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Travel + self-limiting watery or brown/green diarrhea

Traveler diarrhea = ETEC HL or HS toxin

- Bloody diarrhea + poultry consumption

Campylobacter jejuni or Salmonella spp.

- Abx (clindamycin, beta-lactam, cephalosporin) + diarrhea

C. difficile

- Dx of C. diff

stool AB toxin test, not stool culture

- Fever of 104 + abdo distension in C diff

toxic megacolon

- Tx of C. diff

vancomycin, not metronidazole (updated guidelines as of Feb 2018)

- Bloody diarrhea + travel

Entamoeba histolytica

- Tx of E. histolytica

metronidazole + iodoquinol; can give paromomycin

- Close quarters or military barracks or cruise ship + watery diarrhea

Norwalk virus

- Child

rotavirus

- Few organisms causing bloody diarrhea

Shigella

- Bloody diarrhea + appendicitis-like pain (pseudoappendicitis) in a child

Yersinia enterocolitica

- Bloody diarrhea + reactive arthritis in an adult

Y. enterocolitica, Campylobacter, Shigella,

Salmonella

- Diarrhea + Guillain-Barre syndrome

Campylobacter

- GBSyndrome CSF?

albuminocytologic dissociation (high protein + normal cells)

- GBSyndrome Dx?

electromyography + nerve conduction studies (on NBME)

- Cardiac ischemia + need to evaluate

ECG stress test first-line

- Cardiac ischemia + abnormal baseline ECG (e.g., BBB)

Echo stress test (need normal ECG to do ECG

stress test)

- Cardiac ischemia + patient can’t exercise

dobutamine + ECG/echo

- ECG shows diffuse ST-segment elevations

pericarditis

- Pericarditis Tx

NSAID, or steroid, or colchicine

- Central chest pain worse when supine; better when leaning forward

pericarditis

- Lateral chest pain after viral infection + increased CK

pleurodynia (intercostal muscle spasm)

- ST-segment depressions in the anterior ECG leads

posterior MI

- Electrical alternans on ECG

pericardial tamponade / pericardial effusion