Key Qs:
1-female?
2-onset? |
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Definition
*GI (gradual)
Acute Appendicitis
Gastroenteritis
Crohn Ileitis
*GYN (sudden)
Ovarian Torsion
Rupture Ovarian Cyst
Ectopic Pregnancy
*GU (colicky)
Ureteric Stone (radiate groin)
strngulated hernia
testiculor torsion |
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Term
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Definition
*GI (gradual)
Diverticulitis
Crohn Ileitis
Ulcerative Colitis
GE
*GYN (sudden)
Ovarian Torsion
Rupture Ovarian Cyst
Ectopic Pregnancy
*GU (colicky)
Ureteric Stone (radiate groin)
strngulated hernia
testiculor torsion |
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Term
DIARRHEA/CONSTIPATION (1)
Key Qs:
1-duration? frequency? (acute/chronic)
2-describe? (non/bloody)
3-ate out? ill contact? recent travel?
4-meds?(C.diffic)sx hx?(HIV)stress?(IBS) |
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Definition
DIARRHEA
ACUTE (<2-4wks)
*watery
Food Poisoning (IP: few hrs)
Gastroenteritis (IP: few dys)
Infectious Diarrhea
Cryptosporiasis (HIV/AIDS)
Travelers Diarrhea
Giardiasis
Amebiasis
Pseudomembranous Colitis (meds)
*bloody
Infectious Diarrhea
Amoebic Dysentry |
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Term
DIARRHEA/CONSTIPATION (2)
Key Qs:
1-duration? frequency? (acute/chronic)
2-describe? (non/bloody)
3-ate out? ill contact? recent travel?
4-meds?(C.diffic)sx hx?(HIV)stress?(IBS) |
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Definition
DIARRHEA
CHRONIC (>4wks)
*watery
IBS (allev w defecation)(aggrev w stress)
Hyperthyroidism
Carcinoid (flushed skin)
*greasy
LI (milk)
Celiac (wheat)
Chronic Pancreatitis (alcohol)
*bloody
Crohn Ileitis (intermittent)
Ulcerative Colitis (intermittent)
Diverticulitis (old pt)
Colon Cancer (alternating w constipation)
Lymphoma (LAD, night sweats, wt loss) |
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Term
DIARRHEA/CONSTIPATION (3)
Key Qs:
1-duration? frequency? (acute/chronic)
2-describe? (non/bloody)
3-ate out? ill contact? recent travel?
4-meds?(C.diffic)sx hx?(HIV)stress?(IBS) |
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Definition
CONSTIPATION
Low Fiber Diet
Hypothyroidism
Medications (Fe, Opiods)
Substance Abuse
Depression (TCA)
Abdominal Surgery |
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Term
UPPER GI BLEED
Key Qs:
1-color? (bright red/coffee ground)
2-painful?
3-alcohol?
4-meds? |
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Definition
*bright red
-painless
Bleeding PU
Bleeding Esophageal Varices
-painful
Mallory Weiss
*coffee ground
Gastritis
Gastric CA (early satiety & anorexia)
GERD |
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Term
LOWER GI BLEED
Key Qs:
1-color? (bright red/melena)
2-painful?
3-trauma?
4-straining?
4-FH CA? meds? |
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Definition
*melena
Colorectal CA
IBD (leads to CA)
Upper GI Bleed
Diverticulosis
Angiodysplasia
Ischemic Bowel Disease
*bright red
-painless
Hemorroids (int)
-painful
Hemorroids (ext)
Anal Fissure
Proctitis |
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Term
| *GU* (also see Diffuse, RLQ & LLQ Pain) |
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Definition
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Term
FLANK/BACK PAIN
Key Qs:
1-constitutional symptoms? |
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Definition
*w constitutional symptoms
Acute Pyelonephritis
Acute Glomerulonephritis
RCCA (old male smoker + other)
*w/o constitutional
Nephrolithiasis
Ureteral Calculi
AAA (old male smoker) |
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Term
|
Definition
*small volume
UTI
*large volume
DM
DI
Hypercalcemia? |
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Term
DYSURIA
Key Qs:
1-w radiation?
2-w constitutional? |
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Definition
*w/o radiation
Urethritis
Cystitis (bedwetting)
Prostatitis (painful ejaculation)
Vaginitis (discharge, dysparunia)
*w flank radiation
Pyelonephritis (w constitutional)
Nephrolithiasis |
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Term
HEMATURIA (infection, stone, cancer)
Key Qs:
1-describe?(red-upper UT)(clots-lower UT)
2-painful/less? (pain-stone)(less-CA)
3-timing? (start/all thru/end stream) |
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Definition
*painless
Bladder CA (smoker, painter)
Prostate CA(bloody ejaculate,ED,bone pain)
RCC(grosshematuria,flankpain,palpablemass)
PCKD
Coagulation Disorder
*painful (dysuria, SPP, CVAT)
Bladder Stone
KidneyStone(sudden,severe,colicky,radiate)
Urethritis
Cystitis
Prostatitis
Pyelonephritis
Glomerulonephritis(HTN,LLedema,postUR/GI)
OR
*beginning of stream - urethra
Urethritis
*all through stream - kidney/ureter
Acute Pyelonephritis
Acute IgA Glomerulonephritis (post URI/GI)
Renal Calculi
RCC
PCKD
*termination of stream - bladder/prostate
Cystitis
Urolithiasis
Bladder Cancer
Prostatitis
Prostate Cancer
*bleeding other orifices
Coagulation Disorder
"HITTER" |
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Term
INCONTINENCE
Key Qs:
1-sense of urgency? Urge Incontinence
2-w coughing/sneezing? Stress Incontinence
3-incomplete emptying/dribbling? Overflow
4-difficulty reach WC in time? Functional |
|
Definition
Stress Incontinence (gradual leak)(little)
-weakened pelvic floor, put added pressure
eg. pregnancy, prostate surgery, obesity
with exercise, cough/sneeze/laugh
Urge Incontinence (sudden loss)(a lot)
-damage to nerve or muscle
eg. MS, DM, Stroke, Parkinson, UB Stone
Mixed Incontinence (both)
eg. meds
Overflow Incontinence (spill over)
-mass effect blocking urine flow,
eg. BPH, constipation, tumor
Functional Incontinence (non CNS, non MSK)
eg. dementia, arthritis
*w neuro symptoms
NPH (gait, dementia)
DM (tingling, vision)
MS
NS |
|
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Term
OBSTRUCTION
Key Qs:
1-constitutional? |
|
Definition
*w/o constitutional symptoms
BPH
Prostatitis/UTI
Bladder Stone
*w constitutional symptoms
Prostate CA
Bladder CA
RCCA |
|
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Term
ERECTILE DYSFUNCTION
Key Qs:
1-morning erection? erection 0-10?
