1.

Contents
2. Contents
3. Contents
4. Contents
5. Features of angioedema
6. Conditions necessitating mechanical ventilation
7. Suspected acute pyelonephritis
8. Reversible focal neurologic symptoms suggesting TIA
9. Hypoxemia
10. Convulsive seizure
11. Suspected adrenal insufficiency
12. Treatment of community-acquired pneumonia
13. Hyponatremia
14. Suspected meningitis
15. Clinical suspicion of stroke
16. Unresponsive adult
17. Suspected Cushing syndrome
18. Appendicitis suspected
19. Solitary pulmonary nodule
20. GI bleeding
21. DVT diagnosis
22. Hypoglycemic crisis
23. Nipple discharge
24. Intra-abdominal bleeding following trauma
25. Sore throat
26. Suspected precocious puberty
27. Suspected pneumothorax
28. Tested pulmonary embolism
29. Suspected AAA
30. Newly diagnosed a-fib
31. Newly diagnosed a-fib
32. Suspected esophageal variceal bleeding
33. Suspected GERD
34. Hyperkaliemia
35. Symptoms of hemorrhoids
36. Hypertensive crisis
37. Headache
38. Soft tissue infection
39. Sigmoid volvulus
40. Acute chest pain in an adult patient
41. Acute diverticulitis
42. Suspected ARDS
43. Neutropenic fever
44. Confirmed hypernatremia
45. Celiac disease suspected
46. Foreign body aspiration
47. Symptoms of coronary syndrome
48. Acute gout attack
49. Penetrating abdominal trauma
50. Suspected cystic fibrosis
51. Pharmacotherapy of agitated aggressive patient
52. Renal osteodystrophy
53. Polyhydramnios
54. Rate control of A Fib
55. Treatment of nausea and vomiting in pregnancy
56. Age-based evaluation of occult GI bleeding
57. Ectopic pregnancy management
58. Evaluation of short stature
59. Hypertension diagnosis
60. Corneal abrasion
61. Suspected appendicitis
62. Staging of gastric adenocarcinoma/ clostridium difficile infection
63. Variceal bleeding algorithm
64. Management of cirrhosis/ suspected gastrinoma
65. Management of gastric esophageal reflux disease
66. Evaluation of dysphagia
67. Evaluation of bilious emesis in the neonate
68. Evaluation of elevated alkaline phosphatase
69. Approach to straining infant
70. Varicella post-exposure prophylaxis
71. Approach to odynophagia and dysphagia in HIV patient
72. Ventilator-associated pneumonia
73. Acute infectious diarrhea
74. Non-traumatic acute back pain
75. Rabies post-exposure prophylaxis
76. Ottawa ankle rules
77. Rheumatoid arthritis
78. Evaluation of red urine
79. Evaluation of hyponatremia
80. Evaluation of acute kidney injury
81. Differential diagnosis of metabolic alkalosis
82. Management of ureteral stones
83. Evaluation of bladder dysfunction in children
84. Diagnosis of brain death
85. Evaluation of delirium
86. Management of status epilepticus
87. Epidural hematoma
88. Carotid atherosclerotic disease management
89. Ischemic stroke management
90. Parkinson's disease pharmacotherapy/ management of unilateral facial weakness
91. Suspected idiopathic intracranial hypertension
92. Pediatric traumatic brain injury PECARN rule
93. Evaluation and management of pharyngitis
94. Management of suspected peritonsillar abscess
95. Pregnancy management in patients with HSV
96. Migraine in pregnancy
97. Prenatal diabetic screening
98. Management of postpartum hemorrhage due to uterine atony
99. Preterm birth prevention
100. Gestational diabetes mellitus
101. Preterm labor management
102. Prenatal screening for autosomal recessive disease
103. Primary amenorrhea evaluation
104. Ovarian cancer screening
105. Primary amenorrhea
106. Management of breast pain
107. Treatment of menopause
108. AUB and secondary amenorrhea / adnexal mass
109. Palpable breast mass
110. Management of endometriosis
111. Nipple discharge/ breast discharge
112. Post-menopausal bleeding
113. CIN
114. Acetaminophen intoxication
115. Neonatal cyanosis
116. Pulmonary embolism approach
117. Solitary pulmonary nodules
118. Curb-65
119. Subacute and chronic cough
120. Suspected asthma
121. Hemoptysis
122. Drowning
123. ARDS ventilator management
124. Pulmonary function testing
125. Evaluation of gynecomastia
126. Acromegaly
127. Adrenal insufficiency
128. Hyperthyroidism
129. Postpartum thyroiditis
130. Hypertension and hypokalemia
131. Suspected polyurea/ water deprivation test
132. Hypocalcemia
133. Hyperprolactinemia in premenopausal women
134. Evaluation of thyroid nodules
135. Diagnosis of hypercalcemia
136. Precocious puberty
137. Deep venous thrombosis
138. Palpable breast mass
139. Blunt abdominal trauma
140. Hypertrophic cardiomyopathy management
141. Adult cardiac arrest management
142. St-elevation mi stabilization
143. Pulmonary embolism diagnosis and management
144. Evaluation of chest pain in the emergency department
145. Unstable abdominal aorta aneurysm
146. Sinus bradycardia in adults
147. Adult tachycardia with a pulse
148. Aortic dissection
149. Hypertriglyceridemia treatment
150. Suspected ectopic pregnancy
151. Preterm prelabor rupture of membrane management
152. Hydatidiform mole management/ hematuria in children
Angioedema Mx
DVT management
Acute chest pain DDx
Rate control of A Fib
N/V in Pregnancy
FOBT positive
Criteria for TX use – MTX candidate

