1. Polymyalgia rheumatica: 
- Associated with neck, shoulder, hip pain, fatigue, malaise that develops over weeks
- ESR and CRP are up
- Treat with low dose steroids (10-20mg/day) and when the symptoms subside, and taper slowly - over months, because this tends to recur
- MTX can be used as steroid sparing agent
2. GCA: 
- Granulomatous vasculitis of medium to large arteries of head and neck - temporal aa, proximal/distal aorta, opthalmic, ciliac.
- M:F ratio 2:1
- Most have headaches in temporal area, 1/3 will have visual symptoms, may have jaw claudication
- ESR is markedly elevated
- Halo sign on temporal artery ultrasound
- Treat with high dose steroids (40-60 mg/day) - does not affect bx if you get it within 4 weeks of prednisone treatment.
- Taper slowly once symptoms resolve and ESR has normalized over months - 10% reduction q1-2 weeks.
- Aspirin may lower risk of cerebral ischemia.
- Neither MTX nor infliximab is effective as steroid-sparing agent in GCA.
3. De Quervain's tenosynovitis: 
- Severe pain on extension of thumb.
- Finkelstein's test: grab thumb, ulnar-deviate hand sharply; pain along distal radius is positive test
4. DDx knee pain in young patients: 
- Patellofemoral pain syndrome: young/middle aged women, pain with climbing stairs/squatting, compression of patella with extended knee reproduces pain - thought to be due to the way the patella slides over femur (ie more at an angle than in men due to wider hips) - treat with PT to strengthen/stretch thigh muscles - resolution may take weeks to months.
- Patellar tendonitis: affects athletes "jumper's knee", episodic pain and tenderness at inferior patella
- Osgood-schlatter: young people (preteen/teen) s/p recent growth spurt, tenderness at tibial tubercle, pain worse with squatting however not seen in adults (vs patellofemoral pain syndrome)
5. Craniopharyngiomas have a bimodal age distribution - in childhood and again at 55-65.
- In kids, growth retardation (GH and TSH deficiency)/DI are more common features, in adults presents with more sexual dysfunction, amenorrhea.
6. Management of carotid disease: 
< 50% occlusion: medical therapy with aspirin and statins, follow q6-12 months with duplex u/s.
50 - 69% occlusion with symptoms - CEA can be considered
70 - 99% CEA recommended for patients who are good surgical risks
Stent is an alternative for CEA in poor surgical risk patients or who have poor predicted 5 year survival.
7. Facts about hepatic disease: 
- Lamivudine (3TC) is used to treat chronic hep B as well as HIV.
- Low salt diet to manage ascites (less Na = less H20 retention)
- All chronic liver disease pts should be vaccinated against hep A and B, as the risk of hepatic failure with superinfection of hepatitis is higher in a vulnerable liver.
8. Birth injuries: 
- Klumpke's palsy ("claw hand"): C8-T1 injury, manifests with weakness of the extensor tendons; grasp reflex is absent. Rarely can manifest as hand paralysis or horner's from injury to sympathetic chain (portends suboptimal outcome). In most cases, function returns in a few months; no improvement by at 3-9 months - can consider surgical tx.
- Erb-Duchenne palsy ("waiters tip"): C5-6 injury, may have decrease Moro reflex but grasp is intact.
- Perinatal stroke: Can present in many ways, incl hyperreflexia, hypertonia.
9. FEV1/FVC > 80 - restrictive <80 - obstructive
10. Neonatal rashes: 
- Erythema toxicum neonatorum: asymptomatic, scattered erythematous macules, papules, pustules - can occur in any part of the body except palms and soles - affects full term infants in first 2 weeks of life - benign, will resolve on its own, no need to treat.
- Staph scalded skin syndrome: ill appearing, febrile, anti-staph antibiotics
- HSV/VZV skin infections in neonates are dangerous as they can quickly disseminate to vital organs; acyclovir should be given immediately.