Asthma + COPD
State the FEV1/FVC Ratio for COPD Diagnosis?
Post-bronchodilator ratio <0.70 confirms COPD
Which screening tool is preferred for debating outpatient vs inpatient treatment for patients?
Pneumonia Severity Index (PSI)
Perferred medications for treatment of Latent TB?
Once-weekly isoniazid and rifapentine for 12 weeks now recommended over isoniazid for 9 months
A 38-year-old man presents to your sick clinic in the summer of 2026 with 3 days of profuse, non-bloody diarrhea. He denies recent travel or sick contacts but reports eating prepackaged salads daily for the 2 weeks before symptom onset. What is the recommended treatment to shorten the duration of his illness?
Supportive care and hydration are foundational for treatment of Cyclospora infections. Although most healthy people will recover fully without antibiotics, treatment reduces the disease course, which may otherwise persist for weeks to months. Trimethoprim/sulfamethoxazole is the first-line treatment. For healthy adults, the dose is 160 mg/800 mg two times per day for 7 to 10 days. For healthy children 2 months of age or older, the dose is 8 to 10 mg/kg trimethoprim and 40 to 50 mg/kg sulfamethoxazole per day, orally, in two divided doses for 7 to 10 days.
What famous Marvel actor recently died after a battle with colorectal cancer?
Chadwick Boseman (RIP)
What is the first line treatment for COPD?
LAMA or LABA or LABA/LAMA
LAMA: tiotropium, umeclidinium, and aclidinium
LABA: salmeterol (often sold as Serevent Diskus), formoterol, or vilanterol.
LAMA/LABA combinations:
Anoro Ellipta: umeclidium/vilanterol
Bevespi Aerosphere: Glycopyrrolate/formoterol
Duaklir Pressair: Aclidinium/formoterol
Stiolto Respimat: tiotropium/olodaterol
Average adult Pneumococcal vaccination recommended starting at what age?
50 yo
Most common cause of chronic adult cough?
Upper Airway cough syndrome (post nasal drip, allergic rhinitis..)
A 64-year-old man with a history of myocardial infarction and peripheral artery disease presents for a follow-up visit. He is currently taking atorvastatin, 20 mg daily. His most recent lipid panel shows a low-density lipoprotein cholesterol (LDL-C) level of 88 mg/dL (2.28 mmol/L). He asks whether he should increase his statin dose or continue his current regimen, which he tolerates well. Which approach would you take that is most supported by current evidence for patients with established atherosclerotic cardiovascular disease (ASCVD)?
INCREASE target Less than 70
What Actor from the Sixth Sense has been diagnosed with frontotemporal dementia (FTD) 2023?
Bruce Willis
ICS-LABA Inhalers approved for SMART/MART Therapy?
Symbicort and Dulera
58 yo M with history of CKD3a and CAD presents to your clinic with cough and fever found to have pneumonia on XR, what would be preferred outpatient antibiotic treatment?
Beta-lactam PLUS a Macrolide or Doxy (SOR: A)
Amox/clavulanate (2g bid) preferred Alternatives include cefpodoxime, cefuroxime OR Respiratory fluoroquinolone (SOR: A) Moxifloxacin, gemifloxacin, or levofloxacin
63 yo F diagnosed with sarcoidosis is started on 20mg of prednisone daily, if she remains on steroids for 4+ weeks, what med should be given for prophylaxis against what organism?
Pneumocystis jirovecii pneumonia (PJP) prophylaxis Trimethoprim/Sulfamethoxazole (TMP-SMX)
A 21-year-old man presents with exertional chest pain and syncope and has a systolic murmur that increases with the Valsalva maneuver. His maximal left ventricular end-diastolic wall thickness on echocardiography is 18 mm. There is no evidence of heart failure or arrhythmia. Which one of the following medications is appropriate first-line therapy?
hypertrophic cardiomyopathy (HCM) --> BB or CCBs
Which famous Disney singer and actress underwent a kidney transplant?
Selena Gomez due to SLE
Biologic therapy approved for uncontrolled asthma?
Xolair (omalizumab), Nucala (mepolizumab), and Dupixent (dupilumab)
What is the Desert Rheumatism Triad?
Coccidioidomycosis Fever, Myalgias, Erythema nodosum
What is the next best treatment for OSA after CPAP?
Oromandibular device
A 2-year-old child is brought to your clinic for a hoarse, barking cough. On examination, he has no stridor, a normal respiratory rate, and a normal heart rate. Which is first-line therapy for treatment of this illness?
One time dose of dexamethasone
(only add racemic epi with moderate to severe croup)
Justin Bieber was diagnosed with this syndrome causing facial nerve paralysis?
Ramsay Hunt Syndrome
What is the black box warning on the common leukotriene receptor antagonist (LTRA) that is used as an adjunctive treatment to allergic rhinitis and asthma?
Montelukast (Singulair)
Serious neuropsychiatric events including agitation, aggression, sleep disturbances, depression, SI
68 yo F with ESRD presents to you clinic for a PPD reading, diameter of nodule is 12mm, what is your next step?
Positive, get CXR
Name the 5 groups of PAH?
Group 1 - Pulmonary arterial hypertension (PAH)
Group 2 - Pulmonary hypertension due to left-sided heart disease
Group 3 - Pulmonary hypertension due to lung diseases and/or hypoxia
Group 4 - Chronic thromboembolic pulmonary hypertension (CTEPH)
Group 5 - Pulmonary hypertension with unclear or multifactorial etiologies (hematologic, systemic, metabolic, etc.)
A patient returns from a backpacking trip with steatorrhea, abdominal cramping, and weight loss. Stool testing confirms infection with this protozoan, which is typically treated with what antiparasitic medication?
Giardia
Tinidazole
This “back to the future” star was diagnosed with this neurological disease in 1991?
Michael J Fox
Parkinson's Disease