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Step 2CS differential

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eesohbel's version from 2016-07-10 00:22

differential

Question Answer
mnemonic for differential of hematuriaHITTERS heme, infection, trauma, tumor, exercise, renal, stones
renal cell carcinomaclassic triad: hematuria, flank pain and palpable mass
top backpain differential disk herniation (ie sciatica), lumbar spinal stenosis, metastatic prostate cancer, lumbar muscle strain , metastatic prostate cancer, multiple myeloma
best test for suspected disc herniation or malignancyMRI: lumbar spine
top differential chest pain and dyspnea after MVApneumothorax and hemothorax
positive pregnancy testnormal pregnancy, ectopic pregnancy, molar pregnancy
test to support the diagnosis of type 1 DMislet cell antibodies
tests for newly diagnosed diabetesinsulin, c-peptide levels, HbAIC, electrolytes, UA, urine microalbumin, 24 hour urine free cortisol
test for pregnancyurine B-HCG
tests for STDwet mount, KOH prep, cervical culture, gonorrhea, chylamydia, HIV antibody, VDRL, HBV antigen
diagnostic tests for cellulitiswound and blood cultures
differential for hoarsenesslaryngeal cancer, laryngitis, vocal cord nodule
diagnostic test for GERDesophageal pH monitoring
test to evaluate the larynxlaryngoscopy
test for erectile dysfunctiondoppler US penis
differential amenorrhea 36 yo womanpregnancy, hyperprolactinemia, PCOS
signs of PCOSoligomenorrhea, weight gain, hirsutism
vaginal discharge w/fishy odor and pruritisvulvovaginitis
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Question Answer
vaginal discharge and pain w/deep thurstingcervisitis
abnormal ectopic endometrial tissueendometriosis
presentation of PIDuterine tenderness, adnexal tenderness, cervical motion tenderness
painless hematuriabladder cancer, renal cell carcinoma, nephrolithiasis, acute glomerulonephritis, UTI, prostate cancer
tests for painless hematuriaGU exam, UA, urine cytology, BUN/CR, PSA, cystoscopy, U/S-renal/bladder, prostate biopsy
workup for erectile dysfunctiongenital exam, rectal exam, glucose, CBC, testosterone level
workup for rapeforensic exam, pelvic exam, urine HCG, wet mount, KOH prep, cervical cultures, chlamydia and gonorrhea testing
hot knee diagnostic testknee arthrocentesis and synovial fluid analysis
young man with productive cough and pleuritic painpneumonia, URI-associated cough, acute bronchitis
important question to ask in jaundiced patientrelationship of food to pain and travel history
peripheral signs of chronic liver diseasepalmar erythema, spider angiomata, caput medusae
patient says they don't like to use condoms regularlyYou mentioned earlier that you don't always use condoms. I know condoms may be difficult to use regularly, but they are important in help stopping the spread of STDS. Do you have any questions?
questions to ask for gouthow does alcohol affect your joint pain? Does red meat affect your joint pain?
questions to ask for RAask about family history? what is your pain like in the morning? constitutional symptoms?
questions to ask for SLErash? photosensitivity? oral ulcers? abortions?
tests for rheum diseasesANA, DsDNA, RF, anti-CCP (high specificity for RA), knee aspiration, X-raay knee, pelvic exam, cervical cultures, blood culture
heel painplantar fascitis (pain typically gradual and after prolonged sitting), calcaneal stress fracture, achilles tendinitis
someone w chronic cough ask about systemic symptomsweight loss, appetite, fatigue, fever, chills, night sweats
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Question Answer
workup for chronic cough and hemoptysisPPD or quanitferon gold, CBC, blood cultures, sputum gram stain, AFB smear, routine and mycobacterial sputum cultures, cytology, CXR, bronchoscopy, lung biopsy
peripheral signs of lung cancerclubbing
risk factors for pancreatic cancersmoking, chronic pancreatitis, and first degree relative with pancreatic cancer
diagnosis of major depressive disorderdepressed mood or anhedonia and five or more from SIG E CAPS for two weeks or greater. (sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicidal ideations)
RF for chronic pancreatitisalcohol use
definitive test for PUDupper endoscopy
patient comes for follow up of new medication askcompliance, last check up, home monitoring, medication side effects, any other symptoms
for vascular disease notepulses, hair loss, skin changes
symptoms of hyperthyroidismanxiety, tremor, palpitations, sweating, frequent bowel movements, fatigue, menstrual irregularities, weight loss, and heat intolerance
acute causes of pelvic painappendicitis, ruptured ovarian cyst, ovarian torsion, PID, and ectopic pregnancy
if you do a knee tapknee arthrocentesis and synovial fluid analysis (cell count, gram stain, culture)
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Question Answer
activities of daily livingbathing, feeding, toilet, dressing, in and out of chairs
activities of independent daily livingshopping, cooking, housework, and paying the bills
labs for dementia work-upB12, TSH, RPR, electrolytes, calcium, glucose, BUN/CR
peripheral questions to ask about thyroid diseasehot/cold intolerance, skin/hair changes, constipation
test if you think hemorrhoidsanoscopy
good wording for ROSnegative except as above
way to describe gait in Parkinson'sbradykinetic
symptoms of hypothyroidismweight gain, dry skin, cold intolerance, elevated cholesterol, and changes in menstruation
stool studiesstool leukocytes, culture, ova, parasitology and pH
viral gastroenteritis in a child workuprotavirus enzyme immunoassay/norovirus PCR
test for monoCBC w peripheral smear, monospot test, anti-EBV
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peds differential

Question Answer
20 day old child w/ feverneonatal sepsis, meningitis, pneumonia, UTI
weber doesn't lateralize and neither does rinne thinkbilateral sensorineural. inner ear. presbycusis, cochlear nerve damage, otosclerosis
diagnostic workup for hearing lossaudiometry, tympanography, CT head, VDRL/RPR (with Menieres)
causes of early onset jaundice in a newborn (first week of life)physiologic jaundice, ABO or Rh incompatibility, neonatal sepsis, breast feeding jaundice,
late onset neonatal jaundice (after first week of life)breast milk jaundice, biliary atresia, metabolic disorders
diagnostic workup for neonatal jaundicebilirubin, blood typing and coombs test, CRP, CBC, serology for CMV, toxo, rubella, RPR for syphilis, and urine culture for CMV
infants don't forget to ask aboutseizures and daycare centers
child with sick contact of URI and feverviral URI, pneumonia, otitis media, meningitis, UTI
workup for child w/sick contact of URI and feverCBC w/diff, blood culture, UA and urine culture, CXR, respiratory viral panel, pneumatic otoscopy, physical exam
child w/ fever and maculopapular rash and UTD vaccinesthink meningococcal meningitis and scarlet fever
diagnostic work up for scarlet feverthroat culture to isolate s. pyogenes
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for history taking

Question Answer
for painLIQOPRAAA (location, intensity, quality, onset, precipitating event, radiation, alleviating, aggravating, associated)
Adults PMH PAM HITS FOSS pmh, allergies, meds, hospitalization, ill contacts, trauma, surgery, family hx, ob/gyn, sexual, social
social historywharted (work, home, alcohol, recreational drugs, tobacco, exercise, diet)
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