2-stress? sad?
3-PMH? meds? |
|
Definition
*w morning erection
Psychogenic ED
*no morning erection - organic
ED dt Vascular Disease(DM)(Hyperlipidemia)
Drug Related ED (antiHTN)(antipsychotics)
*other
Le Riche (claudication pain, weak femoral pulse, leg weakness/numbness, pain thigh/hip/buttock)
Hypogonadism (loss libido/hair,gynecomast)
Peyronie Disease (fibrosis) |
|
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Term
AMENORRHEA/IRREGULAR MENSES (1)
Key Qs:
1-previous menses?
2-systemic symptoms?
3-constitutional symptoms?
4-lifestyle? |
|
Definition
*secondary
Pregnancy
Premature Ovarian Failure
Peri/Menopause
Sheehan Syndrome
Asherman Syndrome
*primary
Anovulatory Cycles
DUB (14/15yo)
PCOS |
|
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Term
AMENORRHEA/IRREGULAR MENSES (2)
Key Qs:
1-previous menses?
2-systemic symptoms?
3-constitutional symptoms?
4-lifestyle? |
|
Definition
*endocrine - HPA axis
Hyperprolactinemia
2ary to Prolactinoma
Hyperthyroidism
Hypothyroidism
Pitutary CA
Adrenal CA
Ovarian CA
*lifestyle
Anxiety induced
PTSD
Depression
Anorexia
UTI |
|
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Term
VAGINAL BLEED (1)
1-age? (childbearing)(postmenopausal)(all)
2-irreg menses?
3-spotting (inbetween cycles/postcoital) |
|
Definition
*obstetric
Ectopic Pregnancy
Molar Pregnancy
Spontaneous Abortion
*3rd trimester
Placenta Previa (painless)
Abruptio Placenta (painful)
*gynecologic
Ruptured Ovarian Cyst
Ovarian Torsion
Fibroid
Endometrial Hyperplasia
Endometrial Polyps
Cervical Polyps
Cervicitis (postcoital bleeding)
Cervical CA (postcoital bleeding)
PID |
|
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Term
VAGINAL BLEED (2)
1-age? (childbearing)(postmenopausal)(all) |
|
Definition
*post-menopausal
Endometrial CA
Cervical CA (postcoital bleeding)
Atrophic Endometrium
Atrophic Vaginitis
*endocrine
HyperThyroidism
HypoThyroidism
DM
*others
Cervical Laceration
Coagulation Disorder
Dysfunctional Uterine Bleeding |
|
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Term
DYSMENORRHEA
Key Qs:
1-LIQOR-A?
2-menstrual hx? |
|
Definition
Endometriosis (dysparunia, dyschezia)
Adenomyosis (enlarge uterus, abd fullness)
Fibroid
PID
IUD
STD
Ovarian Cyst
Ovarian CA |
|
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Term
VAGINAL DISCHARGE
Key Qs:
1-describe?
2-menstrual hx?
3-sex hx? |
|
Definition
Vaginosis - Gardinella (fishy smell)
Vaginitis - Candida (cottage cheese)
Vaginitis - Trichomonus (itching, frothy)
Cervicitis - Chlamydia (incubation 1-3wks)
Cervicitis - Gonorrhea (incubation 2-5dys) |
|
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Term
DYSPARUNIA
Key Qs:
1-location? (on entry/deep penetration)
2-age?
3-libido?
4-sex hx? |
|
Definition
*superficial (no lubrication/ vag dryness)
Atrophic Vaginitis(postmenop)(hot flashes)
Vulvodyna (premenop dryness)
Vaginismus
Depression
Domestic Violence
*w deep thrusting
Endometriosis (dysmenorrhea)
Cervicitis (postcoital bleeding)
PID |
|
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Term
|
Definition
(12 CC)
WRIST PAIN
ELBOW PAIN
ARM PAIN
SHOULDER PAIN
NECK PAIN
LOWER BACK PAIN
HIP PAIN
GROIN PAIN (ISOLATED / REFERRED)
KNEE PAIN
CALF PAIN
ANKLE PAIN
HEEL/FOOT PAIN |
|
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Term
ANY JOINT PAIN (see also JAW PAIN)
(applied to all MSK cases)
Key Qs:
1-Other joints involved?
2-Any fever/fatigue/wt loss?
3-Any bruises/trauma/overuse?
4-Any weakness/tingling/numbness? |
|
Definition
*monoarticular, w/o constitutional symp
Gouty Arthritis (sudden)(alcohol,red meat)
Pseudogout (any joint)
Osteoarthritis(repetitive use)(wt bearing)
*polyarticular, w constitutional symptoms
RA (small joints)(morning stiffness)
SLE (flitting joints)(malar rash)
Sjogren Synd (RA or SLE + dry eye/mouth)
*w bruising
Domestic Violence
Elder Abuse
Substance Abuse
Factitious Disorder |
|
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Term
|
Definition
*w overuse/trauma
Carpal Bone Fracture (golf, baseball, bowling, falling on outstretched hand)
Wrist Sprain
*w neurologic symptoms
Carpal Tunnel Syndrome
Median N. Compression
Radiculopathy C6,7
De Quervain Tendonitis
(see ANY JOINT PAIN)...
*monoarticular, w/o constitutional symp
*polyarticular, w constitutional symp
*w bruising |
|
|
Term
|
Definition
*overuse/trauma (repetitive movements)
Lat. Epicondylitis (tennis elbow)
(pain; lat elbow, extensors, supinators)
(Mill test, Cozen test)
Medial Epicondylitis (golfer elbow)
(pain; medial elbow, flexors, pronators)
(Golfer elbow test)
Stress Fracture
Ms/Lig Strain
(see ANY JOINT PAIN)...
