3yr old kawasaki-----echo, EKG, cxr, esr, abd US---Aspirin (use warfarin in no improvement), IVIG, e

sepsis-- complete workup----antibiotics very high broad spectrum(piper-tazo+ gentamycin), respira

multiple joint inflammation--xray/ MRI/ Bone scan..esr, aspiration analysis, blood cx, ana, rf, if Sept
/ middle ear effusion in 18 months-- regular labs-- amoxicillin----forward 3 days no response change
HTN.
prostatitis,---<35 yrs ceftriaxone+azithromycin, >35 (also if UTI coexisting) ciprofloxacin/ofloxacin
vit b12 deficancy, panic attack, acute asthma excarebation, DKA, ovarion torsion
Hyperlipidemia--- TSH, DM, regular workup (echo, cardiac workup) lipid profile---High dose statins

spinal stenosis --- MRI,regular workup, pain relief, laminectomy- ortho/ neuro surg -----rehab, phys
meningitis in 6 month old --- complete workup including CSF analysis, give vanc+ceftriaXONE+ DE
ePE -- d-dimer, regular labs, CTA-- high prob, if low prob do d-dimer, treat----anticoag (lovnenox/LM
DM & HTN --- regular workup, lisinopril, eye consult, urine microalbumin, echo, ekg, lipid profile, if
perforated viscous --- regular labs, ABXray, npo, NG tube, foley OR labs (PTT, PT, type and cross, pi
Ectopic pregnancy ---hcgand US transvaginal then ,qualitative <1500 rpet with USG in 48 hrs, >15
SAH---eye exam, STAT CT without contrast then cerebral angio if bleeding, neurosurg consult for "C
hyperkalemia --- regular labs, if EKG calcium gluconate, if not life threatnening , insulin+D5,
Rhabdomyolysis (Heat stroke)--- Remove clothes, cold fluids, NSS, ice packs, Ionized calcium, mag
cholecystitis -- US/HIDA scan, CXR, liver nezymes---antibiotics ampicillin-sulbactum, stabilize first, a
COPD exacerbation -- Pulse OX, PEFR, CXR, EKG ABG, albutero/ipratro/methylpres,,,,, ceftrix-azithr
ovarian ca--CT abd,paracentesis, mamogram, papsmear, colonscopy, CXR, CA125, CEA, then stagin
A Fib-- pulse, oxygen, EKG, cxr, cardiac enzymes, rate control betablocker/diltiazem, rhythm contro
Lung cancer--- cbc, CXR, pefr, ct chest, sputum analysis- once diagnosed staging--CT pelvis/abd/ne
Neutropenia-- cbc, complete hemat workup (PT/PTT.INR, Peripheral, Vitb12, TSH, LDH haptoglob), c
tension pneumo 10 min-- pulse ox/Oxygent/ exam heart and chest--needle thoracostomy, chest tub
dka-- fingerstick/PICOBEFN/ IVA/ NSS/ exam then insulin labs then abg Q4hrs, CBC, source of infect
iron def anemia--FOBT, CBC peripehral IRON STUDIES, smear, retic count tibc, serum iron, TSH, vit
graves dz--tsh, free T4, US, thyroglobulin, FNAC if cancer finidngs on US or prednisone, beta blocke
ca colon vague presentation--maybe fatigue ---start with CBC, hemat workup, BMP, LFT, UA Lipid pr
toxic shock syndrome penis pierc--- MOST IMPORTANT removal of agent (), cbc, bmp, lft, urine and
sob child uri, eczema, asthma 10 min---<6 yr old no PEFR, cbc, bmp, CXR, exam, oxy pulse ox, albu
abd pain child=vague=usg=10 min--- DD-intusussception/appendicitis/ischemic colitis/gastroente
molar preg--- Bhcg, cbc. Bmp, LFT, TSH, CXR, US abd, HCG quantitative and then D&C and start OC
stone old age= sepsis= IVA NSS and percutaneous nephrostomy if distal obstruction, cbc, bmp lft,
pul oedema--pulse ox, OXYGEN, head end elevation, IVA, NO SALINE quick exam , furosemide, NTG
acute mania--- iva, oxygen, quick exam including neuro, cbc BMP LFT, lithium level, uds, ua, CXR, o
lead poison --full physical exam just type "lead", finger sttick lead, and venous blood, cbc bmp lft, u
juv RA will have lypmphadenopathy, RF neg and ANA neg and very high ferritin level but trear exac
bariatric surg= status post resp problem=osa--------complete exam, polysomnograpraphy PICOBE
Acute pancreatitis
MVA with LOC
apkd
copd
cold
mania
heat exhaustion
ovarian cancer
djd
Pneumonia and TB
pul embolus
degenerative joint disease
Prostatitis
sickle cell anemia
Acute anaphylaxia
Appendicitis.CBC,BMP,LFT,FOBT,XRAY, U/S AND CT,UA IF OBESE KIDS,IV CEFOXITIN,PROMETHAZ
Hypothyroidism
BLEEDING IN KIDCBC,BMP,LFT,PT(APTT, INR ),FACTOR(9,10,8,5),VON WILLE,ANTIHEMOPHILLIC F
BLEEDING POST URTI..SAME AS ABOVE ITPNASAL PACK IF BLEED PLAT <20,000=CS AND PLAT IN
consistent with UW and exam
acute PID==CBC,BMP,LFT,LIPID,BHCG,CERVICAL,WETMOUNT,PH,FUNGAL CULTURE,USG ABD,PICOB
acuute perforated appedicitis
septic arthritis
acute pericarditis
cellulitis
acute pericarditis
RCC
perf duodenal ulcer
HTN with DM
childabuse
bipolar
acute bipolar disorder
ovarian torsion
sigmoid volvulous
Gastric CA,
96 y/o confusion

