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.
What is this xray finding called and what is it suggestive of?
Bamboo spine - pathognomonic of ankylosing spondylitis
What is a toonie?
$2 coin, Canadian dollars
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
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.
How many Christmas trees are sold in the US every year? +/- 1 million
25-30 million
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.
What is population of Canada?
+/- 5 million
40.5 million (Oct 1, 2023)
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.
Most appropriate first line treatment(s) for Giardia?
Bonus point doses
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)
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
What joints does RA most commonly involve in the hand?
MCP and PIP, especially 2nd and 3rd MCP and PIP
Name the item?
SpongeBob pendant that a toddler swallowed
https://www.livescience.com/54727-weird-things-people-swallowed.html
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
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.
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.
What is goal uric acid with urate lowering therapy?
What animal is on the Canadian quarter?
Caribou
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
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
In Home Alone, where are the McCallisters going on vacation when they leave Kevin behind?
Paris
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
What is a double-double in Canada?
Coffee with 2 cream, 2 sugar
What medication should be considered for acute hypertension in alcohol withdrawal?
Clonidine 0.1 mg BID PRN
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