*monoarticular, w/o constitutional symp
*polyarticular, w constitutional symp
*w bruising |
|
|
Term
|
Definition
*referred
Angina
MI
*overuse/trauma
Tendinitis
Ms strain
*w constitutional symptoms
Polymyositis (symm, proximal)
Dermatomyositis (w rash)
Inclusion Myositis (asym,distal)(old male)
*w meds
Rhabdomyolsis (statins)
Myopathy (steroids)
(see ANY JOINT PAIN)...
*w bruising |
|
|
Term
|
Definition
*overuse/trauma
Rotator Cuff Injury
Subacromial Bursitis
Frozen shoulder (Adhesive Capsulitis)
Referred pain
Shoulder Dislocation
Fracture Humerus
(see ANY JOINT PAIN)...
*monoarticular, w/o constitutional symp
*polyarticular, w constitutional symp
*w bruising |
|
|
Term
|
Definition
*w neurologic symptoms
Cervical Disc Herniation (W/T/N)
Cervical Radiculopathy C4,5 (W/T/N)
Cervical Disc Fracture (SOB dt phrenic n!)
Osteoarthritis (W/T/N due to spurs)
Meningitis(phphobia,hdche,N/V,ill contact)
*w/o neurologic symptoms
Muscle Strain
Osteoporosis
Metastatic Cancer |
|
|
Term
|
Definition
*w neurologic symptoms
L Disc Herniation (W/T/N, incontin)(SLRT+)
L Radiculopathy (SEVERpain,radiatn)(SLRT+)
L Disc Fracture (W/T/N, incontinence)
Tumor Vertb Canal (W//T/N, incontinence)
Ankylosing Spondylitis (morning stiffness)
*w/o neurologic symptoms
Lumbar Ms Strain (ppt heavy lifting)
Malingering (2ary gain)
*w claudication symptoms
L Spinal Stenosis (pseudo) (incont, no W)
Periph Vascular Disease (true)
LeRiche Syndrome (w ED, W/T/N)
*misc
Kidney Stone
AAA (old male smoker)(flank, leg, back)
Cancer Metastasis (prostate, breast, lung, multiple myeloma, lymphoma)
*female pt
PID
Endometriosis
Dysmenorrhea
Spontaneous Abortion |
|
|
Term
|
Definition
*overuse/trauma
Ms/Ligament Strain
Labral Tear
Tronchanteric Bursitis (during sleep)
Arthritis (fver is septic)
Bursitis
Tendinitis
Avascular Necrosis (hx trauma)
*referred
Spinal Stenosis
Herniated Disc
*trauma
Hip Fracture (femur)(foot outward)
Pelvic Fracture (acetabulum)
Hip Dislocation (foor inward)
(see ANY JOINT PAIN)...
*monoarticular, w/o constitutional symp
*polyarticular, w constitutional symp
*w bruising |
|
|
Term
|
Definition
*overuse/trauma - athlete
**medial; pain w ABDuction, antalgic gait
Osteitis Pubis(pain w/rest after activity)
Add Tendinitis(pain w/rest after activity)
Stress Fracture(aggrev w impact,nightache)
(woman runner, pregnant, military recruit)
Pelv Fract(MVA/fall)(painw/sit/stand/walk)
)(tingling/numbnes to groin/thigh)
(NB; stress fract=incomplete pelvic fract)
**lateral
Athletic Pubalgia (repetitive twisting) "severe" (pain w/sit)
Labral Tear (repetitive twisting) (click/catch/lock)
Muscle Strain (sudden)(no sensory s/s)
Ligament Strain (sudden)(no sensory s/s)
TESTICULAR PAIN;
testicular torsion (TESTIS HANG LOWER)
epididymitis (PAINFUL EJACULATION)
orchitis (STD)
strangulated hernia
trauma |
|
|
Term
|
Definition
*urinary
UTI
Pyelonephritis
Kidney Stone
*male
Orchitis
Epididymitis
Testicular Torsion
*female
Ovarian Cyst Rupture/Torsion
Ectopic Pregnancy
PID
Endometriosis
*abdomen - acute
Appendicitis
Diverticulitis
Psoas Abcess
Aortic Aneurysm
*abdomen - chronic
Hernia
Malignancy
Diverticulosis
IBD
*lower back/buttocks
Lumbar Radiculopathy
Postoperative Neuralgia
Ankylosing Spondylitis (male) |
|
|
Term
KNEE PAIN
Key Qs;
1-fever, rash
2-stiffness
3-abd pain, genital discharge |
|
Definition
*w inflammatory symptoms
-fever +/- rash
Septic Arthritis (open wound)(Staph/Gonoc)
Dissem Gonorrhea (flitting)(sex)(rash)
Lyme Arthritis (tick exposure)(rash)
-rheum like
ParvoB19 Arthritis(rash)(stiffness)
-abd pain/diarrhea
Arthritis w IBD (irreg BM)(stiffness)
Reactive Arthritis(post-GI/GU)(stiffness)
*overuse/trauma
Menisceal Tear
Ligament Damage
Patellar Tendinitis (roofing/running)
(prolonged working while on bent knee)
(see ANY JOINT PAIN)...
*monoarticular, w/o constitutional symp
Gout
Pseudogout (old)
OA (old)
*polyarticular, w constitutional symp
RA (stiffness)
SLE (rash)
Sjogren
*w bruising
Domestic Violence
Elder Abuse
Substance Abuse
Factitious |
|
|
Term
|
Definition
*w immobility
DVT (travel, hosp, OCP, pregn, FH)
*overuse/trauma (cut wound)
Superficial Venous Thrombosis
Cellulitis (cut)(fever,red/warm/tender/sw)
Myositis(trauma)(fever,red/warm/tender/sw)
Baker Cyst Rupt(mimic DVT;hard,swoll,pain)
Rupt Gastrocnemius Ms(pain midleg, pain on tip toes or dorsiflexion ankle)
Ms/Tendon Strain
Hematoma
*w constitutional symptoms
Polymyositis (symm, proximal)
Dermatomyositis (w rash)
Inclusion Myositis (asym,distal)(old male)
*w meds
Rhabdomyolsis (statins)
Myopathy (steroids)
(see ANY JOINT PAIN)...
