1. Giardia: 
- Adhesive disks allow adherence to bowel mucosa
- Cause malabsorption, leading to foul-smelling diarrhea, fatty stools, boating, flatulence, nausea, malaise, cramps
2. Osteogenesis imperfecta: 
- Blue sclerae
- Often associated with dentinogenesis imperfecta - bluish gray to yellow brown discoloration of teeth from dentin showing through translucent/weak enamel
- Hypotonia
- Osteopenia/recurrent fractures
- Easy bruisability
- Hearing loss
3. Nephrotic syndrome causes:
- FSGS: african american/hispanic, heroin, HIV, obesity
- Membranous: adenocarcinoma, NSAIDs, Hep B, lupus
- Membranoproliferative: Hep B/C, lipodystrophy
- Minimal change: idiopathic (kids), NSAIDs/lymphoma (hodgkins) in adults
- Amyloidosis: multiple myeloma, chronic inflammation (RA, bronchiectasis)
- IgA nephropathy (presents with nephrotic syndrome in <10%, more commonly presents as nephritic syndrome after URI)
4. Bladder trauma
- Dome of bladder has developmental hiatus where urachus originates during embryonic life and is most susceptible to rupture with sudden increases n pressure
- Dome is also only part of bladder with peritoneal border- rupture here can cause spillage of contents into peritoneum, resulting in chemical peritonitis
- Most common site of extraperitoneal rupture is bladder neck
5. Baker's cyst: 
- Inflamed synovium produces excess fluid, expanding popliteal bursa beyond normal size and causing a tender mass in popliteal fossa
- Caused by RA, OA, cartilage tears
- May occasionally rupture and cause DVT-like picture of whole calf swelling
6. Bronchiectasis 
- Presents with copious sputum production, hemoptysis, cough, dyspnea, weight loss, fatigue, fevers, pseudomonas infections
- Vs chronic bronchitis which is more of a dry cough
- Work up: high res chest CT, if focal bronch to look for a mass/biopsy, if diffuse test for systemic disease (autoimmune titers, antibody levels for immune deficiency)
- Management: antibiotics, steroids to reduce airway inflammation, chest PT, decongestants/mucolytics
7. Bronchiectasis DDx
- Post infectious: viral, TB
- Immunodeficiency: hypogammaglobulinemia:
- Congenital: a1-antitrypsin, CF
- Obstructive: lung cancer
- Rheumatic/systemic diseases: RA, Sjogrens
- Toxin
8. Histoplasmosis
- Soil, bird, bat droppings; no person-to-person transmission

- Mild pulm disease in immunocompetent, disseminated disease in immunocompromised (pancytopenia, HSM, adenopathy, diffuse reticulonodular/cavitary pneumonia, mucocutaneous lesions). Mortality > 90% in untreated disseminated disease from shock. 

- Diagnose with urine or serum antigen (sens >95%). Other lab abnormalities: cytopenias, elevated LFTs, elevated LDH & ferritin, culture, microscopy. 

- Serum antibody testing is of questionable sensitivity in immunocompromised patients given impaired antibody response; skin testing is also of lower sensitivity, as is culture (60-70% sensitive) 

- Treat mild disease with nothing or PO itraconazole. 

- Treat severe disease (T>39.5/103, lab abnormalities, fungemia) with IV amphotericin B for 2 weeks, switch to oral itraconazole for 1 year once documented response. 

9. Foot pains

- Morton neuroma: pain between 3rd and 4th toes on plantar surface, with clicking sensation when palpating the space and squeezing metatarsal joints (Mulder sign)

- Stress fracture: pain over bony surface (2nd, 3rd, or 4th metatarsals most commonly) can be dorsal or plantar surface. Young female athelete with oligomenorrhea, poor nutrition, osteoporosis) 

- Plantar fasciitis: burning pain in plantar distribution, worse in AM, improves with activity, worsens at end of the day

- Tarsal tunnel syndrome: compression of tibial nerve as it goes through ankle; often s/p fracture. Burning pain in distal plantar surface of foot that can radiate up calf

- Tenosynovitis: usually in hands, following bite or puncture. pain and tenderness along tendon sheath esp with flexion/extension 

10. Premature ovarian failure:
- Symptoms: amenorrhea, hypoestrogenism, elevated FSH for 3 months
- May be due to accelerated follicle atresia or low number of primoridal follicles
- May be due to mumps, oophoritis, radiation, chemo
- May be associated with autoimmune diseases - hashimotos', type I DM, addisons', pernicious anemia.
- Implies lack of viable oocytes-- so the only treatment if the patient desires fertility is donor eggs/IVF.
- If patients have some ovarian reserve (PCOS for example) can induce ovulation with clomiphene citrate or pulsed GnRH agonists (continuous GnRH agonists suppress ovulation)