TOP TWENTIES BY ROTATION
Family Medicine “Top Twenty”
Hypertension Headaches
Diabetes/Metabolic Syndrome Migraines
Upper Respiratory Tract Infections Cluster
otitis media tension
otitis externa Sexually Transmitted Infections
rhinitis Gonorrhea
sinusitis Chlamydia
pharyngitis HPV
Lower Respiratory Tract Infections Syphilis
Bronchitis Herpes
pneumonia Dermatologic Disorders
Depression/Anxiety Psoriasis
Health Promotion/Disease Prevention Eczema
related to smoking cessation and contact dermatitis
obesity acne
COPD/chronic bronchitis/emphysema tinea
Low Back Pain Urological Disorders
Gastroenteritis/Diarrhea UTI
Hyperlipidemia BPH
Hypo/Hypothyroidism Nephrolithiasis
GERD/Dyspepsia/PUD Pyelonephritis
Allergic Rhinitis/Vasomotor Rhinitis erectile dysfunction
Inflammatory Bowel Disorders Ischemic Heart Disease
Crohn’s Acute MI
UC angina)
Osteoarthritis/Rheumatoid
Arthritis/DJD
Internal Medicine “Top Twenty”
ENT disorders
vertigo
Meniere’s disease
Cardiovascular disorders
Chest Pain/Ischemia/MI/CAD
CHF
PVD
pulmonary hypertension
arterial insufficiency
conduction and valve disorders
deep vein thrombosis
Hypertension
Essential
Secondary
Hypotension
Dermatological disorders
TOP TWENTIES BY ROTATION
Basal/Squamous Cell Carcinoma
Melanoma
actinic keratosis
Diabetes/Metabolic Syndrome
Hyperlipidemia
Hyper/hypothyroidism
Anemias, leukemias, and lymphomas
Upper & Lower Respiratory Tract infections
GI disorders
diverticulosis/diverticulitis, malignancies of the colon & rectum, hepatitis, cirrhosis,
pancreatitis)
Genitourinary disorders: Evaluation of hematuria and proteinuria, BPH, UTI, ED, prostate CA
Cancer screening recommendations
Ocular disorders (glaucoma, cataract, macular degeneration)
Renal disorders: Acute/chronic renal failure, acute renal insufficiency, glomerulonephritis,
neprotic syndrome
Neurologic disorders (CVA/TIA, seizures, dementia, delirium, Parkinson disease, multiple
sclerosis, myasthenia gravis)
Muskoloskeletal disorders (osteoporosis, osteoarthritis, rheumatoid arthritis, DDD/DJD,
ankylosing spondylitis, systemic lupus erythmatosis)
Psychosocial conditions (depression/anxiety, sexual abuse, elder abuse, substance abuse)
Pulmonary disorders (COPD, idiopathic pulmonary fibrosis, sleep apnea, lung cancer,
sarcoidosis, pulmonary embolus)
Evaluation of symptoms, such as: fatigue, dizziness, fever of unknown origin, weight loss,
non-cardiac chest pain
Evaluation of polypharmacy and indications for use of blood thinners for specific conditions
(atrial fibrillation, DVT/PE)
Pediatrics “Top Twenty”
Common etiologies associated with prematurity and complications associated with
prematurity
Milestones for growth and development, for newborns to adolescents, including Tanner
Stages
Nutritional recommendations for: newborns, breast feeding, formula feeding, solid food
introduction, fluid/caloric requirements, vitamins & minerals, and childhood obesity
Respiratory disorders: asthma, bronchitis/bronchiolitis, croup, epiglottitis, FB aspiration,
RSV
Cardiovascular disorders: congenital defects, cyanotic/acyanotic defects, innocent
murmurs, rheumatic fever/heart disease
GI disorders: Meckel’s diverticulum, intussusception, pyloric stenosis, hernia, appendicitis,
constipation, gastroenteritis, colic, lactose intolerance, intestinal parasites
Musculoskeletal disorders: congenital foot and hip disorders, Osgood-Schlatter, Slipped
Capital Femoral Epiphysis, Legg-Calve-Perthes, Juvenile Rheumatoid Arthritis, scoliosis
Hematologic Disorders: physiologic jaundice, sickle cell trait/disease, anemias, leukemias,
bleeding disorders, erythroblastosis
TOP TWENTIES BY ROTATION
Neurological disorders: cerebral palsy, seizure disorders/epilepsy, meningitis
(viral/bacterial), lead poisoning, febrile seizures, encephalitis, headaches
HEENT disorders: rhinitis, pharyngitis and tonsillitis, peritonsillar abscess, otitis media and
