COMMON THINGS ARE COMMON
RED FLAG FINDINGS
MECHANISM MATTERS
WHAT'S THE TREATMENT
PHYS EXAM DETECTIVES
100

A 24-year-old presents with fever, productive cough, pleuritic chest pain, and crackles in the right lower lung field. Pulse ox is 93%.

What is community-acquired pneumonia?

Explanation

  • Physiology: Alveolar inflammation and consolidation.
  • Exam: Crackles, egophony, decreased breath sounds.
  • Treatment:

    • Outpatient: Amoxicillin, doxycycline, or azithromycin depending on local guidelines.
    • Severe cases may require IV antibiotics.
  • Red Flags:

    • Hypoxia
    • Sepsis
    • Respiratory distress

 

100

A patient with headache develops neck stiffness and photophobia.

What is meningitis?

Explanation

  • Mechanism:

    • Inflammation of meninges.
  • Exam:

    • Nuchal rigidity
    • Altered mental status
  • Treatment:

    • Immediate antibiotics
    • Dexamethasone
  • Red Flags:

    • Purpuric rash
    • Septic shock
100

This disease results from autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency.

What is Type 1 diabetes mellitus?

Key Points

  • DKA risk
  • Hyperglycemia
  • Ketosis
100

A diabetic patient presents with glucose 550 mg/dL, pH 7.12, ketones positive.

What is diabetic ketoacidosis?

Treatment

  1. IV fluids
  2. Insulin infusion
  3. Potassium monitoring/replacement


100

A patient has elevated JVP, hypotension, and muffled heart sounds.

What is cardiac tamponade?

Beck's Triad

  • Elevated JVP
  • Hypotension
  • Muffled heart sounds

Treatment:

  • Pericardiocentesis
200

A 68-year-old with diabetes presents with dysuria, urinary frequency, and suprapubic pain. Temperature 38.1°C.

What is acute cystitis?

Explanation

  • Mechanism: Bacterial infection of bladder mucosa.
  • Common pathogen: E. coli.
  • Exam:

    • Suprapubic tenderness
    • No CVA tenderness
  • Treatment:

    • Nitrofurantoin
    • TMP-SMX (depending on resistance patterns)
  • Red Flags:

    • Flank pain
    • Sepsis
    • Pyelonephritis
200

A patient with dizziness also develops unilateral facial droop and ataxia.

What is posterior circulation stroke?

Explanation

  • Frequently missed as vertigo.
  • Exam:

    • HINTS exam abnormalities
    • Cerebellar signs
  • Treatment:

    • Stroke protocol
  • Red Flags:

    • Neurologic deficits
    • Dysarthria
    • Limb weakness
200

This condition occurs when inflammatory mediators cause systemic vasodilation, capillary leak, and tissue hypoperfusion.

What is septic shock?

Key Points

  • Elevated lactate
  • Hypotension
  • Organ dysfunction
200

A patient presents with diffuse wheezing, accessory muscle use, and inability to speak full sentences.

What is severe asthma exacerbation?

Treatment

  • Albuterol
  • Ipratropium
  • Corticosteroids
  • Magnesium sulfate
  • Intubation if failing
200

A patient presents with unilateral swollen calf, warmth, and tenderness.

What is deep vein thrombosis?

Exam

  • Unilateral swelling
  • Tenderness
  • Erythema

Red Flag:

  • Pulmonary embolism
300

A 55-year-old smoker complains of progressively worsening exertional dyspnea and chronic productive cough for years.

 

What is COPD?

Explanation

  • Mechanism:

    • Chronic inflammation
    • Airway remodeling
    • Alveolar destruction
  • Exam:

    • Wheezing
    • Prolonged expiration
    • Barrel chest
  • Treatment:

    • Bronchodilators
    • Steroids for exacerbations
    • Oxygen if hypoxic
  • Red Flags:

    • Silent chest
    • Hypercapnia
    • Severe hypoxia
300

A patient with low back pain suddenly develops urinary retention and saddle anesthesia.

What is cauda equina syndrome?

Explanation

  • Mechanism:

    • Compression of lumbosacral nerve roots.
  • Exam:

    • Perineal sensory loss
    • Reduced rectal tone
  • Treatment:

    • Emergent MRI
    • Neurosurgical decompression
300

This disease is characterized by ventricular remodeling following chronic pressure overload from hypertension.

What is heart failure with reduced ejection fraction?

Key Points

  • Neurohormonal activation
  • RAAS involvement
  • Progressive ventricular dysfunction
300

A patient develops facial swelling, wheezing, hypotension, and urticaria after a bee sting.

What is anaphylaxis?

Treatment

  • IM epinephrine (first-line)
  • Oxygen
  • IV fluids
  • Antihistamines
  • Steroids (adjunct)
300

A patient with fever and a new murmur develops splinter hemorrhages and painful finger nodules.

What is infective endocarditis?

Exam

  • New murmur
  • Osler nodes
  • Janeway lesions
  • Splinter hemorrhages

Treatment

  • IV antibiotics
  • Possible valve surgery
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