Cheatography
https://cheatography.com
My personal quick reference before my PANCE
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Peds Extra
Normal weight |
2500-4200 grams |
Immunization Schedule
Birth |
Hep B (B for Birth) |
2 months |
Everything else. Rota, DTAP, HiB, pneumococcal, polio. |
12 months |
Live vaccines. MMR, varricella. Also Hep A |
APGAR
| |
0 points |
1 point |
2 points |
Activity |
Absent |
Flexed limbs |
Active |
Pulse |
Absent |
<100 bpm |
>100bpm |
Grimace |
Floppy |
Minimal |
Prompt |
Appearance |
Blue/Pale |
Pink/Blue ext. |
Pink |
Respiration |
None |
Slow |
Vigourous Cry |
Milestones
6 months |
Sit by self. Babbles. Reaches/self feeds |
12 months |
First word. Walks. |
24 months |
2-word sentences. Kicks ball. Potty training starts. |
GI
Eosinophilic Esophagitis |
Concentric esophageal rings. Dilation + PPI. |
Achalasia |
Solids +liquid dysphagia. Manometry to confirm. Tx: Botox -> myotomy. |
GERD Mgmt |
4 week PPI trial -fails-> EGD -fails-> 24h Acid study to eval for surgery. |
H Pylori |
Dx: Serology/urea breath test. Confirm with stool antigen. |
PUD vs DUD |
PUD usu lose wt. DUD gain, because pain improves c food. |
Zollinger-Ellison Syndrome |
Secretin test to confirm. Present with recurrent PUD, lots of ulcers w/o cause. |
Conjugated bili vs unconjugated |
Unconjugated is pre-liver bili (hemolysis). Post-liver bili is like billiary obstruction. |
Pancreas imaging is CT. |
Not U/S. |
Viral Hepatitis |
ALT super high. ALT>AST by x20 |
EtOH Hepatitis |
AST > ALT |
NASH |
ALT > AST by x2 |
Hep B e Ag |
+ means Active |
Hep C |
Test if born b/t 1945-65 |
Crohn's |
String sign. Cobblestoning. Fistula (b/c transmural). SB CA risk. 5-ASA ->Azothiaprine. Low B-12 possible. |
Ulcerative Colitis |
Perforation/toxic megacolon. Colon CA risk. Tx: 5-ASA. |
Lynch Syndrome |
CEO= Colorectal, endometrial, ovarian CA. |
Anal fissure |
Posterior midline most common., |
Colon CA Screening |
50 for all. 45 blacks. -10 yrs first relative or norm. +8 yrs from IBD dx. |
Cord syndrome
Anterior Cord Syndrome |
Bilateral loss of motor + pain/temp. Keep vib/proprioception. |
Central Cord Syndrome |
Deficits in Upper ext > Lower ext |
Posterior Cord Syndrome |
Bilateral vibration and Proprioception loss |
Brown-Sequard Syndrome |
Ipsilateral vib/proprio + motor loss. Contralateral pain/temp loss. |
TTP vs ITP vs DIC
TTP |
Schistocytes. Hemolytic Anemia. Fever. Neuro changes. AKI/proteinuria/hematuria. Abd pain(elevated lipase/amylase) |
ITP |
Thrombocytopenia only. IgG. |
DIC |
Evidence of bleeding AND clotting. |
|
|
Murmurs
ASD |
Fixed split S2 |
PDA |
Continous machine-like |
Mitral valve prolapse |
Mid systolic click |
Mitral stenosis |
Opening snap. Loud S1. (Stenosis-Snap-S1). Otherwise, low pitched/rumbling and very quiet. |
Mitral Regurg |
Radiate to back. |
Aortic stenosis |
Ejection click |
Valsalva |
Decrease murmurs except HCM/MVP. |
Aortic Regurg |
Any pulse with a name. Wide pulse pressures. |
CHADSVASc
Risk Factors |
Score |
CHF |
1 |
HTN |
1 |
Age >=75 |
2 |
Age >=65 |
1 |
DM |
1 |
Stroke/TIA/thrombo-embolism |
2 |
Vascular Dz |
1 |
Sex - Female |
1 |
Stroke
Anterior Cerebral Artery |
Leg deficits > arm. Poor response to sudden sounds. Lack of concern. |
MCA |
Arm deficits > lg. Bilateral hemiopsia. Aphasia. |
Vertebrobasilar |
Bilateral symmetrical deficits. Ataxia/vertigo. |
PCA |
EOM loss. Visual hallucination. |
tPA |
<4.5 hrs |
Extra: Carotid occlusion |
Gaze deviates toward infarcted hemisphere. |
Arrhythmia
SVT |
Adenosine. Cardiovert-unstable. |
Afib |
