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FM Learner
105 Topics*
Allergy*
Dehydration*
Epistaxis*
Fatigue*
Immigrants*
Loss of Consciousness*
Loss of Weight*
Pain*
Palliative*
Periodic Screening*
Red Eye*
Renal Failure*
Sexual Assault*
Shortness of Breath*
Smoking Cessation*
Travel Medicine*
Trauma*
♥
ACLS*
Acute Coronary Syndrome
Anemia*
Iron-Deficiency Anemia
B12 Deficiency Anemia
Atrial Fibrillation*
Chest Pain*
DVT*
EKG
Heart Failure*
Hyperlipidemia*
Hypertension*
INR
Ischemic Heart Disease*
Pulmonary Embolism
Derm*
Acne
Fungal Disease
Genital Ulcers
Lacerations*
Leg edema
Psoriasis
Rosacea
Urticaria/Angioedema
GI
Abdominal Pain*
Abnormal Liver Tests
Anorectal pathology
Biliary disease
Celiac
Diarrhea*
Dyspepsia*
GI Bleed*
Hepatitis*
Inflammatory Bowel Disease
Irritable Bowel Syndrome
Steatotic Liver Disease
Endo
Diabetes*
Diabetic Ulcer
DKA/HHS
Hyperkalemia
Hyponatremia
Obesity*
Osteoporosis*
Thyroid*
Thyroid Nodule
ID*
Antibiotic Classes
Cellulitis
Dysuria* / UTI*
Earache* / AOM
Fever*
Immunization*
Meningitis*
Pharyngitis
Pneumonia*
Rhinosinusitis
STIs*
URTI*
MSK
Fibromyalgia
Fractures*
Gout
Joint Disorder*
Knee Pain
Neck Pain*
Low-back Pain*
Nocturnal Leg Symptoms
Polymyalgia Rheumatica
Rheumatoid Arthritis
Shoulder Pain
Neuro
Bell's Palsy
Concussion / mTBI
Dementia*
Dizziness*
Tremor
Seizures*
Stroke*
Parkinsonism*
Headache*
OBGYN
Vaginitis*
Vaginal Bleeding*
Urinary Incontinence
Pregnancy Termination
Pregnancy*
Postpartum Complications
Polycystic Ovarian Syndrome
Nipple Discharge
Menopause*
Infertility*
Hypertensive Disorders of Pregnancy
Contraception*
Breast Lump*
Peds
NRP
Pediatric Fractures
Petechiae/Purpura
Pediatric UTI
Pediatric Urology
Pediatric Shock
Pediatric Fever
PALS
Newborn*
Neonatal Jaundice
In Children*
Well-baby Care*
Food protein-induced proctocolitis
Failure to Thrive
Infantile Colic
Hip Pain
Febrile Seizure
Enuresis
Encopresis
Croup*
Ψ
ADHD
Anxiety*
Bipolar
Depression* / Suicide*
Eating Disorders*
Insomnia*
Personality Disorder*
Poisoning*
Schizophrenia*
Somatization*
Substance Use*
Alcohol Use and Withdrawal
Opioid Use
Resp
Hemoptysis
Cough*
COPD*
Asthma*
Uro
Interstitial Cystitis
Hematuria
Nephrolithiasis
Prostate*
Sex*
Other
Bedside Ultrasound
Central Line
Chest Tube
Intraosseous Line
Intubation
Lumbar Puncture
Medical Marijuana
Medical Education
Medical Assistance in Dying
Procedural Sedation
SAMPs
SOOs
Urine dipstick
FM Learner
105 Topics*
Allergy*
Dehydration*
Epistaxis*
Fatigue*
Immigrants*
Loss of Consciousness*
Loss of Weight*
Pain*
Palliative*
Periodic Screening*
Red Eye*
Renal Failure*
Sexual Assault*
Shortness of Breath*
Smoking Cessation*
Travel Medicine*
Trauma*
♥
ACLS*
Acute Coronary Syndrome
Anemia*
Iron-Deficiency Anemia
B12 Deficiency Anemia
Atrial Fibrillation*
Chest Pain*
DVT*
EKG
Heart Failure*
Hyperlipidemia*
Hypertension*
INR
Ischemic Heart Disease*
Pulmonary Embolism
Derm*
Acne
Fungal Disease
Genital Ulcers
Lacerations*
Leg edema
Psoriasis
Rosacea
Urticaria/Angioedema
GI