BREASTFEEDING IS C/I TO MTX

Short stature
HTN

#Algorithm

Corneal abrasion
Actively bleeding

BT if Hb <9
DDx for bilious vomiting

Meconium ileus, HD, Malrotation, Duodenal A; MI and HD - contrast enema.

Straining infant
VAP
back pain
Otawa ankle rules
Hyponatremia
Mx of ureteral stones
Enuresis/Bladder dysfunction
Delirium
SE Mx

#Neuro
EDH algorithm

The Brain Trauma Foundation (BTF) Guidelines for the Management of Severe Head Injury
recommends that patients who exhibit an EDH that measures less than 30 mL, is less than 15
mm thick, and has less than 5-mm midline shift, with no focal neurologic deficit and with GCS
greater than 8, can be treated nonoperatively. NO GLUCOCORTICOIDS
Carotid revasc algorithm

50-69% men vs women; asymptomatic >80; symptomatic >70

Algorithm for AIS

● LV) - hyperdense MCA sign/ CTA - FLOW VOID Mechanical thrombectomy is

independent of thrombolyisis - patient can be eligible for both/one/none
Peritonsillar abscess
HSV
1st line for migraines - PCM
DM screening
PPH algo
Preterm birth prevention

Indications for cerclage in 1st trimester - prior preterm + 2.5 or 2x2nd trimester preterm loses
GDM Dx
Preterm labor management

Risk factors include prior spontaneous preterm delivery, short interpregnancy interval (eg, <6-18
months), and genitourinary tract infection (eg, group B Streptococcus [GBS], Chlamydia
trachomatis).

Magnesium sulphate to decrease the risk of cerebral palsy, which is highest in infants delivered
at <32 weeks gestation.

Indomethacin is the first-line treatment at <32 weeks gestation because of its high efficacy and
few maternal adverse effects; as gestational age increases, however, indomethacin poses
greater fetal risks (eg, premature closure of the ductus arteriosus). Therefore, nifedipine is
preferred between 32 and 34 weeks gestation
Primary amenorrhea
Ovarian Ca screening

This is because the risk for ovarian cancer in the general population is low (~1.4%). In contrast,
the risk for ovarian cancer significantly increases with familial cancer syndromes such as
BRCA1 (~40%), BRCA2 (~20%), and Lynch syndrome (~8%).
AUB in <45 - workup needed vs >45

POST VS PREMENOPAUSAL ADNEXAL mass

CA 125 only in postmenopausal

Breast mass

#OBGYN
#Algorithm
Prolactin and TSH eval for B/L dischrge
#Algorithm PMB - always investigate PMB.

