Rapid Review

Epiglottitis Patient will be complaining of rapid onset of fever and dysphagia PE will show the patient leaning forward, drooling, inspiratory stridor Imaging will show “thumbprint” sign Most commonly caused by H. influenzae, Streptococcus Treatment is IV antibiotics and airway management Sample question: A 5-year-old boy presents to the emergency department because of difficulty breathing that began a few hours prior to consult. read more…

Ottawa Foot and Ankle Rules X-rays required if Patient cannot bear weight for 4 steps Distal 6 cm tibia/fibula tenderness Medial/lateral malleolus tenderness 5th metatarsal tenderness Navicular tenderness Sample question: A 16-year-old boy presents complaining of right ankle pain after injuring himself while playing basketball. He states that he “twisted his ankle” when he landed on read more…

Sample question: A 17-year-old boy presents to the clinic with right-hand pain after punching a wall. Physical examination reveals swelling over the dorsum of the right hand with bony tenderness noted with palpation of the fifth metacarpal. What is the most likely diagnosis?

Sample question: You are called to the nursery to examine a newborn boy. He was born at 36 weeks via C section to a 32-year-old G3, P3 mother. APGAR scores were 7 and 9. After six hours, the neonate developed respiratory distress. On examination, respiratory rate is 70, with nasal flaring, expiratory grunting, intercostal retractions, decreased breath sounds, and diminished read more…

Transient Tachypnea of the Newborn Patient will be a child shortly after birth Sudden onset of difficulty breathing PE will show tachypnea, nasal flaring, retractions, and hypoxia CXR will show parenchymal infiltrates and fluid in the pulmonary fissures Most commonly caused by residual pulmonary fluid Treatment is supportive, self-resolving within 72 hours Comments: Most common cause of neonatal respiratory distress Sample question: A full-term male infant read more…

Septic Arthritis Patient will be complaining of fever, monoarticular pain with decreased ROM Labs will show WBC > 50,000 with > 75% PMNs Diagnosis is made by arthrocentesis Most commonly caused by: Age < 35: N. gonorrhea, S. aureus overall Treatment is IV ABX, surgical washout Sample question: A 23-year-old man with a history of intravenous heroin use presents to the emergency department with a read more…

Sample question: Which muscle is most commonly involved with rotator cuff injuries?

Megaloblastic Anemia Patient will be a vegan or alcoholic Complaining of fatigue, weakness PE will show pallor, glossitis Labs will show MCV > 100 and hypersegmented neutrophils Most commonly caused by vitamin B12 (Cobalamin) or folate deficiency Comments: only vitamin B12 deficiency results in neurological symptoms Sample question: A middle-aged patient in the ED has a hemoglobin of 8.1 g/dL with an MCV of 112 fL. Which of read more…

Coarctation of the Aorta PE will show higher blood pressure in the arms than in the legs EKG will show LVH CXR will show notching of ribs Diagnosis is made by echo Treatment is balloon angioplasty with stent placement or surgical correction Comments: associated with Turner syndrome Sample question: A 5-year-old girl with Turner syndrome is found to have systolic hypertension. Further examination read more…

Sample question: A 71-year-old man presents to the emergency department after falling on ice outside his home. He complains of neck pain. He has an abrasion to his chin and decreased strength in his bilateral upper extremities. Strength is intact in his lower extremities. Which mechanism of trauma is most consistent with the suspected diagnosis?

Sample question: In children under 8 years of age, which of the following is the most common fracture involving the elbow?

Scabies Patient will be complaining of severe pruritus that is worse at night PE will show small papules, vesicles and burrows in the webbed spaces of the fingers and toes Diagnosis is made by microscopic visualization Most commonly caused by Sarcoptes scabiei hominis Treatment is permethrin 5% Sample question: A 15-year-old boy presents with an itchy rash on his hands and wrists. read more…

Ectopic Pregnancy Patient will be a woman With a history of prior ectopic, PID, tubal surgery, IUD Complaining of vaginal bleeding, abdominal pain, amenorrhea PE will show adnexal tenderness or unexplained hypotension Labs will show positive pregnancy test and lower than expected serum beta-hCG levels Diagnosis is made by ultrasound Most commonly located in a fallopian tube Treatment is MTX or surgery Sample question: A 44-year-old woman with read more…

Polycythemia Vera Patient will be complaining of headache, dizziness, pruritus after showering PE will show hypertension, splenomegaly Labs will show increased RBC mass, overproduction of all cell lines, increased Hgb Most commonly caused by mutation of the Janus kinase 2 gene (JAK2) Treatment is phlebotomy, hydroxyurea, aspirin Sample question: A 60-year-old man presents to your office complaining of generalized pruritus following warm showers. He also read more…

Retinal Detachment Patient will be complaining of painless loss of vision, floaters, flashing lights, curtain lowering sensation PE will show retina appears hazy gray with white folds Treatment is stat ophthalmology consult Sample question: A 67-year-old man presents to the emergency department complaining of vision changes for the last few hours. He describes a painless decrease in the vision read more…

Pterygium Patient with a history of excessive sunlight exposure Complaining of something in the eye PE will show triangular-shaped growth on the medial side Sample question: A 62-year-old man presents with complaints of right eye irritation for the past three days. He is a landscaper and he is often outside. Physical examination reveals a fleshy, triangular growth from the read more…