Cardiology
This medication class is indicated for HFrEF patients to reduce mortality and is contraindicated in pregnancy.
What are ACE/ARBs?
This Light’s Criteria pleural fluid to serum LDH ratio cutoff distinguishes exudative from transudative effusions.
What is pleural LDH/serum LDH >0.6 or pleural fluid LDH > 2/3 ULN?
A 45-year-old man with long-standing GERD undergoes surveillance endoscopy, which shows intestinal metaplasia. This premalignant condition increases the risk of esophageal adenocarcinoma.
What is Barrett’s esophagus?
A patient presents with hypertension (difficult to manage), hypokalemia, and low plasma renin.
What is primary hyperaldosteronism (Conn syndrome)?
This life-threatening oncologic emergency is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, typically occurring after initiation of chemotherapy for high-grade lymphomas or leukemias.
What is tumor lysis syndrome?
This stain is used to confirm the presence of amyloid in cardiac tissue biopsies.
What is Congo red stain (shows apple-green birefringence)?
This is the most accurate diagnosis (with severity) for a mechanically-ventilated patient with BL infiltrates on CXR, PEEP of 5, and an ABG with PaO2 72 mmHg on FiO2 0.6.
What is moderate ARDS? (P/F ratio 120)
Berlin Definition (P/F ratio) w/ PEEP of at least 5 cm H20:
- Mild: 200-300 mmHg; Moderate: 100-200 mmHg; Severe: <100 mmHg
This genetic condition predisposes patients to colorectal, endometrial, and ovarian cancers, and is caused by mutations in DNA mismatch repair genes.
What is Lynch syndrome (hereditary nonpolyposis colorectal cancer)?
This systemic vasculitis presents with asthma, eosinophilia, and peripheral neuropathy.
(Bonus 100 pts: this c-ANCA associated small vessel vasculitis presents with chronic sinusitis, hematuria, and pulmonary nodules)
What is eosinophilic granulomatosis with polyangiitis (Churg-Strauss)?
(Bonus Answer: What is granulomatosis with polyangiitis (GPA)?)
This CNS infection is associated with AIDS, India ink staining, and elevated opening pressure on LP. Treatment involves induction with amphotericin and flucytosine.
What is cryptococcal meningitis?
This mechanical complication of MI presents with a new holosystolic murmur best heard at apex and signs of heart failure.
What is papillary muscle rupture, can progress to severe mitral regurgitation?
This autosomal recessive condition should be suspected in a young adult with chronic productive cough, recurrent sinus infections, digital clubbing, and a history of pancreatic insufficiency or male infertility.
What is cystic fibrosis?
This extraintestinal manifestation of IBD does NOT parallel disease activity and may occur even when bowel symptoms are in remission.
What is ankylosing spondylitis?
[Other extra-intestinal manifestations: arthritis, sacroiliitis, pyoderma gangrenosum, erythema nodosum, uveitis, episcleritis, scleritis, PSC, oral ulcers]
This disorder often presents with skin fragility and bullae or erosions on sun-exposed areas (most frequently dorsal hands), with chronic hepatitis C being most common cause followed by alcohol-induced liver damage and hemochromatosis.
(Bonus 100 pts: how might you confirm diagnosis?)
What is porphyria cutanea tarda?
(Bonus Answer: increased plasma or urine porphyrin levels)
This type of kidney stone is radiolucent on XRay, often treated with oral potassium citrate and/or allopurinol if recurrence despite initial therapy, and chronic diarrhea and myeloproliferative disorders are risk factors associated.
What is/are uric acid stones?
This inflammatory syndrome can occur weeks after MI, featuring pleuritic chest pain, pericardial effusion, and elevated ESR.
What is Dressler's Syndrome (post-pericardiotomy syndrome)?
In the diagnosis of asthma, after bronchodilator therapy, this is the minimum percentage and increase in FEV1 from baseline determined to be diagnostic for reversible airflow obstruction in adults.
What is an increase of 12% and at least 200mL in FEV1?
A patient with chronic diarrhea, flushing, and a new heart murmur is diagnosed with this syndrome, confirmed by elevated 5-HIAA in urine.
(Bonus 100 pts: what sided heart murmur, right vs left, would be expected?)
What is Carcinoid syndrome?
(Bonus Answer: right-sided heart murmur much more likely -- left-sided would require bronchial carcinoid [directly drains to left heart] or right-to-left shunt [eg PFO]) Vasoactive substances produced from carcinoid tumors (ie, serotonin, bradykinin, histamine, prostaglandins) can cause fibrosis/thickening of valves, undergo first-pass inactivation in liver and then lungs -- with bronchial carcinoid and/or right-to-left shunt these substances can (rarely) go on to affect left-sided heart
This presents as a rapidly-progressive dementia with myoclonus and triphasic waves on EEG.
What is Creutzfeldt-Jakob disease (prion disease)?
This disorder is characterized by fever with daily evening spikes, evanescent salmon-colored rash, arthritis, and leukocytosis.
What is Adult-Onset Still Disease?
Major criteria are (1) daily evening spiking fever to temperature of 39.0 °C (102.2 °F), (2) arthralgia/arthritis for more than 2 weeks, (3) nonpruritic salmon-colored macular/maculopapular rash on trunk or extremities, and (4) leukocyte count greater than 10,000/μL (10 × 109/L), with more than 80% neutrophils. Minor criteria are (1) lymphadenopathy and/or splenomegaly, (2) elevated aspartate aminotransferase, alanine aminotransferase, or lactate dehydrogenase levels, (3) negativity for antinuclear antibodies or rheumatoid factor, and (4) sore throat.
This syndrome is associated with truncus arteriosus, Tetralogy of Fallot, and absent thymus on imaging. (Bonus 100 pts: what is the deletion associated with this d/o?)
What is DiGeorge syndrome? (22q11.2 deletion)
These antibodies (3) are associated with interstitial lung disease as a complication of antisynthetase syndrome (ILD, inflammatory myopathy, arthritis, Raynaud's, mechanic's hands).
What are anti-Jo-1, anti-PL-7, and anti-PL-12?
This rare disorder causes gastric outlet obstruction due to hypertrophy of the gastric antrum and is associated with elevated gastrin levels.
What is Menetrier’s disease?
This former Wisconsin Badgers running back won the Doak Walker Award twice and became the NCAA’s sixth all-time leading rusher before going pro in 2020.
Who is Jonathan Taylor?
This American general, who played a key role in the Southern campaign, led the forces that captured Augusta from the British in 1781.
(Bonus 100 pts: The name of the 1781 battle that resulted in the British surrendering control of Augusta to the American forces led by the aforementioned general)
Who is Nathanael Greene?
(Bonus Answer: What is the Siege of Augusta?)