*w bruising |
|
|
Term
|
Definition
*overuse/trauma
Foot Sprain
Splinter
Foreign Body
(see ANY JOINT PAIN)...
*monoarticular, w/o constitutional symp
*polyarticular, w constitutional symp
*w bruising |
|
|
Term
|
Definition
*according to location!
Heel Fracture (heel bone)
Stress Fracture(metatarsals or calcaneus)
Plantar Fascitis (runner)(pain w DF toe)
Achilles Tendinitis(runner)(pain w/DF toe)
Splinter
Foreign Body |
|
|
Term
| *NEURO* (see also INCONTINENCE) |
|
Definition
(7 CC)
HEADACHE
WEAKNESS/NUMBNESS
TREMOR/FALL
LOC/SEIZURE
DIZZINESS/VERTIGO
HEARING LOSS
VISION LOSS |
|
|
Term
HEADACHE (1)
Key Qs:
1-location/quality/duration?
2-any fever/fatigue?
3-any weakness/tingling/numbness? |
|
Definition
W/O NEUROLOGICAL SYMPTOMS
*most common
Migraine (unilat/throbbing)(FH)
(4-72hrs, peaks in 1-2hr)
Cluster (unilat/deep orbital)(lacrimation)
(upto 3 hrs; peaks in mins)
Refractive (in eye/dull)(hyperopia/astigm)
(variable; gradual)
Tension (frontal/tightening)(stress)
(mins-days; gradual)
*facial involvement
Temporal Arteritis (unilat/throbbing)
(pain on chewing, visual changes)
Tempromandibular Joint Disorder (clicking)
(pain on chewing)
Carotid Artery Dissection
(pain neck/face, visual changes)
Trigeminal Neuralgia (shock-like)
(pain on chewing, in cheek)(secs; recurs)
*w flu-like symptoms (fever, fatigue)
Sinusitis (sinus tenderness)(cough/sneeze)
Meningitis(neck rigidity/photophobia/rash)
Encephalitis (confusion)
CNS Vasculitis (joint pain, rash)
*lifestyle
Caffeine Withdrawal
Analgesic Withdrawal
Depression/Stress/HTN |
|
|
Term
HEADACHE (2)
Key Qs:
1-location/quality/duration?
2-any fever/fatigue?
3-any weakness/tingling/numbness? |
|
Definition
W NEUROLOGICAL SYMPTOMS
*mass-effect
(vomiting alone,drowsy,visual/behav chge)
IC Neoplasm (morning)(w bending/coughing)
Intracranial Abscess
Intracranial Venous Thrombosis
Pseudotumor Cerebri (female, obese, OCP)
(spontaneous/traumatic)
Subarachnoid Hge (worst)(aneurysm/HTN)
Intracranial Hemorrhage
Vertebral A. Dissection (occipital pain)
Carotid A. Dissection (orbital pain)
*w seizure
Complicated Migraine
Partial Seizure |
|
|
Term
WEAKNESS/TINGLING/NUMBNESS (1)
(consider FATIGUE too)
Key Qs:
1-location/examples/progressive?
2-weakness/tingling/numbness/incontinence?
3-any stiffness?
4-any medications? |
|
Definition
PROXIMAL (eg.comb hair, get out of chair)
*w neuro symptoms
Stroke
TIA
CNS Vasculitis (fever,fatigue,joints,rash)
(w seizures)
Seizure
Todd Paralysis
Complicated Migraine
(mass effect)
IC Neoplasm
Subdural Hge (shaken skull)
Epidural Hge (fractured skull)
*progression (bilat)
Polymyositis (symmetric)
Dermatomyositis (w rash)
Duchenne (ascending)(childhood onset)
Becker (adolescence onset)
MS (episodic)(female)
* w stiffness & pain
Fibromyalgia (yng female)
PMR (old female) (w TA)
Myotonia (w arrhythmia/cataract)
(misc)
Thyrotoxicosis
Corticosteroids |
|
|
Term
WEAKNESS/TINGLING/NUMBNESS (2)
~FALL RISK~
Key Qs:
1-location/examples/progression?
2-weakness/tingling/numbness/incontinence?
3-any stiffness?
4-any medications? |
|
Definition
DISTAL (eg.opening jar, frequent tripping)
*CNS (motor +/- sensory)(more weakness)
GBS (pure motor)(LMNL) (post URI/GIT)
ALS (pure motor)(U&LMNL) (muscle twitches)
Syringomyelia (pain/temp, incontinence)
Neurosyphilis (gait, incontinence)
*PNS(chronic)(more tingling/numbness/pain)
Diabetes Mellitus, Kidney Failure
Alcoholism, Liver Failure
Multiple Myeloma (LL weak)(bony aches)
Raynaud Syndrome (blue digits)(w cold)
*face (bilat or unilat)
MG (worse w use)
Lambert Eaton (improves w use)
Bell Palsy
Horner Syndrome
IC Neoplasm (CN #7 compression)
*hand
(see MSK-wrist)
*psychologic
Hyperventilation (numb/tingling)(hypoCa)
Conversion (weakness)(reflexes N)
Malingering (2ary gain)
*meds
Steroids (more proximal)
Statins (rhabdomyolysis)
Diuretics (hypokalemia) |
|
|
Term
TREMOR/ABNORMAL GAIT/FREQUENT FALLS
(also see 2 last card)
~FALL RISK~
Key Qs:
1-describe position?
2-constant/intermittent?
3-associated symptoms?
4-alcohol intake? last drink?
NB: Basal Gang ~ Movement & Posture
(ex. tremor, chorea, athetosis)
Cerebellum ~ Coordination & Balance
(ex. finger to nose, RAM, gait) |
|
Definition
*resting
Basal Gangilia:
Parkinson(>60yo)(bradyk)(voice)(handwritg)
Wilson(<40yo)(personality chges)(dementia)
Cortex/Brainstem:
Stroke, TIA, Tumor, Trauma, Infection
*postural (holding out arms infront)
Basal Gangilia:
Essential(FH+,allev w/etoh)(voice)(handwr)
Sympathetic:
Physiologic "reversible"
(stress, stimulants, fatigue,
excessive caffeine, alcohol withdrawal,
hypoglycemia, hyperthyroidism, pheochrom)
NB; notice that some of the causes will also have dizziness or seizure..
