Clinical Reasoning — Flashcards

Flashcard 411: Chronic watery diarrhea, crampy abdominal pain and bloating after meals is suggestive of _____

Answer: lactase deficiency

Extra:  https://onlinemeded.org/spa/gastroenterology/malabsorption/acquire?ref=anki 

Flashcard 412: What is the test of choice for confirming the diagnosis of Zenker's diverticulum? _____

Answer: Barium contrast esophagram

Extra:  https://onlinemeded.org/spa/gastroenterology/esophagus/acquire?ref=anki 

Flashcard 413: What is the most accurate (and first) diagnostic test for cystic fibrosis? _____

Answer: Sweat chloride (induce via pilocarpine)

Extra: Normal: ≤ 29 mmol/L Intermediate: 30-59 mmol/L Abnormal: ≥ 60 mmol/L Sweat chloride is induced via pilocarpine iontophoresis.

Flashcard 414: What test is needed to definitely rule out subarachnoid hemorrhage in patients with a normal CT scan? _____

Answer: Lumbar puncture

Extra:  https://onlinemeded.org/spa/neurology/stroke/acquire?ref=anki 

Flashcard 415: The diagnosis of esophageal perforation is confirmed with Gastrografin (water-soluble) contrast esophagram or _____ scan

Answer: CT

Extra:  https://onlinemeded.org/spa/surgery?ref=anki  Gastrografin is water-soluble contrast that is preferred over barium (barium can induce an inflammatory response); can see the leakage through the perforation 

Flashcard 416: How does eustachian tube dysfunction present? _____

Answer: Ear popping, cracking, hearing loss in response to pressure changes, ear fullness

Extra:  https://onlinemeded.org/spa/surgery?ref=anki 

Flashcard 417: In the workup for dementia, _____ is a reversible cause characterized by an increased TSH.

Answer: hypothyroidism

Flashcard 418: Unilateral ear pain and **pain with traction of the pinna** is suggestive of _____

Answer: otitis externa

Extra: Otitis externa (swimmer's ear) is characterized by inflammation of the external auditory canal. A classic physical exam finding is the 'tragus sign' or pain with pinna traction (tug test), which helps distinguish it from otitis media (where the external ear is typically not tender).

Flashcard 419: Patient presents with (+) anterior drawer sign: _____

Answer: ACL injury

Extra:  https://onlinemeded.org/spa/surgery-subspecialty/ortho-injuries/acquire?ref=anki 

Flashcard 420: Nephrolithiasis = _____ or _____

Answer: non-contrast CT scan

Extra:  https://onlinemeded.org?ref=anki