This action might not be possible to undo. Are you sure you want to continue?
This study sheet is used to help you recognize key words and patterns associated with certain diagnosis. It is NOT intended to steer you to remember answers to test, but instead to help you recognize the intent or most likely diagnosis. The information of that specific diagnosis is up to your level of knowledge. It’s to help narrow that differential so you can focus on the specifics of the most likely diagnosis.
CARDIO Description DOE, PND, edema. Echo w/ LVH or RVH, hypokinesis S3 High output heart failure Low output heart failure Heart failure after URI Young athlete with syncope during athletic event or practice. No physical exam abnormalities Alcoholic with DOE, heart failure Alcoholic with palpitations, arrhythmia Irregular irregular Atrial fibrillation or prosthetic valve Hx angina but no acute sx. EKG no acute changes. Crushing CP, dyspnea, palpitations, radiation to neck or left arm CHF CHF, dilagted cardiomyopathy Pregnancy, thyrotoxicosis, anemia, beriberi, paget’s disease Ischemic heart disease, HTN, dilated CM, valve disease, arrhythmia Myocarditis Hypertrophic CM or fatal arrhythmia. Get EKG or Echo Primary dilated CM Atrial fibrillation (Holiday heart) Atrial fibrillation; (if > 48 or chronic – anticoagulate) Warfarin (2 – 3 for Afib; 2.5 – 3.5 for valve); Tx Warfarin OD is vitamin K Do Exercise stress test Angina (if lasts minutes), AMI if lasts > 30 minutes. Acute Ischemia – ST elevation; Injury – T wave depression; Infarct – Q wave Pericarditis Pericardial effusion/tamponade, pericarditis, asthma attack, tension PTX, SVC obstruction Pericardial effusion/tamponade Pericardial effusion/tamponade (Beck’s triad)
Constant, sharp CP worse lying down, better sitting up and leaning forward pulsus paradoxus Electrical alternans, narrow pulse pressure, pulsus paradoxus JVD, Hypotension, muffled heart sounds
PANCE/PANRE Word Associations
Pericarditis post open heart surgery Sudden onset ripping, tearing chest pain, diminished pulses Flank pain, hypotension, pulsatile abdominal mass EKG changes, N, V, yellow-green visual disturbances Hx CHF on diuretic & digoxin Grossly elevated blood pressure esp. w/ signs of EOD HTN Tx w/ meds, cough or angioedema DM & HTN Heart failure, LVH Post MI Tx of HTN w/ alpha-blocker HTN not responsive to basic meds
Dressler’s syndrome. Tx w/ ASA #1. Indomethacin or other NSAID OK. Aortic dissection AAA Digoxin toxicity (Hypokalemia will make worse) Suspect dig toxicity (hypokalemia from diuretic = dig toxicity) Malignant or Urgent HTN ACEI is cause ACEI is best choice ACEI (improves survival, prevents development of heart failure Sx) Beta-blockers SE is postural Hypotension Think secondary HTN most likely Renal artery stenosis (infrarenal artery). Bacterial endocarditis (strep. Viridians) prevention Bacterial endocarditis (strep. Viridians) Aortic stenosis (due to calcifications – age related (or bicuspid valve congenital) Aortic stenosis Aortic Regurgitation/Insufficiency: Quincke’s pulse (subungual capillar pulsation), Corrigan (rapid rise and fall), Austin filnt (low pitch middiastolic murmur at apex) Mitral stenosis (ARMS are BAD)
Mechanical valve or prosthesis & Dental, GU, GI, or ortho procedure prophylaxis IVDA w/ new murmur Elderly w/ systolic murmur Diamond shaped, blowing systolic murmur. May have angina, syncope, CHF Lateral displaced PMI, Canon “a” waves, Quincke’s pulse, Corrigan’s pulse, Austin flint murmur, deMusset’s sign, water Diastolic murmur best heart at apex without radiation
(ABI < 0. calf or LE pain esp. pectus excavatum. unequal UE & LE pulses. if apical systolic) Murmur & Hx rheumatic heart disease Continuous harsh. brittle nails.4) 3 Wolf-parkinson-white. ateriogram gold standard) Tx is arterial bypass . flexible joints LE rubor. Marfan’s Syndrome – MVP. systolic ejection murmur +/click Holosystolic murmur @ LSB.PANCE/PANRE Word Associations Systolic ejection murmur heard best at base with radiation to left clavicle Female or Post MI. Delta wave Young female (<30yo). palpitations. abnormal heart sounds. machine-like murmur Cyanotic infant with systolic thrill @ LSB. Holosystolic murmur @ LSB. Tricuspid Stenosis #2 PDA Tetralogy of falot VSD VSD Coarctation of aorta Short PR. ectopic lentis Arterial insufficiency/PAD. may have ventricular hypertrophy Infant w/ dyspnea. difficulty feeding. avoid Digoxin. systolic murmur best @ apex preceded by click without radiation Systolic murmur heard best at apex with radiation to left axilla (apical systolic) New murmur after MI (esp. Aortic root dilatation. long arms & fingers. with walking short distances relieved with rest or at PM Claudication with rest pain. Intermittent claudication (ABI best choice. Aortic regurgitation. LVH & RVH Peds w/ leg pain after physical activity. pallor on elevation. Aortic dissection. rib notching Pulmonary stenosis Mitral valve prolapsed Mitral regurgitation Mitral regurgitation (caused by papillary muscle rupture) Mitral stenosis #1. no hair. 3rd ICS. wide QRS. ectopic lentis.
