High Yield Review by

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PHYSCIANASSISTANTBOARDS !1

Clinical Medicine

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High Yield Review 1 CARDIOLOGY 3 PULMONOLOGY 4 MUSCULOSKELETAL RHEUMATOLOGY 5 GASTROENTEROLOGY 7 REPRODUCTIVE 8 GENITOURINARY 9 EENT 10 ENDOCRINOLOGY 11 NEUROLOGY 12 HEMATOLOGY 13 PSYCHIATRY 14 DERMATOLOGY 15 INFECTIOUS DISEASE 16

PHYSCIANASSISTANTBOARDS !2

CARDIOLOGY

PHYSCIANASSISTANTBOARDS !3

Condition Fact / Association CHF Orthopnea, paroxysmal nocturnal

dyspnea, jugular venous distention, S3

HOCM Sudden death in athlete

Atrial Septal Defect Fixed wide splitting of S2

Coarctation of Aorta X-Ray, Rib notching, 3 sign

PDA Machine like murmur

Tetralogy of Fallot Cyanosis with crying or feeding

VSD Holosystolic Murmur

Cardiogenic Shock Hypotensive, cool, clammy skin, and MI

Atrial Fibrillation Irregularly irregular rhythm

Atrial Flutter Saw tooth pattern

AV Block Long PR interval

Mobitz 1 Progressively lengthening PR Interval

Mobitz 2 Dropped QRS without lengthening

Third Degree Block Independent P wave and QRS complex

Paroxysmal Supraventricular

Tachycardia

Narrow complex tachycardia

Stable Angina Chest pain relieved with rest

Prinzmetal Angina

Diffuse ST segment elevations, coronary artery spasm

Condition Fact / Association ACS UA, STEMI, NSTEMI, Morphine,

Nitrates, loading dose of P2y12

Cocaine Induced MI NO Betablockers, give benzodiazepines

Aortic Aneurysm Tobacco - ultrasound > 65

Aortic Dissection

Marfan Syndrome, ehlers danlos Syndrome, Tearing chest pain, Wide

mediastinum

GCA Jaw claudication, Visual disturbance, >50 years of age. Elevated ESR

PAD Leg pain relieved with rest, cilostazol

Superficial Thrombophlebitis

Palpable Cord

DVT Virchow’s Triad, unilateral LE swelling, pain, and erythema. Homan

sign

Murmurs Squatting/leg raise/ handgrip increases the sound of all murmurs

except MVP and HOCM

Aortic Stenosis Systolic, 2nd right intercostal space, radiates to neck

Mitral regurgitation Holosytolic murmur

MVP Women, anxiety, mid-systolic click

Aortic Regurgitation Wide pulse pressure. Water hammer pulse

Endocarditis New murmur, fever, injection drug use, streptococcus viridans, Jane way

lesions, Osler nodes, Roth Spots

Pericarditis Pleuritic chest pain. Worse upon laying, Improves with sitting. ST

segment elevation, PR depression

PULMONOLOGY

PHYSCIANASSISTANTBOARDS !4

Condition Fact / Association

Asthma Wheezing, reversible airway disorder. Samters triad: Asthma, ASA allergy, nasal polyp. Reduced

FEV1 to FVC ratio

Acute Bronchitis Viral, cough, negative CXR

Bronchiolitis RSV

Epiglottitis HIB. Hot potato voice, sniffing position, drooling. X-ray: Thumb

sign

Croup Barking cough. X-ray: Steeple sign

Pertussis Inspiratory whoop

Pneumonia Productive cough, pleuritic chest pain, fever. lobar consolidation =

bacteria. bilateral interstitial infiltrates =

viral/pneumocystis

TB Fever, night sweats, hemoptysis. AFB/culture x 3 days. RIPE therapy. Screen with TNF inhibitors, immigration

Carcinoid Syndrome Diarrhea, flushing, bronchospasm

Bronchiectasis Cystic fibrosis. Tram lines. Obstructive pattern.

