Christmas
Joint aches
Random
Holidays
Pepto-Bismol
100

Around how many people nationwide end up in hospital on Christmas Day? +/- 1000

According to the Royal Society for the Prevention of Accidents, more than 6,000 people will end up in hospital on Christmas Day, and over the Christmas period more than 80,000 people visit A&E. Over recent years, there has been an increase in injuries involving falls from ladders while stringing lights and cuts from broken glass ornaments. Christmas trees alone account for more than 1,000 injuries each year.

100

What is this xray finding called and what is it suggestive of?

Bamboo spine - pathognomonic of ankylosing spondylitis 

100

What is a toonie?

$2 coin, Canadian dollars

100

What medication should be avoided with chest pain in context of cocaine intoxication?

Beta blockers

Cocaine affects both alpha (vasoconstriction) and beta receptors (vasodilation). Beta blocker use could lead to unopposed alpha receptor activation --> HTN

100

What percentage of people defrost the turkey unsafely? 

29%, 49%, 69%

Research by the Food Standards Agency (FSA) found 69% of those who purchased a frozen turkey for Christmas lunch leave it in an unsafe place – such as the bath, garage or shed – to defrost it.

200

How many Christmas trees are sold in the US every year? +/- 1 million

25-30 million

200

What diagnostic test has the highest specificity for RA?

Anti-CCP


The sensitivities for anti-CCP and RF were 62 and 64% (P = 0.83), and the specificities were 97 and 90% (P < 0.001), respectively...The anti-CCP test has statistically shown significant higher specificity, PPV, and LR for RA than the RF test in a clinically diverse population. If new criteria are to be devised to help diagnose early RA, anti-CCP should be included because it has a greater diagnostic impact than RF.

Silveira IG, Burlingame RW, von Mühlen CA, Bender AL, Staub HL. Anti-CCP antibodies have more diagnostic impact than rheumatoid factor (RF) in a population tested for RF. Clin Rheumatol. 2007 Nov;26(11):1883-9. doi: 10.1007/s10067-007-0601-6. Epub 2007 Apr 5. PMID: 17410320.  

200

What is population of Canada? 

+/- 5 million

40.5 million (Oct 1, 2023)

200

11 Mistletoe berries are...

A: Poisonous – they can cause hallucinations and even kill you

B: High in vitamin D

C: Mildly addictive – they contain tryptophan, the same substance that is in chocolate

Mistletoe is poisonous as its berries contain toxic proteins that slow the heart rate and can cause hallucinations.

200

Most appropriate first line treatment(s) for Giardia?

Bonus point doses


Tinidazole (adults: 2 g single dose; children 3 or older: 50 mg/kg, max 2 g, single dose)


Nitazoxanide (adults: 500 mg BID x 3 days; children age 1 - <4: 100 mg BID x 3 days, age 4- < 12: 200 mg BID x 3 days,  12 or older: 500 mg BID x 3 days)

Metronidazole (adults: 500 mg BID 5-7 days, 250 mg TID 5-7 days; children 28 days or older 15 mg/kg/day PO in 3 divided doses 5-7 days, max 250 mg per dose)

300

Which of these poses the biggest safety hazard?

A: Christmas trees

B: Fairy lights

C: Undercooked turkey

You are 50% more likely to die in a house fire at Christmas than any other time of the year. Fairy lights and candles are two of the most common fire risks

300

What joints does RA most commonly involve in the hand?

MCP and PIP, especially 2nd and 3rd MCP and PIP

300

Name the item?

 SpongeBob pendant that a toddler swallowed 

https://www.livescience.com/54727-weird-things-people-swallowed.html

300

What tests should be obtained following an electrocution injury after ABCs stabilized and exam complete?

ECG

BMP

CK

Troponins

+/- UA - myoglobinuria - if persistent sx or cutaneous burns

300

Which of these luxury treats is most likely to bring on an attack of gout? 

A: A glass of port

B: A fresh lobster canape

C: A portion of stilton

Lobster is very high in organic compounds purines which can cause a build-up of uric acid. This gets deposited in the joints and can cause gout. It is commonly thought gout attacks port drinkers, but beer is far higher in purines. 


400

What is Christmas tree syndrome?

Real trees may harbour moulds and allergens that can trigger rhinitis symptoms such as an itchy nose, watery eyes and coughing bouts. Choose an artificial tree if you’re allergy prone.

400

What is goal uric acid with urate lowering therapy?

<6
400

What animal is on the Canadian quarter?

Caribou

400

What illicit drug would you consider in following presentation...

Bizarre, agitated, violent behaviour

Horizontal, vertical, or rotary nystagmus 

Hypertension, tachycardia 


PCP intoxication

Blood pressure elevation is reported in 32 to 57 percent of patients with PCP intoxication.

Tachycardia occurs in 30 to 43 percent of patients with a positive urine PCP test 

Horizontal, vertical, or rotatory nystagmus is common with reported rates ranging from 57 to 89 percent of cases

 https://www.uptodate.com/contents/phencyclidine-pcp-intoxication-in-adults?search=PCP%20intoxication&sectionRank=2&usage_type=default&anchor=H7&source=machineLearning&selectedTitle=1~19&display_rank=1#H7

400

2 first line options for initial episode of C. difficile?

Fidaxomicin 200 mg orally twice daily for 10 days

Vancomycin 125 mg orally 4 times daily for 10 days

For nonsevere disease, alternative regimen if above agents are unavailable: Metronidazole 500 mg orally 3 times daily for 10 to 14 days

500

In Home Alone, where are the McCallisters going on vacation when they leave Kevin behind?

Paris

500

When to consider urate-lowering therapy for gout?

1) 2 or more gout flare-ups/year

2) Tophaceous gout

3) Damage attributable to gout on radiography

Consider:

2nd flare up, even if not within 1 year

Serum urate >= 9 mg/dL

Urothilaisis

CKD Stage 3 or greater

500

What is a double-double in Canada?


Coffee with 2 cream, 2 sugar

500

What medication should be considered for acute hypertension in alcohol withdrawal?

Clonidine 0.1 mg BID PRN

500

Quadruple therapy for H. pylori infection, including duration?


PPI BID

Bismuth sub citrate or bismuth subsalicylate (Pepto-Bismol)

Tetracycline (e.g. clarithromycin)

Metronidazole 

10-14 days

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