Lung scan with perfusion defects Venous stasis. Tx w/ racemic epi and glucocorticosteroids if stridor at rest. tortuous. stridor Varicose veins. TB (Gohn focus) TB Mesothelioma Lung Ca Silicosis (Sandblasters) Asbestosis (shipbuilders. LE Fx. lower respiratory FB. Metabolic acidosis Cheyne-Stokes breathing – heart failure. travel (airplane). veins Trendelenberg test of extremities Blue extremities worse w/ cold exposure. building demolition) Coal Miner’s lung Farmers lung Sarcoidosis DVT/PE PE DVT/PE (Virchow’s triad) viral croup (laryngotracheobronchitis). asthma 4 Pediatric wheezing . small bronchi and small blood vessels Dyspnea after surgery. F. vessel wall injury. Acrocyanosis Diagnosis Associated Kussmaul breathing – DKA. Tx w/ compression stockings Tests for veinous insufficiency. Dilated. brain damage Infections – lung abscess. improves w/ warming PULMONARY Description Rapid. hypercoagulability Pediatric with barking cough.PANCE/PANRE Word Associations LE pain after long periods of standing. May have c/o calf pain also. deep labored breathing Deep breathing alternating w/ apnea Cavitations on CXR Apical infiltrates. dry cough Pleural thickening on CXR Hilar mass on CXR Eggshell pattern on CXR Ground glass appearance on CXR Reticular to nodular pattern on CXR Patchy fibrosis on CXR Granulomas and inflammation of alveoli. C.
chronic care facility. COPD PNA w/ DM. +/. CXR – infiltrates or consolidation >35yo with PNA. Toxic looking PNA from Nursing homes. neutrophils. PNA w/ Water. lymphocytes Fever. muscle aches Bullous myringitis PNA w/ Smokers. sniffing position. Diffuse 5 Epiglottitis Epiglottitis FB. construction site. Fever. loss. tear drop heart Wheezing. chronic productive cough. sputum. prolonged expiration Airway edema with eosinophils. pectoriloquy. influenza Klebsiella Legionella Staphylococcus aureus Pneumocystis jerovecii. wt. college students. Crackles. viral croup (laryngotracheobronchitis) FB. air bronchograms Smoker. Immunocompromised. NO hemoptysis. Diarrhea. Acute onset F/C <35 yo. +egophony. immunocompromised. TMP-SMX = Drug of choice . Purulent sputum PNA & HIV+. decreased breath sounds. Sx out of proportion to exam.sputum. Currant color sputum. cough Hyperinflation on CXR. DOE. tripod. dullness to percussion. cough. EtOH. AIDS. chills.PANCE/PANRE Word Associations Drooling. toxic Thumbprint sign Steeple sign Inspiratory stridor Premature infant with respiratory distress Preemie CXR w/ hypoexpansion (ATX). cough. Smoker. Rusty colored or yellow-green sputum. viral croup (laryngotracheobronchitis) Hyaline Mb Disease Hyaline Mb Disease Brochitis (COPD) COPD Emphysema Asthma Asthma Pneumonia Strep. Pneumonia Mycoplasma pneumonia Mycoplasma pneumonia H. late summer.
intubation) GI/NUTRITION Description Fat. RUQ pain. obese. pancreatitis. Patchy infiltrates in dependant lung zones Pediatric with Hx recurrent lung infections. decreased breath sounds. forty. PM wakening s/p thoracic trauma. hyperresonance to percussion. dentures. Chest wall moves in with inspiration. HTN. tympany Stqb wound. skinny. daytime fatigue Obstructive sleep apnea & drowsy. female. fertile w/ RUQ pain Fever. dullness to percussion. dyspnea Stab wound to chest. Multiple rib fractures. Tall. incentive spirometry. pulmonary toilet. male. poor dental hygiene. bronchiectasis. band student. Hypotension. tracheal shift Aspiration PNA Cystic fibrosis (Staph & Pseudomonal infections usually cause of death) Cystic fibrosis Pseudomonas aueroginosa causative agent Atelectasis Pneumothorax Hemothorax Spontaneous PTX Tension PTX Poor sleeping. foul smelling sputum. acute onset one-sided chest pain. radiation to back Elevated Alkaline phosphatase. Flail chest (pain control. 6 Diagnosis Associated Cholelithiasis or Cholecystitis Cholecystitis Cholecystitis . snoring. reproductive problems. out with expiration.PANCE/PANRE Word Associations interstitial & alveolar infiltrates PNA & decreased mental status. decreased breath sounds. FTT Sweat chloride test Cystic fibrosis w/ PNA < 2 days post-op with fever Stab wound.
and extrahepatic duct sclerosing and dilatation) Hepatitis Gilbert’s syndrome Crigler-Najjar Dz Porphyria 2antibiotics & PPI GERD Zollinger-Ellison Syndrome N/V. bloating. bitter taste in mouth or throat. indirect bilirubin Isolated elevated indirect bilirubin Elevated indirect bilirubin w/ defective glucuronyl transferase Photosensitivity. or following fatty meals Peri-umbilical or flank ecchymosis Abdominal distension. highpitched rushes & tinkles Air fluid levels on upright abd plain film Air under diaphragm. abd pain w/ neurologic dysfunction. RUQ pain. wt loss. colicky pain. gallstones & dilated common duct on US Hx IBD. perforated ulcer Diverticulitis. fluids. ERCP with bile duct stenosis. dilatation Elevated AST. ALT. NPO. LLQ pain Elderly. caused by alcohol ingestion. IV Abx. intermittent. worse Acute pancreatitis supine. F. dyspepsia Multiple or constant GI ulcer pain despite medications Ascending cholangitis (Charcot’s triad) Primary sclerosing cholangitis (diffuse intra. epigastric abdominal pain.PANCE/PANRE Word Associations urinary bilirubin F. Hx atherosclerosis. progressive RUQ pain. Mesenteric ischemia . Jaundice. Dull crampy periumbilical pain postprandial 7 Acute pancreatitis (Cullen & Grey Turner’s Sign) SBO SBO Perforated viscus.pylori gastritis Chronic cough. jaundice & pruritis. Elevated bilrubin & alkaline phosphate. rigid board-like abdomen >60yo F. erythema or skin fragility H.