externa, conjunctivitis, strabismus, cervical adenopathy, oral candidiasis, FB of ENT,
cerumen impaction, hearing deficit
Common complaints in pediatrics: teething problems, diaper rash, enuresis, common
injuries
Dermatologic disorders: contact dermatitis, eczema, fungal skin infections, bacterial
infections, lice, molluscum contagioussum
Viral Exanthems: Chicken Pox, Fifth’s disease, rubella, measles, mumps, roseola
Infectious Disease: sepsis, aphthous ulcers, herpes, CMV, mono, streptococcal pharyngitis
Genioturinary disorders: UTIs in children, undescended testes, hydrocele, testicular torsion,
paraphimosis/phimosis, hypospadias, ovarian torsion, menstrual disorders, Wilm’s tumor
Metabolic & Endocrine Disorders: phenylketonuria (PKU), lipid disorders, carbohydrate
disorders, cholesterol disorders, Diabetes, hyper/hypothyroid, childhood obesity
Social issues: verbal/physical/sexual abuse, substance use/abuse
Psychiatry/Behavioral Medicine issues: Autism, Asberger’s disease, ADD/ADHD, mood
disorders, behavioral disorders, developmental delays, eating disorders, fetal alcohol
syndrome
Genetic disorders: Muscular dystrophy, Down’s syndrome, Turner’s syndrome, Klinefelter’s
syndrome
Common health problems associated with adolescence: sexual maturity, contraception use,
adolescent pregnancy, medication/drug use, health risks associated with sexuality,
mortality/morbidity prevention
Women’s Health “Top Twenty”
Cardiovascular disorders: pregnancy induced hypertension, hypertension,
thrombophlebitis, DVT/PE, ecclampsia/pre-ecclampsia
Menstrual Cycle disorders: amenorrhea, oligomenorrhea, metrorrhagia, dysmenorrhea,
dysfunctional uterine bleeding
GYN/Urological: PMS, PMDD, menopause, urinary stress incontinence, cystocele, UTI
Infertility
Contraceptive options
Vaginitis: differentiating normal from abnormal and determining etiology (candidiasis,
trichomonas, BV, GC, etc.)
Sexually Transmitted Infections: syphilis, chlamydia, trichomonas, HPV, HIV, HSV,
gonorrhea, pelvic inflammatory disease, cervicitis, condylomata acuminata
Pelvic pain/masses: endometriosis, ovarian cysts, ovarian torsion, vaginitis, PID, uterine
fibroids, mittelschmerz, carcinoma of uterus or ovaries
Cervical/Vulvar lesions: Bartholin’s and Skene’s cysts, carcinoma, inflammatory lesions,
polyps
Polycystic Ovarian Syndrome (PCOS)
Breast pain/masses: mastitis, fibrocystic changes, fibroadenoma, cancer
Obstetrics: clinical/laboratory diagnosis of pregnancy, medications safe for use, indications
for pregnancy screening tests, Rh incompatability, ectopic pregnancy
Antepartum: understand diet, exercise recommendations and common complaints and
issues associated with pregnancy
TOP TWENTIES BY ROTATION
Medical conditions associated with pregnancy: anemia, diabetes, urinary tract disorders,
herpes, rubella, Group B streptococcus, cytomegalovirus, toxoplasmosis, varicella,
parvovirus,
Stages of Labor: pain management, fetal monitoring, operative indications, recognized true
vs. false labor, recognize abnormal labor patterns
Pregnancy/Labor complications: premature rupture of membrane, abruptio placenta,
placenta previa, ectopic pregnancy, all types of abortions
Complications of Delivery: hemorrhage, retained placenta, puerperal infections, surgical
abdomen, episiotomy
Neonatal evaluation: Apgar, umbilical cord care, resuscitation
Postpartum issues: anxiety/depression, fetal death, genetic abnormalities
Cancer screening recommendations: breast, cervical, ovarian, uterine cancer
Surgery “Top Twenty”
Preoperative Care: Screening for bleeding disorders, adrenal insufficiency, cerebrovascular
disease, cardiac/pulmonary function, hepatic/renal function, diabetic patient
Wound Healing: Stages of healing, classification of surgical wounds, factors affecting
healing, wound complications, suture selection.