trying finishing block in 45 min

Not in UW

Brian tumor
PPH
6 week baby with VSD
Rape
nSTEMI
stroke
glyburide overdose
molar pregnanacy
anemia in child
kidney stones
osteomylitis
acute pyleo in child
SLE
Schizopherenia
necrotizing fascitis
diarrhea
endometrial cancer
metastatic breast cancer to brain
aLL with neutropenia
hypocalcemia
caeffine and anxiety
aute renal failure
STEMI
crohns
mesentric ischemia
homosexual with painfiul ejaculation
neonatal sepsis
conns syndrome
CHF
thrombophlebitis
HOCM
RSV
carotd stenosis
intestinal obstruction
TTP
hip fracture with surgery
gastric bypass
DM tyoe 1
Pul HTN
post partum endometritis
subdural hematoma
PROM
endometiosis
hematuria
ecclamsia
post op atelectasis
hyperlipidemia
asympt bacturia in preg
domestic abuse
DM with BPH
DM with HTN
Megaloblastic anemia Vit B12
Otitis media
severe preecclamsia
pyloric stenosis
knee pain-gout
laryngeal carcinoma
DCM-----young pt post URI-- cxr echo, holosystolic murmur with pedal edema, bnp, cardiac enzyme
septic shock
HUS
gastric outlet obstruction

corazon
lymes arthritis=RA,ANA,CCP,ESR,,ARTHROCENTESIS,
ca vocal cords
HOCM with LVH
maxillary sinusitis
cocaine induced vasospasm
Anaphylaxis peanut allergy

Others--crush CCS Dou

ATN---- on aminoglycosides-----do all workup of prerenal and post renal including urine creat protein
Gastric cancer 60+smoker with decreased apetitie and fobt positive--Gastric cancer---office --comp
cific, Urine, swan ganz, A-line, lactate levels
A coverage---monitor with ESR
treat accordingly

sult and IV antibiotics (genta+clinda+ampicillin)

and diet consult, ----f/u LFT, CPK,

ension) if no contraindication, coumadin (warfarin) long term anti coag---- monitor (heparin (APTT), till INR ev
t occasion 4 weeks apart, low sodium and low fat, exercise, diet consult, vaccine,

e of methotrexate, > 6000, >3.5cms, fetal cardiac activity+ then go for salpingostomy, if rupture anytime ---

carb and till urine PH>6.5, CPK every 4 hr, BMP every 4 hrs, mag phos every 4 hrs, then monitor CPK/BMP/MA

