PANCE Word Association

PANCE/PANRE Word Associations

Word Associations This study sheet sheet is used to help you recognize recognize key words words and patterns patterns associated associated with certain diagnosis. diagnosis. It is NT intended to steer you to re!e!"er answers answers to test# "ut instead to help you recognize the intent or !ost likely diagnosis. diagnosis. The in$or!ation o$ that speci$ic diagnosis is up to your le%el o$ knowledge. It&s to help narrow that di$$erential di$$erential so you can $ocus on the speci$ics o$ the !ost likely diagnosis.

CARDIO Description

Diagnosis Associated

'E# PN'# ede!a. Echo w/ ()* or R)*# hypokinesis ,*igh output heart $ailure

C*+ C*+# dilagted cardio!yopathy Pregnancy# thyrotoicosis# ane!ia# "eri"eri# paget&s disease Ische!ic heart disease# *TN# dilated C# %al%e disease# arrhyth!ia yocarditis

(ow output heart $ailure *eart $ailure a$ter 0RI 1oung athlete with syncope during during athletic e%ent or practice. No physical ea! a"nor!alities Alcoholic with 'E# heart $ailure Alcoholic with palpitations# arrhyth!ia Irregular irregular

*ypertrophic C or $atal arrhyth!ia. *ypertrophic 2et E32 or Echo Pri!ary dilated C Atrial $i"rillation 4*oliday heart5 Atrial $i"rillation6 4i$ 7 89 or chronic : anticoagulate5 War$ Wa r$ar arin in 4; 4; : - $or $or A$i A$i"6 "6 ;.< ;.< : -.< -.< $or $or %al%e56 T War$arin War$arin ' is is %ita!in 3

Atri At rial al $i" $i"ri rill llat atio ion n or pro prost sthe heti tic c %al% %al%e e

* angina "ut no acute s. E32 no acute changes. Crushing CP# dyspnea# palpitations# radiation to neck or le$t ar!

'o Eercise stress test

Constant# sharp CP worse lying down# "etter sitting up and leaning $orward pulsus paradous

Pericarditis

Angina 4i$ lasts !inutes5# AI i$ lasts 7 -= !inutes. Acute Ische!ia Ische!ia : ,T ele%ation6 In>ury : T wa%e depression6 In$arct : ? wa%e

Pericardial e$$usion/ta!ponade# pericarditis# asth!a attack# tension PT@# ,)C o"struction Pericardial e$$usion/ta!ponade

Electrical alternans# narrow pulse pressure# pulsus paradous )'# *ypotension# !u$$led heart sounds

Pericardial e$$usion/ta!ponade 4Beck&s triad5 


Peri Pe rica card rdit itis is pos postt ope open n hea heart rt su surg rger ery y

'ressl 'res sler er&s &s syn syndr dro! o!e. e. T w/ A, A,A A D. D. Indo!ethacin or other N,AI' 3.

,udden onset ripping# tearing chest pain# di!inished pulses +lank pain# hypotension# pulsatile a"do!inal !ass

Aortic dissection

E32 changes# N# )# yellowgreen %isual distur"ances

'igoin toicity 4*ypokale!ia will !ake worse5

* C*+ on diuretic F digoin

,uspect dig toicity 4hypokale!ia $ro! diuretic G dig toicity5

2rossly ele%ated "lood pressure esp. w/ signs o$ E' *TN T w/ !eds# cough or angioede!a ' F *TN *eart $ailure# ()*

alignant or 0rgent *TN

AAA

ACEI is cause ACEI is "est choice ACEI 4i!pro%es sur%i%al# pre%ents de%elop!ent o$ heart $ailure ,5 Beta"lockers ,E is postural *ypotension Thin Th ink k se seco cond ndar ary y *T *TN N !os !ostt li like kely ly Renal artery stenosis 4in$rarenal artery5.

Post I T o$ *TN w/ alpha"locker *TN *T N not not re resp spon onsi si%e %e to "a "asi sic c !ed !eds s

echanical %al%e or prosthesis F 'ental# 20# 2I# or ortho procedure prophylais I)'A w/ new !ur!ur

Bacterial endocarditis 4strep. )iridians5 pre%ention Bacterial endocarditis 4strep. )iridians5 Aortic stenosis 4due to calci$ications : age related related 4or "icuspid "icuspid %al%e %al%e  congenital5 Aortic stenosis

Elderly w/ systolic !ur!ur

'ia!ond shaped# "lowing systolic !ur!ur. ay ha%e angina# syncope# syncope# C*+ (ateral displaced PI# Canon Ha wa%es# ?uincke&s pulse# Corrigan&s pulse# Austin $lint !ur!ur# deusset&s sign# water

Aortic Regurgitation/Insu$$iciencyJ ?uincke&s pulse 4su"ungual capillar pulsation5# Corrigan 4rapid rise and $all5# Austin $ilnt 4low pitch !iddiastolic !ur!ur at ape5 itral stenosis 4AR, are BA'5

'iastolic !ur!ur "est heart at ape without radiation ;


,ystolic e>ection !ur!ur heard "est at "ase with radiation to le$t cla%icle +e!ale or Post I# systolic !ur!ur "est K ape preceded "y click without radiation ,ystolic !ur!ur heard "est at ape with radiation to le$t ailla 4apical systolic5 New !ur!ur a$ter I 4esp. i$ apical a pical systolic5 ur!ur F * rheu!atic heart disease Continuous harsh# !achinelike !ur!ur Cyanotic in$ant with systolic thrill K (,B# systolic e>ection !ur!ur L/ click

Pul!onary stenosis itral %al%e prolapse

itral regurgitation

itral regurgitation 4caused "y papillary !uscle rupture5 itral stenosis D# Tricuspid ,tenosis D; P'A Tetralogy o$ $alot

*olosystolic !ur!ur K (,B# !ay ha%e %entricular hypertrophy In$ant w/ dyspnea# di$$iculty $eeding. *olosystolic !ur!ur K (,B# - rd IC,. ()* F R)*

),'

Peds w/ leg pain a$ter a $ter physical acti%ity# a"nor!al heart sounds# uneMual 0E F (E pulses# ri" notching

Coarctation o$ aorta

,hort PR# wide ?R,# 'elta wa% a%e e

Wol$p pa arki kin nso son nw wh hite6 a%oid 'igoin#

),'

1oung $e!ale 4-=yo5# 4-=yo5# palpitations# long ar!s F $ingers# pectus eca%atu!# ectopic lentis# $lei"le >oints

ar$an&s ,yndro!e : )P# Aortic regurgitation# Aortic dissection# Aortic root dilatation# ectopic lentis

(E ru"or# no hair# "rittle nails# pallor Arterial insu$$iciency/PA'# on ele%ation# cal$ or (E pain esp. with Inter!ittent claudication 4ABI "est walking short distances relie%ed with choice# ateriogra! gold standard5 rest or at P Claudication with rest pain# 4ABI  T is arterial "ypass =.85 -


(E pain a$ter long periods o$ standing. 'ilated# tortuous# %eins Trendelen"erg test o$ etre!ities etre!ities

)aricose %eins. T w/ co!pression stockings Tests $or %einous insu$$iciency. insu$$iciency.

