Lenin-gitis
Bourgeois Bleeding
Beans of Production
Skin Marx
Trotskycardia
100
Name 4 reasons to get a CT head prior to LP
FND, AMS, Immunosuppressed, structural Lesion, new onset Seizure within the past week. Also papilledema.
100
What are the key features of Heyde Syndrome and what is it's mechansim?
Aortic stenosis -> recurrent GIB from angioectasias due to AS shearing of VWf
100
What test can be used to estimate GFR in patients in whom creatinine-based GFR may be inaccurate?
Cystatin C
Cr is often less reliable in patients w/ abnormal body habitus (Class III obesity or underweight), severe illness (HF, cirrhosis, cancer)
100
What is the medical treatment for this slow-growing lesion?
Salicyclate acid
100
What comorbidity is most commonly associated with multifocal atrial tachycardia?
Pulmonary pathology - COPD
200
What is the empiric treatment for bacterial meningitis in a 55-year-old immunocompetent man?
Dexamethasone followed by vanc + ceftriaxone + ampicillin
200
How quickly should a suspected UGIB undergo endoscopy? What if you suspect variceal bleeding?
Within 24 hours for UGIB, with 12 for variceal
200
What are the thresholds for normal, moderate, and severe albuminuria?
0-30
30-300
>300
200
Patient with celiac disease presents with this? What is the first line treatment?
Dapsone (check G6PD first)
200
Which two SVT subtypes are most likely to respond to vagal maneuvers?
AVRNT, AVRT
Both AVNRT and AVRT are AV node–dependent tachycardias — they require the AV node to maintain the circuit. Vagal maneuvers transiently slow AV node conduction, breaking the loop.
300
What is the classic antibody seen in autoimmune encephalitis?
anti-N-methyl-D-aspartate receptor (NMDAR)
300
How do you diagnose Hepatorenal Syndrome?
Diagnosis of exclusion - increase in serum creatinine by ≥0.3 mg/dL within 48 hours, or an increase in serum creatinine to ≥1.5 times baseline that does not improve after two days of volume expansion with IV 25 percent albumin (1 g/kg of body weight per day up to 100 g/day), and withdrawal of diuretics for at least two days.
300
What are the normal cutoffs for blood pressure when using a 24 hr ambulatory BP measurement? Must include 3: average, daytime, nightime
Average: >115/75
Daytime >120/80
Nighttime >100/65
300
Patient presents with this lesion that rapidly grew over the past 6 weeks. What is the most likely diagnosis and next step?
Keratoacanthoma
Must undergo excisional biopsy to rule out SCC.
300
Which patient populations with atrial fibrillation have been shown to have reduced mortality and hospitalizations when treated with a rhythm control strategy over rate control?
Patients with comorbid HF and patients diagnosed in past year (EAST-AFNET4).
400
Name 3 groups of people that need antimicrobial prophylaxis after Neisseria meningitidis exposure
400
What workup should be done for post-menopausal women and all men found to have iron deficiency anemia without a clear cause?
H pylori testing, anti-TTG, IgA level, Colonoscopy and Endoscopy
Colonic malignancy seen in 9%, upper GI malignancy in 2%
400
Medication other than RAAS blocker that slows kidney function decline in adults at risk for rapidly progressing ADPKD
Vasopressin V2 Blockade with Tolvaptan
400
Leser-Trelat sign - seborrheic keratoses, underlying internal cancer
Most commonly colon, breast, or stomach adenocarcinomas but has also been associated with renal, hepatic, and pancreatic malignancies.
400
Pt presents with syncope and this EKG:
What is the diagnosis and the treatment?
Brugada Syndrome + PPM
10% annual risk sudden cardiac death
500
What is the empirical therapy for cryptococcal meningitis and for what length is each given?
Induction - Amphotericin B + flucoytosine 2 weeks
Consolidation - high dose fluconazole for 8 weeks
Maintenance - low dose fluconazole for 6-12 months
500
What medication is first line for fistulizing perianal Crohn's disease?
Infliximab (thought to be TNF-a generally, but data mostly being abstracted from inflix trials)
500
For what two patient populations with atrial fibrillation does the ACC have a class 1 indication for cathater ablation?
Non-responders to anti-arrhythmic
First line for rhythm control in younger+ healthier with symptomatic a fib
Symptomatic or clinically significant a flutter