Frequently Pimped Questions on Clinical Clerkships: By: Tanya Oberoi Pandya D.O., M.B.A.

Common causes of Acute Pancreatitis Ranson's Criteria What is McBurney's point, what does it signify? What is lloyd's sign, rovsing sign, murphy's signwhat do they signify? What are common peritoneal signs? What is Hesselbach's triangle? Landmark for inguinal region outlined by rectus abdominis muscle medially, the inguinal ligament inferiorly and the inferior epigastric vessels laterally What is the most common type of hernia in any patient? Indirect inguinal Know the difference between direct and indirect hernia What is Charcot's Triad? Right Upper Quadrant pain, Jaundice, Fever What does Charcot's Triad signify? Acute Cholangitis What does 'porcelain gallbladder' on ultrasound signify? Gallbladder cancer Acid-base disturbance: what is this, is it compensated/uncompensated Hyponatremia: know the algorithm Most Common Causes of Acute Sinusitis, Pneumonia, Acute Otitis Media Streptococcus pneumoniae, H. influenzae, Moraxella catarrhalis Treatment of Acute Otitis Media? Always say amoxicillin FIRST! Then any other antibiotics! Differential Diagnosis for Chest Pain, Shortness of Breath, Abdominal Pain, Tachycardia, GI bleed Signs and symptoms of Appendicitis, Cholecystitis Causes of abdominal pain FAQ on Clinical Rotations Tanya Oberoi Pandya D.O., M.B.A.

 Acute renal failure: how to identify Causes of Altered Mental Status? AEIOU-TIPS: Alcohol Endocrine (DKA vs Electrolytes vs hypoglycemia), Encephalopathy (hypertensive or alcoholic) Infection, Infarction (of heart so check cardiac enzymes), Insulin Opiates, Oxygen(hypOxia) Trauma, Tumor, Temperature Poisonings, Psychiatric Seizures, Stroke Delirium vs dementia: know the difference between the two Diabetic Ketoacidosis How to calculate Sliding Scale Insulin. (Blood Glucose 100)/40 = units of regular insulin Main causes of Post-operative fever Wind: atelectasis, pneumonia; Water: UTI, Wound: infection, [Womb: endometritis/uterine infection (if a C-section was done)]; Walking: DVT, Wonder drug Different types of Shock Cardiogenic, cardiac compressive shock, neurogenic, hypovolemic, septic Know ALL of your heart murmurs: systolic and diastolic Know the different stages of labor and how you differentiate between them Know basics on preeclampsia and shoulder dystocia What is a Bishop Score? How do you calculate it? What are the risk factors for heart disease What muscles make up the Rotator Cuff? SITS: Supraspinatus, Infraspinatus, Teres Minor, Subscapularis What are the atypical causes of Community Aquired Pneumonia? Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila Know how to diagnose diabetes and hypertension

FAQ on Clinical Rotations

Tanya Oberoi Pandya D.O., M.B.A.

 Common causes of Hematuria? I (Infection, Infraction, Iatrogenic[drugs]); T (Trauma, Tumor, TB); S (Stone, sickle cell, cystitis) Goal values for: -Lipid panel -LDL in diabetic: <100 -LDL in non-diabetic: <70 -Blood Pressure in diabetic: in 120s/70s (<130/80) -Blood pressure in non-diabetic: <140/90 -HbA1C value in a diabetic: <7 What are the causes of secondary hypertension? Use mneumonic: ABCDE: Accuracy of diagnosis, obstructive sleep Apnea, Aldosteronism, presence of renal artery Bruits (suggesting renal artery stenosis), renal parenchymal disease (Bad kidneys), excess Catecholamines (pheochromocytoma), Coarctation of the aorta, Cushing's syndrome, Drugs, Diet, excess Erythropoietin, and Endocrine disorders (hypothyroidism, hyperthyroidism, hyperparathyroidism, acromegally). What is the risk of correcting hypernatremia too fast? Cerebral edema What is the risk of correcting hyponatremia too fast? Central pontine myelinosis What is a Hamptons Hump indicative of upon chest radiograph? A wedge-shaped, pleural-based, convex opacity in costophrenic angle indicative of pulmonary embolism. Also called Westermarks sign. Most common clinical findings (i.e. signs) with a pulmonary embolus? Tachycardia, tachypnea, hypoxia Most common EKG finding for a pulmonary embolus? Sinus tachycardia Classic EKG finding for a pulmonary embolus? (probably what you may be asked on boards) S1Q3T3: means that a deep S wave in lead I, a Q wave in lead III, T wave inversion in lead III Name two things that could cause Kaussmauls Sign? Right heart failure and pericarditis. EKG findings with Pericarditis? Square root sign. PR segment depression with diffuse ST segment elevation What condition do you see a delta wave on an EKG? FAQ on Clinical Rotations Tanya Oberoi Pandya D.O., M.B.A.

WPW: Wolff-Parkinson-White syndrome What is the order in which jaundice appears on physical exam? Under the tongue first, then sclera, then skin What are the three symptoms of Horners Syndrome? Miosis, ptosis, and anhidrosis What vitamin deficiency should one be concerned of when treating a pediatric patient with bili lights? Vitamin B2 - Riboflavin is light sensitive. How much does 10MEQ of potassium increase the potassium level? 10MEQ = an increase in 0.1 points. Example: if patient has a potassium level of 3.5, you need to give him/her 50MEQ to get it to 4.0 Why do you give thiamine (Vit B1) to alcoholics especially before giving any glucose in Intravenous Fluids? Prevent Wernicke-Korsakoff syndrome What does a positive Cervical Motion Tenderness (CMT) most likely indicate? Pelvic Inflammatory Disease (PID) What bugs do you cover when treating Pelvic Inflammatory Disease (PID)? Gonorrhea and Chlamydia Recommended potassium level for patients with Coronary Artery Disease? Potassium = 4.0 Recommended potassium level for patients with Coronary Artery Disease? Magnesium = 2.0 Each Gram of Magnesium changes serum Magnesium level by? 0.1 to 0.2 points Recommended hemoglobin/hematocrit level for patients with Coronary Artery Disease? Hb: 7; Hct: 30 Causes of Anion Gap Metabolic Acidosis? Methanol, Uremia, DKA, Paraldehyde, INH/Iatrogenic, Lactic Acidosis, ETOH/Ethylene glycol ingestion, Salicylates Most common cancers that metastasize to the bones? Breast, Lung, Thyroid, Kidney, Prostate (BLT with Kosher Pickle) What are the features of Compartment Syndrome? Pain, Pallor, Paresthesia, Poikilothermia, Paralysis (pulses may STILL be present) FAQ on Clinical Rotations Tanya Oberoi Pandya D.O., M.B.A.