• recent abx use (c. diff is a concern); pseudomembranous colitis.
• stool rarely contain gross blood.

FA Step 2 CS p. 167

• most common cause of lower GI bleeding: diverticulosis
• angiodysplasia
• hemorrhoids
• colon cancer
• ulcerative colitis

FA p. 167

• invasive bacterial infection
• inflammatory bowel disease

FA p. 167

• JVD
• carotid bruit
• CV: inspection, auscultation, palpation
• extremities: peripheral pulses, BP b/l, inspect for edema/cyanosis, and palpate calves for DVT

FA p. 170 

• TEE - transesophageal echocardiogram
• TTE - transthoracic echo can demonstrate segmental wall motion abnormalities in suspected acute MIs (infarction is unlikely in absence of wall motion abnormalities).

FA p. 174

• viral URI
• pneumonia
• meningitis
• otitis media
• UTI
• gastroenteritis
• occult bacteremia
• dx workup: pneumatic otoscopy, tympanometry, CBC (w/ diff, blood culture, UA, urine culture), LP, CT head, CXR.

FA p. 180

• ear pulling
• ear discharge
• runny nose (rhinorrhea)
• difficulty swallowing
• rash
• shaking (seizures)
• Social Hx: sick contacts, daycare, vaccination, last check up, birth hx.

FA p. 185

• otitis media
• meningococcal meningitis (concern for DIC; in additon to LP check platelete, PT/PTT, D-dimer, fibrin split products, fibrinogen)
• scarlet fever
• 5th disease or other viral exanthem
• varicella

FA p. 185

• acute cough frequently follows URI ("postinfectious" rhinosinusitis or acute bronchitis) and can commonly persist for 1-2 weeks (6-8 if pt is asthmatic).
• bronchitis is primarily caused by viruses.

FA p. 187, 193

• CBC: loof for macrocytic anemia (B₁₂ deficiency).
• Electrolytes, Ca, glucose, BUN/Cr: to screen for medical conditions that can present with cognitive dysfxn (hypernatremia, hypercalcemia, hyperglycemia, uremia).
• Serum B₁₂, TSH, RPR: screen for reversible causes of dementia.
• CT-head: subdural hematoma, mass, strokes, dilated ventricles.
• MRI-brain

FA p. 215

• medication side effects
• alcohol use → ↑ risk of ED
• depression
• libido
• dx workup should include testosterone (hypogonadism)

FA p. 271

• multiple myeloma or paraproteinemias
• test with SPEP (serum protein electrophoresis)

FA p. 222

1. sweating
2. tachycardia
3. palpitations
4. tremor
5. anxiety
6. weakness
7. confusion
8. seizures

FA p. 222

• doppler u/s of penis

FA p. 222

• nerve conduction studies

FA p. 222

• brain stem auditory evoked potentials

FA p. 229

• penile scarring
• ED
• workup with genital exam
• rectal exam for ED pt as well; to detect masses or prostatic abnormalities.

FA p. 271

• cut back
• angry
• guilt
• eyeopener

• gout
• pseudogout
• SLE - think oral ulcers
• RA
• gonococcal septic arthritis → pelvic exam, knee aspiration w/ synovial fluid analysis.
• nongonococcal septic arthritis
• osteoarthritis

FA p. 277

1. joint symptoms
2. constitutional symptoms (fever, chills, appetite, weight loss).
3. raynaud's
4. rash
5. photosensitivity
6. oral ulcers
7. serositis
8. renal disease

FA p. 278

• essential tremor includes: postural tremor (eg, when arms are held outstretched) and/or action tremor (eg, tremor ↑ at end of goal directed activity such as finger-to-nose).
• physiologic tremor: low amplitude high frequency tremor present in normal individuals. Tremor can be accentuated with anxiety, excitement, fatigue/sleep deprivation, hypoglycemia, caffeine intake, etOH withdrawal, thyrotixocosis, fever, and pheochromocytoma.

FA p. 286

• FSH > 40 is dx for premature ovarian failure
• PCOS, although a clinical dx, LH > FSH; ↑ levels of estrone (derived from obesity) → ↓ FSH.

FA p. 308

• domestic violence (physical, emotional, sexual abuse)

FA p. 315

• vulvovaginitis - infxn or inflammation of vagina
• cervicitis
• endometriosis
• vulvodynia - pain may be constant or intermittent, focal or diffuse. No PE findings; dx of exclusion. vulvar erythema → vulvar vestibulitis (subset of vulvodynia)
• domestic violence
• pelvic tumor
• vaginisumus
• ask about vaginal d/c; ask pt to describe it.
• pelvic exam, wet mount, KOH prep, whiff test, cervical cultures, laparoscopy.

FA p. 315

• metastatic prostate cancer → rectal exam

FA p. 320

• urine toxicology
• blood etOH

FA p. 348

• pelvic exam
• urine βhCG
• wet mount, KOH prep, cervical culture
• XR - skeletal survey
• HIV Ab, VDRL, HBV antigen
• CXR
• collect evidence with rape kit

FA p. 354

• breast/pelvic exam
• urine hCG
• u/s pelvis - confirm location and gestational age
• CBC, glucose - baseline value in case pt develops gestational diabetes.
• TSH - neurologic developlment may be adversely affected in children born to mothers with hypothyroidism.
• RPR, rubella IgG, HBsAb, HIV Ab
• Blood type, Rh Ab screen
• Pap smear
• Cervical gonorrhea and chlamydia DNA testing
• UA, urine culture

FA p. 362

• anxiety
• caffeine-induced insomnia
• hyperthyroidism → TSH, free T₄, ECG
• insomnia related depression
• adjustment insomnia
• illicit druge use → urine toxicology
• OSA → polysomnography

• substance-induced psychosis
• brief psychotic disorder
• psychosis secondary to medical condition - CNS infection/neoplasm, thyroid/parathyroid, adrenal abnormalities, hepatic, and renal disorders → electrolytes, LFTs, TSH, free T₄.
• narcolepsy - hypnagogic or hynopompic
• seizure
• w/u: U tox, mental status exam, lytes/LFT/TSH, EEG, polysomnogram.

FA p. 376

• Cushing syndrome → 24-hour free cortisol
• w/u: glycosylated Hb/HbA_1c, UA/urine microalbumin, insulin and C-peptide, islet cell Ab, 24-hour free cortisol.

FA p. 383

• CBC (infection)
• ESR (temporal arteritis)
• CT/MRI brain
• LP
• CT-sinus (sinusitis)

FA p. 256