1. Acute monocular vision loss:
- Central retinal artery occlusion: acute onset, retinal pallor, cherry red fovea, boxcar segmentation of retinal veins
- Central retinal vein occlusion: painless, subacute onset, "blood and thunder" retinal exam - swollen tortuous veins, retinal hemorrhages, optic disk edema, cotton wool spots. Risk factors: coagulopathy, artherosclerosis, chronic glaucoma.
- Amarugosis fugax: temporary, carotid emboli
- Uveitis: painful, red sclera
- Acute angle closure glaucoma: painful, hard eye, halos around lights.
- Optic neuritis: severe pain, swollen optic disk, central scotoma visual defficit
2. Side effects of antithyroid treatments: 
- PTU: black box for hepatic damage. Also causes vasculitis, which methimazole does not cause. Both can cause rash and arthralgias. Safer than methimazole in first trimester of pregnancy though, so indicated in that circumstance. Allergic reaction in 2% (most common), agranulocytosis in 0.3% - monitor cbc if pt has symptoms of sickness, however routine cbc is not indicated.
- Methimazole: teratogenic towards fetus in first trimester. Can also cause hepatitis, arthralgias, rash, agranulocytosis.
- People are typically treated for 1 year, and then the drugs are stopped to see if someone has gone into permanent remission (30-40% of people will); if so, they can stop; if not, they have to go back on the drugs for life.
- Radioiodine ablation: can cause permanent hypothyroidism, worsening of exopthalmos.
3. Subcortical strokes: 
- Pure motor - subcortical white matter, brainstem
- Pure sensory - thalamus
- Ataxia-hemiparesis: pons
4. Cortical strokes: 
- ACA: lower body weakness/sensory deficit, dyspraxia, abulia (lack of will/initiative), emotional disturbances, urinary incontinence
- MCA: weakness, aphasia (dominant), hemineglect (nondominant), eye deviation towards infarct
5. Posterior circulation strokes: 
- Midbrain: ipsilateral CN III palsy, contralateral weakness/ataxia
6. Menorrhea: 
- Primary: normal exam, pain concomitant with onset of menses
- Adenomyosis (ectopic endometrium in the myometrium) uterine enlargement & tenderness
- Endometriosis: adenexal lumpiness and tenderness; pain typically precedes menses
- Infection: cervical motion tenderness, purulent discharge
- Fibroids: lumpy uterus
7. Anti-TPO antibodies: 
- Present in 10% of general population, 30% of older females, 90% of those with hashimotos
- May herald thyroid disease if pt is asymptomatic
- Titers higher earlier in disease course, fall with time.
8. Graves disease: the lesser known symptoms
- A-fib
- Proximal muscle weakness/wasting (up to 60-80% of untreated people will develop acute/chronic myopathy)
- Acute thyrotoxic myopathy: distal or proximal muscles, but spares bulbar/respiratory
- Chronic: proximal muscle weakness weeks to months after onset of hyperthyroidism
- Hyperreflexia
9. DDx proximal muscle weakness (can't comb hair, drops into chair)
- Connective tissue disease: polymyositis, dermatomyositis
- Endocrine: hyperthyroidism, hypothyroidism, cushings
- Neuromuscular junction: lambert eaton, myasthenia gravis
- Drugs: steroids
10. Inherited immune deficiencies: 
- SCID: recurrent sinopulm, diarrhea, candidiasis from birth. No tonsils, lymph nodes, thymus. Severely reduced levels of B/T/NK cells
- CVID: presents like Bruton's, but with less severe symptoms at a later age (15-35). Decreased IgA, IgG, IgM, IgE, but NORMAL B-cell counts
- Bruton's/x-linked: recurrent onset of pyogenic infections (S.pneumo and H. flu) at 6-9 months of age, with decreased IgG, IgA, IgM (dx criteria: 2 SD below mean), and DECREASED B-cell counts (dx criteria: <2% CD19+ B cells in circulation). Absent isohemagglutinins, poor response to vaccines
- Wiskott Aldrich: x-linked. Eczema, thrombocytopenia, recurrent infections with encapsulated organisms. May present with bleeding early on (bleeding c circumcision, petechiae, bloody stools). Low IgM, high IgA and IgE, poor antibody responses to polysaccharide antigens, moderately reduced T cells and platelets
- Chronic Granulomatous Disease: recurrent infections with catalase-positive organisms - lymphadenitis, abscesses of skin and viscera (liver). Defect in NADPH oxidase complex. Nitro blue tetrazolium test.