Postoperative Care/Complications: drains, pain management,
respiratory/cardiac/urinary/psychiatric complications, postoperative fever
Nosocomial infections and infection control
Fluids, Electrolytes & Nutrition: Volume disorders, electrolyte balance disorders, acid-base
balance/abnormalities, nutritional support
Shock and Pulmonary Failure: hypovolemic, cardiogenic, neurogenic, acute pulmonary
failure, ARDS
Burns: burn depth, “rule of nines”, management of burns and their complications
Skin/Soft Tissues: benign skin tumors, basal and squamous cell carcinoma, melanoma,
lymphoma
Head and Neck: Thyroid cancer, oral cancer, laryngeal cancer, thyroid nodules and goiters,
inflammatory thyroid disease, hyper/hypothyroid, hyper/hypoparathyroid
Esophagus, Stomach and Duodenum: Esophageal cancer, motility disorders, diverticula,
Barrett’s, hiatal hernia, perforation, foreign bodies, corrosive esophagitis, GERD resistant to
medical therapy, duodenal and gastric ulcers, gastrinoma, stomach cancer
Lung, Mediastinum, Pleura, and Thoracic Wall: Pleural effusion, pneumothorax, mediastinal
masses, lung cancer, solitary pulmonary nodules, pulmonary embolism, empyema
Breast: Benign breast disorders, breast nodules/masses, carcinoma of the female and male
breast
Biliary Tract, Pancreas, and Liver and Portal Venous System: liver cancer, portal
hypertension, variceal bleeding, ascites, hepatic trauma, biliary colic,
cholelithiasis/cholecystitis, cholangitis, pancreatitis, pancreatic cancer
Renal/Urological: nephrolithiasis, renal cell carcinoma, bladder carcinoma, evaluation of
hematuria, testicular torsion, testicular cancer, hyperaldosteronism, pheochromocytoma,
Cushing’s Disease/Syndrome
GI: acute/chronic abdominal pain, diverticulosis/diverticulitis, appendicitis, small/large
bowel obstruction, Crohn’s disease, colon polyps, colon cancer, Ulcerative Colitis, Volvulus,
antibiotic-associated colitis, ischemic colitis
TOP TWENTIES BY ROTATION
Anorectum: hemorrhoids, anal fissures, pilonidal disease, perianal fistulas/abscesses,
tumors
GI bleeding: Upper and Lower GI Bleeding
Hernias: Inguinal, Femoral, Umbilical, Ventral, Incisional
Blood Vessels and Lymphatics: peripheral arterial insufficiency, acute arterial occlusion,
arterial aneurysms, renal artery stenosis, mesenteric ischemia, varicose veins, deep vein
thrombosis, superficial thrombophlebitis, chronic venous insufficiency, lymphedema,
lymphangitis
Trauma: Splenic injury, Retroperitoneal hematoma, trauma support basics, fractures (types,
general management, complications)
Emergency Medicine “Top Twenty”
Resuscitation and Trauma basics: BLS, ACLS, airway obstruction, airway management
Ocular disorders: acute angle-closure glaucoma, retinal detachment, corneal abrasion, FB of
the eye, corneal ulcer, acute anterior uveitis, central retinal artery and vein occlusion,
orbital cellulitis
Head and neck: epiglottitis, epistaxis (anterior/posterior), peritonsillar abscess,
retropharyngeal abscess, foreign bodies, sinusitis, pharyngitis, otitis media/externa,
