Doctor diagnosis
Besty Testy
Screening
What's new?
Healing hands
100
Tetracyclines, NSAIDs, Bisphosphonates and Iron tablets have this disorder in common
What is medication induced esophagitis?
*Typically presents with substernal chest pain with swallowing occurring several hours to days after taking the medication
100
Hollenhorst plaque
Pathognomic for this condition
What is aortic atheroemboli?
Clinical thromboembolism:
A hollenhorst plaque is a golden or brightly refractile cholesterol body within a retinal artery. Associated with livedo reticularis, gangrene of the digits (blue toe syndrome)
Think of aortic atheroemboli in patients with:
Recent invasive procedures (catheterization), thrombocytopenia, eosinophilia, urinary eosinophils
Confirm diagnosis with biopsy
100
This is the new age to start colonoscopy in a patient per USPSTF
What is 45?
100
A recently FDA approved medication for lowering LDL and improving cardiovascular outcomes as an adjunct to diet and maximally tolerated statin therapy for the treatment of hyperlipidemia
What is Bempedoic acid?
100
In women with recurrent genital HSV, daily suppressive therapy with this medication is the most effective strategy for reducing HSV transmission
What is valacylovir?
Important: condom use is beneficial to reduce male to female transmission but not female to male
200
Classically seen 1-3 weeks after a URI or GI infection, this is an uncommon inflammatory disorder with painful cutaneous papules, fever, neutrophilic leukocytosis and dense neutrophilic infiltration on skin biopsy without s/o vasculitis
What is Sweet Syndrome
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200
This test is the most reliable marker for levothyroxine replacement therapy
What is TSH?
Don't use T3 and T4
200
A Class B recommendation to screen this population group for asymptomatic bacteriuria
What is pregnancy
200
This medication has been found to be more beneficial in treatment resistant depression in combination with SSRI or SNRI as compared to quetiapine
What is esketamine?
200
Triple vessel disease
L main >50%
2 vessel disease one of which is proximal LAD
Treatment
What is CABG?
300
Triad of: Ataxia, Encephalopathy and Oculomotor dysfunction. Diagnosis:
What is Wernicke's Encephalopathy?
Suspect this in not only alcoholic patients but other "at-risk" populations including anorexia, post-bariatric surgery, hyperemesis gravidarum: Patients receive dextrose WITHOUT thiamine
300
These tests should be ordered to diagnose acromegaly
BONUS: (100 points): Frequency of colonoscopy in these patients?
What are: -Serum IGF-1
-OGTT (fails to suppress GH)
Colonoscopy is indicated at the time of diagnosis and every 3-4 years after the age of 50 years
300
Hypertension screening should be started at this age in the outpatient setting?
What is 18 years?
300
The SAPHYR trial aimed to look at remission of this disease with use of an IL-6 antibody
What is polymyalgia rheumatica?
300
2 medications to treat prolactinoma
What is cabergoline and bromocriptine
*Keep in mind that prolactin levels increase during pregnancy due to high estrogen-but they should normalize within 1-2 months after delivery
Diagnosis: MRI of the brain (Prolactin levels: >200ng/ml)
400
Name this condition:
Middle aged woman, RUQ discomfort, fatigue, pruritus, hyperpigmentation
Positive Antimitochondrial Antibody titre
What is Primary Biliary Cholangitis
Progressive AI cholestatic liver disease seen in women between 40-60 years
Treatment: Ursodeoxycholic acid
400
Unexplained exertional leg symptoms with cramping and a borderline resting ABI value
What is the next best test?
What is Exercise treadmill ABI testing?
Normal ABI:>0.9 to <1.4
<0.9: PAD
>1.4: Occurs with calcified non compressible arteries (think DM, CKD)
400
A Central DEXA scan measures BMD in these 2 locations of the body to determine risk of osteoporosis
What is the hip and lumbar spine?
400
This new netflix film stars Benedict Cumberbatch as a man who can see without his eyes
What is the Wonderful World of Henry Sugar
400
Commonly caused by drinking windshield wiper fluid or deicing solution, this poisoning causes CNS depression and vision loss.
BONUS (100 points): Treatment
What is methanol poisoning?
What is fomepizole (will accept dialysis)?
Remember that methanol poisoning causes an anion gap and an osmolar gap
500
Bidirectional ventricular tachycardia: a rare ventricular dysrhythmia characterized by a beat-to-beat alternation of the frontal QRS axis.
Alternatively an alternating LBBB or RBBB
Name the drug
What is severe digoxin toxicity?
500
Occurring in immunocompromised patients, this infection characteristically displays a "halo sign" on CT chest.
BONUS (100): Treatment
What is invasive aspergillosis?
What is voriconazole?
500
In men aged 65-75 years who have ever smoked, AAA screening is recommended ___ number of times
What is ONE?
500
A recently FDA approved medication to reduce flushing and sweating (vasomotor symptoms) in menopausal women which is not a hormone therapy
What is Fezolinetant? (Veozah)
500
Splenomegaly, neutropenia and RA
Treatment?
What is methotrexate/DMARDs?
Felty syndrome is an AI condition characterized by splenomegaly, neutropenia and RA.
Can also present with pleuropericarditis, mononeuritis multiplex and LAD
