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86 Cards in this Set
- Front
- Back
Headache, throbbing, L. temporal pain, lasts 2-3hrs., flashes of light, weakness and numbness on the right risde of her body for a few minutes.
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Migraine
Tension HA Cluster HA Pesudotumor Cerebri Trigeminal Neuralgia CNS Vasculitis Partial Seizure Intracraneal Neoplasia |
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Migraina HA is associated w/ what sympt.?
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nausea/vomiting
family Hx |
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Headache, blurred vision, temporal region, pain in jaw when chewing?
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Temporal Arteritis (giant cell)
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Headache, temporal region, ipsilateral rhinorrhea, eye tearing, redness.
Episodes at same time/night lasts for 45 min. |
Cluster HA
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Diff. for Temporal Arteritis?
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migraine
tension meningitis Carotid Artery Dissection Pesudotumor Cerebri |
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Diff. sinusitis?
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Mirgaine
Tension HA Meningitis IC neoplasm |
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HA + Confusion, vomiting?
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Subarachnoid Hemorrhage
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Diff for Subarachnoid Hemorrhage?
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Migraine
Meningitis Encephalitis Vertebral artery dissection IC venous Thrombosis |
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Diff. Pseudotumor Cerebri?
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Cluster HA
Meningitis IC venous thrombosis Migraine |
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HA, pain on R. cheek, 1 mo., electric character?
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Trigeminal Neuralgia
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Diff Trigeminal Neuralgia?
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Tension HA
Migraine Cluster HA TMJ dysfunction IC neoplasma BRUXISMUS |
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Patient w/ confusion, forgetfulness?
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Vascular Dementia
Alzheimer's Dz Normal Pressure Hydrocephalus Chronic Subdural Hematoma IC tumor B12 def. Neurosyphilis Hypothyroidism |
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Pat. w/ dizziness?
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Meniere's Dz
Vestibular Neuronitis Labyrinthitis Benign Positional Vertigo Acoustic Neuroma |
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Dizziness w/ severe diarrhea that started 2 days ago?
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Orthostatic Hypotension due to dehydration
Vestibular neuronitis BPV (benign pos. vertigo) |
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Pat. w/ psychosis?
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Schizophrenia
Schizotypical Personality disorder depression w/ psychotic features |
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Dizziness w/ URI 2 days ago, n/v+
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Vestibular Neuronitis
Labyrinthitis Meniere's Dz Vertebrobasilar insufficiency |
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Tests for Dizzines?
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Audiogram
Electronystagmography MRI/MRA- brain |
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Don't forget to ask patient w/ trauma?
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did you loose consciousness...
did you have any seizures... |
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Pat. falls and loses consciousness at work, movementes of limbs, bit his tongue... loss bladder control
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Seizure, grand mal
substance abuse malingering hypoglycemia |
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65 M losing consciousness for few seconds, had palpitations before falling?
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Cardiac Arrythmia
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Differentials for sudden loss of conciousness?
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Sever aortic stenosis
syncope Seizure Pulm. embolism |
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Pat. w/ numbness?
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TIA
hypoglycemia seizure |
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Pat. w/ R. Knee pain Dx?
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Osteoarthrtitis
Septic Arthritis Pseudogout Gout Meniscal/Lig. damage Reiter's Arthritis |
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Dx. Test for R. Knee pain?
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XR-knee
CBC ESR Knee Arthrocentesis/synovial fluid analysis MRI-Knee |
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Pat. 65M w/ R. foot pain?
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Planta Fascitis
Stress Fx Foot sprain/strain |
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30 yo F multiple facial and physical injuries?
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Rape
Attacked and raped by two men |
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Dx Test Rape?
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Pelvic Exam
hCG (urine) Wet mount, KOH CBC HIV Ab Viral Hepatitis Serologies |
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70 yo fem, loss of hearing?
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Acoutic Neuroma
Lyme Ototoxicity from DRUGS Stroke |
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Fem. renal pain? back pain?
What physical findings? |
Check for Murphy, check for CVA?
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Diff. dx of renal pain/CVA tenderness? back pain...
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Renal Cell Carcinoma
Nephrolithiasis Acute glomerulonephritis Pyelonephritis Prostate CANCER Bladder CANCER |
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Diff dx. painless hematuria?
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Bladder CANCER
Renal Cell CA Nephrolithiasis Acute Glomerulonephritis Coagulation Disorder Polycystic Kidney Dz |
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60yo. M, nocturia, urgency, weak stream, terminal dribbling. C/o 2 episodes of urinary retention...
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Benign Prostatic Hyperplasia (BPH)
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Diff Dx. of urinary retention, nocturia, urgency?