Abdominal Pain*
Abnormal Liver Tests
Anorectal pathology
Biliary disease
Celiac
Diarrhea*
Dyspepsia*
GI Bleed*
Hepatitis*
Inflammatory Bowel Disease
Irritable Bowel Syndrome
Steatotic Liver Disease
Endo
Diabetes*
Diabetic Ulcer
DKA/HHS
Hyperkalemia
Hyponatremia
Obesity*
Osteoporosis*
Thyroid*
Thyroid Nodule
ID*
Antibiotic Classes
Cellulitis
Dysuria* / UTI*
Earache* / AOM
Fever*
Immunization*
Meningitis*
Pharyngitis
Pneumonia*
Rhinosinusitis
STIs*
URTI*
MSK
Fibromyalgia
Fractures*
Gout
Joint Disorder*
Knee Pain
Neck Pain*
Low-back Pain*
Nocturnal Leg Symptoms
Polymyalgia Rheumatica
Rheumatoid Arthritis
Shoulder Pain
Neuro
Bell's Palsy
Concussion / mTBI
Dementia*
Dizziness*
Tremor
Seizures*
Stroke*
Parkinsonism*
Headache*
OBGYN
Vaginitis*
Vaginal Bleeding*
Urinary Incontinence
Pregnancy Termination
Pregnancy*
Postpartum Complications
Polycystic Ovarian Syndrome
Nipple Discharge
Menopause*
Infertility*
Hypertensive Disorders of Pregnancy
Contraception*
Breast Lump*
Peds
NRP
Pediatric Fractures
Petechiae/Purpura
Pediatric UTI
Pediatric Urology
Pediatric Shock
Pediatric Fever
PALS
Newborn*
Neonatal Jaundice
In Children*
Well-baby Care*
Food protein-induced proctocolitis
Failure to Thrive
Infantile Colic
Hip Pain
Febrile Seizure
Enuresis
Encopresis
Croup*
Ψ
ADHD
Anxiety*
Bipolar
Depression* / Suicide*
Eating Disorders*
Insomnia*
Personality Disorder*
Poisoning*
Schizophrenia*
Somatization*
Substance Use*
Alcohol Use and Withdrawal
Opioid Use
Resp
Hemoptysis
Cough*
COPD*
Asthma*
Uro
Interstitial Cystitis
Hematuria
Nephrolithiasis
Prostate*
Sex*
Other
Bedside Ultrasound
Central Line
Chest Tube
Intraosseous Line
Intubation
Lumbar Puncture
Medical Marijuana
Medical Education
Medical Assistance in Dying
Procedural Sedation
SAMPs
SOOs
Urine dipstick
More
105 Topics*
Allergy*
Dehydration*
Epistaxis*
Fatigue*
Immigrants*
Loss of Consciousness*
Loss of Weight*
Pain*
Palliative*
Periodic Screening*
Red Eye*
Renal Failure*
Sexual Assault*
Shortness of Breath*
Smoking Cessation*
Travel Medicine*
Trauma*
♥
ACLS*
Acute Coronary Syndrome
Anemia*
Iron-Deficiency Anemia
B12 Deficiency Anemia
Atrial Fibrillation*
Chest Pain*
DVT*
EKG
Heart Failure*
Hyperlipidemia*
Hypertension*
INR
Ischemic Heart Disease*
Pulmonary Embolism
Derm*
Acne
Fungal Disease
Genital Ulcers
Lacerations*
Leg edema
Psoriasis
Rosacea
Urticaria/Angioedema
GI
Abdominal Pain*
Abnormal Liver Tests
Anorectal pathology
Biliary disease
Celiac
Diarrhea*
Dyspepsia*
GI Bleed*
Hepatitis*
Inflammatory Bowel Disease
Irritable Bowel Syndrome
Steatotic Liver Disease
Endo
Diabetes*
Diabetic Ulcer
DKA/HHS
Hyperkalemia
Hyponatremia
Obesity*
Osteoporosis*
Thyroid*
Thyroid Nodule
ID*
Antibiotic Classes
Cellulitis
Dysuria* / UTI*
Earache* / AOM
Fever*
Immunization*
Meningitis*
Pharyngitis
Pneumonia*
Rhinosinusitis
STIs*
URTI*
MSK
Fibromyalgia
Fractures*
Gout
Joint Disorder*
Knee Pain
Neck Pain*
Low-back Pain*
Nocturnal Leg Symptoms
Polymyalgia Rheumatica
Rheumatoid Arthritis
Shoulder Pain
Neuro
Bell's Palsy
Concussion / mTBI