Blue etre!ities worse w/ cold eposure# i!pro%es w/ war!ing

Acrocyanosis

PULMONARY Description

Diagnosis Associated

Rapid# deep la"ored "reathing

3uss!aul "reathing : '3A# eta"olic acidosis

'eep 'ee p "reat "reathin hing g altern alternati ating ng w/ w/ apnea apnea

Cheyne,t Cheyne ,toke okes s "reat "reathin hing g : heart heart $ailure# "rain da!age

Ca%itations on C@R

In$ections : lung a"scess# TB 42ohn $ocus5 TB esothelio!a (ung Ca ,ilicosis 4,and"lasters5

Apical in$iltrates# +# C# dry cough Pleural thickening on C@R *ilar !ass on C@R Eggshell pattern on C@R 2rou 2r ound nd gl glas ass s appe appear aran ance ce on C@ C@R

As" s"e est stos osiis 4sh 4shiip" p"ui uillde derrs# "ui "uild ldiing de!olition5 Coal Co al i ine ner& r&s s lun lung g +ar!ers lung ,arcoidosis

Reticu Reti cula larr to to nod nodul ular ar pa patt tter ern n on on C@R C@R Patchy $i"rosis on C@R 2ranulo!as and in$la!!ation o$ al%eoli# s!all "ronchi and s!all "lood %essels 'yspnea a$ter surgery# tra%el 4airplane5# (E +. ay ha%e c/o cal$ pain also. (ung scan with per$usion de$ects

')T/PE

)enous stasis# %essel wall in>ury# hypercoagula"ility

')T/PE 4)irchow&s triad5

Pedi Pe diat atri ric c wi with th "a "ark rkin ing g co coug ugh# h# st stri rido dorr

%irall cr %ira crou oup p 4laryngotracheo"ronchitis56 4laryngotracheo "ronchitis56 T w/ race!ic epi and glucocorticosteroids i$ stridor at rest. lower respiratory +B# asth!a

PE

Pediatric wheezing 8


'rooling# sni$$ing position# tripod# toic Thu!"print sign ,teeple sign

Epiglottitis Epiglottitis +B# %iral croup 4laryngotracheo"ronchitis5 +B# %iral croup 4laryngotracheo"ronchitis5

Inspiratory stridor

Pre!ature in$ant with respiratory distress Pree!ie C@R w/ hypoepansion 4AT@5# air "ronchogra!s

*yaline " 'isease

,!oker# chronic producti%e cough. N he!optysis# wt. loss. ,!oker# 'E# cough *yperin$lation on C@R# tear drop heart Wheezing# prolonged epiration Airway ede!a with eosinophils# neutrophils# ly!phocytes

Brochitis 4CP'5

*yaline " 'isease

CP' E!physe!a Asth!a Asth!a

+e%er# cough# sputu!. Crackles# decreased "reath sounds# dullness to percussion# Legophony# pectoriloMuy. C@R : in$iltrates in$iltrates or consolidation 7-
Pneu!onia

,trep. Pneu!onia

ycoplas!a pneu!onia

ycoplas!a pneu!onia *. in$luenza 3le"siella (egionella

,taphylococcus aureus Pneu!ocystis >ero%ecii6 >ero%ecii6 TP,@ G 'rug o$ choice <


interstitial F al%eolar in$iltrates PNA F decreased !ental status# poor dental hygiene# dentures# $oul s!elling sputu!# "ronchiectasis. Patchy in$iltrates in dependant lung zones

Aspiration PNA

Pediatric with * recurrent lung in$ections# pancreatitis# reproducti%e pro"le!s# +TT ,weat chloride test Cystic $i"rosis w/ PNA

Cystic $i"rosis 4,taph F Pseudo!onal in$ections usually cause o$ death5 Cystic $i"rosis Pseudo!onas aueroginosa causati%e agent

 ; days postop with $e%er

Atelectasis

,ta" wound# hyperresonance to percussion# decreased "reath sounds# ty!pany ,tM" wound# dullness to percussion# decreased "reath sounds. Tall# skinny# !ale# "and student# acute onset onesided chest pain# dyspnea ,ta" wound to chest. *ypotension# tracheal shi$t

Pneu!othora

*e!othora ,pontaneous PT@

Tension PT@

Poor sleeping# o"ese# dayti!e $atigue "structi%e sleep apnea F drowsy# snoring# *TN# P wakening

s/p thoracic thoracic trau!a. ultiple ri" $ractures. Chest wall wall !o%es !o%es in with inspiration# out with epiration.

+lail chest 4pain control# incenti%e spiro!etry## pul!onary toilet# spiro!etry intu"ation5

GI/NUTRITION Description +at## $orty# +at $orty# $e!ale $e!ale## $ertil $ertile e w/ R0? pain pain +e%er# R0 R0? pai pain n# rad radiiat atiion to to "ac "ack k Ele%ated Alkaline phosphatase#

Diagnosis Associated Cholel Cho lelith ithias iasis is or Cholec Cholecyst ystiti itis s Cholecystitis Cholecystitis O


urinary "iliru"in +# R0? pain# aundice# gallstones F dilated co!!on duct on 0,

Ascending cholangitis 4Charcot&s triad5

* IB'# progressi%e R0? pain# wt loss# +# >aundice F pruritis. Ele%ated "ilru"in F alkaline alkaline phosphate. ERCP with "ile duct stenosis# dilatation

Pri!ary sclerosing cholangitis 4di$$use intra and etrahepatic duct sclerosing and dilatation5

Ele%at Ele% ated ed A, A,T# T# A( A(T# T# in indi dire rect ct "i "ili liru ru"i "in n Iso Is ola late ted d el ele%a %ate ted d ind indiirec ectt "il "iliiru" u"iin Ele%ated indirect "iliru"in w/ de$ecti%e glucuronyl trans$erase

