CURRENT

Medical Diagnosis
& Treatment
Flashcards
Edited by
Gene R. Quinn, MD, MS
Nathaniel W. Gleason, MD
Maxine A. Papadakis, MD
Stephen J. McPhee, MD
Department of Medicine
School of Medicine
University of California
San Francisco
New York Chicago San Francisco Lisbon London Madrid Mexico City
Milan New Delhi San Juan Seoul Singapore Sydney Toronto
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Contents
Skin Disorders
1. Atopic Dermatitis 1A-F
2. Contact Dermatitis 2A-F
3. Psoriasis 3A-F
Pulmonary/Ear, Nose & Throat Disorders
4. Asthma 4A-F
5. Chronic Obstructive
Pulmonary Disease 5A-F
6. Cough 6A-F
7. Dyspnea 7A-F
8. Lung Cancer 8A-F
9. Pharyngitis 9A-F
10. Pneumonia 10A-F
11. Pulmonary Embolism 11A-F
12. Sinusitis 12A-F
Heart/Hypertension/Lipid Disorders
13. Acute Myocardial Infarction 13A-F
14. Aortic Regurgitation 14A-F
15. Aortic Stenosis 15A-F
16. Chest Pain 16A-F
17. Dyslipidemia 17A-F
18. Heart Failure 18A-F
19. Hypertension 19A-F
20. Mitral Regurgitation 20A-F
21. Mitral Stenosis 21A-F
22. Shock 22A-F
Hematologic Disorders
23. Hypercoagulable States 23A-F
24. Iron-Defciency Anemia 24A-F
25. DVT and Tromboembolism 25A-F
26. Vitamin B
12
Defciency Anemia 26A-F
Gastrointestinal/Liver/
Pancreas Disorders
27. Cholecystitis, Acute 27A-F
28. Cirrhosis 28A-F
29. Colorectal Cancer 29A-F
30. Crohn Disease 30A-F
31. Diarrhea 31A-F
32. Gastrointestinal Bleeding, Lower 32A-F
33. Gastrointestinal Bleeding, Upper 33A-F
34. Hepatitis, Viral 34A-F
35. Pancreatitis, Acute 35A-F
36. Pancreatitis, Chronic 36A-F
37. Ulcerative Colitis 37A-F
Gynecologic/Urologic Disorders
38. Breast Cancer 38A-F
39. Benign Prostatic Hyperplasia 39A-F
40. Dysmenorrhea 40A-F
41. Prostate Cancer 41A-F
Musculoskeletal Disorders
42. Back Pain, Low 42A-F
43. Gout 43A-F
44. Knee Pain 44A-F
45. Rheumatoid Arthritis 45A-F
46. Systemic Lupus Erythematosus 46A-F
Kidney/Electrolyte Disorders
47. Glomerulonephritis 47A-F
48. Hypokalemia 48A-F
49. Hyponatremia 49A-F
50. Kidney Injury, Acute 50A-F
51. Kidney Disease, Chronic 51A-F
52. Kidney Stone Disease 52A-F
53. Metabolic Acidosis 53A-F
54. Nephrotic Syndrome 54A-F
Nervous System/Psychiatric Disorders
55. Altered Mental Status 55A-F
56. Dementia 56A-F
57. Depression 57A-F
58. Epilepsy 58A-F
59. Meningitis, Bacterial 59A-F
60. Myasthenia Gravis 60A-F
61. Parkinson Disease 61A-F
62. Stroke 62A-F
63. Smoking Cessation 63A-F
64. Substance Abuse 64A-F
Endocrine/Metabolic Disorders
65. Adrenocortical Insuf ciency 65A-F
66. Cushing Syndrome 66A-F
67. Diabetes Mellitus, Type 1 67A-F
68. Diabetes Mellitus, Type 2 68A-F
69. Hyperaldosteronism 69A-F
70. Hypercalcemia 70A-F
71. Hyperparathyroidism, Primary 71A-F
72. Hyperthyroidism 72A-F
73. Hypothyroidism 73A-F
74. Obesity 74A-F
75. Osteoporosis 75A-F
Infectious Disorders
76. Fever 76A-F
77. HIV and AIDS 77A-F
78. Health CareAssociated Infections 78A-F
79. Infective Endocarditis 79A-F
80. Sepsis 80A-F
Preface
Current Medical Diagnosis and Treatment (CMDT) is the
leading internal medicine textbook known for its com-
prehensive coverage of current inpatient and outpatient
care with diagnostic tools relevant to day-to-day practice.
Tese CMDT Flashcards provide study aids for 80 of the
most common topics in internal medicine. Te CMDT
Flashcards provide a synopsis of the medical topic for a
quick review and a study aid for a variety of standard-
ized examinations. As such it will be very useful to medi-
cal, nursing, pharmacy, and other health professional
students, to house of cers, and to practicing physicians.
Te CMDT Flashcards are engaging and patient-centered
since all topics begin with presentation of a typical patient
to help the reader think in a step-wise fashion through
the various clinical problem-solving aspects of the case.
Outstanding Features