H. watery or loose stool. respiratory distress. multiple polyps found on colonoscopy AFP CA 19-9 CA-125 Chemotherapy induced N&V Traveler’s Diarrhea Greasy. CEA Family history of young age colon cancer. testicular seminoma (germ cell tumor) Pancreatic Ca Ovarian Carcinoma Treat with Ondansetron (Zofran) (5HT3 blockers) E. Pear-shaped flagellated protozoan w/ 2 “eyes”. TCA’s (nortriptyline) good if diarrhea predominant symptom Ulcerative colitis Virchow’s node – metastatic abdominal cancer Sister mary Joseph nodule = indicates metastatic gastric and pancreatic cancers Gastric Ca Colon Cancer Colon Cancer – get colonoscopy Colon Carcinoma Familial adenomatous polyposis (Gardner’s syndrome) Hepatocellular carcinoma. foul smelling. floating stools. Hydration & Cipro to treat Giardia Viral Gastroenteritis . constipation. increased secretions in 1st hours of life Painless rectal bleeding in pediatrics Alcoholic with massive hemoptysis Female with recurrent abdominal pain. Pain relieved with defecation. Olive sized mass. alternating diarrhea. Choking. Pernicious anemia (Type A Gastritis). pylori Apple core lesion Elderly with positive hemmocult. Bloody Diarrhea Supraclavicular LAD (L > R) Hard periumbilical nodule PUD. No 8 Pyloric stenosis Tracheoesophageal fistula Meckel’s diverticulum Esophageal varicies (Tx w/ octreotide) IBS. camping history Afebrile. Water. coli is cause. cyanosis.PANCE/PANRE Word Associations Neonate w/ projectile vomiting. travel.
dementia. Bulging perianal mass w/ straining Pediatric with perianal pruritis esp. then crampy abd pain & diarrhea Painless rectal bleeding. cream. recurrent infections. bleeding ENDOCRINE Description Diabetic w/ anorexia. anemia. No masses. N. Eaten ham. death). Neuro Sx Niacin (4D’s dermatitis. pallor Gastroparesis. F. stocking-glove paresthesia Hypoglycemia despite glucose administration. abd cramping. Tx is Mebendazole Celiac Sprue Celiac Sprue Thiamine. hair & tooth loss. diarrhea after picnic/party.PANCE/PANRE Word Associations blood or mucus Abdominal pain. custards. dizziness after eating. recurrent greasy stools (steatorrhea) mixed with diarrhea after certain foods Anti-endomysial antibodies Beriberi Pellagra Scurvy Rickets Night blindness Magenta tongue s/p gastric bypass surgery or gastric surgery. 9 Staphylococcus aureus infectious diarrhea Campylobacter jejuni – most common cause of acute bacterial diarrhea Internal hemorrhoids Pruritis ani – Pinworms (enterobiasis). joint pain & swelling) Vit D (Osteomalacia) Vit A deficiency Riboflavin deficiency (B2) Dumping syndrome Diagnosis Associated CRF Diabetic neuropathy (Treat w/ TCA (amitriptyline) Insulinoma Give Thiamine before glucose to prevent Wernicke’s encephalopathy Hashimoto’s thyroiditis . wt loss. Alcoholics. bruising. mayonnaise Acute bacterial diarrhea w/ prodrome of HA. diarrhea. Positive cellophane tape test Weight loss. Increased C-peptide Hypoglycemia in alcoholic Decreased radioactive iodine uptake. at PM. impotence. bright red tongue Vit C (easy bleeding.
hypocalcemia. glucosuria Urinary catecholamines. large protruding tongue. atrial fibrillation Exophthalmos. enlarged abdomen. constipation. palpitations. hx transphenoidal surgery & radiation Tetany. HTN. buffalo hump. HTN not responding to Pheochromocytoma – Tx pre-op w/ meds. hyperglycemia. abdominal stria. edema. coarse dry skin. weight loss. increased TSH Female. Graves Dx – Tx w/ Radioactive iodine Recurrent laryngeal nerve = hoarseness Hypocalcemia Congenital Hypothyroidism Recurrent HA. cataracts Exogenous corticosteroid use Dexamethasone suppression test Central obesity. wt. umbilical hernia. hypokalemia Primary Aldosteronism Wt. gain. T4) Hyperthyroid. Elevated radioactive idodine uptake Post thyroidectomy – most likely injury Post thyroidectomy – electrolyte watch Infant w/ round face. delayed developmental milestones Hyperthyroid (work it up with TSH. cold intolerance. dry skin. loss. easy bruising Acute steroid withdrawal Hypothyroidism Hypoparathyroidism Cushing syndrome Cushing syndrome Cushing syndrome Addison’s disease. menorrhagia. urinary metanephrines HTN not responsive to meds Renal artery stenosis (Infrarenal artery) HTN w/ hypernatremia. moon facies. hair. poor feeding.PANCE/PANRE Word Associations decreased free T4. sweating alpha blocker Attacks of severe HA. palpitations. crisis 10 .