*epati *epa titi tis s 2il" l"e ert& t&s s sy synd ndrro! o!e e CriglerNa>>ar 'z

Photosensiti%ity# a"d pain w/ neurologic dys$unction# erythe!a or skin $ragility

Porphyria

*.pylori gastritis Chronic cough# "itter taste in !outh or throat# dyspepsia ultiple or constant 2I ulcer pain despite !edications

;anti"iotics F PPI 2ER'

N/)# epigastric a"do!inal pain# worse supine# caused "y alcohol ingestion# or $ollowing $atty !eals

Acute pancreatitis

Peri Pe riu u!" !"il ilic ical al or $l $lan ank k ecc ecchy hy!o !osi sis s

ollingerEllison ollingerElli son ,yndro!e

Acute Acut e pan pancr cre eat atit itis is 4C 4Cul ulle len n F 2re 2rey y Turner&s ,ign5

A"do!inal distension# "loating# inter!ittent# colicky pain# high pitched rushes F tinkles Air $luid le%els on upright a"d plain $il! Air under diaphrag!# rigid "oardlike a"do!en

,B

7O=yo +# ((? pain

'i%erticulitis. I) I ) A"# $luids# NP.

Elderly# * atherosclerosis. 'ull cra!py periu!"ilical pain post prandial

esenteric ische!ia

,B Per$orated %iscus# per$orated ulcer

Q


Neonate w/ w/ pro>ectile pro>ectile %o!iting. %o!iting. li%e Pyloric stenosis sized !ass. Choking# cyanosis# respiratory Tracheoesophageal $istula st distress# increased secretions in  hours o$ li$e Painle Pai nless ss rec rectal tal "le "leedi eding ng in ped pediat iatri rics cs ecke e ckel&s l&s di% di%er ertic ticulu ulu! ! Alco Al coho holi lic c wit with h !as !assi si%e %e he he!o !opt ptys ysis is Esop Es opha hage geal al %a %ari rici cies es 4T 4T  w/ w/ octreotide5 +e!ale with recurrent a"do!inal pain# alternating diarrhea# constipation. Pain relie%ed with de$ecation.

IB,. TCA&s 4nortriptyline5 4nortriptyline5 good i$ diarrhea predo!inant sy!pto!

Bloody 'iarrhea

0lcerati%e colitis

,upracla%icular (A' 4( 7 R5

)irchow&s node : !etastatic a"do!inal cancer ,ister !ary oseph nodule G indicates !etastatic gastric and pancreatic cancers 2astric Ca

*ard periu!"ilical nodule

P0'# Pernicious ane!ia 4Type A 2astritis5# *. pylori Apple core lesion Elderly with positi%e he!!ocult.

Colon Cancer Colon Cancer : get colonoscopy

CEA

Colon Carcino!a

+a!ily history o$ young age colon cancer# !ultiple polyps $ound on colonoscopy A+P

+a!ilial adeno!atous polyposis 42ardner&s syndro!e5 *epatocellular carcino!a# testicular se!ino!a 4ger! cell tu!or5 Pancreatic Ca %arian Carcino!a Treat with ndansetron 4o$ran5 4< *T- "lockers5

CA  CA;< Che!otherapy induced NF)

Tra%eler&s 'iarrhea 'iarrhea

E. coli is cause. *ydration F Cipro to treat 2iardia

2reasy# $oul s!elling# $loating stools. Pearshaped $lagellated protozoan w/ ; Heyes. Water# tra%el# ca!ping history A$e"rile# watery or loose stool. No

)iral 2astroenteriti 2astroenteritis s 9


"lood or !ucus A"do!inal pain# diarrhea a$ter picnic/party. Eaten ha!# crea!# custards# !ayonnaise Acute "acterial diarrhea w/ prodro!e o$ *A# +# then cra!py a"d pain F diarrhea

,taphylococcus aureus in$ectious diarrhea Ca!pylo"acter >e>uni : !ost co!!on cause o$ acute "acterial diarrhea

Painless rectal "leeding. Bulging perianal !ass w/ straining

Internal he!orrhoids

Pediatric with perianal pruritis esp. at Pruritis ani : Pinwor!s 4entero"iasis5. P. Positi%e cellophane tape test test T is e"endazole Weight loss# recurrent greasy stools 4steatorrhea5 !ied with diarrhea a$ter certain $oods Antiendo!ysial anti"odies

Celiac ,prue

Celiac ,prue

Beri"eri Pellagra

Thia!ine6 Alcoholics# Neuro , Niacin 48'&s der!atitis# diarrhea# de!entia# death5# "right red tongue )it C 4easy "leeding# "ruising# hair F tooth loss# >oint pain F swelling5 )it ' 4steo!alacia5 )it A de$iciency Ri"o$la%in de$iciency 4B;5

,cur%y Rickets Night "lindness agenta tongue s/p gastric "ypass surgery or gastric gas tric surgery. N# a"d cra!ping# dizziness a$ter eating. No !asses# "leeding ENDOCRINE Description 'ia"etic w/ anoreia# ane!ia# wt loss# pallor 2astroparesis# i!potence# recurrent in$ections# stockingglo%e paresthesia

'u!ping syndro!e

*ypoglyce!ia despite glucose ad!inistration. Increased Cpeptide

Insulino!a

*ypoglyce!ia in alcoholic

2i%e Thia!ine "e$ore glucose to pre%ent Wernicke&s encephalopathy

'ecreased radioacti%e iodine uptake#

*ashi!oto&s thyroiditis

Diagnosis Associated CR+ 'ia"etic neuropathy 4Treat w/ TCA 4a!itriptyline5




decreased $ree T8# increased T,* +e!ale# weight loss# palpitations# atrial $i"rillation Eopthal!os# palpitations# wt. loss. Ele%ated radioacti%e idodine uptake

*yperthyroid 4work it up with T,*# *yperthyroid T85 *yperthyroid# *yperthyro id# 2ra%es ' : T w/ Radioacti%e iodine

Post thyroidecto!y : !ost likely in>ury

Recurrent laryngeal ner%e G hoarseness

Post thyroidecto!y : electrolyt electrolyte e watch

*ypocalce!ia

In$ant w/ round $ace# large protruding tongue# dry skin# u!"ilical hernia# constipation# enlarged a"do!en# poor $eeding# delayed de%elop!ental !ilestones

Congenital *ypothyroidis!

Recurrent *A# *TN not responding to !eds# sweating Attacks o$ se%ere *A# *TN# glucosuria 0rinary catechola!ines# urinary !etanephrines *TN no not re responsi%e to !e !eds

Pheochro!ocyto!a : T preop w/ Pheochro!ocyto!a alpha "locker

*TN *T N w/ hyper hyperna natr tre! e!ia ia## hypok hypokal ale! e!ia ia

Wt. gain# ede!a# coarse dry skin# hair# !enorrhagia# cold intolerance# h transphenoidal surgery F radiation Tetany# hypocalce!ia# cataracts cataracts

Renal artery stenosis 4In$rarenal artery5 Pri! Pr i!ar ary y Aldost Aldoster eron onis is! !