80 common internal medicine topics useful to learners

in their preparation for a variety of examinations

Material drawn from the expert source, Current

Medical Diagnosis and Treatment

Concise, consistent, and readable format is organized

in a way that allows for quick study

Medical and nursing students, physicians assistants,

nurse practitioners, house of cers, and practicing
physicians will fnd the clear organization and brevity
useful
Organization
Te 80 topics in the CMDT Flashcards were selected as
core topics because of their relevance to the feld of inter-
nal medicine and to learners of the discipline.
Tere are 3 CMDT Flashcards for each topic. On
the front of the frst, a case is presented and the reader
is then asked 2 questions regarding the salient features
of the patients complaints and how to think through the
problem, the answers to which are printed upside down
on the card. In a similar fashion, the front and back of
each of the CMDT Flashcards ask questions that develop
the learners clinical problem-solving skills regarding the
case. Te questions concern the Essentials of Diagnosis
and General Considerations; Symptoms and Signs; Dif-
ferential Diagnosis; Laboratory, Imaging and Procedural
Findings; and Treatments.
Te CMDT Flashcards follow the organization of
Quick Medical Diagnosis and Treatment (AccessMedicine
and app) and concern disorders in 11 general categories:

Skin Disorders

Pulmonary/Ear, Nose & Troat Disorders

Heart/Hypertension/Lipid Disorders

Hematologic Disorders

Gastrointestinal/Liver/Pancreas Disorders

Gynecologic/Urologic Disorders

Musculoskeletal Disorders

Kidney/Electrolyte Disorders

Nervous System/Psychiatric Disorders

Endocrine/Metabolic Disorders

Infectious Disorders
Intended Audience
Medical students on their internal medicine clerkship
will fnd these CMDT Flashcards a useful aid as they care
for patients with these common medical problems. Tese
CMDT Flashcards will assist PA, NP, and medical students
taking their internal medicine rotation and house of cers
to review the core topics as they prepare for standardized
examinations. Nurse practitioners and practicing physi-
cians will similarly fnd these CMDT Flashcards useful in
order to stay current in clinical problem solving, as well
as to review a brief overview of diagnostic studies and
treatments.
Gene R. Quinn, MD, MS
Nathaniel W. Gleason, MD
Maxine A. Papadakis, MD
Stephen J. McPhee, MD
San Francisco, CA
Skin Disorders
Pulmonary/Ear, Nose &
Throat Disorders
Heart/Hypertension/
Lipid Disorders
Hematologic Disorders
Gastrointestinal/Liver/
Pancreas Disorders
Gynecologic/
Urologic Disorders
Musculoskeletal Disorders
Kidney/Electrolyte Disorders
Endocrine/
Metabolic Disorders
Infectious Disorders
Nervous System/
Psychiatric Disorders
ACUTE MYOCARDIAL INFARCTION
What are the salient features of this patients problem?
How do you think through his problem?
A 71-year-old man presents to the emergency department
with a sudden onset of substernal chest pain 1 hour ago. He
describes the pain as a heavy pressure sensation that radiates
down both arms and is 10 of 10 in intensity. His pain started
while he was walking around his yard and improved, but did
not resolve, with rest. His medical history is signicant for
diabetes mellitus. He has smoked 1 pack of cigarettes per
day for the past 50 years. His mother died of a myocardial
infarction (MI) at age 56 years. On heart examination, you hear
an S
4
gallop, and on lung examination, you hear bibasilar ne
crackles. His electrocardiogram (ECG) shows 3-mm ST-segment
elevations in leads II, III, and aVF.
13A
Salient features: Advanced age; sudden onset of substernal chest
pain radiating to the arms; pain worse with exertion; cardiac risk
factors of diabetes mellitus, smoking, and family history; S
4
gallop
and crackles consistent with pulmonary edema; ECG with ST
elevations in an inferior distribution
How to think through: Acute coronary syndrome (ACS)
includes unstable angina, nonST elevation MI, and ST elevation
MI; all result from myocardial ischemia caused by thrombosis at
a site of coronary atherosclerosis. Tere are other causes of MI,
but ACS is the most common. Tis patient has typical chest pain,
meaning substernal, pressure or squeezing, exertional, and
relieved by rest or nitroglycerin. Radiation to the arms correlates
strongly with cardiac chest pain. To evaluate a patient with chest
pain, frst determine the likelihood of ACS as its cause; then
stratify the risk for mortality to ensure timely intervention in high-
risk patients. Here the history alone strongly suggests ACS. Te
patient is deemed to be at high risk because of the ST elevations
on ECG. If the ECG showed ST depressions, would he still be
considered a high-risk patient? (Yes. Evidence of new heart failure
confers high risk.) What medications should be administered
upon diagnosis? (Aspirin; clopidogrel, heparin, or low-molecular-
weight heparin [LMWH]; nitroglycerin; morphine, if needed.)
Should he receive a -blocker? (No. His new heart failure is a
relative contraindication.) If the hospital lacks facilities for cardiac
catheterization, how should he be managed? (If transfer to another
facility for percutaneous coronary intervention [PCI] within
90 minutes of frst medical contact is not possible and barring
contraindication, fbrinolytic therapy should be given.)
ACUTE MYOCARDIAL INFARCTION
13B
What are the essentials of diagnosis and general considerations regarding
acute myocardial infarction?
Essentials of Diagnosis
Sudden development of prolonged (>30 minutes) anterior chest
discomfort or pressure
Sometimes masquerading as acute heart failure (HF), syncope,
stroke, or shock
ECG: ST-segment elevation or lef bundle branch block
Immediate reperfusion treatment is warranted with PCI within
90 minutes (preferred) or thrombolysis within 30 minutes of
arrival and within 6 to 12 hours of symptom onset
General Considerations
Results, in most cases, from an occlusive coronary thrombus
at the site of a preexisting (although not necessarily severe)
atherosclerotic plaque
More rarely, may result from prolonged vasospasm, inadequate
myocardial blood fow (e.g., hypotension), or excessive metabolic
demand
Very rarely, may be caused by embolic occlusion, vasculitis,
aortic root or coronary artery dissection, or aortitis
Cocaine use may cause MI and should be considered in young
individuals without risk factors