*purposeful/intention/action (finger2nose)
Cerebellar:
(ataxia/gait,dysarthria/speech,dysmetria/intention tremor, nystagmus, dysdiadochok)
Stroke, Tumor
MS (episodic)(nystagmus, incontinence)
NB: LCF (w estrogen changes)= Astrexis!
NB!! in FA, Essential & Physiologic tremor could both be postural / action tremors
NB1: Chronic Alcoholism can cause ALL types of tremor!
NB2: Alcohol Withdrawal
6-12hrs; tremor w sympathetic overactivity
12-24hr; tremor w hallucination(w insight)
24-48hrs; withdrawal seizures
48-72hrs(DT); tremor w fever, confusion, sympathetic overactivity, visual hallucinations (no insight) |
|
|
Term
LOC(SYNCOPE,FAINT,BLACKOUT)/SEIZURE (1)
Key Qs:
1-pls describe more/was it witnessed?
2-any prodroma symptoms?
(palpitations, sweating, pallor)
3-duration of shaking?
(1-2min or 10-30sec)
4-any postictal symptoms?
(confusion, incontinence, tongue biting) |
|
Definition
*(-prodroma/+postictal)(1-2min shaking)
GTC Seizure (dt CNS insult)(possible aura)
Epilepsy (if recurrent)
Alcohol Withdrawal (last drink 1-2dys)
Drug Withdrawal (CNS depressants)
Substance Abuse (CNS stimulants)
*(+prodroma/-postictal)(10-30secs shaking)
Convulsive Syncope (trigger unidentified)
Vasovagal Sync(fainting)(trigger identified)
Hypoglycemia (skipped meal, over exertion)
NB1: CNS insult
Trauma, Tumor, Infection, Hge, Stroke/TIA
~falls, then LOC/seizure -
ex. tremor, periph weakness
(causes of fall, leads to hd trauma & LOC, assess for possible IC hge etc)
~LOC, then falls -
ex. seizure, syncope
(assess hd trauma & possible IC hge etc)
(if lying supine, will still have LOC & shaking!)
NB2:
prodroma= palpitations, lightheaded, sweating, nausea, pallor (these symptoms are similar to symptoms of arrhythmia; palpitation, lightheaded, fainting, sweating, fatigue, dyspnea, chest pain)
during= rhythmic shaking / jerking of arms & legs (duration important), tongue biting, incontinence
postictal=confusion, drowsiness/fatigue, weakness/numbness, speech difficulty (& in GTC; vomits)
NB3: may note reason of falling from; NUMBNESS/WEAKNESS
TREMOR/ABN GAIT
DIZZINESS/VERTIGO |
|
|
Term
LOC(SYNCOPE,FAINT,BLACKOUT)/SEIZURE (2)
Key Qs:
1-pls describe more/was it witnessed?
2-any prodromal symptoms?
(palpitations, sweating, pallor)
3-duration of LOC?
(1-2min or 10-30sec)
4-any postictal symptoms?
(confusion, incontinence, tongue biting) |
|
Definition
*(-prodroma/-postictal)(10-30secs shaking)
Cardiogenic Syncope(DOE,SOB,PH/FH hrt dis)
(rhythm/structure,decreased COP)(w exertion"$"; if heart structure or valve problem. ie all except arrhythmia)
-Arrhythmia (both irreg HR)(SVT-yng pt)
-AS,MS(both PH hrtdis/murmur)(AS-adult)($)
-MVP,HOCM(both yng,FH+)(HOCM-athlete)($)
*lifestyle (LOC/Fainting/Syncope/Seizure)
(compare to Dizziness/Lightheaded)
o HypoTN (Dehyd, Meds)(postural)
Heat Stroke (Dehyd)(yng athlete)(old pt)
Hypoglycemia (if SEVERE)
Anemia
Malingering (2ary gain) |
|
|
Term
DIZZINESS(LIGHTHEADED)/VERTIGO(ROOM SPINS) ~FALL RISK~
Key Qs:
1-pls describe meaning? course? duration?
2-w HL?
3-w neurological symptoms?
4-any medications? risks of falling? |
|
Definition
*peripheral/episodic
Meniere (20min-1dy)(w HL 1st)(& tinnitus)
!!Labrynthitis (~dys-wks)(w HL)(&tinnitus)
BPPV (20sec-1min)(no HL)(w nystagmus)(MC)
!!VestNrnitis(~dys-wks)(no HL)(w nystagm)
*central/continuous - w neuro symptoms
Acoustic Neuroma(Schwannoma)(w uni HL 1st)
VestibuloBasilar Insuffic(atherosc)(no HL)
CerebellarTumor (no HL)
Multiple Sclerosis (no HL)
*misc (Dizziness/Lightheaded)(no LOC!)
Hypoglycemia
oHypoTN dt Dehydration
(Diarrhea, Alcohol, Diuretics, vDilators)
Heat Exhaustion
MVP, AS
Anemia |
|
|
Term
HEARING LOSS
Key Qs:
1-unilat/bilat?
2-words understood/mumbled?
3-can hear in noisy areas?
4-assoc w dizziness? |
|
Definition
*SNHL (mumbled)(worse in noisy areas)
Cochlear Nerve Damage
(Loud noise, Post viral, Head trauma, Familial)
Presbycusis (old pt)(low freq better)
Meds (Loops, Aminoglycosides)
*CHL (better in noisy areas)
Otosclerosis (old pt)
Infection (w pain) (OM w URI, OE in canal)
Effusion (post URI)
TM Perforation
Wax Impaction
FB Impaction
*w balance problems(see Dizziness/Vertigo)
Meniere
Labrynthitis
Acoustic Neuroma |
|
|
Term
VISION LOSS
Keys Qs:
1-sudden/gradual?
