PA Family Medicine EOR
*MUGR* - Fracture of the Forearm - ANS-*Monteggia*
- Broken Ulna w/ displaced Radius
*Galezzia*
- Radial brake w/ Ulna dislocation
Dx: Xray
Tx: ORIF, Long-arm or dbl sugar-tong cast
6 P's of Lichen Planus - ANS-*P*lanar - flat
*P*urple
*P*olygonal
*P*ruritic
*P*apule or
*P*laque
ABC's of Small Bowel Obstruction - ANS-Adhesions #1
Bowel Hernias #3
Cancer #2 - (#1 if Large Bowel)
Abruptio Placentae - ANS-Risk: *previous abruption*, twins, smoking
Sx's: Acute Abdominal pain & bleeding
Monitor maternal hypotension & fetal heart rate
Fibrinogen levels = severity of bleed (DIC)
*Retroplacental Hematoma* on US
Tx: Emergent C-sec
Absent Seizures - ANS-
Acanthosis nigricans - ANS-Velvety, verrucous, thick *darkening* of the neck skin
Obesity, Diabetes, Endocrine disorders
GI or GU malignancy, Lymphoma
Achilles Tendon Rupture - ANS-Running/jumping, *hear a pop*, present w/ limp
PE: gap where tendon should be
Dx: Clinical
Tx: Surgery: weeks to heal, Cast: months to heal
ACL or PCL injury - ANS-ACL
,*Unhappy Triad: ACL + MCL + Meniscus*
Anterior drawer (+)
Lachman's Test
PCL
Anterior trauma
Posterior drawer (+)
Dx: MRI
Tx: Sugery (if athlete), Cast (all others)
Acne vulgaris - ANS-Comedonal - Retinoid
Mild - Retinoid + BPO + Topical Abx
Moderate - Retinoid + BPO + Oral Abx
Severe - Oral Isotretinoin
Actinic keratosis - ANS-Older (male) pt
Hx of sun exposure
PE: *rough, scaly, erythematous papules* on skin
Pre-SCC
Tx: Cryotherapy > Topical (5-FU, Imiquimod, Diclofenac)
Acute bronchitis in adults - ANS-MC: viral
*Productive cough <1wk* w/ wheezing & rhonchi
Few systemic Sxs
MCC of minor hemoptysis
CXR: Bronchial wall thickening in both lower lobes
Supportive - NSAIDs/Tylenol, cough-suppressants
Acute Closed- Angle Glaucoma - ANS-Painful, acute, unilateral vision loss from occlusion of
trabecular meshwork in the eye and increased IOP.
Pt c/o halos around lights, has a cloudy, injected cornea
Most commonly seen w/ hyperopia, large cataracts, women, Eskimo/Asian ancestry
Tx: *1st Line: Acetazolamide* - avoid in sulfur-allergic pts
Mannitol (↓ IOP)
Timolol (↓ aqueous humor production)
Pilocarpine
Acute Gastritis
"Always *Cushion* the brain"
"Burned by the *Curling* iron" - ANS-Erosion of stomach mucosal layer
EtOH, NSAIDs, *Stress*, Uremia
,Head Trauma: *Cushing* Ulcer
Burn: *Curling* Ulcer
Acute lower back pain - ANS-
Acute Lymphocytic Leukemia - ANS-Children
B-Cell Precursors
Good Prognosis
Tx:
Acute Myelogenous Leukemia - ANS-Adults
*Auer rods* (owl eyes) w/ microscopy
Fair prognosis
Tx:
Acute painful nodular inflammatory process of the eyelid
Sub-acute painless nodular process of the eyelid - ANS-Acute & Painful: Hordeolum (see pic)
Sub-acute & Painless: Chalazion
Tx: Warm compresses, Topical erythromycin > I&D if refractory
Acute Respiratory Distress Syndrome - ANS-↓ PaO2 and ↑ PaCO2 from fluid collapsing the
*alveoli*
MCC: 6-72 hrs s/p *Sepsis*
Associated w/ Renal & Hepatic failure
↓ BP or shock w/ crackles, rales, wheezing
Tx: Mechanical Vent w/ *PEEP*
Acute Sinusitis - ANS-Nasal congestion < 7 days
Viral URI Sxs
PND
Tx: supportive
Acute Tubular Necrosis - ANS-