tympanic membrane perforation, mastoiditis, Ludwig’s angina
Pulmonary: foreign body aspiration, asthma, COPD, pneumonia, pleural effusion,
pulmonary edema, pulmonary embolism, pneumothorax, upper airway obstruction,
bronchiolitis
Cardiovascular: evaluation of chest pain, myocardial infarction (STEMI vs. NSTEMI), angina
pectoris (stable vs. unstable), aortic dissection, shock (all types), conduction disorders (SVT,
v-tach, v-fib, a-fib/flutter heart blocks), identify abnormal EKG tracings,
endocarditis/myocarditis/pericarditis, cardiac arrest, HTN, valvular lesions,
cardiomyopathies, heart failure
Peripheral Vascular: peripheral arterial occlusion, venous thrombosis, superficial
thrombophlebitis
GI: appendicitis, pancreatitis, cholecystitis, perforated peptic ulcer, intestinal obstruction,
GI bleeding, diverticulitis, nausea & vomiting, gastroenteritis, hepatitis, cholangitis, splenic
infarct/rupture, intussusception, volvulus, esophageal varices, pilonidal abscess
Neurological Disorders: seizure disorders, status epilepticus, migraine headache, cluster
headache, subdural hematoma, subarachnoid hemorrhage, TIA, CVA, meningitis,
encephalitis, concussion, post-concussive headache, skull fracture, cerebrospinal fluid leak,
trauma, dementia, delirium
Musculoskeletal System Disorders: common fractures, dislocations/subluxations, Whiplash
injury, sprains/strains, ruptured Achilles tendon, low back pain
Renal/Urological Disorders: nephrolithiasis, testicular torsion, priapism, acute renal failure,
urinary retention, UTIs, pyelonephritis, Fournier’s gangrene, epididymitis, STIs, penile
fracture, hematuria, electrolyte and acid/base disorders
Gynecologic Disorders: Hyperemesis gravidum, pre-eclampsia/eclampsia, trauma in
pregnancy, bleeding during pregnancy, cervicitis, pelvic inflammatory disease, ovarian
torsion, ectopic pregnancy, Bartholin’s cyst/abscess, spontaneous abortion, ovarian cyst
rupture, toxic shock syndrome
Psychiatric/Behavioral Medicine Disorders: abuse (physical, sexual, verbal, elder), acute
panic attacks, manic/depressive states, suicidal states, schizophrenia
TOP TWENTIES BY ROTATION
Endocrine Disorders: diabetic ketoacidosis, hypoglycemia, thyroid storm, myxedema coma,
acute adrenal insufficiency (Addisonian crisis), pheochromocytoma (Catecholamine crisis)
Dermatological Disorders: viral exanthems, meningococcemia, contact dermatitis, urticaria,
drug eruptions
Environmental Disorders: smoke inhalation, chemical burns, sunburn, electrical burns,
hypothermia, frostbite, heat exhaustion/stroke, drowning
Animal Bites: dogs, cats, venomous snakes, bee/wasp stings, Black Widow and Brown
Recluse spider bites
Poisoning or Overdose: benzodiazepines, alcohol, narcotics, cocaine, Tylenol, cyanide,
ethylene glycol
Other Conditions: anaphylaxis, angioedema
Common Diagnostics in the ED: various laboratory testing, EKG, radiographs, CT, US
Common presenting complaints to evaluate: chest pain, abdominal pain, headache, back
pain, abscess, shortness of breath, palpitations, trauma/injury, fever, disorientation