*ypothyroidis!

*ypoparathyroidis! *ypoparathyroidi s!

Eogenous corticosteroid use 'ea!ethasone su suppression te test Central o"esity# a"do!inal stria# hyperglyce!ia# hyperglyce!i a# !oon $acies# "u$$alo hu!p# easy "ruising

Cushing syndro!e Cushing sy syndro!e Cushing syndro!e

Acute steroid withdrawal

Addison&s disease# crisis =


*yperpig!entation# hypoglyce!ia# *yperpig!entation# orthostatic hypotension# hypotension not responsi%e to $luids# hypotension $ollowing an illness# trau!a# or surgery

Addison&s disease# crisis 4(ow aldosterone6 get Rando! or A cortisol# ACT* sti!ulation test5

Worsening $atigue# wt loss# weakness# recurrent a"do!inal pain# hair loss# hyperpig!entation. *yponatre!ia# hyperkale!ia *yponatre!ia# hyperkale!ia

Addison&s disease# crisis 4(ow aldosterone6 get Rando! or A cortisol# ACT* sti!ulation test5

Polyuria# polydipsia. 'ilute urine# *ypernatre!ia Conc Co ncen entr trat ate ed ur urin ine e. *ypo *ypona nattre! e!iia

Acute adrenal insu$$iciency 4Addison&s crisis5 'ia"etes insipidus ,IA' ,I A'* *

8<#@ : low hairline# low set ears# we""ed neck# short stature6 shield chest# wide set nipples# in$ertility# lack o$ ,econdary se characteristics

Turners 4gonadal dysgenesis

@@1 ♂  short stature# s tature# S intelligence6 s!all $ir! testes# gyneco!astia# a"n ar!"ody length

3line$elters 4hypogonadis!5

GU/ELECTROLTES Description *yaline Casts Increased B0N/Cr# low +eNa

Diagnosis Associated Nor!al 4!ay "e present a$ter $e"rile illness# strenuous eercise5 Prerenal +ailure 4Azote!ia5

Irritati%e %oiding sy!pto!s# +e%er# chills# C)A tenderness

Pyelonephritis

Crush in>ury# alcoholic on ground# ele%ated CP3# AR+

Rha"do!yolysis

Painless he!aturia# $lank pain or !ass

Renal cell Carcino!a




liguria# he!aturia# proteinuria $ollowing streptococcal in$ection *e!aturia# purpuric rash $ollowing streptococcal in$ection *e! *e !at atur uriia# RB RBC C cas astts# pr prot ote einu nurria RBC casts 3idney F lung "leeding 4he!aturia# he!optysis5

Acute glo!eruloneprhi glo!eruloneprhitis tis 2lo!erulonephritis# 2lo!erulone phritis# *,P 2lo! o!er erul ulon one eph phri riti tis s 2oodpasteures

+i"rous "and on lateral penis Can&t retract $oreskin In$la!!ation o$ glans

Peyronie&s disease Phi!osis Balanitis

 8= yo !ale with +e%er# perineal pain# dysuria.

7<= yo o"structi%e %oiding s# nocturia. +ir! s!ooth enlarged prostate. Nl P,A

Acute prostatitis caused "y Chla!ydia F N. gonorrhea. Treat accordingly 4Bactri! D; choice5. choice5. 7 8=yo think e. coli is cause 4T w/ +?5 BP*. 4Cancer would ha%e $ir!# irregular# nodular nontender prostate# ele%ated P,A5

Incontinence with straining

,tress

Peaked Twa%es 0 wa%es ?T prolongation Recurrent kidney stones# ele%ated Calciu!# decreased phosphorus

*yper3ale!ia *ypo3ale!ia *ypocale!ia *yperparathyroidis!

*earing loss or tinnitus w/ !eta"olic acidosis

Aspirin '

NEURO Description *ead trau!a# disoriented : lucent : co!a (ens shaped he!orrhage Conca%e (P w/ decreased glucose# increased protein (P w/ decreased protein# %ery $ew neutrophils eningitis and rash

Diagnosis Associated Epidural *e!ato!a Epidural *e!ato!a ,u"dural *e!ato!a Bacterial !eningitis syphilitic !eningitis eningiococcal ;


eningitis F ;!o

2rp B ,trep# E. coli 4T  yo G )anco L Rocephin5

eningitis  8yo eningitis 7 ;yo# adults

*. inlu# 2rp B strep# N. !eningititis ,trep# N. !eningititis

)iral eningitis

u!ps

0nilateral $acial weakness w/ ina"ility to close eye

Bell&s palsy 4sel$li!iti 4sel$li!iting5 ng5

Adolescent $e!ale w/ *A. L+*. ,e%ere *A# N/)# N/)# photpho"ia. photpho"ia. L/ auras ale# recurrent relapsing *A. Worsened w/ Et*# (acri!ation# sali%ation# rhinorrhea ,udden onset thunderclap *A# Hworse *A o$ !y li$e 7<= yo yo $e!ale $e!ale w/ *A. Te!poral artery tenderness or "lindness

igraine *A

Cluster *A

,u"arachnoid he!orrhage Te!poral arteritis arteritis 42iant cell arteritis5. Ele%ated E,R# get te!poral artery "iopsy

Recurrent episodes o$ %ision change# diplopia# weakness F tingling in etre!ities etre!itie s that resol%e !yelin $rag!ents#  Ig2# oligoclonal "ands 4Pathognoonic56 (her!itte&s sign G electrical sensation down "ody w/ neck $leion

,

*A worse in A w/ $ocal neuro de$icits

Brain Tu!or 4C is glio!a5

s/p +all w/ "ilateral (E weakness# urinary and rectal incontinence# decreased rectal tone

Cauda eMuine syndro!e G neurosurgical consult

Ascending paralysis Paralysis a$ter Campylobacter enteritis Weakness and $atigue in upper li!"s# "lurry %ision# diplopia# respiratory

2B, 2B,

,

yasthenia gra%is -


distress 1oung kid with di$$iculty standing $ro! seated position. Cal$ !uscle !uscle wasting

uscular dystrophy 4weakness "egins at pel%ic girdle5

Pediatric with $e%er or * 0RI with encephalopathy# e!esis# hyperacti%e re$lees# hepato!egaly# ele%ated li%er enzy!es

Reye&s syndro!e $ro! 0RI/post$lu or aspirin use

Pediatric with episodes o$ "lank stares - !*z spikes on EE2

A"sence 4petit!al5 seizures. A"sence 4petit!al5 seizures.