ARF Painless hematuria. ↓ intelligence. alcoholic on ground. low set ears. elevated CPK. polydipsia. ACTH stimulation test) Acute adrenal insufficiency (Addison’s crisis) Diabetes insipidus SIADH Turners (gonadal dysgenesis Klinefelters (hypogonadism) GU/ELECTROLTES Description Hyaline Casts Increased BUN/Cr. Hypernatremia Concentrated urine. crisis (Low aldosterone. trauma. Dilute urine. weakness. crisis (Low aldosterone. recurrent abdominal pain. strenuous exercise) Prerenal Failure (Azotemia) Pyelonephritis Rhabdomyolysis Renal cell Carcinoma 11 . hypoglycemia. abn arm-body length Addison’s disease. hypotension not responsive to fluids.X – low hairline. get Random or AM cortisol. short stature. hyperkalemia Polyuria. orthostatic hypotension. small firm testes. gynecomastia. hair loss. CVA tenderness Crush injury. wide set nipples. hyperkalemia Hyponatremia. Hyponatremia. chills.short stature. lack of Secondary sex characteristics XXY ♂ . hyperpigmentation. webbed neck. flank pain or mass Diagnosis Associated Normal (may be present after febrile illness. get Random or AM cortisol.PANCE/PANRE Word Associations Hyperpigmentation. low FeNa Irritative voiding symptoms. or surgery Worsening fatigue. hypotension following an illness. infertility. shield chest. wt loss. Hyponatremia 45. Fever. ACTH stimulation test) Addison’s disease.
very few neutrophils Meningitis and rash Acute Glomerulonephritis Glomerulonephritis. elevated PSA) Stress HyperKalemia HypoKalemia Hypocalemia Hyperparathyroidism Aspirin OD Diagnosis Associated Epidural Hematoma Epidural Hematoma Subdural Hematoma Bacterial meningitis syphilitic meningitis Meningiococcal 12 . disoriented – lucent – coma Lens shaped hemorrhage Concave LP w/ decreased glucose. hematuria.PANCE/PANRE Word Associations Oliguria. >50 yo obstructive voiding sx. decreased phosphorus Hearing loss or tinnitus w/ metabolic acidosis NEURO Description Head trauma. proteinuria following streptococcal infection Hematuria. hemoptysis) Fibrous band on lateral penis Can’t retract foreskin Inflammation of glans < 40 yo male with Fever. purpuric rash following streptococcal infection Hematuria. irregular. RBC casts. Treat accordingly (Bactrim #2 choice). HSP Glomerulonephritis Goodpasteures Peyronie’s disease Phimosis Balanitis Acute prostatitis caused by Chlamydia & N. perineal pain. nocturia. proteinuria RBC casts Kidney & lung bleeding (hematuria. gonorrhea. Nl PSA Incontinence with straining Peaked T-waves U waves QT prolongation Recurrent kidney stones. increased protein LP w/ decreased protein. Firm smooth enlarged prostate. (Cancer would have firm. nodular non-tender prostate. coli is cause (Tx w/ FQ) BPH. > 40yo think e. dysuria. elevated Calcium.
“worse HA of my life” >50 yo female w/ HA. Severe HA. decreased rectal tone Ascending paralysis Paralysis after Campylobacter enteritis Weakness and fatigue in upper limbs. recurrent relapsing HA. photphobia. Grp B strep. oligoclonal bands (Pathognomonic). +FHx. N/V. get temporal artery biopsy MS MS Recurrent episodes of vision change. E. N. respiratory Brain Tumor (MC is glioma) Cauda equine syndrome = neurosurgical consult GBS GBS Myasthenia gravis 13 . urinary and rectal incontinence. weakness & tingling in extremities that resolve myelin fragments. meningititis Mumps Bell’s palsy (self-limiting) Migraine HA Cluster HA Subarachnoid hemorrhage Temporal arteritis (Giant cell arteritis). rhinorrhea Sudden onset thunderclap HA. Temporal artery tenderness or blindness Grp B Strep. ↑ IgG. Worsened w/ EtOH. diplopia. blurry vision. Elevated ESR. Lhermitte’s sign = electrical sensation down body w/ neck flexion HA worse in AM w/ focal neuro deficits s/p Fall w/ bilateral LE weakness. +/auras Male. N. Lacrimation. salivation. meningititis Strep.PANCE/PANRE Word Associations Meningitis & <2mo Meningitis < 4yo Meningitis > 2yo. coli (Tx < 1yo = Vanco + Rocephin) H. diplopia. inlu. adults Viral Meningitis Unilateral facial weakness w/ inability to close eye Adolescent female w/ HA.