Dementia*
Dizziness*
Tremor
Seizures*
Stroke*
Parkinsonism*
Headache*
OBGYN
Vaginitis*
Vaginal Bleeding*
Urinary Incontinence
Pregnancy Termination
Pregnancy*
Postpartum Complications
Polycystic Ovarian Syndrome
Nipple Discharge
Menopause*
Infertility*
Hypertensive Disorders of Pregnancy
Contraception*
Breast Lump*
Peds
NRP
Pediatric Fractures
Petechiae/Purpura
Pediatric UTI
Pediatric Urology
Pediatric Shock
Pediatric Fever
PALS
Newborn*
Neonatal Jaundice
In Children*
Well-baby Care*
Food protein-induced proctocolitis
Failure to Thrive
Infantile Colic
Hip Pain
Febrile Seizure
Enuresis
Encopresis
Croup*
Ψ
ADHD
Anxiety*
Bipolar
Depression* / Suicide*
Eating Disorders*
Insomnia*
Personality Disorder*
Poisoning*
Schizophrenia*
Somatization*
Substance Use*
Alcohol Use and Withdrawal
Opioid Use
Resp
Hemoptysis
Cough*
COPD*
Asthma*
Uro
Interstitial Cystitis
Hematuria
Nephrolithiasis
Prostate*
Sex*
Other
Bedside Ultrasound
Central Line
Chest Tube
Intraosseous Line
Intubation
Lumbar Puncture
Medical Marijuana
Medical Education
Medical Assistance in Dying
Procedural Sedation
SAMPs
SOOs
Urine dipstick
Tremor
General Overview
Children with tremor is potentially serious (Wilson, fragile X, nutritional deficiency, heavy metal, essential) - refer to neuro
Types of Tremor
Resting (most commonly
parkinsonism
)
Action
Postural - against gravity (essential, physiologic, cerebellar, dystonic, drug-induced)
Isometric - contraction against stationary object
Kinetic - any form of voluntary movement (essential, cerebellar, dystonic, drug-induced)
Intention - amplified as target reached (cerebellum)
Enhanced Physiologic Tremor
Normal tremor enhanced by anxiety, stress, medication, caffeine, fatigue
Does not need further testing
Essential Tremor
Action tremor - postural, kinetic, may even be sporadic resting
Bilateral involving wrists/hands, head, lower extremities, voice
50% of cases are autosomal-dominant
Parkinsonism
Resting, low-frequency, pill-rolling fingers, progression to forearm pronation/supination and elbow flexion/extension tremor
Typically unilateral, rest, and fades with voluntary movement
Can involve leg and jaw as well
Associated with classic parkinsonism syndrome (bradykinesia, rigidity, postural instability)
Drug-Induced Tremor
r/o medication use in new-onset tremor
Metabolic-Induced Tremor
Consider work-up for hepatic encephalopathy (ammonia), hypocalcemia, hypoglycemia, hyponatremia, hypomagnesemia, hyperthyroidism, hyperparathyroidism, B12 deficiency
Cerebellar Tremor
Disabling, low-frequency, slow-intention or postural tremor (r/o MS, stroke, brainstem tumor)
Most have signs of cerebellar dysfunction - dysmetria (overshoot on finger-to-nose), dyssynergia (abnormal heel-to-shin) and hypotonia)
Psychogenic
Abrupt onset, spontaneous remission, changing tremor characteristics (location, frequency), and extinction with distraction
References:
AAFP 2018.
https://www.aafp.org/afp/2018/0201/p180.html
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