March Madness
This medication is first line for management of movement symptoms in Parkinson Disease
Carbidopa-levodopa
179445
A 64-year-old woman presents for evaluation of urinary incontinence. She reports that for the past year, she has been losing large amounts of urine after a strong sensation of needing to void. She reports no dysuria or pelvic pain and does not experience urinary leakage with coughing or laughing. What is the most likely diagnosis?
Urge incontinence
513189
What is the most effective first-line pharmacotherapy for moderate symptoms of allergic rhinitis?
Glucocorticoid nasal spray daily
129754
A 32-year-old man presents with shaking chills, fever, severe headache, and nausea. His symptoms seem to wax and wane and are separated by periods of fatigue. Recent travel history reveals that he returned from visiting family in Kenya approximately 2 weeks ago. Physical exam reveals a palpable spleen.
Malaria - Anopheles mosquito
679376
This now common spring figure is thought to originate from Germany, with the first known mention from a 1572 German text which translates to: “Do not worry if the ________ escapes you; should we miss his eggs, we will cook the nest”
Easter Bunny
A 35-year-old man presents to the clinic with a three-month history of worsening involuntary facial movements. He also describes feelings of depression. Physical exam is significant for rapid, non-stereotyped involuntary movements of his face, mild bradykinesia, hypotonia, and hyperreflexia. What is the most likely diagnosis?
Huntington Disease
125042
In what anatomical location of the prostate do most prostate cancers arise?
The peripheral zone.
644173
A 32-year-old man presents to the clinic for an annual physical examination after recently moving to the area. He reports a history of developing facial swelling and diffuse urticaria after taking amoxicillin. Which other class of medications would he most likely have an allergic reaction to?
Cephalosporins - More likely with 1st generation
A 21 y/o male presents with 2 days of malaise, fever, anorexia, and painless swelling of the upper and lower eyelids on the right side. He recently returned from a mission trip to rural Panama 2 weeks ago.
Chagas' disease - Kissing bug (Triatoma)
What traditional spring celebration in Europe involves weaving ribbons around a tall, decorated pole?
Maypole dancing
This is the most commonly identified cause of sporadic encephalitis worldwide and can present with fever, altered mental status, focal neurologic deficits, seizures, and behavioral changes. Temporal lobe edema can be seen on MRI
Herpes simplex virus type 1 encephalitis
170653
This cause of renal artery stenosis is more often seen in younger patients and presents with a “string of beads” appearance on renal arteriography
Fibromuscular dysplasia
105971
A 28-year-old man was exposed to poison ivy. 2 days after exposure, he developed a pruritic, erythematous, papulovesicular eruption on his arms and neck. He was given a 6 day oral methylprednisolone taper. His condition began to improve, but on day 6, he noted a dramatic exacerbation of the eruption, with intense pruritus, erythema, and vesiculation involving extensive areas of his arms, neck, and face. What would be the most appropriate management at this time?
Oral prednisone 60 mg PO tapered over 2 weeks
387623
A 20-year-old man presents to the clinic with a two-day history of malaise, severe headache, nausea, fever, myalgias, and arthralgias. He reports he was camping last week. This morning, he noticed a nonpruritic rash on his ankles and wrists that appears to be spreading proximally toward his trunk. Physical examination reveals a blanching erythematous rash with macules ranging in size from 1 to 4 mm in diameter over his upper and lower extremities. What is the most likely diagnosis?
Rocky Mountain spotted fever - Dermacentor tick
120663, 138783
What is the name of the first day of spring when day and night are nearly equal in length?
The Vernal Equinox
A 10-year-old boy is brought to the clinic by his mother. She states that her son was doing his math homework when he suddenly began rapidly blinking his eyes and smacking his lips. The episode lasted about 15 seconds. She says this has occurred several times in the past but seems to be getting worse. What is the first-line treatment for this patient’s most likely condition?
Ethosuximide
175721
What is the most common histologic type of bladder cancer in the United States?
Transitional cell (urothelial) carcinoma
103543
This type of hypersensitivity reaction involves IgE mediated mast cell degranulation and includes seasonal allergies, food allergies, and anaphylaxis.
A 35-year-old man presents to the clinic with fever, chills, and muscle ache. He hiked in the woods near his home in the Nashville suburbs about a week earlier. Exam shows a diffuse erythematous rash on his trunk. CBC reveals leukopenia and thrombocytopenia. A peripheral smear shows clusters of organisms present in monocyte vacuoles.
Human monocytic ehrlichiosis (HME) - Lone star tick
156001
What are the 3 spring Zodiac signs?
Aries - March 21 to April 19
Taurus - April 20 to May 20
Gemini - May 21 to June 20
A 65-year-old man presents to the clinic to establish care. He describes a 4-year history of slowly progressing rigidity and gait difficulties and has had three falls in the last 2 months, none of which resulted in an injury. Physical examination reveals gait ataxia, bradykinesia, and slowing of vertical saccades. What is the most likely diagnosis?
Progressive supranuclear palsy
100586
This infantile syndrome is characterized by pulmonary hypoplasia, positional limb deformities, and characteristic facial features (recessed chin, flattened nose, pseudoepicanthus, and posteriorly rotated, flattened ears) as a result of severe oligohydramnios.
Potter syndrome
171554
A 45-year-old man presents to the ED with severe cellulitis of his left leg. He is started on IV vancomycin. He reports intense pruritus and lightheadedness 10 minutes after the infusion is initiated. Erythema is noted on his face and neck, and his lungs are clear to auscultation. He has a HR of 110 bpm and vitals are otherwise normal. What is the best next step in management?
Administer intravenous diphenhydramine and suspend the infusion
198983
A 67-year-old man presents to the clinic with a three-day history of fever, chills, malaise, arthralgia, myalgia, and headache after camping two weeks ago. He has no abdominal pain, diarrhea, or vomiting. Physical examination is normal with no rash, except for evidence of an insect bite on his right lower extremity. Laboratory studies reveal leukopenia and intracytoplasmic inclusions within neutrophils on peripheral blood smear.
Human granulocytic anaplasmosis - Ixodes scapularis tick
101841
This is the scientific term for the distinctive, earthy, and often pleasant smell that fills the air after rainfall.
Petrichor
Put the following in the appropriate controlled substance class:
Oxycodone
Testosterone
Pregabalin (Lyrica)
Lisdexamfetamine (Vyvanse)
Eszopiclone (Lunesta)
Oxycodone - II
Testosterone - III
Pregabalin (Lyrica) - V
Lisdexamfetamine (Vyvanse) - II
Eszopiclone (Lunesta) -IV