Allergic rhinitis & conjunctivitis - ANS-Allergic Shiners
watery eyes & runny nose
cobblestone mucosa
Tx:
Olopatadine (antihistamine)
, Naphazoline (vasoconstrictor)
Alopecia - ANS-Balding - hair follicle stopped in resting phase
Tx: Minoxidil, Finasteride
Alpha Thalassemia - ANS-
Alzheimer disease - ANS-
Anal fissure - ANS-MC site: *Posterior* Anal Midline > Anterior > Lateral
Assoc w/ Crohn's, HIV, Leukemia, TB, Syphilis
Tx: fiber, sitz bath, topical analgesic, & nifedipine or nitroglycerin
Anaphylaxis (Type 1 Hypersensitivity) - ANS-Upper airway obstruction
Urticaria
Bronchospasm
Hypotension
Cardiovascular Collapse
Tx: Epinephrine + O2 + IVF
Anemia of chronic disease - ANS-
Ankle Fracture - ANS-Over-Eversion
Over-Inversion
Sx's: *Non-ambulatory* w/ pain & swelling
Dx: Xray
Tx: ORIF
Anorexia - ANS-
Anterior Communicating Artery Aneurysm - ANS-
Anterior Cord Syndrome - ANS-Mechanism: Flexion or Vascular
Loss of *Motor, Pain & Temp* below injury
Preserved position & vibratory function
Anterior Dislocation of Shoulder - ANS-Abducted & Ext rotated (*shaking hands*)
*Axillary n. injury* = Deltoid parasthesia
Dx: Xray
Tx: Reduction & Sling
Anterior Epistaxis Management - Kiesselbach's plexus - ANS-Conservative: Alae pressure,
bend at waist, oxymetazoline spray
*MUGR* - Fracture of the Forearm - ANS-*Monteggia*
- Broken Ulna w/ displaced Radius
*Galezzia*
- Radial brake w/ Ulna dislocation
Dx: Xray
Tx: ORIF, Long-arm or dbl sugar-tong cast
6 P's of Lichen Planus - ANS-*P*lanar - flat
*P*urple
*P*olygonal
*P*ruritic
*P*apule or
*P*laque
ABC's of Small Bowel Obstruction - ANS-Adhesions #1
Bowel Hernias #3
Cancer #2 - (#1 if Large Bowel)
Abruptio Placentae - ANS-Risk: *previous abruption*, twins, smoking
Sx's: Acute Abdominal pain & bleeding
Monitor maternal hypotension & fetal heart rate
Fibrinogen levels = severity of bleed (DIC)
*Retroplacental Hematoma* on US
Tx: Emergent C-sec
Absent Seizures - ANS-
Acanthosis nigricans - ANS-Velvety, verrucous, thick *darkening* of the neck skin
Obesity, Diabetes, Endocrine disorders
GI or GU malignancy, Lymphoma
Achilles Tendon Rupture - ANS-Running/jumping, *hear a pop*, present w/ limp
PE: gap where tendon should be
Dx: Clinical
Tx: Surgery: weeks to heal, Cast: months to heal
ACL or PCL injury - ANS-ACL
,*Unhappy Triad: ACL + MCL + Meniscus*
Anterior drawer (+)
Lachman's Test
PCL
Anterior trauma
Posterior drawer (+)
Dx: MRI
Tx: Sugery (if athlete), Cast (all others)
Acne vulgaris - ANS-Comedonal - Retinoid
Mild - Retinoid + BPO + Topical Abx
Moderate - Retinoid + BPO + Oral Abx
Severe - Oral Isotretinoin
Actinic keratosis - ANS-Older (male) pt
Hx of sun exposure
PE: *rough, scaly, erythematous papules* on skin
Pre-SCC
Tx: Cryotherapy > Topical (5-FU, Imiquimod, Diclofenac)
Acute bronchitis in adults - ANS-MC: viral
*Productive cough <1wk* w/ wheezing & rhonchi
Few systemic Sxs
MCC of minor hemoptysis
CXR: Bronchial wall thickening in both lower lobes
Supportive - NSAIDs/Tylenol, cough-suppressants
Acute Closed- Angle Glaucoma - ANS-Painful, acute, unilateral vision loss from occlusion of
trabecular meshwork in the eye and increased IOP.