seizures. hyperactive reflexes. elevated liver enzymes Pediatric with episodes of blank stares 3 mHz spikes on EEG Muscular dystrophy (weakness begins at pelvic girdle) Reye’s syndrome from URI/post-flu or aspirin use Absence (petit-mal) seizures. Calf muscle wasting Pediatric with fever or Hx URI with encephalopathy. Ass. fixed upward gaze. “Ash leaf” hypopigmentation of trunk Tuberous sclerosis & Ext. Absence (petit-mal) seizures. profound hypoxemia Optic chiasm lesion Ipsilateral optic nerve lesion Temporal optic radiation Ipsilateral optic tract lesion Orbital blow-out fracture. shagreen patch. diplopia. mental retardation. TCA. w/ PCK. emesis. Exophthalmos. Immediate ophthalmology referral Chalazion 14 Bilateral hemianopia Loss of central vision Superior contralateral quadrantopia Temporal field loss Eye trauma. sebaceous adenomas. nontender nodule on upper . hyphema Painless. antiparkinsonian drugs.ils Diagnosis Associated DM retinopathy (MCC) Macular degeneration Optic nerve lesion. Tertiary syphilis (marcus-gunn) Pontine hemorrhage Anticholinergics.PANCE/PANRE Word Associations distress Young kid with difficulty standing from seated position. renal hemartomas HEENT Description < 70 yo blindness > 70 yo blindness Afferent papillary defect. marcusgunn pupils Bilateral pinpoint pupils Bilateral DILATED pu. hepatomegaly.
dysarthria. embolic source Painless vision loss. hyperemia. steamy cornea. Allergic rhinitis Mycoplasma pneumonia Strep. yellow – green nasal discharge Sneezing. new onset floaters Transient monocular vision loss Painless vision loss. Nedocromil effective Tx. Pyogenes. w/ MS) EOM Recurrent episodes of vision change.PANCE/PANRE Word Associations or lower eyelid Painful swelling of upper or lower eyelid Painless. MS diplopia that resolve Red eye. watery discharge. preauricular LAD Red eye. Onset after being in dark room Diplopia. edematous. influenza. hazy. emboli CRAO (pale retina. arrhythmia. postnasal drip. nasal congestion seasonal occurance Pale. strep. palpitations. nodular conjunctivia Acute Painful red eye. H. copious purulent discharge Red eye. painful Optic Neuritis (assoc. clear rhinorrhea. moraxella catarhallis 15 . chemosis. Pupil is fixed and (mid) dilated. dysphagia Unilateral foul smelling or purulent nasal discharge in a pediatric patient HA. History of HTN Hordeolum Pinguecula (more common on nasal side) Retinal detachment Amaurosis fugax – TIA. sinus pressure. cherry red macula) CRVO (blood & Thunder. retinal hemorrhages) Vision loss over hours to days. boggy turbinates Bullous myringitis Otitis media Viral conjunctivitis Gonococcal conjunctivitis Allergic conjunctivitis Acute angle-closure glaucoma Vertibrobasilar insufficiency Nasal Foreign body Sinusitis – CT is gold standard Allergic rhinitis. History of TIA. carotid disease. yellow triangular nodule on conjunctivia Curtain or veil over my eyes. Pneumonia. halos (or colored rings around lights).
Neck or axilla). LN pain after drinking alcohol Diagnosis Associated CML AML Hodgkin’s lymphoma Hodgkin’s lymphoma 16 .PANCE/PANRE Word Associations Swimmer with ear pain. Pseudomonas. tinnitus Dix-hallpike maneuver Sudden vertigo with changes in head position Sudden dizzy.mononucleosis HEMATOLOGY/ONCOLOGY Description Philadelphia chromosome Auer rods Reed-sternberg cells Painless LAD (us. acute onset vertigo Smoker. rule out oral cancer Diphtheria EBV . insidious onset vertigo Horizontal Nystagmus. N. “B” signs + pruritis. rash. supraclavicular LAD College student with sore throat. vertigo. ear pain Tinnitus and metabolic acidosis Sudden dizzy. discharge Diabetic. NO tinnitus. hearing loss. hearing loss. anterior cervical LAD. V. Treat w/ diuretics & low-sodium diet BPPV BPPV Vestibular neuronitis. splenomegaly. Enlarged tonsils. LAD in orderly fashion. splenomegaly. white mouth lesion cannot be rubbed off Gray pharyngeal pseudomembrane. labrynthitis Acoustic neuroma (order MRI) Presbyacussis (Hi freq sounds 1st to go) Central lesion (tumor) Peripheral lesion Leukoplakia. CBC – elevated atypical lymphoctyes Otitis externa MOE. IV abx (FQ). CT head Salicylate Ingestion Meniere’s disease. Recent URI Unilateral nerve deafness in middle age Pt Sensorineural loss > 50yo Vertical Nystagmus. Splenomegaly.
Cheilosis Anemia after colectomy. low fever. Given multiple blood transfusions. gentamicin. Hct. epistaxix.PANCE/PANRE Word Associations Fatigue. menorrhagia Continuous bleeding post-op or trauma. Glossitis. engorged retinal veins Splenectomy Sickle cell Spontaneous Hemarthrosis Mucosal or gingival bleeding. Tx = Phlebotomy Pneumococcal vaccine Autosomal Recessive. priaprism Hemophilia A Von Willebrand disease DIC INFECTIOUS DISEASE Description MRSA Diagnosis Associated “spider bite” appearing lesion that turns into abscess. Pregnant & fatigue. linezolid 17 . Menstruation. Scattered. pain in extremities after exercise. splenomegaly. weight loss. partial gastrectomy. PM sweats. gingival bleeding. decreased vibratory sensation G6PD + Quinidine. Sulfa Fatigue. CRF or Renal insufficiency. Low platelets. Know CBC. post showering pruritis. No HSM Elevated Hgb. plethora. purpura. weakness. painless LAD or neck mass Painless LAD us. Nitrofurantoin. PICA. + fibrin split products (increased d-dimer) Lymphoma – do Lymph node biopsy. “B” signs Hx HTN. increased PT. INR. Bone marrow Bx and CT scan used for staging Non-Hodgkin’s lymphoma Anemia Fe Deficiency Anemia B12 or Pernicious anemia Hemolytic anemia Aplastic anemia Polycythemia vera. nephrotic syndrome. pallor. Tx w/ Vanco +/rifampin.
