Clinical Reasoning — Flashcards

Flashcard 411: 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 412: What is the most accurate test in the diagnosis of PCP pneumonia? _____

Answer: Bronchoalveolar lavage (with silver stain)

Extra:  https://onlinemeded.org/spa/infectious-disease/pneumonia/acquire?ref=anki 

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

Answer: hypothyroidism

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: 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 418: 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

Extra: https://onlinemeded.org/spa/pediatrics/congenital-defects/acquire?ref=anki

Flashcard 419: HbA1c ≥ _____ = diabetes HbA1c < _____ = normal

Answer: 6.5%

Extra: https://onlinemeded.org/spa/endocrinology/outpatient-diabetes/acquire

Flashcard 420: Nephrolithiasis = _____ or _____

Answer: non-contrast CT scan

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