1. Septic joint in kids: 
- WBC will be >50K
- Organisms: birth to 3 mos - staph, GBS, and GRAM NEGATIVES - so treat with antistaph agent (vanc or nafcillin) PLUS gram neg coverage (gent or cefotaxime)
- Organisms: 3 mos and older - staph, GAS, strep pneumo - anti-staph agent (naf, ancef, vanc)
2. Tinea corporis vs erythema multiforme: 
- Tinea corporis: ring shaped scaly patches, commonly trichophyton rubrum, diagnose with microscopic examination with KOH (hyphae), treat with 2% antifungal lotions like terbinafine - extensive disease - w/u for immunosuppression (DM, HIV)
- Erythema multiforme does not have peripheral scaly border, is mostly acral in distribution, can follow HSV infection but has a huge differential diagnosis.
3. Clubfoot
- Casting, stretching, manipulation should begin from day 1
- Failure to attain satisfactory results may go to surgery - typically at 3-6 mos of age, always before 12 mos.
4. VIPoma vs carcinoid: 
- Both can present with diarrhea, flushing
- VIPoma - "pancreatic cholera" people will get muscle cramps from hypokalemia (intestinal losses), achlorhydria (decreased gastric acid secretion); may have other MEN 1 syndromes. Secretory diarrhea labs. VIP < 75 pg/mL confirms, located in pancreas tail 75% of time and 60-80% have mets to liver at diagnosis. Treat with octreotide, fluid replacement, surgery
- Carcinoid: generally occur in small intestine (70-80%), rarely occur in pancreas
- Gastrinoma can also cause diarrhea but will typically also cause ulcers (zollinger ellison)
5. Peptic vs duodenal ulcers: 
- Gastric - worsen with with food
- Duodenal - improve with food
6. Management of GERD: 
- If alarm symptoms (melena/hematemesis, weight loss, dysphagia/odynophagia, lots of vomiting, male age > 50, any cancer risk factors) => scope
- If no alarm symptoms, manage with qD PPI for 2 months. If that doesn't work, BID PPI or different qD PPI. If that doesn't work, scope.
7. Paraneoplastic weakness: 
- Myasthenia gravis: ocular, bulbar, face, neck, limb
- Lambert eaton: proximal muscles, autonomic dysfunction (dry mouth), CN involvement, diminished or absent reflexes 
- Dermatomyositis/polymyositis: symmetrical, more proximal muscle weakness, other autoimmune (ILD, esoph dysmotil, raynaud's), skin findings (heliotrope rash, grotton's nodules) in dermatomyositis
8. If you suspect diverticulitis (or any acutely inflamed bowel condition) do not scope the colon- the insufflation of air or introduction of scope can cause perforation. Same logic no barium enema. CT for working up diverticulitis
9. Palpable kidneys, nephrotic syndrome, enlarged liver, ventricular hypertrophy, in setting of chronic disease (bronchiectasis or RA) => amyloidosis. Treat underlying disease + colchicine for prophylaxis and treatment of AA.
- vs PCKD- where you will see more of a nephritic syndrome
10. Hydroxychloroquine can cause retinopathy!! Eye exams q6 mos.