erythema. give Ig. bats. ankles then moves up extremities then trunk. PM. central necrosis Woods. Tx w/ hyperbaric oxygen. hikers. complement Target lesion. Erythrasma (coral red) Black widow (neurotoxin) Brown recluse RMSF (Rickettsia rickettsia) RMSF (Rickettsia rickettsia) Lyme Dz (Borrelia Burgdorfi) Scabies Rabies. Gram negative intracellular diplococci Red cervix w/ mucopurulent discharge in sexually active female FTA-ABS. Macular rash at wrist. forest. MTA-TP Malaria prophylaxis Chlamydia Syphilis diagnosis Chloroquine 18 . elbows. WeilFelix rxn. skunks Gangrene Herpes virus (Genital) Herpes virus (Genital) Herpes virus (Genital) Condyloa acuminata Dermatophytes infections. webs of fingers Raccoons.PANCE/PANRE Word Associations Clear vulvar vesicles. surgical excision Gonorrhea Gonorrhea Gram negative intracellular diplococcic Sexually active. After 5 days rash at palms & soles Indirect immunofluorescent Ab. urethral discharge. arthralgia. bradycardia. rhinorrhea. Penicillins. multiple or new partner. HTN. Rabies vaccine if animal is not caught and tested Clostridium infection – an anaerobic bacteria. tachyarrhythmias Bite with local edema. hands. lacrimation. Bell’s Palsy Intense pruritis esp. inguinal LAD Giant Multinucleated cells Tzank Smear Acetowhitening Wood’s light fluoroscopy Bite w/ fever. Burrow like lesions at wrists.
stress fracture. Tx w/ NSAIDs. tenderness over tibial tuberosity Retropatellar knee pain esp.PANCE/PANRE Word Associations MSK/RHEUMATOLOGY Description Shoulder pain after repetitive activity. Ulnar gutter w/ intrinsic plus positioning. Hand injury after a punch Diagnosis Associated Rotator cuff injury (SITS muscles) Brachial plexus neurapraxia. hip pain (knee XR normal) Adolescent male with knee pain. + drop arm test or apprehension test Football player with burning pain. in females Pain on plantar foot @ 2 – 3rd metatarsal. pregnant may worsen Pain at base of thumb. Caused by stretching of brachial plexus Colle’s Fx. distal radial styloid. wide shoes. knee pain 12 – 15yo overweight male knee pain. then steroid injections Female exam. dinner-fork deformity Typing. Pain reproduced with ulnar deviation of clenched fist. athletic activity (running sports) Knee injury during football game 8 – 10yo male with limp. Associated w/ tight 19 . numbness. “stinger”. Radial fracture w/ dorsal displacement. secretary wrist pain and numb/tingling from wrist to hand. tingling from shoulder to hand which resolves FOOSH. Tx = volar splint Carpal Tunnel syndrome deQuervain’s tenosynovitis Boxer’s fracture. point tenderness at anterior humerus or AC joint. asymmetric posterior chest wall or uneven scapula height with forward bending Tibial pain after running (military recruits). Get bone scan if negative x-ray ACL (look for description of lachman or drawer test) Legg-Calve-Perthes Disease SCFE Osgood-schlatter disease Patellorfemoral pain syndrome – increased Q angle. ORIF if angulation > 40 degress Scoliosis (> 25 degree Cobb angle = surgery) Shin splints. limp. strengthen quadriceps Morton’s neuroma. New mothers.
iritis. warm. MCP joint swelling. sleeping problems. tender points Cold induced pain at extremities with Compartment syndrome Ankylosing spondylitis. stiffness. Reiter’s syndrome Septic arthritis (synovial fluid = leukocytosis. arthritis. osteophytes. bouchard – DIP) Rheumatoid arthritis. Tx = NSAIDs (Indomethacin) Reiter’s syndrome Systemic autoimmune diseases (RA. cervicitis. low glucose) Osteoarthritis. pelvic girdle Male w/ low back pain. relieved by removing shoes. Swollen. Large joint pain. ulnar deviation Acute swollen big toe Proximal symmetric muscle pain & stiffness esp. + anti-double stranded DNA antibodies. +anti-phospholipid antibodies dusky red. well localized single or multiple papules or plaques usually of face Female. erythema. Plain films show sacroiliac abnormality. Methotrexate (DMARDs) #1. DIP Female morning joint pain & stiffness esp. OCP SLE Discoid lupus Fibromyalgia (exercise program good management) Raynaud’s phenomenon 20 . Gout Polymyalgia rheumatica Ankylosing spondylitis.PANCE/PANRE Word Associations shoes. Knees w/ medial joint space narrowing. fatigue. shoulder. HLAB27 positive Conjunctivitis. improve during day. malar rash. IBD). Pain worse wakening. urethritis Erythema nodosum Female with Arthralgias. Acetaminophen #1 choice Osteoarthritis (herberden – PIP. general aching. pain at neck. +ANA. Palpable painful mass Pain after tx of fracture w/ cast HLA-B27 Acute joint pain. Enlarged PID. Decreased ROM at spine. upper shoulders. hand/wrists. neck. No erythema or warmth.