Emphysema Smoking, alpha 1 antitrypsin deficiency, barrel chest, decreased

DLCO and FEV1

Chronic Bronchitis Smoking, decreased FEV1

Cystic Fibrosis Autosomal recessive, infertility, sweat chloride test

Condition Fact / Association

PE Virchows triad, sinus tachycardia, pleuritic chest pain, S1Q3T3,

Westermark sign, Hampton hump

Asbestosis Insulation, ship building

Silicosis Sandblasting, mines, egg shell calcification

Coal Workers Pneumoconiosis

Coal

Beryllium Aerospace, electrical plants

Sarcoidosis Non caseating granulomas, erythema nodosum, bilateral hilar

adenopathy, elevated ACE

Pneumothorax Smoking, family history, males tall/skinny, pleuritic chest pain

MUSCULOSKELETAL RHEUMATOLOGY

PHYSCIANASSISTANTBOARDS !5

Condition Fact / Association Anterior Shoulder

DislocationAbducted, externally rotated.

Axillary nerve affected

Posterior Shoulder Dislocation

Adducted, internally rotated. Electrical injury, lightning, seizure

Rotator Cuff Tear Empty can test

Mid-Shaft Humerus Fracture

Wrist drop (radial nerve)

Clavicle Fracture middle third most commonly affected. Treat with sling

Supracondylar Fracture

Children. Median nerve and brachial artery affected. Anterior

sail and posterior fat pad sign. Gun stock deformity. Volkmann’s

contracture

Elbow Dislocation Posterior dislocation most common

Scaphoid Fracture FOOSH. Snuffbox tenderness. Thumb spica splint

Carpal Tunnel Syndrome

Median nerve. Phalen Sign. Tinel Sign. Compression test. Thenar

eminence atrophy

Boxer Fracture 5th metacarpal fracture. Ulnar gutter splint

Dequervain Tenosynovitis

Pregnancy. Finklestein test

Chronic Bronchitis Smoking, decreased FEV1

Ankylosing spondylitis

Young male, HLA B27, Bamboo sign

Cuada Equina Bowel/bladder incontinence, saddle paresthesia

Condition Fact / Association Spinal Stenosis Shopping cart sign (pain relieved

with forward bending)

Avascular Necrosis Femoral neck fracture, limp, frog leg lateral X-ray

Legg-Calve-Perthes Knee pain, avascular necrosis of hip

Slipped capital Femoral Epiphysis

Obese. X-ray: posterior displacement of the femoral

epiphysis.

Developmental Hip Dysplasia

Positive Ortalani and Barlow test. Palpable clunk. Pavlick harness

Hip Fracture External rotation and shortening

ACL Deceleration, hyperextension, pop, and swelling. Positive lachman or

anterior drawer test

Meniscal Tear Mechanical symptoms. Baker cyst. Positive McMurry and Apley test

Osgood-Schaltter Disease

Knee pain worse with exercise. Children. Tenderness over tibial

tuberosity.

Achilles Ankle Tear Positive Thompson test

Osteomyelitis Staph aureus

Ewing Sarcoma Moth eaten pattern and onion peel appearance

Osteoarthritis Knee. Bouchard (PIP) and Heberdens (DIP) nodes

Osteoporosis Risk factors: Smoking, glucocorticoids, amenorrhea

Osteosarcoma Sunburst pattern

MUSCULOSKELETAL RHEUMATOLOGY

PHYSCIANASSISTANTBOARDS !6

Condition Fact / Association

Compartment Syndrome

pain out of proportion. 6 Ps: pain, pressure, paresthesia,

pulselessness, pallor, paralysis

RA Bilateral symmetric and progressive. Boutonniere and Swan neck deformity. Felty

syndrome: rheumatoid arthritis, splenomegaly and neutropenia

Fibromyalgia Women, depression, pain

Psuedogout Calcium pyrophosphate. Positive birefringent rhomboid shaped

crystals

Juvenile RA Polyarthritis, spiking fevers, salmon colored rash. Risk of

uveitis.

Polyarteritis Nodosa Hepatitis B (etiology). Livedo reticularis, mononeuritis

multiplex.

Polymyositis Progressive proximal muscle weakness, dysphagia

Dermatomyositis Heliotrope rash, guttron papules, shawl sign. Risk of malignancy. Anti-jo-1 and Mi-2 antibodies

Polymyalgia Rheumatica

> 50 years of age. Giant Cell arteritis

Reactive Arthritis GI/GU infection, urethritis, conjunctivitis

SLE Malar rash, Positive ANA, discoid rash. Double stranded DNA and

anti-Smith antibodies

Condition Fact / Association

Scleroderma Fibrosis. Calcinosis, Raynaud phenomenon, GERD,

sclerodactyly, telangiectasis. Anticentromere antibodies and

SCL-70 antibodies

Sjogren Dry eyes. Positive Shirmer test. Positive anti-ro (SSA) and anti-la

(SSB) antibodies. Oral candidiasis and non-hodgkin lymphoma

association.