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Benign Prostatic Hyperplasia
Prostate CA UTI Bladder Stones |
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45 yo. DM, dysuria, fever, chills, Nausea+?
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Urethritis
Cystitis Prostatitis |
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Boy w/ Fever?
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Acute Otitis Media
URI Meningitis UTI |
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20 day old M, fever, decreased breast-feeding, lethargy?
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PROM probably:
NEONATAL SEPSIS MENINGITIS PNEUMONIA UTI |
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Pat. w/ back pain, diff dx?
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Disk Herniation
Lumbar muscle strain Tumor in the vertebral canal Abdominal Aortic Aneurysm Vertebral Compression Fracture |
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45 yo M pain in lower back, legs during prolonged standing/walking?
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Lumbar Spinal Stenosis
Lumbar muscle Strain Tumor in the vertebral canal Peripheral Vascular Disease |
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55 yo M with crampy bilateral thigh + calf pain, fatigue, dark urine? taking simvastatin/clofibrate for hyperlipidemia
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Rhabdomyolisis due to simvastatin or clofibrate
Polymyositis Inclusion Body myositis Thyroid Dz |
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17 yo M trying to get out of gym class at school, complains of back pain?
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Malingering
Lumbar Muscle Strain Disk Herniatioin Knee or leg fracture Ankylosing Spondylitis |
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Pat. w/ chest pain?
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don't forget to obtain JVD
pulses, chest examination |
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Diff. Chest Pain? African American...
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Sickle Cell Dz- pulmonary Infaction
Acute Chest Syndrome Penumonia Pulmonary EMBOLISM MI Pneumothorax Aortic Dissection |
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W/U Chest Pain?
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CBC, ret. count, LDH, peripheral smear
ABG CXR CPK-MB, troponin ECG V/Q Scan CT-Chest with IV Contrast |
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60 yo M sudden onset?
30 min., rad. to L. arm? |
MI
GERD Angina Costochondritis Aortic Dissection Pericarditis Pulmonary Embolism Pneumothorax |
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45yo F, persents w/ retrosternal burning pain, after heavy meals/when lying down worsening?
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GERD
Esophagitis Peptic Ulcer Dz Esophageal Spasm MI Angina |
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Syncope/Loss of Consciousness?
LOC... 26yo. M bit tongue |
Seizure, grand mal
now Complex Tonic-Clonic Seizure Convulsive Syncope Substance Abuse/Overdose Malingering Hypoglycemia |
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Syncope/Loss of Consciousness?
55yo, hx HTN, IVDU... |
Drug-induced orthostatic Hypotension (cause)
Cardiac Arrythmia Syncope (Vagal) Stroke MI Pulm. EMBOLISM |
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Syncope/Loss of Consciousness?
65yo M, Hx of CABG? |
Cardiac Arrythmia
Severe Aortic Stenosis Syncope (Vagal) Seizure Pulmonary embolism |
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W/U for Syncope/Loss of Consciousness?
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CBC, electrolytes, glucose
Urine Toxicology EEG MRI-brain CT - Head LP -CSF analysis ECG Echocardiography V/Q scan |
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Pat. w/ weakness/lightheadedness at gocery store?
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TIA
hypoglycemia Seizure |
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Pat. 68yo M slurred speech, R. facial dropping/numbness, R. hand weakness? Totally resolved at E.R.? Dx of HTN, DM or heavy smoking
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TIA
Hypoglycemia Seizure |
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Pat. w/ tingling/numbness on hands feet? glove distribution...
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Diabetic Peripheral Neuropathy
Alcoholic Peripheral Neuropathy B12 def. Hypocalcemia Hyperventilation Paraproteinemia/myeloma |
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W/U for tingling/numbness?
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ESR
Calcium serum B12 Glucose, HbA1c Serum/Urine Protein Electrophoresis |
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25 yo. M hemiparesis after seizure that resolves after hours?
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Todd's Paralysis
TIA Stroke Complicated Migraine Malingering |
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40 yo F, ocassional double vision, droppy eyelids at night with normalization by morning?
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Myasthemia Gravis
Horner's Sx Multiple Sclerosis Intracraneal Tumor Compression of III, IV or VI Amyotrophic Lateral Sclerosis (ALS) |
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W/U for droppy eyelids and double vision?
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Tensilon Test
ACh receptor Abs CXR CT- Chest MRI-Brain EMG |
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Pat. w/ difficulty swallowing?
solids 1st... now liquids |
Esophageal CANCER
Achalasia Esophagitis Systemic Sclerosis Esophageal Stricture Amyotrophic Lateral Sclerosis |
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W/U of dysphagia?
