Clinical Reasoning — Flashcards

Flashcard 411: What is needed to confirm diagnosis of high blood pressure: _____

Answer: Measurements outside of the clinical setting

Flashcard 412: What is the most accurate test in the diagnosis of PCP pneumonia? _____

Answer: Bronchoalveolar lavage (with silver stain)

Flashcard 413: In the workup for dementia, _____ is a reversible cause characterized by an increased TSH.

Answer: hypothyroidism

Flashcard 414: 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 415: What test is needed to definitely rule out subarachnoid hemorrhage in patients with a normal CT scan? _____

Answer: Lumbar puncture

Flashcard 416: The diagnosis of esophageal perforation is confirmed with Gastrografin (water-soluble) contrast esophagram or _____ scan

Answer: CT

Extra: Gastrografin is water-soluble contrast that is preferred over barium (barium can induce an inflammatory response); can see the leakage through the perforation

Flashcard 417: How does eustachian tube dysfunction present? _____

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

Flashcard 418: Patient presents with (+) anterior drawer sign: _____

Answer: ACL injury

Flashcard 419: Pt who had pharyngitis and impetigo a little bit ago now has RBC casts: _____

Answer: Post-Streptococcal glomerulonephritis

Flashcard 420: How is biliary atresia diagnosed? _____

Answer: Ultrasound (initial) → triangular cord sign or absent gallbladder If U/S equivocal: HIDA scan (after phenobarbital) → no excretion into duodenum