Tx supportive care & antipyretics 21 . facial tics. ataxia Pt on antipsychotic meds develops altered consciousness. Binge eating. anxiety. mental status fluctuations. Plain films = stalky or broad-based projection from bone surface Lytic lesions in the back or skull Pseudomonas aeruginosa (foam padding in shoes) Ewing sarcoma – periosteal “onion skin” reaction Osteochondroma Multiple myeloma PSYCHE Description Deterioration of cognitive function. tremors. weight loss. irritability Paplitations. daytime sleepiness. multi-laminated periosteal reaction Painless bony mass. tongue disorders. XR w/ lytic mass. chafed. apathy. numb or tingling mouth or extremities Feelings of worthlessness. lip smacking. Thoughts of suicide Raw red hands.PANCE/PANRE Word Associations color change as they warm up Osteomyelitis after stepping on nail wearing sandals or tennis shoes Teenage female with long bone pain without trauma or injury. metabolic alkalosis Tardive dyskinesia Neuroleptic malignant syndrome. memory Rapid onset of cognitive symptoms. laxative use. lead-pipe Diagnosis Associated Dementia Delerium Anxiety Depression (SSRI = drug of choice) Obsessive compulsive disorder Bulimia nervosa (Tx w/ SSRI – Fluoxetine) Hypokalemia. starvation Bulimia with electrolyte disorders Antipsychotic meds (phenotiazines). hopelessness. blinking. insomnia. hyperventilation or respiratory alkalosis.
diaphoresis. bradykinesia. dysuria. diminished or delayed secondary sex characteristics. small firm testicles. Lithium toxicity TCA overdose Diagnosis Associated Trichomonas Bacterial vaginitis. rigidity. shuffling gait. Low serum testosterone & infertility. orthostatic hypotension REPRO Description Frothy. Pt on antipsychotic meds Infrequent blinking. catatonia. buying. fever. Antidepressant use w/ anticholinergic side effects. dysrhythmias. tremor. long arms & legs (eunechoid body habitus) Hyponatremia w/ bizarre behavior.PANCE/PANRE Word Associations rigidity. Thin grayish vaginal Neuroleptic malignant syndrome. Gardnerella 22 . diaphoresis. muscle rigidity. Flagellated protozoa Fishy odor. masked facies Short lived. pulmonary congestion. clear – white or yellow-green to gray adherent vaginal discharge. dry mouth. Periods of excessive drinking. vaginal pruritis. Vulvar and cervical erythema. intense relationships. sedation. hyperpyrexia. when feeling abandoned. dysarthria. tachypnea. BP changes. Hyperthermia. spending Male w/ gynecomastia. Difficulty controlling anger esp. blood pressure changes. Hx sexual promiscuity and substance abuse. altered consciousness. Extrapyradimidal signs. Tx supportive care & antipyretics Parkinson’s Borderline personality disorder Manic phase of bipolar disorder Klinefelter Syndrome XXY. CV instability.
tender. Relieved w/ NSAIDs Dysmenorrhea. bloody nipple discharge Overweight. Amenorrhea). firm. dyschezia. vaginal petechiae Secondary amenorrhea Female with acute abdominal pain. elevated blood sugar. retroflexed. serous. Give vaccine AFTER delivery 23 . hyphae & buds on KOH prep Postmenopausal. May have palpable pelvic mass Firm irregular shaped. non-tender breast lesion. Uterus is fixed. bilateral breast masses that increase in pain and size before menses Spontaneous bloody. wellcircumscribed. thin vaginal discharge. irregular menstrual cycles (poss. Tx = topical estrogen Pregnancy Ectopic pregnancy Fibroadenoma Fibrocystic breast disease Intraductal papilloma Breast cancer (mass is most common presenting clinical manifestation) PCOS (stein-leventhal syndrome) Mittelschmerz Endometriosis. dyspareunia. or cloudy nipple discharge Breast mass. diffusely globular uterine enlargement 6cm unilateral. multiple. hirsutism Adolescent female with midcycle pain alternating from left to right side. Palpable pelvic mass – “chocolate cyst” Leiomyoma Adenomyosis Tubo-ovarian abscess Nagel’s rule: LMP + 7 – 3 mo Rubella. mobile. painful. nipple retraction. post-auricular or vaginalis Candida Atrophic vaginitis. NONTENDER enlarged uterus Softened.PANCE/PANRE Word Associations discharge. No characteristic acute abdomen pattern 20yo female w/ rubbery. doesn’t change w/ cycle 30 – 50yo female. tender adnexal mass Pregnant Pregnant + rash. Clue cells Thick white vaginal discharge. dyspareunia. Cyclic pelvic pain. atrophic vulvar changes.
spaghetti & meatballs Bacterial infections Candida: Tx: Nystatin/Lotrimin cream QID x14d. Tissue at or said to be passed from open cervical os. tender skin with possible induration or fluctuance Red. complete passage of fetal tissue. Blood from closed cervical os. pain resolves after passage of tissue) Fetal alcohol syndrome – low birth weight Uterine Atony.PANCE/PANRE Word Associations occipital LAD Pregnant. less distinct borders. erythematous. abd & pelvic pain. Coral red fluorescence under Wood’s lamp Distinct. Tx = uterine massage Endometrial Ca – do endometrial biopsy Ovarian Ca DERM Description Procainamide. seizures Pregnant < 20 wks gestation w/ vaginal bleeding. visual disturbance Pregnant. chills. HA. Pregnant < 20 wks gestation w/ vaginal bleeding. Pregnant who drinks during pregnancy and inadequate peri-natal care Postpartum hemorrhage Postmenopausal vaginal bleeding Postmenopausal adnexal mass Pre-eclampsia Eclampsia Threatened abortion Incomplete abortion (complete abortion will have empty uterus. if fails Ketoconazole Cellulitis Erythrasma Erysipelas Herpes virus 24 . under breast folds with satellite lesions Warm. sharp bordered rash in groin (infants). abd & pelvic pain. Sulfa drugs Coral red = Erythrasma Fungus. Candida. hydralazine & rash Photosensitive rash Wood’s light KOH Gram stain Beefy red. sharp raised demarcated border with fever. Group A Strep Grouped vesicles on erythematous Diagnosis Associated Lupus-type eruptions TCN. Hyphae & buds.
