Clinical Reasoning — Flashcards

Flashcard 491: What is the first test/imaging study that should be ordered to diagnose pancreatitis in a patient with acute epigastric abdominal pain that radiates to the back? _____

Answer: Serum amylase and lipase

Flashcard 492: Patient with diabetes presents with pain around the waist that feels like a "burning belt" along the T12 distribution is suggestive of _____

Answer: diabetic thoracic radiculopathy

Flashcard 493: Is 1+ proteinuria considered trace proteinuria? _____

Answer: No; 1+ is suggestive of pathology

Flashcard 494: Imaging for renal trauma = _____

Answer: CT w/contrast

Flashcard 495: Bruising, petechiae, bleeding, non-tender lymphadenopathy and hepatosplenomegaly is suggestive of _____

Answer: acute lymphoblastic leukemia

Flashcard 496: What is done 1st in workup of esophageal cancer to identify location of lesions/safety of EGD? _____

Answer: Barium swallow

Flashcard 497: What imaging modalities are preferred for detecting kidney stones? _____

Answer: Abdominal CT scan w/o contrast (preferred) and ultrasound

Extra: - Ultrasound can detect radiolucent stones (e.g., uric acid) that are missed on plain X-ray (KUB). - Note: Almost all stones (except indinavir) are seen on non-contrast CT. - RUQ US is typically for biliary disease; for kidney stones, a Renal/Bladder US is used.

Flashcard 498: Loud pop in the heel → sudden pain and inability to plantarflex the foot:\n_____

Answer: Achilles tendon tear

Extra: Associated with a positive Thompson test (squeezing the calf does not result in plantarflexion).

Flashcard 499: Adolescent with back pain worsened by lumbar extension with a palpable step-off is suggestive of _____

Answer: Spondylolisthesis

Flashcard 500: Unilateral pounding headache a/w nausea, photophobia, and phonophobia is suggestive of _____

Answer: migraine