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
