Better Safe Than Sorry
Lub Dub Club
Saturday Derm Consult
Not That Much Worse
My Spotify Wrapped
100
Initiate this therapy for incidental moderate-to-severe coronary atherosclerosis on noncardiac CT.
What is high-intensity statin?
100
Name the S2 phenomenon, in which inspiration delays P2 and widens the A2–P2 interval.
What is physiologic splitting?
Inspiration increases right heart filling, which delays P2 and widens A2-P2 interval
100
This common drug eruption shares the morphology of early DRESS but has a shorter latency (typically 1–2 weeks).
What is morbilliform drug eruption?
Morbilliform drug eruption: 1-2 weeks after drug initiation (1-3 days after if previously sensitized)
DRESS: 2-8 weeks after drug initiation
100
In a noninferiority trial, this prespecified value represents the maximum amount the intervention can fall short of the control and still be considered "not much worse."
What is the noninferiority margin (delta)?
100
Classy, bougie, ratchet
Sassy, mood, nasty
What is Savage (by Megan Thee Stallion)?
200
Order an A1C on hospitalized patients with an admission blood glucose above this threshold.
What is 140 mg/dL?
200
During the strain phase of the Valsalva maneuver, decreased preload softens most murmurs but intensifies/lengthens these two murmurs.
What are HOCM and MVP?
HOCM: decreased preload augments outflow murmur
MVP: reduced LV volume shifts the click and murmur earlier in systole, lengthening the audible murmur
200
Name 3 of the 5 most common drugs associated with DRESS in the United States.
What are (1) allopurinol, (2) vancomycin, (3) lamotrigine, (4) carbamazepine, and (5) trimethoprim-sulfamethoxazole?
200
Interpret the second outcome of the following noninferiority study.
Options include noninferiority, inferiority, superiority, inconclusive.
What is noninferiority?
The upper limit of the confidence interval is less than the noninferiority margin
200
To the window
To the wall
What is Get Low (by Lil Jon)?
300
Utilize these two screening tools in medically hospitalized patients at increased risk for OSA.
What are the STOP-BANG questionnaire and overnight continuous pulse oximetry?
AASM Guidelines (conditional recommendation)
300
***DAILY DOUBLE***
Upon hearing an interscapular systolic murmur, evaluate for this most commonly associated cardiac defect.
What is a bicuspid aortic valve?
Bicuspid aortic valve coexists in the majority (50-75%) of patients with coarctation of the aorta.
300
Order these viral serologies in patients with suspected DRESS, as viral reactivation is an observed phenomenon.
What are human herpesvirus (HHV-6, HHV-7, EBV, CMV)?
Viral reactivation may be a marker for chronicity as well as a prognostic marker for disease severity
300
Interpret the fifth outcome of the following noninferiority study.
Options include noninferiority, inferiority, superiority, inconclusive.
What is inferiority?
The upper limit of the confidence interval is greater than the noninferiority margin AND the confidence interval excludes 1
300
Because
When the sun shine, we shine together
Told you I'll be here forever
Said I'll always be your friend
Took an oath, I'ma stick it out to the end
What is Umbrella (by Rihanna)?
400
Measure this value at the L1 vertebral body on an inpatient CT to opportunistically screen for osteoporosis.
What are Hounsfield units?
<100 HU: PPV 68%
>200 HU: NPV 99%
400
Perform echocardiography in asymptomatic patients with any of these ausculatory findings.
What are diastolic murmurs, continuous murmurs, holosystolic murmurs, grade ≥3 midsystolic murmurs, late systolic murmurs?
400
***DAILY DOUBLE***
After recovery from DRESS, monitor patients for the development of these medical conditions, which can appear months-years later.
What are autoimmune sequale?
Most commonly autoimmune thyroiditis and T1DM
400
Perform both intention-to-treat (ITT) and per-protocol (PP) analysis in noninferiority studies, as ITT introduces bias toward this outcome.
What is noninferiority?
Crossovers, nonadherence, and dropout dilute difference between treatment arms, making them look similar (the very thing a noninferiority study is trying to prove)
400
This one is for the boys with the boomin' system
Top down, AC with the cooler system
When he come up in the club, he be blazin' up
Got stacks on deck like he savin' up
What is Super Bass (by Nicki Minaj)?
500
Use this two-tier screening approach for advanced liver fibrosis when hepatic steatosis is incidentally found on imaging.
What is FIB-4 index followed by VCTE (e.g. FibroScan)?
500
Use this terminology to describe S2 splitting in an ASD as compared to a VSD.
What is wide fixed splitting (as compared to physiologic splitting)?
Wide: chronic left-to-right shunt causes RV volume overload and increased flow across pulmonic valve, delaying P2 and widening A2-P2 interval
Fixed: inspiratory rise in venous return is offset by reciprocal drop in left-to-right shunt flow, keeping RV filling and thus A2-P2 interval constant
500
List 5 of the 7 components of the RegiSCAR score used to determine the likelihood of DRESS.
What are (1) fever ≥38.5°C, (2) lymphadenopathy at ≥2 sites, (3) eosinophilia, (4) atypical lymphocytes, (5) rash (>50% BSA, morphology consistent with DRESS, or suggestive biopsy), (6) internal organ involvement, and (7) resolution time >15 days?
500
Interpret the fourth outcome of the following noninferiority study.
Options include noninferiority, inferiority, superiority, inconclusive.
What is inconclusive?
The upper limit of the confidence interval is greater than the noninferiority margin AND the confidence interval includes 1, suggesting an underpowered comparison
500
I'm having wicked dreams of leaving Tennesse
Hear Santa Monica, I swear it's callin' me
Won't make my mama proud, it's gonna cause a scene
She sees her baby girl, I know she's gonna scream
What is Pink Pony Club (by Chappell Roan)?