HAsh lea$ hypopig!entation o$ trunk Tu"erous sclerosis F E Et# t# sh shagr agree een n pat patch ch## se se"a "ace ceou ous s adeno!as# seizures# !ental retardat atiion6 Ass. w/ PC3# renal he!arto!as

!EENT Description  Q= yo "lindness 7 Q= yo "lindness A$$erent papillary de$ect# !arcus gunn pupils Bilateral pinpoint pupils Bilateral 'I(ATE' pu6ils

Diagnosis Associated ' retinopathy 4CC5 acular degeneration ptic ner%e lesion. Tertiary syphilis 4!arcusgunn5 Pontine he!orrhage Anticholinergics# TCA# anti parkinsonian drugs# pro$ound hypoe!ia

Bilateral he!ianopia (oss o$ central %ision ,upe ,uperi rior or cont contra rala late tera rall Mua Muadr drant antop opia ia

ptic chias! lesion Ipsilateral optic ner%e lesion Te!p Te!por oral al opti optic c radi radiat atio ion n

Te!poral $ield loss Eye trau!a# diplopia. Eophthal!os# $ied upward gaze# hyphe!a Painless# nontender nodule on upper

Ipsilateral optic tract lesion lesion r"ital "lowout $racture6 I!!ediate ophthal!ology re$erral Chalazion 8


or lower eyelid Pain$ul swelling o$ upper or lower eyelid Painless# yellow triangular nodule on con>uncti%ia Curtain or %eil o%er !y eyes# new onset $loaters Transient !onocular %ision %ision loss Painless %ision loss. loss. *istory o$ TIA# TIA# palpitations# arrhyth!ia# carotid disease# e!"olic source Pain Painle less ss %isi %ision on loss. loss. *ist *istor ory y o$ *TN *TN

*ordeolu! Pinguecula 4!ore co!!on on nasal side5 Retinal detach!ent A!aurosis $uga : TIA# e!"oli CRA 4pale retina# cherry red !acula5

CR) CR) 4"lo 4"lood od F Thun Thunde der# r# reti retina nall he!orrhages5 )ision loss o%er hours to days# pain$ul ptic Neuritis 4assoc. w/ ,5 E Recurrent episodes o$ %ision change# , diplopia that resol%e

Red eye# watery discharge# preauricular (A' Red eye# eye# copiou copious s puru purulen lentt dis discha charge rge Red eye# hypere!ia# che!osis# nodular con>uncti%ia Acute Pain$ul red eye# halos 4or colored rings around lights5# hazy# stea!y cornea. Pupil is is $ied $ied and 4!id5 dilated. nset a$ter a$ter "eing "eing in dark roo!

)iral con>uncti%itis con>uncti%itis

'iplopia# dys dysarthria# dy dysphagia

)erti"ro"asilar in insu$$iciency

2onoco 2onococca ccall con>un con>uncti cti%it %itis is Allergic con>uncti%itis Acute angleclosure glauco!a

0nilateral $oul s!elling or purulent Nasal +oreign "ody nasal discharge in a pediatric patient *A# sinus pressure# yellow : green ,inusitis : CT is gold standard nasal discharge ,neezing# clear rhinorrhea# post Allergic rhinitis. Nedocro!il e$$ecti%e nasal drip# nasal congestion seasonal T. occurance Pale Pale## ede! ede!at atou ous# s# "ogg "oggy y tur" tur"in inat ates es Alle Allerg rgic ic rhin rhinit itis is Bullous !yringitis titis !edia

ycoplas!a pneu!onia ,trep. Pneu!onia# *. in$luenza# strep. Pyogenes# !oraella catarhallis <


,wi!!er with ear ear pain# d diisc sch harge 'ia"etic# ear pain

titis e eterna E# Pseudo!onas# I) a" 4+?5# CT head

Tinnitus and !eta"olic acidosis ,udden dizzy# %ertigo# hearing loss# tinnitus

,alicylate Ingestion eniere&s disease6 Treat w/ diuretics F lowsodiu! diet

'ihallpike !aneu%er ,udden %ertigo with changes in head position ,udden dizzy# dizzy# N# ). N tinnitus# tinnitus# hearing loss. Recent 0RI 0nilateral ner%e dea$ness in !iddle age Pt ,ensorineural loss 7 <=yo )ertical Nystag!us# insidious onset %ertigo *orizontal Nystag!us# acute onset %ertigo ,!oker# white !outh lesion cannot "e ru""ed o$$ 2ray pharyngeal pseudo!e!"rane# rash# spleno!egaly# supracla%icular (A' College student with sore throat. Enlarged tonsils# anterior cer%ical (A'. ,pleno!egaly. CBC : ele%ated atypical ly!phoctyes

!EMATOLOGY/ONCOLOGY Description Philadelphia chro!oso!e Auer rods Reedstern"erg cells Painless (A' 4us. Neck or ailla5# (A' in orderly $ashion6 HB signs L pruritis6 spleno!egaly6 (N pain a$ter drinking alcohol

BPP) BPP) )esti"ular neuronitis# la"rynthitis Acoustic neuro!a 4order RI5 Pres"yacussis 4*i $reM sounds st to go5 Central lesion 4tu!or5 Peripheral lesion

(eukoplakia# rule out oral cancer 'iphtheria

EB)  !ononucleosis

Diagnosis Associated C( A( *odgkin&s ly!pho!a *odgkin&s ly!pho!a

O


+atigue# P sweats# weight loss# painless (A' or neck !ass Painle Pai nless ss (A' (A' us. us. ,cat ,catter tered. ed. HB sig signs ns

(y!pho!a : do (y!ph node "iopsy. Bone !arrow B and CT scan used $or staging Non*o Non *odgki dgkin&s n&s ly! ly!pho pho!a !a

* *TN# nephrotic syndro!e# CR+ or Renal insu$$iciency. 3now CBC. PICA# Pregnant F $atigue# enstruation. Cheilosis Ane!ia a$ter colecto!y# partial gastrecto!y. 2lossitis# decreased %i"ratory sensation 2OP' L ?uinidine# Nitro$urantoin# ,ul$a +atigue# weakness# low $e%er# purpura# pallor# gingi%al "leeding. No *,

Ane!ia

Ele%ated *g"# *ct# spleno!egaly# s pleno!egaly# post showering pruritis# plethora# engorged retinal %eins

Polycythe!ia Polycythe! ia %era6 T G Phle"oto!y

,plenecto!y

Pneu!ococcal %accine

,ickle cell

Autoso!al Recessi%e# pain in etre!ities etre!iti es a$ter eercise# priapris!