2-painful/less? |
|
Definition
*sudden
retinal artery occlusion
retinal vein occlusion
retinal detachment (flashes/floaters)
temporal arteritis (w chewing)
*w pain
optic neuritis
narrow angle glaucoma (w darkness)
*gradual
cataract
open angle glucoma
diabetic retinopathy
refractive error |
|
|
Term
*PSYCH*
(analyze CC in HPI, ask any assoc S/S, then shift immed to PH, to uncover risk factors or leading clues, to narrow DD) |
|
Definition
|
|
Term
CONFUSED/FORGETFUL
Key Qs:
1-course?
2-affect? support? ADL/IADL
3-neuro?
4-screen; sad, cold, Etoh, STDs?
by exclusion= Alzheimer (pt>65yo) |
|
Definition
*progressive
^^Alzheimer^^ Dementia(steady)(onset very insiduous)(>60yo)
^^Vascular^^ Dementia(stepwise/fluctuates)(onsets related to ministrokes/MI)(RF atherosclerosis)(early loss IADL)(personality change)
Lewy Body Dementia (fluctuate) (parkinson; tremor, brady, rigid, gait) (visual hallucination!!!) (>60yo)
Creutzfeldt Jacob (rapidly) (myoclonus)
Subdural Hematoma (old pt/trauma)(lucid)
Intracranial Neoplasm (neuro symptoms)
*reversible
Wernicke Encephalitis (B1/alcohol) (gait)
SCD (B12/gastritis) (gait, WNT)
^^Depression^^ (pseudodementia) (sadness) (primarily I/ADL loss, more than sadness)
HIV Dementia (>1mo)
NPH (gait, incontinence)
Neuro Syphilis (gait, incontinence, WTN)
Hypothyroidism
*fluctuating (acute)(disoriented)=Delerium
Delerium Tremens
Hypoglycemia
Hypoxia (Resp or Heart failure)
Acute Liver Failure
Uremia (Renal Failure)
Electrolyte Imbalance
Fever
Meds Side Effect |
|
|
Term
HALLUCINATIONS/PSYCHOSIS
Key Qs:
1-duration?
2-mood? |
|
Definition
*according to duration
Schizophrenia (>6mo)
Schizophreniform (1-6mo)
Brief Psychotic Disorder (<1mo) (stress)
Schizotypal (magical thinking)
Schizoid (prefers isolation)
*w mood disturbance
Schizoaffective Disorder (2wks+sad/manic)
Mood Disorder w Psychotic Features
Depression w Psychotic Features
*misc
Substance induced Psychosis (no insight)
Illness induced Psychosis
NB: Narcolepsy (hypnopompic/gogic halluc) |
|
|
Term
DEPRESSION
Key Qs:
1-duration?
2-severity?
3-pyschosis? |
|
Definition
*according to duration
Normal Bereavement (2mo)
Adjustment w Depressed Mood (strong reaction to stressful event)
Major Depressive Disorder (6-12mo) (early morning awakening)
Seasonal Affective Disorder (winter time)
*according to severity
Dysthymic (>2yrs) (less severe)
Cyclothymic (>2yrs) (dysthymia/hypomania)
Bipolar I (manic+/-depressive episode)
Bipolar II (hypomanic+depressive episode)
(NB:manic=1wk, hypomanic=4dys)
*w pyschotic features
Major Depression w Psychosis
Schizoaffective Disorder
Substance Induced Mood Disorder
Domestic Violence!! |
|
|
Term
FATIGUE ---> PH & CT
(consider WEAKNESS/Proximal too)
Key Qs:
1-psych;sad?stress?sleep?
2-organic;pallor?polyuria?intolerant cold?
3-assoc? |
|
Definition
*psychologic
Major Depression (early morning awakening)
Atypical Depression (increased sleep & wt) (able to react happily to pleasant stuff)
Adjustment Disorder (severe response to stress)
Domestic Violence!!
Acute Stress Disorder (3dys-1mo)
PTSD (w/in 3mo, lasts>1mo) (related to traumatic event, nightmares, flashbacks, avoids relevant triggers)
GAD (>6mo) (unrelated to anything)
Psychotic/Delusional Disorder
*organic
Colorectal CA
Anemia- Menorrhagia, Bleeding PUD
Hypothyroidism
*w polyuria/dypsia
DM
DI
HyperCalcemia
1ary Polydypsia
*sleep related
Obstructive Sleep Apnea
Narcolepsy (excessive daytime sleepiness)
Chronic Fatigue Syndrome (Caregiver)
Workshift Sleep Disorder
Jet Lag (recent travel)
*progressive!!!!
Myasthenia Gravis (diplopia, ptosis, difficulty chewing, dysphagia, dyspnea, limb weakness) |
|
|
Term
INSOMNIA
Key Qs:
1-falling/maintaining/awakening?
2-affect on life?
3-2ary; medical/psychologic/life style? |
|
Definition
*difficulty initiating
Stress Induced Insomnia
(see Anxiety; GAD, Adjustment, etc)
Caffeine Induced Insomnia
Circadian Rhythm Disorder
(Delayed Phase, Work Shift, Jet Lag)
Hyperarousal (excluded ALL causes)
*difficulty maintaining
Obstructive Sleep Apnea
Restless Leg Syndrome
Alcohol / Substance Abuse
Medical Illness (Thyroid, Menopause)
Nightmares/PTSD (multiple awakenings)
*early morning awakenings
Major Depression
Advanced Phase |
|
|
Term
ANXIETY
Key Qs:
1-duration?