BB/CCB. Cardiovert-unstable. <150 bpm; differs from SVT. |
V tach |
Amiodarone. Cardiovert-unstable. |
Torsades |
Mg. Cardiovert-unstable. |
Afib Tx |
If <48h old - Cardiovert. If >48h, TTE to see if valvular then anticoagulate -> TEE -> Cardiovert -> More anticoagulation. |
|
|
ENT/Optho
BPPV |
Lasts 1 minute or less |
Labrinthitis |
Lasts days to a week. Hx of viral infection. Tx: Steroids. |
Meniere's Dz |
Triad: Episodic vertigo + SNHL + Tinnitus. Tx: Diuretics + life style changes/Sx control. |
Otosclerosis |
FHx of hearing loss. Bilateral but asymmetrical. Refer. |
Acoustic Neuroma/Vestibular Schwannoma |
Unilateral SNHL +/- Tinnitus. Tx: Surg. |
Iritis/Uveitis |
Cell/Flare (WBC in ant chamber) or hypopion (wbc meniscus) |
Hordeolum/Stye |
Painful and red. Meibomian gland infect. |
Chalazion |
Painless, not red. If friable, consider CA. |
Cataracts |
Halo around lights. Worse at night. Tx: glasses -> Surg. |
Macular degen |
Central vision loss. Drusen (yellow spots on macula). Scotoma. |
Retinal Detachment |
Pulling the shade |
Hypertensive retinopathy |
AV nicking |
Retinal artery occlusion |
Cherry red on macula |
Retinal vein occlusion |
Diabetic. Cotton wool spots. Blurry when waking up. |
Papilledema |
Increased ICP. Loss of venous pulsations. No vision changes. |
Hyphema |
Sleep sitting up (avoid staining). Eye shield and refer. |
Optic neuritis |
Acute red/green color loss. Painful EOM. Loss of vision. Assoc with MS. |
Marcus Gunn |
+Swining flashlight test. |
Glaucoma |
Acute - Anhydrase inhib (ex. acetazolamide). Chronic - topical BB. |
Overall perm blindness in US - Macular degen.
<65 yo perm blindness - DM
Black blindness - Glaucoma
Heme
Thalassemia |
Target cells |
Sideroblastic anemia |
Basophilic stipping. |
Folate deficiency |
Howell-Jolly bodies. |
B12 Def. |
+Schillings test. |
G6PD |
Heinz bodies. |
Hereditary spherocytosis |
Osmotic fragility test. |
Cancer Markers/Mutations + extra
Polycythemia Vera |
JAK2 mutation. Itchy after showers. |
Primary thrombocythemia. |
Tx: hydroxyurea |
CML |
WBC > 150 + thrombocytosis + anemia |
CLL |
Smudge cells. Most common leukemia. B-cell most common. |
AML |
Auer rods. Kids. Better prognosis than ALL. |
ALL |
Pancytopenia with circulation blasts. |
Multiple myeloma |
Bence-Jones. Osteolytic bone lesions. New AKI + compression fx. 3 No's: No fever. No ALP incr. No splenomegaly. |
Hodgkins Lymhoma |
Reed-Sternberg. Assoc with EBV. |
Primary biliary cholangitis |
+AMA |
Autoimmune Hepatitis |
+ASMA (anti-smooth muscle) |
Autoimmune Pancreatitis |
Elevated IgG4 |
Pancreatic CA |
CA 19-9 |
Liver CA |
AFP |
Colon CA |
CEA |
Celiac Sprue |
Anti-endomysial. Anti-tTG. Total IgA. Biopsy for Dx. |
Hemochromatosis = transferritin >65%
Tx of Wilson's dz - penicillamine
Extra Neuro
Tx of Tourettes |
Pimozide -> Haldol. |
Acute Tx of MS |
Steroids |
Tx of mysthenia gravis |
Pyridostigmine/anticholinesterate inhibs |
CN |
On Old Olympus Tower Tops A Fin and German Viewed Some Hops |
Ortho
MUGR |
Monteggia's - prox Ulnar fx. Galeazzi's - distal Radial fx. |
Colles - CD |
Dorsal angulation |
Smith's |
Volar angulation |
Boutonniers and Swan fx |
At PIP |
Sag sign |
PCL tear |
Knee effusion after 6 hours |
Meniscal tear > ACL. ACL has it early. |
Patellofemoral Syndrome |
Adolescent female. Pain c walking stairs and going seated to standing. |
Legg Calve-Perthes |
<12 yo hip avascular necrosis. |
Slipped Capital Femoral Epiphysis |
Teenager. Fat. |
SALTR |
Separated. Above. Lower. Through/three. Rammed. |
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