Pt c/o halos around lights, has a cloudy, injected cornea
Most commonly seen w/ hyperopia, large cataracts, women, Eskimo/Asian ancestry
Tx: *1st Line: Acetazolamide* - avoid in sulfur-allergic pts
Mannitol (↓ IOP)
Timolol (↓ aqueous humor production)
Pilocarpine
Acute Gastritis
"Always *Cushion* the brain"
"Burned by the *Curling* iron" - ANS-Erosion of stomach mucosal layer
EtOH, NSAIDs, *Stress*, Uremia
,Head Trauma: *Cushing* Ulcer
Burn: *Curling* Ulcer
Acute lower back pain - ANS-
Acute Lymphocytic Leukemia - ANS-Children
B-Cell Precursors
Good Prognosis
Tx:
Acute Myelogenous Leukemia - ANS-Adults
*Auer rods* (owl eyes) w/ microscopy
Fair prognosis
Tx:
Acute painful nodular inflammatory process of the eyelid
Sub-acute painless nodular process of the eyelid - ANS-Acute & Painful: Hordeolum (see pic)
Sub-acute & Painless: Chalazion
Tx: Warm compresses, Topical erythromycin > I&D if refractory
Acute Respiratory Distress Syndrome - ANS-↓ PaO2 and ↑ PaCO2 from fluid collapsing the
*alveoli*
MCC: 6-72 hrs s/p *Sepsis*
Associated w/ Renal & Hepatic failure
↓ BP or shock w/ crackles, rales, wheezing
Tx: Mechanical Vent w/ *PEEP*
Acute Sinusitis - ANS-Nasal congestion < 7 days
Viral URI Sxs
PND
Tx: supportive
Acute Tubular Necrosis - ANS-
Allergic rhinitis & conjunctivitis - ANS-Allergic Shiners
watery eyes & runny nose
cobblestone mucosa
Tx:
Olopatadine (antihistamine)
, Naphazoline (vasoconstrictor)
Alopecia - ANS-Balding - hair follicle stopped in resting phase
Tx: Minoxidil, Finasteride
Alpha Thalassemia - ANS-
Alzheimer disease - ANS-
Anal fissure - ANS-MC site: *Posterior* Anal Midline > Anterior > Lateral
Assoc w/ Crohn's, HIV, Leukemia, TB, Syphilis
Tx: fiber, sitz bath, topical analgesic, & nifedipine or nitroglycerin
Anaphylaxis (Type 1 Hypersensitivity) - ANS-Upper airway obstruction
Urticaria
Bronchospasm
Hypotension
Cardiovascular Collapse
Tx: Epinephrine + O2 + IVF
Anemia of chronic disease - ANS-
Ankle Fracture - ANS-Over-Eversion
Over-Inversion
Sx's: *Non-ambulatory* w/ pain & swelling
Dx: Xray
Tx: ORIF
Anorexia - ANS-
Anterior Communicating Artery Aneurysm - ANS-
Anterior Cord Syndrome - ANS-Mechanism: Flexion or Vascular
Loss of *Motor, Pain & Temp* below injury
Preserved position & vibratory function
Anterior Dislocation of Shoulder - ANS-Abducted & Ext rotated (*shaking hands*)
*Axillary n. injury* = Deltoid parasthesia
Dx: Xray
Tx: Reduction & Sling
Anterior Epistaxis Management - Kiesselbach's plexus - ANS-Conservative: Alae pressure,
bend at waist, oxymetazoline spray