,pontaneous *e!arthrosis ucosal or gingi%al "leeding# epistai# !enorrhagia Continuous "leeding postop or trau!a. 2i%en !ultiple "lood trans$usions. (ow platelets# increased PT# INR# L $i"rin split products 4increased ddi!er5

*e!ophilia A )on Wille"rand disease

IN"ECTIOUS DISEASE Description R,A

+e 'e$iciency Ane!ia B; or Pernicious ane!ia

*e!olytic ane!ia Aplastic ane!ia

'IC

Diagnosis Associated Hspider "ite appearing lesion that turns into a"scess. T w/ )anco L/ ri$a!pin# genta!icin# linezolid Q


Clearr %u Clea %ul% l%ar ar %e %esi sicl cles es## in ingu guin inal al (A (A' ' 2iant ultinucleated cells Tzank ,!ear Acetowhitening Wood&s light $luoroscopy

*erpes *erp es %i %iru rus s 42 42en enit ital al55 *erpes %irus 42enital5 *erpes %irus 42enital5 42enital5 Condyloa acu!inata 'er!atophytes in$ections# Erythras!a 4coral red5

Bite w/ $e%er# lacri!ation# rhinorrhea# "radycardia# *TN# tachyarrhyth!i tachyarrhyth!ias as Bite with local ede!a# erythe!a# central necrosis

Black widow 4neurotoin5

Woods# $orest# $orest# hikers. hikers. acular rash at wrist# ankles then !o%es up etre!ities etre!itie s then trunk. A$ter < days rash at pal!s F soles

R,+ 4Rickettsia rickettsia5

Indirect i!!uno$luorescent A"# Weil +eli rn# co!ple!ent

R,+ 4Rickettsia rickettsia5

Target lesion# arthralgia# Bell&s Bell&s Palsy

Brown recluse

(y!e 'z 4Borrelia 4Borrelia Burgdor$i5

Intense pruritis pruritis esp. esp. P. Burrow like lesions at wrists# el"ows# hands# we"s o$ $ingers

,ca"ies

Raccoons# "ats# skunks

Ra"ies6 gi%e Ig# Ra"ies %accine i$ ani!al is not caught and tested

2angrene

Clostridiu! in$ection : an anaero"ic "acteria. T w/ hyper"aric oygen# Penicillins# Penicilli ns# surgical ecision

2ra! negati%e intracellular diplococcic ,eually acti%e# !ultiple or new partner# urethral discharge# 2ra! negati%e intracellular diplococci

2onorrhea

Red cer%i w/ !ucopurulent discharge in seually acti%e $e!ale +TAAB,# TATP

Chla!ydia ,yphilis diagnosis

alaria prophylais

ChloroMuine

2onorrhea

9


MS#/R!EUMATOLOGY Description ,houlder pain a$ter repetiti%e acti%ity# point tenderness at anterior hu!erus or AC >oint. >oint. L drop ar! test or apprehension test +oot"all player with "urning pain# nu!"ness# tingling $ro! shoulder to hand which resol%es +,*# Radial $racture w/ dorsal displace!ent# dinner$ork de$or!ity Typing# secretary wrist wrist pain and nu!"/tingling $ro! wrist to hand. New !others# pregnant !ay worsen Pain at "ase o$ thu!"# distal radial styloid. Pain reproduced with ulnar de%iation o$ clenched $ist. *and in>ury a$ter a punch

+e!ale ea!# asy!!etric posterior chest wall or une%en scapula height with $orward "ending Ti"ial pain a$ter running 4!ilitary 4!ilitary recruits5# athletic acti%ity 4running sports5 3ne 3n ee in> in>ur ury y dur duriing $o $oot ot"a "alll ga! ga!e e 9 : = =yo yo !a !ale le wi with th li li!p !p## kne knee e pai pain n ; : 
Pain on plantar $oot K ; : - rd !etatarsal. Associated w/ tight

Diagnosis Associated Rotator cu$$ in>ury 4,IT, !uscles5

Brachial pleus neurapraia# Hstinger. Caused "y stretching o$ "rachial pleus Colle&s +6 T G %olar splint splint Carpal Tunnel syndro!e

de?uer%ain&s tenosyno%itis

Boer&s $racture. 0lnar gutter w/ intrinsic plus positioning. RI+ i$ angulation 7 8= degress ,coliosis 47 ;< degree Co"" angle G surgery5

,hin splints# stress $racture. 2et "one scan i$ negati%e ray AC( 4l 4loo ook k $or $or de desc scrript ptiion o$ lac ach! h!an an or drawer test5 (egg (e ggC Cal al%e %eP Per erth thes es 'i 'ise seas ase e ,C+E sgoodschlatter disease Patellor$e!oral pain syndro!e : Patellor$e!oral increased ? angle# strengthen Muadriceps orton&s neuro!a6 T w/ w/ N,AI's# N,AI's# wide shoes# then steroid in>ections 


shoes# relie%ed "y re!o%ing shoes. Palpa"le pain$ul !ass Pain a$ter t o$ $racture w/ cast

Co!part!ent syndro!e

*(AB;Q

Ankylosing spondylitis# Reiter&s syndro!e ,eptic arthritis 4syno%ial $luid G leukocytosis# low glucose5 steoarthritis. Aceta!inophen D choice

Acute >oint pain. ,wollen# war!# erythe!a. (arge >oint >oint pain. 3nees w/ w/ !edial !edial >oint space narrowing# osteophytes. osteophytes. No erythe!a or war!th. Enlarged PI'# 'IP +e!ale !orning >oint pain F sti$$ness esp. hand/wrists. hand/wrists. CP >oint swelling# ulnar de%iation Acute swollen "ig toe Proi!al sy!!etric sy!!etric !uscle pain F sti$$ness esp. shoulder# neck# pel%ic girdle ale w/ w/ low "ack pain# sti$$ness. Pain worse wakening# i!pro%e during day. 'ecreased R at spine. Plain $il!s $il!s show sacroiliac a"nor!ality. *(A B;Q positi%e Con>uncti%itis# iritis# arthritis# cer%icitis# urethritis Erythe!a nodosu! +e!ale with Arthralgias# !alar rash# LANA# L antidou"le stranded 'NA anti"odies# Lantiphospholipid anti"odies

steoarthritis 4her"erden : PIP6 "ouchard : 'IP5 Rheu!atoid arthritis. ethotreate 4'AR's5 D. 2out Poly!yalgia Poly!yalgi a rheu!atica