2-ppt factor? |
|
Definition
*trigger identified
Acute Stress Disorder
PTSD (traumatic event, w/in 3mo, avoids +)
Specific Phobia
Panic Attack
*no trigger
Avoidant Personality
Social Phobia
GAD |
|
|
Term
| ((explaining Insomnia types)) |
|
Definition
TYPES OF INSOMNIA!!
imp to determine treatment method
**primary(10%)/secondary
primary-hyperarousal (after excluding all other possible causes)
secondary-all other causes
**acute(temporary)/chronic
acute-few dys/wks, resolves on own
chronic-4nights/wk, for more than 1mo
**onset/maintenance/terminal
onset-mind can't relax, body not ready to sleep, overstimulation, circadian changed & not aligned w light/darkness outside
maintenance-second half of sleep is light, so easily aroused from sleep, whether from etoh, eating too much (alot of energy), meds or subs abuse, or environmental (light/noise/temp) or medical conditions (pain, urination, hot flashes/intolerance) etc
NB:
circadian rhythm disorder=
delayed/advanced phase
jet lag/work shift |
|
|
Term
|
Definition
|
|
Term
|
Definition
*chest
Hemothorax
Pneumothroax
Pneumonia
*abdomen
Rib Fracture
Rupture Spleen
Hemoperitoneum |
|
|
Term
|
Definition
Domestic Violence
Rape
Substance Abuse
Consensual Violent Sex
Osteogenesis Imperfecta |
|
|
Term
|
Definition
*D.E.M.D.E.M.C.C.C.*
Diagnosed
Educate
Monitor
Diet
Exercise
Meds
Compliance
Complications
Chronic Illness Effect |
|
|
Term
|
Definition
|
|
Term
|
Definition
*S.P.I.K.E.* protocol
Setup
Perception
Invitation
Knowledge
Emotions
Strategy/Summary |
|
|
Term
RASH
Key Q;
itchy?
(border, elevation, spread)
(itch, burn, numbness)
(tender, blister)
(assoc-red eye, joint pain)
(insect bite,animal contact,recent travel) |
|
Definition
Herpes Zooster (hx of chicken pox)(stress)
Contact Dermatitis (trigger) |
|
|
Term
|
Definition
|
|
Term
PEDS FEVER (N=97-99F, HIGH=102F/39C)
1-how much/how measured?
2-lethargy, feeding?
3-daycare?
4-red eyes/rash? assoc symptoms? |
|
Definition
Neonatal Sepsis (high fever, lethargy)
Meningitis (high fever, lethargy)
Pneumonia (high fever, cough)
Pertussis(fever, cough, vomit)(vaccine?)
Pyelonephritis (high fever, chills)
Febrile Convulsion(high fever,shake<10min)
Occult Bacteremia (high fever)(NO immuniz)
Viral Exanthem (high or low fever)(immun?)
URI (runny nose, sneeze, cough)(daycare)
Acute OM (preceeded URI,ear pull)
GE (diarrhea)(daycare)
Hepatitis (jaundice)
UTI (daycare)
Viral Exanthem |
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Term
PEDS FEVER W RASH
Key Qs;
1-high/low fever
2-face/trunk
3-flat/raised
4-non/itchy |
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Definition
Roseola/Sixth(HIGH fever,rash-spares face)
Scarlet (HIGH fever, face & trunk)
sandpaperrashcircumoralpallorstrwbrytongue
Measles (red eyes) (Koplik spot)(vaccine?)
German Measles/Rubella (red eyes(vaccine?)
Fifth (itchy)(slap cheek)
Varicella (itchy)(raised)(vesicle crops)
Viral Exanthem |
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Term
PEDS NOISY BREATHING/STRIDOR
Key Qs;
1-fever
2-inspiratory; above/larynx
expiratory; below larynx
biphasic; trachea |
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Definition
*fever
Epiglottitis (drool) (NO wheeze)
Croup/Laryngotracheobronchitis (barking)
Bronchiolitis (wheeze) (NO drool)
*no fever
FB Aspiration (insp stridor) |
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Term
PEDS ENURESIS
Key Qs;
1-frequency, timing, dry nights before
2-constipation, snoring
3-urinary, diabetic, neurologic symptoms
3-environmental changes, stress |
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Definition
*regularly bedwetting (most wet nights)
Nocturnal Enuresis
*transient bedwetting (few wet nights)
Secondary Enuresis due to DM
Secondary Enuresis due to UTI
Secondary Enuresis due to Constipation |
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Term
PEDS JAUNDICE
Key Qs;
1-age
2-extent of jaundice, pale stool/tea urine
3-breastfeeding |
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Definition
*early onset - 1st wk life
Physiologic Jaundice (peak 3rd-7th dy)
Rh or ABO Incompatibility (1st wk)
Neonatal Sepsis (HIGH fever)(1st few wks)
Cephalohematoma (obstructed birth)
Breastfeeding Jaundice (poor breastfeed)
*late onset
Breastmilk Jaundice (breastfeeding well)
Biliary Atresia
Metabolic Disorder
(hypothyroid, galactosemia, hereditary hemolytic; spherocytosis, G6PD defic) |
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Term
PEDS VOMITING
Key Qs;
1-fever
2-non/bilious
3-onset
4-bloody stool |
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Definition
NO FEVER, NO DIARRHEA
*non-billious
Pyloric Stenosis(projectile)(15-30m after)
Head Injury (lethargy,no fever)(hx trauma)
Reflux (non forceful)(milk spit)
Formula Allergy (milk spitting w colic)
*bilious
Meconium Ileus (immed) (common in CF pt)
Dudenal Atresia (few hrs) (in 25% Down pt)
Volvulus (3-7 dys)(bloody stool)
NEC (10-12 dys)(bloody stool)
*misc (different presentation than adult)
Meningitis (low appetite, lethargy)
UTI (low appetite, irritability)
*w fever (see FEVER)
*w diarrhea (see DIARRHEA) |
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Term
PEDS DIARRHEA
Key Qs;
1-fever? flatulence?