Permethrin (Elimite) is drug of choice 25 . at sun-exposed areas Non-pruritic. NO steroids. raised. sandpaper feel. Get immediate ophthalmology referral) HSP (Hx post Strep A infection) Impetigo. dome-shaped nodule with central plug Herpetic whitlow Herpes Zoster (if involved eye = herpes keratitis. warty brownblack plaques. Spots occur before rash Rubeola (Measles) Scarlet fever (Grp A Strep) Scarlet fever (Grp A Strep) Urticaria Varicella (Chicken Pox) Actinic Keratosis Seborrheic keratosis Lentigines Keratoacanthoma Raised pearly-borders. general LAD Scabies & Pediatrics Secondary syphilis (Money spots). telangiectasia. stuck onto skin feel greasy Flat brown spots with sharp borders on dorsum of hand Erythematous. pink or yellow-brown lesion with rough. VDRL will confirm NO LINDANE (KWELL). pustules & vesicles at different stages of healing Flesh-colored. Basal cell Ca central ulcer Pearly papule with umbilicated center Molluscum contagiosum Sexually active person w/ rash on palms & soles. positive ASO titer Strawberry tongue Pruritic raised erythematous plaques Dewdrops on rose petal. coryza. Tx = Mupirocin Koplick spots – Rubeola (Measles). posterior thighs Honey colored crusts on erythematous base around nose & mouth Small white papules on diffusely red base on buccal mucosa Cough. conjunctivitis Pastia’s lines.PANCE/PANRE Word Associations base Infant or pediatric w/ grouped vesicles on thumb or “tapioca” vesicles on thumb Pain preceding vesicular rash in dermatomal pattern Hx URI the palpable purpuric rash to buttocks.
PANCE/PANRE Word Associations Christmas tree pattern. scaly. Rash preceded by lagre oval plaque w/ central clearing & scaly border Hypopigmented lesions. cracking. pericarditis. brittle nails Infant w/ erythematous. look for cardiac complications (myocarditis. Gets worse w/ tanning or sun exposure Erythematic ring with scaly border & central clearing spaghetti & meatballs Thick. warm olive oil compress. Koebner’s phenomena Rat bite erosions on XR 26 . “sandpaper” rash over face. lip fissures Erythema marginatum Silvery scaling plaques on extensor sensors. mild Hydrocortisone cream. symptomatic treatment Roseola infantum (Herpesvirus). Tx = PO Terbinafine Cradle cap – seborrheic dermatitis (Tx in infants w/ baby shampoo. Herald patch Pityriasis Alba Tinea (fungal infection). Adults – selenium sulfide shampoo) Hand-Foot-Mouth disease. arteritis. (rash after defervesence) Truncal Rash in pediatric after fever Fever. extremities High fever (up to 105oF) x 5 days then rash. hands. erythematous papules w/ oval plaues w/ scaly itchy border. May have conjunctivitis. “5th Dz”. scaly crusty lesions at vertex of scalp Pityriasis rosea. KOH prep = hyphae Tinea (fungal infection Onychomycosis. Motrin. white. neck. aneurysms) Rheumatic Fever Psoriasis Psoriatic arthritis Children < 10yo w/ vesicles on pharynx. Roseola infantum (Herpesvirus). Coxksackie Virus Erythema infectiosum “Slapped cheek”. pharyngitis. feet w/ NO ulceration Healthy looking < 5yo with lace-like rash on both cheeks – red papules Pediatric with high fever then after fever macular rash over trunk and neck. symptomatic treatment Scarlet Fever Kawasaki’s Disease. Motrin. trunk. yellow. Ausptiz sign. mouth.
builds tower < 2mo fever < 5yo fever.blood Cx. after 6 mo add meat. nitrofurantoin. Hx pernicious anemia or other autoimmune disease PEDIATRICS Description Introduce solid foods (cereal. starchy foods 6 – 8 mo 15 mo 24 mo Septic w/u .PANCE/PANRE Word Associations Dark skinned person with “whitening or lightening” of skin. LP Febrile seizure Give corticosteroids Fetal distress G6PD deficiency (hemolytic anemia w/ oxidative drugs – sulfa. eggs. fetal maturity Meconium-stained amniotic fluids Positive osmotic fragility test Mousy urine Vit D – Rickets Hemophilia A. Duchennes MD Neurofibromatosis Sickle cell. fees self w/ spoon. fruits) 1st tooth (central incisor) Walks alone 3 words. quinidine) PKU X-linked dominant X-linked Recessive Autosomal dominant Autosomal Recessive 27 . CF. PKU Vitilligo. seizures Premature birth. Skin biopsy to diagnose Diagnosis Associated 4 – 6 mo.
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue reading from where you left off, or restart the preview.