Gout Monoarticular. podagra. needle shaped negatively birefringent crystals under polarized light.

GASTROENTEROLOGY

PHYSCIANASSISTANTBOARDS !7

Condition Fact / Association GERD Relaxed LES. Chronic cough.

Aggravated by caffeine, obesity, ETOH, tobacco. PPI

Esophagitis HIV = Candida

Zenker Diverticulum Undigested food

Achalasia Birds beak

Plummer Vincent Syndrome

Iron therapy

Mallory Weis Tear Coughing/Vomitting = blood

Esophageal Varices Bleed = Ocreotide/fluoroquinolone followed by TIPS. Beta blockers to

prevent bleeding

Dyspepsia >55 = scope

Gastric cancer Hpylori, ETOH, and smoking. Palpable mass. Gastric ulcers =

repeat endoscopy to rule out cancer.

Pyloric Stenosis Projectile vomitting; olive sign

Cholecystitis Murphys Sign. Referred pain to right shoulder

Cirrhosis Hepatitis C and ETOH

Pancreatitis Epigastric pain radiating to the back. Increased lipase >3x

Appendicitis Periumbilical then RLQ. McBurney's point. Clinical

diagnosis

Celiac Disease Tissue transglutaminase and endomysial antibody. Gluten free

Condition Fact / Association Diverticulosis Red meat and fat. LLQ pain.

Constipation. Colonoscopy

Diverticulitis Infection. CT scan. Augmentin. Cipro + Metronidazole

Crohn’s Skip leasions, transmural, fistulas ASCA positive. 5-asa

UC Colon, pANCA positive. 5-ASA

Intussusception Abdominal pain, current jelly stool, vomiting. Diagnostic enema

IBS pain relieved with defecation

Small bowel obstruction

Abdominal X-rays - dilated loop of bowel with air fluid levels

Toxic megacolon >6cm dilation

Indirect hernia Scrotal mass

Umbilical hernia Self resolves by 3 years of age

Infectious Diarrhea Blood. WBC. Campylobacter Fluroquiolone

REPRODUCTIVE

PHYSCIANASSISTANTBOARDS !8

Condition Fact / Association Amenorrhea HCG, TSH, Prolactin.

Progesterone challenge.

DUB Anovulation. Coagulation disorder. OCP

Endometrial Cancer Risk: Obesity, anovulation, Nulliparity, FHX, Post menopausal

bleeding = biopsy. Endometrial stripe >5 mm

Endometriosis chocolate cyst. Chronic pelvic pain. laparoscopy. OCP. leuprolide

Leiomyoma Estrogen/progesterone dependent. Shrink at menopause.

Ovarian Cancer Early satiety and bloating. Complex Cyst. CA-125. BRCA-1/2

Cervical Cancer Pap >21 every 3 years. HPV 16 and 18.

Bacterial Vaginosis Clue cells

Trichomoniasis Green frothy discharge. Strawberry cervix

Candidiasis Cottage cheese. budding yeast. hyphae

Menopause 51y/o. Elevated FSH. HRT: Give progesterone to protect uterus.

Breast cancer Mammogram > 50. BRCA-1/2. Biopsy. Positive receptors =

tamoxifen

Galactorrhea Prolactin

PID Chlamydia and gonorrhea. Cervical motion tenderness. Pelvic

pain.