2-red current jelly/greasy stool
3-food allergy, formula fed
4-stress, meds |
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Definition
*fever
GE
Food Poison
*abdominal distension
LI
Food Allergy
Intussusception (red current jelly)
*misc
IBS (stress)
Pseudomembranous Colitis (antibiotic) |
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Term
PEDS CONSTIPATION
Key Qs;
1-bloody/melena
2-painful/less |
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Definition
Hirschsprung (no BM in 1st 2dys)
Meckel Diver (melena)(painless)(upto 2yrs)
(leading to intest obstruction/ abd pain)
Imperforate Anus
Anal Stenosis
Anal Fissure (red blood)(painful)
Low Fiber
Dehydration
Hypothyroidism (delayed development)
Lead Poison(delayed develop)(old building) |
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Term
PEDS BLOODY STOOL
Key Qs;
1-red/black tarry
2-pain/less
3-assoc symptoms |
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Definition
*bright red
Intussusception (bld/mucus mix)(abd pain)
Anal Fissure(bld not mixed)(pain defecate)
*black tarry
Volvulus (bilious vomit)(abd pain)
NEC (bilious vomit) (painless)
Meckel Diverticulum (painless) |
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Term
PEDS ABD PAIN
Key Qs;
1-fever
2-vomiting
3-other symptoms |
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Definition
*w fever
Appendicitis (>3hrs)
Gastroenteritis (diarrhea)
UTI (poly/dysuria/bedwetting)
*abd distention (see VOMITING)
*stress
IBS
Somatoform
Malingering
Child Abuse
*misc
Infantile Colic
Blunt Trauma
Testicular Torsion
Strangulated Hernia |
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Term
PEDS INCONSOLABLE CRYING
Key Qs;
1-fever |
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Definition
OM (head turning/ear pulling)
UTI (irritability)
Infantile Colic (abd distention)
Formula/Cow Milk Allergy (abd distention)
Teething
Trauma
Strangulated Hernia
Testicular Torsion
NB; Consolable Crying
Hunger
Thirst
Emotional Distress
Physical Reassurance
NB; Day care infections; URI > GE > UTI |
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Term
PEDS DIABETES
Key Qs;
1-hyperglycemia symptoms
2-emergency kit, hypoglycemia symptoms
3-infections, neuro symptoms |
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Definition
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Term
PEDS RED EYE/PINK EYE
1-ill contact
2-constitutional symptoms |
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Definition
Bact Conjunctiv(discharge)(URI/sorethroat)
Viral Conjunctivits(tears)(URI/sorethroat)
Seasonal Allergies (itchy, sneeze)
Keratitis (pain)
Uveitis (pain) |
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Term
PEDS SHORT STATURE
1-FH
2-any medical illness
3-assoc vomiting or diarrhea
4-other developmental milestones |
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Definition
Constitutional Short Stature
Genetic Causes
Chronic Renal Insufficiency
Cystic Fibrosis
GH Deficiency
Hypothyroidism
Malabsorption
Failure to Thrive |
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Term
PEDS BEHAVIOR PROBLEMS
Key Qs;
1-age |
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Definition
ADHD
Opposition Defiant Disorder
Conduct Disorder
Adjustment Disorder
Age Appropriate Behaviour
Substance Abuse
Intoxication
Manic Episode
Hyperthyroidism |
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Term
| ((Alcohol Withdrawal Timeline)) |
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Definition
6-12hrs; tremor w sympathetic overactivity
12-24hr; tremor w hallucination(w insight)
24-48hrs; withdrawal seizures
48-72hrs(DT); tremor w fever, confusion, sympathetic overactivity, visual hallucinations (no insight) |
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Term
FREQUENT FALLS/RECENT FALL
Key Qs; |
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Definition
(see DISTAL WEAKNESS, TREMOR, DIZZINESS)
*Distal Weakness
-CNS
ALS
NS
Syringomyelia
-PNS
Alcoholism
Diabetic Neuropathy
*Tremor
Parkisonism
MS
*Dizziness
Syncope
-neurogenic: vasovagal, convulsive
-cardiogenic; AS, MVP
Orthostatic Hypotension
-diarrhea
-diuretic
Multiple Medications
Poor Vision
Foot Wear |
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Term
DIZZINESS (LIGHTHEADEDNESS)
Key Qs: |
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Definition
*Cardiac
AS
MVP
*Lifestyle
Hypoglycemia
Hypotension; Orthostatic (diarrh/diuretic)
*Environmental
Heat Exhaustion |
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Term
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Definition
Common Problems;
Falls, Dizziness, Depression, Incontinence
Atypical Presentations;
MI, Thyroid, Fever
History questions, screen for;
Cancer
Depression
Dementia (including I/ADL)
Abuse
Workup screen for; Cancer above 50yo
Mammography x2yrs
Colonoscopy x10yrs |
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Term
JAW PAIN
Key Qs;
1-bruises |
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Definition
Temporal Arteritis (hdche,tender temples)
Carotid A Dissection (atherosclerosis)
Domestic Violence (bruises) |
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Term
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Definition
Parkinson (shuffling)
MS (AbN tandem)
Cerebellar (ataxic)
?? (magnetic gait) |
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Term
JAUNDICE
Key Qs:
1-color skin/urine/stool
2-itching
3-blood borne; (tatoo,transfusion,needle)
4-food borne; (contact, travel, immuniz) |
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Definition
*CONJUGATED; "pale stool & dark urine"
-Hepatic
Hepatocellular Dis
(Viral Hepatitis, Alcoholic Hepatitis, Acetaminophen Hepatotoxicity)
Drugs
Sepsis
Hereditary (ex Dubin Johnson)
-Nonhepatic
Extrahepatic Biliary Obstruction
((constant))
Pancreatic CA
Cholangio CA
Asc Cholangitis (f/c,shock,RUQpain)
Sclerosing Cholangitis (f/c,itch,RUQpain)
1aryBiliary Cirhos(female,itch,w/other AI)
((intermittent))
Choledocholithiasis (stone CBD)
Ampullary Carcinoma
Sphincter Oddi Dysfunction
*UNCONJUGATED; N stool/urine (unnoticed)
-Hepatic
Gilbert (unnoticed)
-Nonhepatic
Hemolysis (unnoticed) ex; G6PD, Sickle cell, Transfusion Reaction |
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Term
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Definition
Celiac Disease
Atopic Dermatitis
Contact Dermatitis
Chicken Pox
Primary Biliary Cirrhosis
Cholangio Carcinoma |
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Term
PEDS SEIZURE
Key Qs;
1-fever? high grade (febrile convulsion)
2-duration shaking? (<10min; simple)
3-assoc? irritable/lethargy (meningitis!)
febrile illness (URI, other) |
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Definition
*high grade fever
Neonatal Sepsis
Meningitis
Occult Bacteremia
Febrile Convulsion
*no fever
Hyponatermia (diluting formula)
CAH (hirsutism etc..) |
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