omy (better), gyn consult, oncology consult then CA 125 followup, counsel cancer diagnosis
day, warfarin, monitor EKG, telemetry, rhythm check
ology consult, cardiothoracic, monitor sodium level ACTH, PTH calcium, rehab, breathing excercises
nco then 48hrs no improvement then add caspofungin then 48 hrs not improving Granulate CSF--IF ALL then
ysical exam
CRP,once Glucose <250 D5\half NS, once Anion gap<12 and Bicar>15 or taking po then change to sub cuta
s, d-dimer, colonoscopy if bleeding elderly.severe iron def give IV ferrous, or else for mild po ferrous sulph
or Total T4 and free T4... neck, calium PTH, 24 hr urine cathcolamine, ACTH, low dose dexameth test, EKG EC
epression Index, serum protein electrophoresis, CXR US abd, ALP, CEA, colonoscopy, CT abdomen once diag
clindamycin/vancomycin, f/up culutre and ICU transfer, IV fluids and dopamine support dopamine/norepinep

omplete exam including rectum and complete workup like sepsis, NG tube, cbc, bmp, LFT, UA Urine culture, U
ntain on OCP throughtout this period
ne culture blood culture, ionotropic support if needed in ICU <MAP65 surg consult---
P, swan ganz, UO foley, ABG, CXR, ECHO, cardiac enzymes and EKG
ementia).start lithium if not on it, send TSH, Urine sodium, psych consult, transfer ward, revaluate, frequen
te, lead paint assay, lead abatement agency (just type lead and everything for lead appears), Venous blood
anti ccp, esr crp, comlement level, ANA neg, US abdmen for hepato spleenomegaly start steroids(only form
y consult bosentan, Weight LOSS, EXERCISE DIET CONSULT, pt ptt INR Bhcg, TSH HIV VDRL, depression index
T ,COUNSEL NO ASPIRIN
D ASPIRATE),CONSULT HEMATOLOGY AND
tablocker)---not improving cadriac consult and cardiac transplant

upportive with furosemide only and if very severe and rising do dialysis
n index, with UGI and then gastrectomy with surgical and hemonco consult and then monitoring and diet con
parin (APTT), till INR every 1 day till 2-3), CBC day 3 and 5 for HIT, INR

if rupture anytime ---Laprotomy, f/u beta hcg 3-5 days, OBS/GYN consult----f/up LFT and CBC every 4-6 week

n monitor CPK/BMP/MAg/Phos every 6 hrs then monitor CPK/BMP/MAg/Phos every 12 hrs then

g excercises
late CSF--IF ALL then Calla antigen, CYtosine abrainoside and dunorubicin+ithrathecal methotrexate

en change to sub cutaneous insulin (2 hours overlap) with once regular discontinued )basal glargine
mild po ferrous sulphate, retic increases in 48 hrs and 4 weeks later HB increases
exameth test, EKG ECHO, PRA, endocrine consult, avoid caffeine... keep monitoring T$ and thyroglobulin for
T abdomen once diagnosed then surgical consult then hemicolectomy, oncology consult,
t dopamine/norepinephrine, Urine output, foley tylenol, f/u CBC and CMP everyday... once improved then star

FT, UA Urine culture, UDS, blood culture, Stool analysis, Abd US and Xrar, CT if needed, CXR, ECHO, EKG, VAn

rd, revaluate, frequently 2 minute screen tsh and free t4 evels for later
ppears), Venous blood level, oral succimer (baseline CBC/LFT/protoporphyrin) for >44 and monitor calcium r
start steroids(only form) for exacerbation and to also start Methotrexate for long term treatment
DRL, depression index, conult genreal surgery, Gastric bYpass/ sleeve
onitoring and diet consult replace
d CBC every 4-6 weeks and DO NOT give methotrexate of renal failure or liver failure-- give RHogam if Negat

methotrexate

asal glargine

and thyroglobulin for cancer, pregnant pt monitor total T4

ce improved then start changing to oral and transfer to ward

CXR, ECHO, EKG, VAnco and gent

and monitor calcium rich diet, iron rich diet and iron rich multivitamin, keep monitoring CBC/LFT and Venoud
reatment
give RHogam if Negative

CBC/LFT and Venoud lead level and protoporphyrin...f/u every 4 weeks with these test