Endometrial biopsy is considered the gold standard for diagnosis of endometrial cancer due to
its high sensitivity and specificity. However, in postmenopausal women, a transvaginal
ultrasound may be performed initially; women with an endometrial thickness ≤4 mm have a low
likelihood of endometrial cancer and require no additional evaluation. In contrast, women with
an endometrial thickness of >4 mm require an endometrial biopsy because the likelihood of
endometrial cancer is increased.
#Algorithm
<4 hr, >7.5 gm = charcoal + levels -- NAC
PE approach

start AC if no C/I and highly likely

Early and effective AC improves mortality frm 30% to 2-8%
SPN algorithm

#Pulmonology
Pneumonia CURB 65 and Rx
UACS

Upper-airway cough syndrome (UACS) (eg, postnasal drip), gastroesophageal reflux disease
(GERD), and asthma cause >90% of chronic cough in nonsmokers without pulmonary disease
Massive hemoptysis

#Algorithm
Ventilator settings

Oxygenation - Fio2 and PEEP, Ventilation- paCo2 - RR and TV

PFT - RLD vs OLD
Gynecomastia
Acromegaly
PAI - cosyntropin
Hyperthyroid Algo
PP thyroiditis
Hyperaldosteronism Dx
DI water deprivation
Hypocalcemia - tetany algo

Despite PTH deficiency, phosphorus levels are normal or low in magnesium deficiency; this is
possibly due to intracellular phosphorus depletion.
Prolactinoma approach

If >3cm or macroprolactinoma not responding to DAs – trans sphenoidal resection

First Line DAs
Thyroid nodule
Hypercalcemia
Assessment of precocious puberty

girls age <8 or in boys age <9.

- BONE AGE ESTIMATION with Xrays of Wrist
- If central - elevated LH -MRI to confirm -- GnRH agonist for idiopathic
DVT algo
Breast mass - male/female
Blunt abd trauma BAT - depending on hemodynamic stability

Frank rigidity = peritonitis - immediate lap

HOCM Mx

Novel agents - mavacamten reduce contractility via modulation of cardiac myosin.

#Algorithm
Cardiac arrest

PEA/Asystole - CC only till shockable /rosc,

No use of Atropine
IV lidocaine only in monomorpic hemodynamically stable pt
Defib for VT/V fib pulseless.

MI - STEMI/ NSTEMI & UA

B blockers avoided if decomp HF or Brady. Frusemide for PE

IV fluids if hypotension - RVMI signs
Acute PE Algorithm and DVT criteria - Wells

#Algorithm

Wells criteria
Long-distance flights, although a risk factor for venous thromboembolism (VTE), do not qualify
as immobilization per Wells criteria,
Cp eval
Aortic aneurysm algo - if not a known case - and unstable -FAST

#Medicine
#Medicine
Tachycardia ACLS

#Algorithm
Ao Dissection
Hyperlipidemia algorithm

#Algorithm #Medicine
Pregnancy of unknown location - non diagnostic USG algorithm

#Algorithm

Quantitative BhCG every 48 hrs

>3500 discriminative zone - perform TVS to confirm

>6000IU -- TAS
PPROM

Prophylactic latency antibiotics: PPROM is commonly due to a subclinical intraamniotic

infection, and latency antibiotics prevent the infection from becoming fulminant, thereby
increasing the time interval between membrane rupture and delivery (ie, prolong latency).

Antenatal corticosteroids (eg, betamethasone): These are administered to promote fetal lung
maturation (eg, pneumocyte development, surfactant release), thereby reducing neonatal
morbidity and mortality.
#Algorithm
Monitoring of HMole - GTD

Contraception 6 months - HTD rare after 6 months. monitoring of BhCG difficult if pregnant.
Monitor weekly till undetectable. - continue till 6 months
#Algorithm