Ankylosing spondylitis6 T G N,AI's N,AI's 4Indo!ethacin5

Reiter&s syndro!e

,yste!ic autoi!!une diseases 4RA# IB'5# CP ,(E

dusky red# well localized single or !ultiple papules or plaMues usually o$ $ace +e!ale# $atigue# general aching# pain at neck# upper shoulders# sleeping pro"le!s# tender points

'iscoid lupus

Cold induced pain at etre!itie etre!ities s with

Raynaud&s pheno!enon

+i"ro!yalgia 4eercise 4eercise progra! good !anage!ent5

;=


color change as they war! up

steo!yelitis a$ter stepping on nail steo!yelitis wearing sandals or tennis shoes Teenage $e!ale with with long "one pain without trau!a trau!a or in>ury. @R w/ lytic !ass# !ultila!inated periosteal reaction Painless "ony !ass. Plain $il!s $il!s G stalky or "road"ased pro>ection $ro! "one sur$ace (ytic lesions in the "ack or skull

Pseudo!onas aeruginosa 4$oa! padding in shoes5 Ewing sarco!a : periosteal Honion skin reaction

steochondro!a

ultiple !yelo!a

PSYC!E Description 'eterioration o$ cogniti%e $unction# !e!ory Rapid onset o$ cogniti%e sy!pto!s# !ental status $luctuations# aniety# irrita"ility Paplitations# tre!ors# hyper%entilation hyper%entilatio n or respiratory alkalosis# nu!" or tingling !outh or etre!ities +eelings o$ worthlessness# hopelessness# apathy# weight loss# inso!nia# dayti!e sleepiness. Thoughts o$ suicide Raw red hands# cha$ed. Binge Bin ge eatin eating# g# laati laati%e %e use# use# star% star%ati ation on Buli Bu li!i !ia a wi with th el elec ectr trol olyt yte e di diso sord rder ers s Antipsychotic !eds 4phenotiazines5# $acial tics# lip s!acking# tongue disorders# "linking# ataia Pt on antipsychotic !eds de%elops altered consciousness# leadpipe

Diagnosis Associated 'e!entia 'eleriu!

Aniety

'epression 4,,RI G drug o$ choice5

"sessi%e co!pulsi%e disorder Buli!ia Buli!i a ner%osa ner%osa 4T 4T w/ ,,RI ,,RI : +luoetine5 *ypo *y poka kale le!i !ia# a# !e !eta ta"o "oli lic c al alka kalo losi sis s Tardi%e dyskinesia

Neuroleptic !alignant syndro!e. T supporti%e care F antipyretics ;


rigidity# diaphoresis# catatonia. *yperther!ia# *yperther!i a# tachypnea# "lood pressure changes. Etrapyradi!idal signs# BP changes# altered consciousness# hyperpyre hyperpyreia# ia# !uscle rigidity# dysarthria# C) insta"ility# $e%er# pul!onary congestion# diaphoresis. Pt on antipsychotic !eds

Neuroleptic !alignant syndro!e. T supporti%e care F antipyretics

In$reMuent "linking# tre!or# rigidity# "radykinesia# shu$$ling gait# !asked $acies

Parkinson&s

,hort li%ed# intense relationships. 'i$$iculty controlling anger esp. when $eeling a"andoned. * seual pro!iscuity and su"stance a"use.

Borderline personality disorder

Periods o$ ecessi%e drinking# "uying# spending

anic phase o$ "ipolar disorder

ale w/ gyneco!astia# di!inished or delayed secondary se characteristics# s!all $ir! testicles# long ar!s F legs 4eunechoid "ody ha"itus5

3line$elter ,yndro!e @@1. (ow seru! testosterone F in$ertility.

*ypona *ypo natr tre e!ia w/ "i "iz zar arrre "eh "eha% a%iior or.. (ith (i thiiu! to toi ic cit ity y Antidepressant use w/ anticholinergic TCA o%erdose side e$$ects# dry !outh# dysrhyth!ias# sedation# orthostatic hypotension

REPRO Description +rothy# clear : white or yellowgreen to gray adherent %aginal discharge# dysuria# %aginal pruritis. )ul%ar and cer%ical erythe!a. +lagellated protozoa +ishy odor# Thin grayish %aginal

Diagnosis Associated Tricho!onas

Bacterial %aginitis6 2ardnerella ;;


discharge# Clue cells Thick white %aginal discharge# hyphae F "uds on 3* prep Post!enopausal# dyspareunia# thin %aginal discharge# atrophic %ul%ar changes# %aginal petechiae

%aginalis Candida Atrophic %aginitis6 T G topical topical estrogen

,econdary a!enorrhea +e!ale with acute a"do!inal pain. No characteristic acute a"do!en pattern

Pregnancy Ectopic pregnancy

;=yo $e!ale w/ ru""ery# $ir!# well circu!scri"ed# nontender "reast lesion# doesn&t change w/ cycle -= : <=yo $e!ale# pain$ul# !ultiple# "ilateral "reast !asses that increase in pain and size "e$ore !enses

+i"roadeno!a

,pontaneous "loody# serous# or cloudy nipple discharge

Intraductal papillo!a

Breast !ass# nipple retraction# "loody nipple discharge

Breast cancer 4!ass is !ost co!!on presenting clinical !ani$estation5

%erweight# irregular !enstrual cycles 4poss. A!enorrhea5# ele%ated "lood sugar# hirsutis! Adolescent $e!ale with !idcycle pain alternating $ro! le$t to right side. Relie%ed w/ N,AI's 'ys!enorrhea# dyspareunia# dyschezia. 0terus is $ied# retro$leed. Cyclic pel%ic pain. ay ha%e palpa"le pel%ic !ass +ir! irregular shaped# NNTEN'ER enlarged uterus ,o$tened# tender# di$$usely glo"ular uterine enlarge!ent

PC, 4steinle%enthal syndro!e5

Oc! unilateral# !o"ile# tender adneal !ass Pregnant Pregnant L rash# postauricular or

+i"rocystic "reast disease

ittelsch!erz

Endo!etriosis. Palpa"le pel%ic !ass : Hchocolate cyst

(eio!yo!a Adeno!yosis

Tu"oo%arian a"scess

Nagel&s ruleJ (P L Q : - !o Ru"ella. 2i%e %accine A+TER deli%ery ;-


occipital (A' Pregnant# *A# %isual distur"ance Pregnant# seizures Pregnant  ;= wks gestation w/ %aginal "leeding# a"d F pel%ic pain. Blood $ro! closed cer%ical os. Pregnant  ;= wks gestation w/ %aginal "leeding# a"d F pel%ic pain. Tissue at or said to "e passed $ro! open cer%ical os.

