Heart
Lung
ID
Brain
GI
100
What should you give for endocarditis prophylaxis for a dental procedure?
Amoxicillin
100
Treatment for a patient with COPD who has been having consistent dyspnea while walking uphill but can walk on a level surface easily. No hospitalizations or exacerbations. Has been using albuterol multiple times a week.
LABA or LAMA (GOLD Criteria type A)
100
What are the first line treatment for outpatient pyelonephritis
Ciprofloaxin
100
What is the diagnosis for a patient with a year long history of behavioral changes, which has progressed to decreased movement. Has been seeing animals and people who were not there. Clock drawing and delayed recall are impaired, language is intact, Narrow based gait and short stride, masked facies, cogwheel rigidity, and stooped posture.
Lewy-Body dementia
100
What is the indication for steroid use in acute alcoholic hepatitis
MELD score > 20
200
Mobitz type 2
200
What is the next step in management for a 61 year old male patient, hx of smoking with a 7 mm nodule
CT in 6-12 mos, and then if stable repeat in 18-24 mos
200
Antibiotic prophylaxis is recommended in Lyme disease if what criteria are met?
- Tick is blacklegged deer tick
- Tick is attached ≥36 hours
- Antibiotics can be started within ≤72 hours of tick removal
- Patient is not pregnant or lactating
200
What is the usual pathophysiology explaining the image below? 
When an arterial structure is breached usually from trauma, limited by dural attachments
200
How do you treat mild left sided ulcerative colitis (Gi bleeds, mild left sided abdominal pain)
Oral mesalamine and mesalamine enemas
300
What are the criteria for cardiac resynchronization therapy in heart failure?
Heart failure < 35% and LBBB
300
Intrathoracic variable obstruction
300
62year old with COPD, smoking hx presents from home with fever, sob, pleuritic chest pain, confusion/disorientation and cough. Respiratory rate 24, Temperature 35.4, BUN 25, Sodium 128. CXR revealed multilobar infiltrates.
Where should the patient go (Floor, Observation, ICU) and what treatment should this patient get?
ICU. Ceftriaxone and doxycycline.
300
What is the treatment for:
a patient with a 5 year history of head tremor and family history of head tremors, rhythmic flexion-extension that does not change when asked to turn or tild head to either side, along with mild tremors in the bilateral upper extremities when holding hands in an outstretched position and while writing. (there are three, I need one)
Primidone
Propranolol
Topiramate
300
A patient underwent a colonoscopy in which resulted in 7 adenomas that ranged 6-8 mm in size, all taken out. When should the next colonoscopy be?
3 years
400
A 72-year-old woman is evaluated in the emergency department for a 2-hour history of mild substernal chest discomfort and shortness of breath. One year ago, she had an ischemic stroke with no residual neurologic effects. Troponins negative. EKG below. Next step in management?
Get posterior leads
400
What is the treatment for a patient with COPD GOLD Criteria E, currently remains symptomatic with multiple exacerbations despite tiotropium, fluticasone-salmeterol, and albuterol. Has completed pulmonary rehab.
IgE level normal
Eosinophil count elevated
Dupilumab
400
What is the most likely cause of fever, neck pain, cervical lymphadenitis, acid fast staining in lymph nodes in a patient with advanced HIV just starting ART therapy
MAC lymphadenitis
400
Patient w/ PMH of multiple sclerosis originally presents with painful acute monocular vision loss, blurry vision that developed in 2 days. Fundoscopic exam revealed pale, flat optic disc. What is the diagnosis and treatment?
optic neuritis - IV methylprednisolone
400
What is the next best step in management in a patient chronic diarrhea, bloating, weight loss, constipation, who currently is off a gluten free diet and has noted improvement in their symptoms.
HLA DQ2, DQ8
500
What is the treatment for exertional angina that is unresponsive to medications and the patient is not a candidate for PCI or CABG?
External counter pulsation/Spinal cord stimulation
500
What is the treatment for a patient with OSA who is intolerant to CPAP, Apnea-Hypopnea index > 30, and BMI of 33.
Maxomandibular advancement surgery
500
How would you treat a female patient with:
Stable vitals
Fever, leukocytosis
Vaginal discharge
TVUS revealing tubulo-ovarian abscess size of 4cm. Normal appendix
Ceftriaxone, doxycycline, metronidazole.
500
24 year old who sustained a mild closed head injury in a vehicle rollover collision 2 years ago complaining for headaches after the injury. The pain is global, pressure like and moderate in intensity, with no nausea/visual/neurological complaints. Lasts 3 days a week and persists for 6-8 hours. Improves mildly with ibuprofen and exercise. MRI is unremarkable. What is the most appropriate treatment?
amitriptyline
500
How to treat H. Pylori infection which is still persisting despite quadruple therapy with PPI, bismuth subcitrate , tetracycline, metronidazole