Abortion <20 weeks. Vaginal bleeding. Pelvic pain

Condition Fact / Association Ectopic Pregnancy Fallopian tube.Positive pregnancy

test, vaginal bleed, pelvic pain, cervical motion tenderness. IUP

seen when HCG >2,000

Molar Pregnancy HCG >100,000. Snow storm pattern

Chronic hypertension < 20 weeks

Gestational HTN > 20 weeks. No end organ damage or proteinuria. Labetolol and

methyldopa

Eclampsia Preeclampsia + seizure. Magnesium

Placenta Previa Painless 2nd and 3rd trimester bleed. No digital or TV ultrasound

Post partum Hemorrhage

Uterine Atony

PROM < 37 weeks

Placental abruption Painful third trimester bleed

GENITOURINARY

PHYSCIANASSISTANTBOARDS !9

Condition Fact / Association BPH Lower urinary tract obstructive

symptoms. Increased PSA. Alpha blockers

Cryptorchidism Surgery by 6 months. Risk of cancer and infertility

Hydrocele Self resolves by 2 years

Varicocele Bag of worms. Left side

Stress Incontinence Sneezing, coughing, laughing, Kegal exercise. Pessaries and

surgery

Urge Incontinence Overactivity of detrusor muscle. Kegal. Oxybutinin

Nephrolithiasis Calcium oxylate. > 10mm = lithotripsy or uteroscopy. Flank

pain and hematuria. Thiazide for prevention.

Paraphimosis Skin retracted behind gland. Emergency

Torsion Bell clapper deformity. Absent prehn sign and cremasteric reflex.

Surgery

Pyelonephritis Cystitis + fever + CVA tenderness

Epididymitis Positive prehn sign

Orchitis Mumps

Bladder carcinoma Painless hematuria. > 40 years

Prostate cancer No routine screening

Renal cell carcinoma Abdominal mass, hematuria, flank pain. Nephrectomy

Testicular carcinoma 15-35 years. Germ cell

Condition Fact / Association Wilms tumor < 5 years of age. Painless

unilateral abdominal mass

Pre-renal failure BUN: Cr > 20:1. Dehydration. Decreased urinary sodium

Intrinsic failure BUN: Cr 10:1. ATN. Increased Urinary Sodium

Post renal Failure Obstruction. Catheter

Nephrotic Syndrome > 3.5 grams urinary protein. Edema, hyperlipidemia,

hypoalbuminemia

Renal Artery Stenosis Resistant hypertension. Abdominal bruit

Anion gap acidosis MUDPILERS

EENT

PHYSCIANASSISTANTBOARDS !10

Condition Fact / Association Blepharitis Seborrheic, warm compress, baby

shampoo

Blow out fracture Enopthalmos and Dystopia. Periocular ecchymosis, diplopia,

infraorbital nerve damage.

Cataract Opacity of lens. UV light. Absent red reflex.

Chalazion Chronic painless nodule

Allergic Conjunctivitis Ropy watery. Pruritis

Bacterial conjunctivitis

Unilateral purulent discharge.

Viral conjunctivitis

Bilateral mucoserous discharge

Corneal Abrasion Fluorescein staining

Glaucoma Optic neuritis. Increased ocular pressure may or may not occur. No

screening.

Closed angle Halo, headache, vomiting, fixed pupil

Hordeolum Warm compress

Macular Degeneration

Central vision loss. > 65. Smoking. Amsler grid. Drusen. AREDS II

formulation.

Orbital Cellulitis Staph and Strep. Pain with movement. EOM paralysis. CT

scan.

Retinal Detachment Painless vision loss. Curtain being pulled down over their eyes.

Retinal artery occlusion

Amaurosis fugax. Pale retina

Strabismus Correct by 4 months. Cover/uncover test

Condition Fact / Association Otitis media Strep, moraxella, haemophilus.

Tugging of ear. Immobility of TM. Bulging TM. Amoxicillin.

Acoustic Neuroma 8th cranial nerve. Benign tumor. Sensorineural hearing loss.

Cholesteatoma Painless otorrhea. Retraction pockets. CT scan.

Otitis Externa Swimming and Qtips. Otorrhea. Pain with tragus/pinna movement.

Acute sinusitis < 4 weeks. Viral

Chronic sinusitis > 12 weeks. Anosmia. CT scan. Glucocorticoids, antibiotics

(weeks), nasal saline

Epistaxis Keisselbach plexus

Pharyngitis Centor criteria. Penicillin

Acute laryngitis < 3 weeks. Viral

Oral candidiasis White patch bleeds when scraped. Oral Nystatin

Oral leukoplakia White patches can’t be scraped. Pre-cancerous. Biopsy

Peritonsilar Abscess unilateral sore throat, hot potato voice, truisms, displaced uvula.

I&D

ENDOCRINOLOGY

PHYSCIANASSISTANTBOARDS !11

Condition Fact / Association Primary

hyperparathyroidElevated PTH and calcium. Low phosphate. Short QT interval.

