Commonly Confused Topics in Healthcare

Rocky Mountain Spotted Fever vs. Lyme Disease

• Both are caused by tick bites.

Rocky Mountain Spotted Fever

• Presentation: Fever and a distinctive rash on the hands and feet.
• Mnemonic: Patient climbing a mountain with their hands and feet.
• Treatment: Doxycycline for everyone, including young children and during pregnancy.

Lyme Disease

• Presentation: Bull's eye lesion (erythema migrans).
• Mnemonic: "Eye" and "erythema" have a "y" in them, as does "Lyme."
• Treatment: Doxycycline is preferred, except during pregnancy.
  • Pregnancy: Amoxicillin is the go-to medication.
  • Young children can still receive doxycycline.
• Summary: Treat both conditions with doxycycline, except for Lyme disease during pregnancy.

Herbal Supplements: St. John's Wort vs. Kava Kava

St. John's Wort

• Use: Depression.
• Caution: Drug interactions, especially with serotonergic medications (SSRIs).
• Monitoring: Watch for serotonin syndrome.
• Serotonin Syndrome Symptoms: Confusion, headache, nausea, vomiting, diarrhea, dilated pupils, tachycardia, and sweating.

Kava Kava

• Use: Anxiety.
• Mnemonic: Kava is repeated twice (kava kava), like an anxious person might stutter.

Meniscus Tears vs. ACL Tears

ACL Tear

• Affects: Anterior cruciate ligament, which stabilizes the knee joint.
• Mechanism: Sudden stops or changes in direction.
• Symptoms:
  • Loud pop at the time of injury.
  • Immediate swelling.
  • Painful; patients usually unable to continue activity.
• Mnemonic: Associate the letter A in ACL to help you remember that automatic spelling
• Tests:
  • Anterior drawer test.
  • Lachman test (more specific).
• Mnemonic: Rearrange the letters in ACL to get LAC, the first three letters of Lachman. Also, Anterior drawer test because this affects the anterior cruciate ligament.

Meniscal Tear

• Affects: Meniscus, a piece of cartilage in the knee that stabilizes the knee joint.
• Mechanism: Twisting with weight on the knee.
• Symptoms:
  • Knee catching or locking up.
  • Delayed swelling.
  • Pain is not always immediate.
  • Patients sometimes able to continue activity.
• Tests:
  • McMurray test.
  • Apley grind test.
• Mnemonic: McMurray and Apley both end in the letter y.

Chronic Venous Insufficiency (CVI) vs. Peripheral Arterial Disease (PAD)

Chronic Venous Insufficiency (CVI)

• Pathophysiology: Pooling of blood.
• Mnemonic: VEINS
  • V: Very great pulses, warm extremities, varicose veins.
  • E: Edematous (swelling in lower extremities).
  • I: Irregularly shaped wounds, irritation to the skin.
  • N: No severe pain, but dull pain.
  • S: Stasis (blood pooling), causing skin issues.
• Treatment: Push blood back up to the body.
  • Compression stockings.
  • Leg elevation.
  • Exercising.

Peripheral Arterial Disease (PAD)

• Pathophysiology: Narrowing of arteries leading to decreased oxygenated blood flow to extremities.
• Arteries: Arteries = Away (pump oxygenated blood away from the heart).
• Symptoms:
  • Cool, shiny skin.
  • Decreased peripheral pulses.
  • Ischemic ulcers.
  • Intermittent claudication (muscle pain with activity, relieved by rest).

Ethical Principles: Fidelity vs. Veracity

Fidelity

• Definition: Being faithful, loyal, and keeping promises.
• Mnemonic: F in fidelity and faithful.
• Example: Calling a patient when you say you will.

Veracity

• Definition: Truthfulness.
• Mnemonic: Being very truthful.
• Example: Being honest, clear, and truthful about a diagnosis, even when it's difficult.