Preecla!psia Ecla!psia Threatened a"ortion

Inco!plete a"ortion 4co!plete a"ortion will ha%e e!pty uterus# co!plete passage o$ $etal tissue# pain resol%es a$ter passage o$ tissue5

Pregnant who drinks during pregnancy and inadeMuate perinatal care

+etal alcohol syndro!e : low "irth weight

Postpartu! he!orrhage

0terine Atony. T G uterine !assage

Pos ostt!en enop opau ausa sall %ag %agiina nall "l "lee eedi ding ng

End ndo! o!et etri rial al Ca : do do end endo! o!et etrria iall "iopsy %arian Ca

Post!enopausal adneal !ass

DERM Description Procaina!ide# hy hydralazine F ra rash Photosensiti%e rash

Diagnosis Associated (upust ty ype er eruptions TCN# ,ul$a drugs

Wood&s light 3*

Coral red G Erythras!a +ungus# Candida6 *yphae F "uds# spaghetti F !eat"alls Bacterial in$ections

2ra! stain Bee$y red# sharp "ordered rash in groin 4in$ants5# under "reast $olds with satellite lesions War!# erythe!atous# tender skin with possi"le induration or $luctuance Red# less less distinct "orders. Coral red red $luorescence under Wood&s la!p 'istinct# sharp raised de!arcated "order with $e%er# $e%er# chills. chills. 2roup A ,trep 2rouped %esicles on erythe!atous

CandidaJ TJ Nystatin/(otri!in crea! ?I' 8d6 i$ $ails 3etoconazole Cellulitis Erythras!a Erysipelas

*erpes %irus ;8


"ase In$ant or pediatric w/ grouped %esicles on thu!" or Htapioca %esicles on thu!" Pain preceding %esicular rash in der!ato!al pattern * 0RI the palpa"le purpuric rash to "uttocks# posterior thighs *oney colored crusts on erythe!atous "ase around nose F !outh ,!all white papules on di$$usely red "ase on "uccal !ucosa Cough# coryza# con>uncti%itis

*erpetic whitlow

*erpes oster 4i$ in%ol%ed eye G herpes keratitis. N steroids. 2et i!!ediate ophthal!ology re$erral5 *,P 4* post ,trep A in$ection5 I!petigo. T G upirocin

3oplick spots : Ru"eola 4easles5. ,pots occur "e$ore rash Ru"eola 4easles5

Pastia&s li lines# po positi%e A, A, ti titer ,traw"erry tongue Prur Pr urit itic ic rai raise sed d eryt erythe he!a !ato tous us pla plaMu Mues es 'ewdrops on rose petal# pustules F %esicles at di$$erent stages o$ healing

,carlet $e $e%er 42 42rp A ,trep5 ,carlet $e%er 42rp A ,trep5 0rti 0r tica cari ria a )aricella 4Chicken Po5

+leshcolored# pink or yellow"row yellow"rown n lesion with rough# sandpaper $eel# at suneposed areas Nonpruritic# raised# warty "rown "lack plaMues# stuck onto skin $eel greasy +lat "rown spots with sharp "orders on dorsu! o$ hand Erythe!atous# do!eshaped nodule with central plug

Actinic 3eratosis

,e"orrheic keratosis

(entigines 3eratoacantho!a

Raised pearly"orders# telangiectasia# Basal cell Ca central ulcer Pearly Pear ly papule with u!"il u!"ilicate icated d center center oll olluscu! uscu! conta contagiosu giosu! !

,eually acti%e person w/ rash on pal!s F soles# general (A'

,econdary syphilis 4oney spots56 )'R( will con$ir!

,ca"ies F Pediatrics

N LINDANE (KWELL). (KWELL). Per!ethrin 4Eli!ite5 is drug o$ choice ;<


Christ!as tree pattern# erythe!atous papules w/ o%al plaues w/ scaly itchy "order. Rash preceded preceded "y lagre o%al o%al plaMue w/ central clearing F scaly "order *ypopig!ented lesions# white# scaly. 2ets worse w/ tanning or sun eposure Erythe!atic ring with scaly "order F central clearing spaghetti F !eat"alls Thick# yellow# "rittle "rittle nails In$ant w/ erythe!atous# scaly crusty lesions at %erte o$ scalp

Children  =yo w/ %esicles on pharyn# !outh# hands# $eet w/ N ulceration *ealthy looking  uncti%itis# cracking# lip $issures Erythe!a !arginatu! ,il%ery scaling plaMues on etensor sensors. Ausptiz sign# 3oe"ner&s pheno!ena Rat "ite erosions on @R

Pityriasis rosea6 *erald patch

Pityriasis Al"a

Tinea 4$ungal in$ection56 3* prep prep G hyphae Tinea 4$ungal in$ection nycho!ycosis. T G P Ter"ina$ine Cradle cap : se"orrheic der!atitis 4T in in$ants w/ "a"y sha!poo# war! oli%e oil co!press# !ild *ydrocortisone crea!6 Adults : seleniu! sul$ide sha!poo5

*and+ootouth disease. Coksackie )irus Erythe!a in$ectiosu! H,lapped cheek# H
Psoriatic arthritis ;O


'ark skinned person with Hwhitening or lightening lightening o$ skin. * pernicious pernicious ane!ia or other autoi!!une disease

)itilligo. ,kin "iopsy "iopsy to diagnose

PEDIATRICS Description Intr In trod oduc uce e soli solid d $ood $oods s 4cer 4cerea eal# l# $r $rui uits ts55 st t to ooth 4central incisor5 Walks alone - words# $ees sel$ w/ spoon# "uilds tower

Diagnosis Associated 8 : O !o !o66 a$te a$terr O !o !o add add !ea !eat# t# egg eggs# s# starchy $oods O : 9 !o < !o ;8 !o

 ;!o $e%er 
,eptic w/u  "lood C# (P +e"rile seizure

Pre!ature "irth# $etal !aturity econiu!s sttained a!niotic $luids

2i%e corticosteroids +etal dist strress

Positi%e os!otic $ragility test

ousy urine

2OP' de$iciency 4he!olytic ane!ia w/ oidati%e drugs : sul$a# nitro$urantoin# Muinidine5 P30

)it ' : Rickets *e!ophilia A# 'uchennes ' Neuro$i"ro!atosis ,ickle cell# C+# P30

@linked do!inant @linked Recessi%e Autoso!al do!inant Autoso!al Recessi%e

;Q

PANCE Word Association

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