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CBC
CXR Endoscopy w/ biopsy Barium Swallow CT-chest |
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45 yo. F dysphagia for 2 weeks + fatigue + craving ice clay?
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Plummer-Vinson Sx
Esophageal Cancer Esophagitis Achalasia Systemic Sclerosis Mitral Valve Stenosis |
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W/U dysphagia + fatigue/craving ice/clay?
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CBC
Serum Fe, ferritin, TIBC Barium Swallow Endoscopy Manometry |
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48 yo. F w/ dysphagia for both solids+liquids that slowly progressed in severity for 1 year ocassional regugitation of undigested food at night...
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Achalasia
Plummer-Vinson Sx Esophageal Cancer Esophagitis Systemic Sclerosis Mitral Valve Stenosis Esophageal Stricture Zenker's Diverticulum |
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W/U dysphagia for Solids+liquids?
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Esophageal Manometry
Barium Swallow CXR Endoscopy |
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38 yo M dysphagia/pain on swallowing solids > liquids.
Oral Thrush seen... |
Esophagitis (CMV, HSV, pill-induced)
Systemic Sclerosis GERD Esophageal Stricture Zenker's Diverticulum |
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45 yo. F presents w/ pain in both legs, induced by walking/relieved by rest
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DVT
Baker's Cyst Rupture Myositis Cellulitis Superficial Venous Thrombosis |
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W/U for DVT?
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doppler US -right leg
CBC CPK D-dimer |
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60 yo F c/o L. arm pain started while seh was swimming and was relieved by rest?
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Angina/MI
Tendonitis Osteoarthritis Shoulder Dislocation |
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W/U L. arm pain?
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XR-Shoulder
XR-arm MRI-Shoulder |
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60 yo F c/o L. arm pain started while seh was swimming and was relieved by rest W/U Tests?
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CPK-MB, ECG
CBC ESR XR-Shoulder CXR Stress Test |
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67 yo M R. shouder pain after falling onto outstrectch arm?
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Elder Abuse
Shoulder Dislocation Fx of the Humerus Rotator Cuff Injury |
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COPD pat. w/ cough? What to offer them?
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dont' forget to offer them water
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Patient that is crying... what to do?
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keep silent... 2-3 seconds
then offer Kleenex |
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Patient w/ Photophobia what to do?
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Make sure to lower the lights
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Pat. w/ shortness of breath, cough that is productive occured over the past two years for at least three mo. each year?
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COPD-chronic bronchitis
Bronchiectasis Lung Cancer Tuberculosis |
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30yo. M shortness of breath, cough, wheezzing worsen w/ cold air?
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Asthma
GERD Bronchitis Penumonitis Foreign Body |
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W/U w/ pat. shortness of breath?
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CBC
Sputum Gram Stain + Culture CXR CT- CHEST ECG PPD |
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25 yo. F cough 2 weeks, non-productive?
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Atypical Pneumonia
Reactive Airway Dz URI-associated post-infectious Postnasal Drip GERD |
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W/U for non-productive cough?
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CBC
Induced sputum gram stain/culture CXR IgM Mycoplasma Urine Legionella Ags |
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65yo M. cough worsening cough/ 6 months/ hemoptysis, dyspnea, weakness and weight loss/ smoker+
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Lung CANCER
Tuberculosis Lung Abscess COPD Vasculitis (Wegner's) Intersitial Lung Dz CHF |
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W/U for worsening cough >6months?
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CBC
Sputum Gram Stain/Cult.+cytology CXR CT- Chest PPD Bronchoscopy |
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34 yo. Nurse, presents w/ cough, weight loss, fatigue, night sweats, fever... what else do you ask for?
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dont' forget to ask for contacts?
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34 yo. Nurse, presents w/ cough, weight loss, fatigue, night sweats, fever?
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TB
Pneumonia Lung Abscess Vasculitis Lymphoma Metastatic CA HIV/AIDS |
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50yo. cough when lying down/improved by pillows?
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CHF
Cardiac Vascular Dz GERD Pulmonary Fibrosis COPD Postnasal Drip |
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What else do you need to ask for cough when lying down?
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Occupation!!!
Could have Pulm. fibrosis or Meds since Busulfan Bleomycin cause pulm fibrosis |
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W/U for cough when lying down?
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CBC
CXR ECG Echocardiography PFTs |
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Pat. 35 yo.w/ headache + photophobia?
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Subarachnoid Headache
"worst HA of life" Migraine Meningitis/Encephalitis IC hemorrhage Vertebral Artery Dissection IC venous thrombosis Acute HTN IC neoplasms |
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W/U of severe Headche?
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CT-Head
CBC LP PT/PTT MRI/MRA Brain Electrolytes |