Bones, stones, and moans, psych groans

Secondary hyperparathyroid

Elevated PTH. Normal/Low calcium. Renal failure and Vit D

deficiency

Hypoparathyroid Neck Surgery. Chvostek and Trousseau. Prolonged QT

Graves Eye and Skin manifestation

Hyperthyroid Treatment

PTU - first trimester. methimazole - after first trimester

Central hypothyroid Low TSH and Free T4. Check adrenal function

Thyroid nodule TSH. Ultrasound. Warm Nodules are benign. Cold nodules are

cancer.

Cushings Pituitary adenoma. Lung tumor. Adrenal tumor. Low ACTH =

adrenal. High ACTH = pituitary or lung.

Addisons Increased ACTH = adrenal. Low ACTH = pituitary. ACTH

stimulation test. Hyponatremia and hyperkalemia.

Fludrocortisone

Adrenal cortical carcinoma

Androgen and/or estrogen secreting = cancer. CT scan.

Surgery

Acromegaly Increased growth hormone. Pituitary tumor. Large hands/feet.

Increased insulin like growth factor.

Condition Fact / Association Type 1 DM Low C-peptide. Antibodies. Beta

cell destruction.

Type 2 DM Insulin insensitivity. Weight loss. Metformin.

Diabetic Ketoacidosis Hyperglycemia( < 1,000 (but usually about 350). Type 1. Anion

gap metabolic acidosis and serum ketones. Infection. Hypokalemia.

HHS Glucose > 1,000. Type 2

Hyperlipidemia Triglycerides > 1,000 = pancreatitis. Statins first line.

Prolactinemia Galactorrhea, oligomenorrhea, amenorrhea. Hook effect. HCG,

TSH, MRI. Cabergoline.

NEUROLOGY

PHYSCIANASSISTANTBOARDS !12

Condition Fact / Association Migraine Unilateral. Pulsating.

Photophobia. Aura. 4-72 hours. Triptan.

Cluster Headache + Lacrimation + rhinorrhea. Men. 100% oxygen.

Tension Bilateral. Band like

Encephalitis Confused or altered mental status. Fever. HSV. CT scan, then LP

Meningitis Brudzinski. Kernig. Fever. CT and LP. Dexamethasone, ceftriaxone,

vancomycin.

Essential Tremor Not a rest. Improves with alcohol. Treat with propranolol.

Huntington Disease Chorea, psychiatric change, dementia. Genetic testing. Tetrabenazine. Quitiapine.

Parkinsons Decrease dopamine. Pill rolling. Cogwheel rigidity, Shuffling gait.

Anticholingerics. Levodopa-carbidopa.

SAH Berry aneurism. Anterior circle of willis. Stop smoking. Thunderclap headache, meningeal signs + LOC.

CT and LP.

Stroke Ischemic > Hemorrhage. Facial paresis, arm drift/weakness,

abnormal speech. CT scan. TPA <4.5 hours. Angiography.

TIA Signs and symptoms of stroke without infarct

Concussion Confusion and amnesia. Post concussion syndrome.

Condition Fact / Association GBS Ascending weakness/paralysis.

Absent DTR. Campylobacter infection. IVIG or plasma

exchange.

Dementia Gradual. Progressive. TSH and Vitamin B12. Cholinesterase

inhibitor. Mamantine.

Delirium Acute. Reversible. Fluctuations of consciousness.

Multiple Sclerosis Affects white matter. > 2 distinct episodes. Women. Sensory symptoms. Optic neuritis.

Oligoclonal bands. Glucocorticoids.

Myasthenia Gravis Muscle weakness. Acetacholine receptor antibodies. Worse at the end of day. Ptosis and diplopia. EMG. Thymectomy < 60 or with

thymoma.

Seizure Postictal confusion. Tongue biting. Urination. Foaming of mouth.

Absence Petit mal. Generalized. Children. Staring. Lip smacking.

Ethosuximide.

Status Epilepticus

> 5min. Benzodiazepine. Fosphenytoin or phenytoin.

Phenobarbital.

HEMATOLOGY

PHYSCIANASSISTANTBOARDS !13

Condition Fact / Association B12 Deficiency Megaloblastic. Peripheral

neuropathy. MMA

Folate Deficiency Megaloblastic. No neuro symptoms

Iron Deficiency Blood loss. Microcytic. Low ferritin.

