Bugs
Picture this
<3
What is ast you ask?
Thanksgiving!
100
The most common pathogen to cause Lemierre syndrome?
What is Fusobacterium necrophorum?
100
A 23-year-old woman is admitted to the hospital with fulminant liver failure and hemolytic anemia. She has a history of behavioral problems. 
What is the diagnosis?
Alpha-1 antitrypsin deficiency
Autoimmune hepatitis
Hemochromatosis
Hepatolenticular degeneration (Wilson disease)
What is Wilson disease
Kayser-Fleischer rings, which are circumferential discolorations that occur in the cornea due to copper deposition
100
What did the left heart cath show?
Occlusion of RCA
(inferior STEMI)
100
How would you describe AST to a patient who asked?
An enzyme that is found in the liver and muscle which helps with protein building.
An enzyme, aspartate transaminase, that catalyzes the interconversion of aspartate and glutamate which is crucial for amino acid degradation and biosynthesis.
100
This is the percentage of people who eat Turkey on Thanksgiving (per a random website I found):
A. 66%
B. 77%
C. 88%
D. 99%
C. 88%
200
A 61-year-old man is evaluated for fever, cough, hypoxic respiratory failure, and a pulmonary infiltrate. He produces a sputum specimen for Gram stain.
Anerobic organisms
Mycoplasma pneumoniae
Poor-quality sputum specimen
Streptococcus pneumoniae
What is a poor-quality sputum specimen?
- presence of squamous epithelial cells with mixed population of organisms
200
What is shown here?
What is ascites?
200
Name the abnormality
What is a RBBB?
200
Why does AST rise disproportionately to ALT in alcoholic hepatitis?
Direct damage to mitochondria results in release of AST into serum. Also, there is decreased ALT activity due to B6 depletion in the liver of patients with AUD.
200
This professional football team has played almost every Thanksgiving since 1934
Detroit Lions
(Dallas cowboys, every year since 1975)
300
What is a praying mantis?
300
A 33-year-old woman is evaluated for acute onset of productive cough and fever.
What is the diagnosis?
Acute bronchitis
RLL PNA
RML PNA
RUL PNA
What is a RLL PNA?
300
Describe the rhythm
What is 3rd degree heart block?
300
Where are ALT and AST located?
ALT: only in hepatocyte cytoplasm
AST: hepatocyte cytoplasm + mitochrondria
300
This balloon character has flown more than any other balloon in the Macy's Thanksgiving Day Parades
Snoopy
400
A 56-year-old man is evaluated for hemoptysis. He has a past history of previously treated cavitary tuberculosis.
An enlarged image from a frontal radiograph is shown.
Aspergilloma
Lung caner
PE
Reactivation TB
What is an aspergilloma?
Fungus balls form in cavitary lesions of the lung, most often present owing to conditions such as tuberculosis, bronchiectasis, carcinoma, or lung abscesses. They may be asymptomatic or present with complications, such as hemoptysis. 
400
A 76-year-old man is evaluated for a 9-month history of progressive shortness of breath without cough or wheezing.
what is the most likely diagnosis?
Asbestosis
Idiopathic pulm fibrosis
Mesothelioma
Nonspecific interstitial pneumonia
What is asbestosis?
calcified pleural plaques, diffuse pleural thickening, parenchymal bands. Patients overtime develop pulmonary fibrosis caused by inhalation of asbestos fibers.
400
What is the rate and rhythm?
Sinus tach, ~114
400
If the hepatic proportion of AST/ALT is 2.5:1, why is the baseline level of AST not twice as high in healthy individuals?
AST is removed from serum by the liver sinusoids twice as quickly (half life = 18hr compared to 36 hours of ALT).
400
Scientific name for a female turkey?
Hen
(male = tom)
500
A 26-year-old woman is evaluated for fever, painful tenosynovitis, migratory polyarthralgia, and the skin lesions shown.
Disseminated gonococcal infection
HSV
Scabies
Secondary syphilis
Disseminated gonococcal infection
500
A 31-year-old man is evaluated for a 3-week illness consisting of fever, dyspnea, and dry cough. He has risk factors for HIV infection. What is the most likely infection? 
Angioinvasive Aspergillosis
Miliary TB
Pneumococcal pneumonia
Pneumocystis pneumonia
What is Pneumocystis pneumonia?
500
Name one treatment options if you see this on the EKG:
1. vagal
2. adenosine
3. cardioversion (if unstable)
500
A 45-year-old woman is evaluated at follow-up for abnormal alkaline phosphatase levels on three previous blood tests. She has mild pruritus. She has no family history of liver disease. She has no other medical concerns and does not take any medications.
Vital signs and other physical examination findings are normal.
Her complete blood count and alanine aminotransferase, aspartate aminotransferase, serum albumin, serum total bilirubin, and total protein are within normal limits. The alkaline phosphatase level is 212 U/L.
Which do you preform next:
AMA
Anti-smooth muscle antibody
Liver biopsy
Serum IgG4
What is AMA?
500
How many calories are in a typical holiday dinner?
1500
2000
2500
3000
3000