The "C" Word
SIADH, ectopic ACTH production, and Lambert-Eaton syndrome are linked with this type of lung cancer.
What is small cell lung cancer?
Bonus: Hypercalcemia (from a PTH-secreting tumor) can be caused by this type of lung/head/neck cancer.
Check this level on the chemistry panel when considering the possibility of hyponatremia.
What is glucose?
Bonus: This is the equation by which we obtain a correct sodium level in the presence of hyperglycemia.
This is the first and most important step in the management of severe hypercalcemia.
What is vigorous hydration with IV normal saline?
Bonus: This isotonic solution is preferrable in the treatment of hyperkalemia.
These are the USPSTF guidelines for annual screening with LDCT of the chest.
What are patients who are between fifty and eighty years of age, have smoked >/= twenty pack-years, and are either current smokers or who have quit within the past fifteen years?
This antibody is highly specific for RA (~97%), and portends a poorer prognosis.
What is anti-CCP?
In leukemias, in addition to cytopenia, patients often have these findings of tumor lysis syndrome due to the high cell turnover. [bonus if >2]
What are hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia?
Someone with hyponatremia would have to have this serum osmolality for it to be real.
What is less than 270-280?
Bonus: This substance comprises the lion's share of serum osmolality.
If the patient was already on metformin, cut the dose in half if the GFR levels dips somewhere within this range.
What is between thirty and 45?
People with one first-degree relative under sixty or two first-degree relatives of any age diagnosed with colorectal cancer or advanced adenoma should begin getting colonoscopies at this age.
What is forty years or ten years younger than the age at which the index case is diagnosed—whichever is earlier.
Bonus: These are the two Tier One modalities of colon cancer screening.
This is confirmed by the presence of rhomboid-shaped, positively birefringent (blue when parallel) crystals on polarized light microscopy, along with inflammatory joint fluid (>2,000 cell/mcL).
What is calcium pyrophosphate deposition disease (CPPD, or pseudo-gout)?
Bonus: These crystals are found in gout.
Treatment of acute promyelocytic leukemia differs from treatment of other types of AML in that it includes this, along with either arsenic trioxide or daunorubicin.
What is all-trans retinoic acid?
This electrolyte acts similarly to a thiazide diuretic in helping to lower blood pressure, and is recommended to be consumed in moderation in those with kidney disease.
What is potassium?
Bonus: Determine this electrolyte level in a patient with hypokalemia of unknown cause.
This mutation induces unregulated erythropoiesis. It is found in almost all patients with polycythemia vera and in about half of those with essential thrombocytopenia or primary myelofibrosis.
What is JAK2?
If you order a PSA to screen for prostate cancer, if PSA is >4 ng/mL or more than age-specific upper limit of normal, this is the next step.
What is transrectal U/S-guided needle biopsy?
This is the preferred initial monotherapy for most patients with early active rheumatoid arthritis: specifically, those with moderate-to-severe RA without poor prognostic features.
What is methotrexate?
This is the follow-up interval for hyperplastic polyps discovered on colonoscopy.
What is every ten years? (These have no malignant potential and contain no features of dysplasia.)
Bonus/Salvage: Patients with more than ten adenomas should repeat colonoscopy in this amount of time.
Use 3% saline infusions for severe hyponatremia (<125 mEq/L) of either less than this many hours' duration, or more than that many hours' duration but with severe symptoms (coma or seizure).
What are 48 hours?
Perform this test in patients with endocarditis caused by either Streptococcus gallolyticus (FKA bovis) or Clostridium septicum.
What is a colonoscopy? (These spp. are associated with colorectal cancer.)
The USPSTF recommends screening for osteoporosis with DEXA to prevent osteoporotic fracture in women this age or older.
What is 65 years?
Bonus: Use this tool to calculate the ten-year probability of fracture with bone mineral density data.
Supplementation with this, known as leucovorin rescue, reduces the risk for MTX side effects, including bone marrow suppression, peumonitis, elevated LFTs, and oral ulcers.
What is folate?
The combination of increased blast cell count (>100,0000/mL) and decreased tissue perfusion can increase the viscosity of the blood, thereby causing end-organ disease, such as stroke or respiratory distress: a phenomenon known as this.
What is leukostasis?
Bonus/Salvage: Hyperviscosity symptoms can also occur with this. [bonus for >1]
This is the urine osmolality that we can expect in someone whose hyponatremia is due to the tea and toast diet, beer drinker's potomania, or primary polydipsia.
What is less than 100?
Bonus: SIADH tends to manifest with this urine sodium level, and this urine osmolality.
Patient with a CD4# or lymphocyte% less than this should be given preventive therapy for PCP. [bonus for both]
What is 200/mm3 or 14%?
Besides those 65 years of age or older, give a pneumococcal vaccine in adults with these comorbidities. [bonus for >1]
What is...
HCQ is used for mild RA diease activity (and is commonly used for SLE). It is safe in pregnancy. This is its main side effect, seen in 1/5,000 patients after prolonged usage.
What is retinopathy?