Anemia of chronic disease

Microcytic/normocytic. Normal ferritin.

Hemolysis Increased LDH, reticulocyte, Indirect bilirubin. Decreased

haptoglobin.

Aplastic Anemia Pancytopenia. Low retic count. Bone biopsy.

G6PD X-linked enzyme deficiency. Infection. Fava beans. Bite cells.

Heinz body

Von Willebrand Most common bleeding disorder. Elevated aPTT. Von willebrand

factory activity. RIPA. Desmopressin

Hemophilia X-linked recessive disorder. Hemarthosis. Normal Platelets.

prolonged aPTT.

Factor V Leiden Thrombophilia. DVT. PE. No screening.

Antiphospholipid Syndrome

Anticardiolipin antibody. Recurrent pregnancy loss.

Prolonged aPTT. Russel Viper Venom test. DVT

Heparin Induced Thrombocytopenia

4 > days. Thrombosis. ELISA. Venous limb gangrene

Condition Fact / Association Immune

ThrombocytopeniaShiga Toxin producing ECOLI

0157:H7. Quinine. Microangiopathic hemolytic

anemia and thrombocytopenia.

AML 65. Myeloid. Auer rod. Phi bodies. M3 all-trans-retinoic acid. > 20%

blasts

ALL Children. Lymphoid. > 20% blasts. TdT

CML Neutrophils. Basophilia. Leukocytosis. 9:22 translocation.

Philadelphia chromosome. Tyrosine Kinase Inhibitor.

CLL Non functioning B cells. Lymphadenopathy. Lymphocytosis

Flow cytometry. Rituximab.

Hodgkin Lymphoma Painless cervical lymphadenopathy. B symptoms.

Reed Sternberg cells. Mediastinal mass. Excisional node biopsy

Multiple Myeloma Plasma cells. IgG, IgA. Bence Jones Protein. Rouleax Formation. > 10%

clonal plasma cells

Sickle cell Vaso occlusion. Hemolytic anemia. Cold, Hypoxia, alcohol,

infection. Howell Jolly bodies. Penicillin < 5 years of age.

Hydroxyurea.

PSYCHIATRY

PHYSCIANASSISTANTBOARDS !14

Condition Fact / Association GAD Excessive/Persistent worrying. 6

months. SSRI. Benzodiazepine

Panic Disorder Episodes of fear. Agoraphobia. TSH. EKG. SSRI. Benzodiazepine

Phobia Irrational fear. CBT

PTSD > 6 months. Trauma. Hyperarousal. Reliving event

ADHD Hyperactivity, Inattention, impulse. > 6 months. < 12 years

old. Present 2 separate areas.

Austim Poor social communication. Poor eye contact. Male. Repetitive

patterns. Large head circumference.

Anorexia Low bodyweight. Ego-syntonic. Psychotherapy.

Bulimia Normal - Overweight. Ego-dystonic. SSRI. Psychotherapy

Bipolar 1 Mania-hyperarousal, no sleep, elevated mood. Hospitalization.

> 7 days. Mood stabilizer

Bipolar 2 Hypomania. > 4 days. No hospitalization.

Depression > 2weeks. SIGECAPS. CBC. TSH. SSRI. Severe: Hallucinations, catatonia, Suicidal thoughts

Schizophrenia Psychosis. Hallucinations. Delusions. Catatonia. > 6 months. Disorganized thoughts. Atypical

antipsychotics.

OCD Obsessions. Compulsions. Suicidal thoughts. SSRI. CBT

DERMATOLOGY

PHYSCIANASSISTANTBOARDS !15

Condition Fact / Association Atopic Dermatitis Infants: Extensor. Children: Flexor.

Allergies. Asthma. Antihistamines. Steroids

Dyshidrosis Fingers. Vesicles. Steroids

Lichen Simplex Chronicus

Rubbing/Scratching. Steroids

Lichen Planus Hepatitis C. Purple. Pruritic. Polygonal. Plaque. Wickham

striae.

Pityriasis Rosea Herald Patch. Christmas Tree Pattern.

Psoriasis Papules. Silvery plaques. Extensor. Scalp. Steroids

Erythema multiforme HSV. Mycoplasma. Meds. Target like lesions. Self limiting.

SJS < 10% Nikolski sign. Meds. Life threatening

TEN > 30% Nikolski sign. Meds Life threatening.

Bullous Pemphigoid Bullous. > 60. Biopsy. Direct immunofluorescence. Steroids.

BP180 levels

Acne Pilosebaceous glands. PCOS. OCP. Retinoids. Benzoyle peroxide.

Rosacea Facial flushing. Alcohol. Spicy foods. Sun. Hot temp. Rhinophyma

(men)

Actinic Keratosis Pre-cancer. Erythematous scaling macule.

Condition Fact / Association Scabies Pruritus worse at night. Burrows.

Spares head. Permethrin 5%

Basal cell Carcinoma UV light. Face. Pearly papule with telangiectatic vessel.

Squamous Cell Carcinoma

Ulcer that fails to heal.

Melanoma ABCDE. Ugly duckling sign

Cellulitis Staph. Strep. Deep infection. Purulence MRSA.

Impetigo Honey crusted plaques. Mupirocin

Acanthosis Nigricans Velvety hyper pigmentation. Insulin Resistance.

Melasma UV light. Hormone changes. Genetics. Sunblock.

Hydroquinone.

Vitiligo Autoimmune. Melanocyte destruction. Depigmentation.

Steroids.

Kaposi Sarcoma HHV8. GI tract. AIDS. Mucous membranes.

Erysipelas Strep. Superficial infection. Clear line of demarcation.

Seborrheic Keratosis > 50 Warty. Stuck on Benign

INFECTIOUS DISEASE

PHYSCIANASSISTANTBOARDS !16

Condition Fact / Association Cryptococcus Fungus. Lungs. CNS. HIV.

Papilledema CT scan. Cryptococcal antigen. India Ink

stain. Amphotericin B. Fluconazole

Histoplasmosis Fungus. Bird and Bat droppings. Lung. Hilar/Mediastinal

lymphadenopathy. Histoplasma antigen. Itraconazole.

Pneumocystis AIDS. < 200 CD4. Bilateral interstitial infiltrates.

Trimethoprim/sulfamethoxazole

Rheumatic Fever Strep pharyngitis. 2 weeks post infection. Jones criteria. Penicillin.

Botulism Descending weakness/paralysis. Canned food. Raw honey in infants. Penicillin. Antitoxin

Cholera Profuse rice watery diarrhea

Diptheria Pharyngitis. Gray membrane. Antitoxin. Penicillin or

erythromycin.

Tetanus Trismus (lock jaw) Contraction. Spasms. Dirty wound.

Immunization

TB Mycoplasma. Night sweats. Productive cough. Hemoptysis. CXR. Acid fast bacilli smear.

RIPE. Isoniazid + B6

Toxoplasmosis Cat feces. Undercooked meat. Pregnancy. Cerebral abscess.

Multiple ring enhancing lesions.

Lyme Deer tick. Northeastern states. Erythema migrans. Carditis. AV

block. Bells palsy. Clinical Diagnosis. Doxycycline, amoxicillin, cerufoxime.

Condition Fact / Association EBV Mononucleosis. Pharyngitis.

Posterior cervical lymph nodes. Morbilliform rash with amoxicillin/ampicillin.

Spenomegaly

HSV Painful vesicles that ulcerate. Prodrome. PCR, culture, or

serology. Antivirals

Herpes Zoster Varicella Zoster virus. > 50 year old women. pain before rash.

Dermatome. Hutchingson sign. Post herpetic neuralgia. Antivirals.

Measles Cough, coryza, conjunctivitis, koplik spots

Mumps Parotid gland swelling. Elevated Amylase

Rubella Forchheimer spots

Erythema infectiosum

Slapped cheek appearance. Parvo virus B19

Roseola High fever, resolves, followed by rash. Herpes virus 6/7. 6 months

of age.

HIV Attacks CD4 cells. Asymptomatic.ELISA. Western blot. Everyone is treated. Two

NRTI and NNRTI

Rocky Mountain spotted fever

Dog tick. Rash on wrists spreading centrally. Affects palms and soles.

Doxycycline

Syphilis Treponema. Painless genital ulcer. Rash affecting palms and soles.

Dark field microscopy. RPR. FTA-ABS. Penicillin