Beans of Production
Proletariat Proliferation Initiation
Stalin's Shoulders
Geri Comrade Care
Burgiouse Princeton
100
What is the first line imaging to evaluate for kidney stone?
Non-con CT
Can use RBUS in pregnant women as an alternative.
100
What is the recommended duration of therapy with PPI for patients diagnosed with Barrett's Esophagus
Indefinite, at least once daily. Can increase to BID for symptom control.
71% reduction in the risk of high-grade dysplasia or esophageal adenocarcinoma
lower progression to dysplasia or cancer in PPI users (adjusted hazard ratio 0.32)
AGA 2022 guidelines
100
Name 2 risk factors for adhesive capsulitis
Increased risk w/ DM, thyroid disease, immobilization; age 40-60
100
Define the patient population that is eligible for general hospice and inpatient hospice.
Advanced illness and life expectancy <6mo.
Short-term symptom management needs that cannot be adequately provided outside the hospital (high flow O2, uncontrolled sx requiring IV medications, high RN needs for wound care/suctioning)
100
What is the Rapid Effective Diuresis Pathway?
New evidence-based workflow for heart failure patients to optimize diuretic dosing with the goal of reducing length of stay. Bedside nurses will be empowered to rapidly administer a second dose of diuresis based on the patient’s urine sodium level after the first dose.
200
In a patient for whom you are concerned for membranous nephropathy, a positive ____ test can obviate need for biopsy
Anti-PLAR2
200
In the 2025 American College of Cardiology guidelines, which patient population did the committee recommend empiric treatment with PPI be initiated on?
Patients with high risk of GI bleeding on DAPT or APT + anticoagulation.
*High risk = 1 major or 2 minor criteria.
200
A 28-year-old woman is evaluated for a 2-month history of left-sided neck and shoulder pain and paresthesia in her left arm from her fingers to her shoulder. Her symptoms worsen with overhead arm activity. She takes no medications.
On physical examination, she has full range of motion in her left neck, shoulder, elbow, and wrist. Muscle bulk, tone, and strength in the upper extremities are normal bilaterally. Neurologic examination reveals normal reflexes and sensation in the upper extremities bilaterally. Upper extremity pulses are full and equal. There is no cyanosis, swelling, or edema.
A. Arterial thoracic outlet syndrome
B. Cervical radiculopathy
C. Neurogenic thoracic outlet syndrome
D. Venous thoracic outlet syndrome
Compression of brachial plexus by interscalene triangle of the neck. Most common young thin active women w/ overhead movements. Anomalous cervical rib increases risk. First line therapy PT, surgical decompression can be considered. 90% of TOS. 3-5% Venous, 1-3% arterial.
200
What does the american geriatrics society recommend to use to assess gait in patients over 65 years old?
Timed Up and Go - >12 seconds increased fall risk
World fall guidelines recommend gait speed
200
What famous Nobel Laureate physicist died in Princeton Hospital in 1955?
Albert Einstein
300
Name the acid/base disorder based on the following values
pH 7.21 / pCO2 15 / bicarb 9 / Gap 27
Concomitant AGMA and Resp alkalosis
Expected pCO₂ = (1.5 × [HCO₃⁻]) + 8 ± 2
= 13.5 + 8 ± 2
Expected pCO₂ = 19.5 ± 2 → range 17.5–21.5
15 is lower
Delta:Delta
Normal gap ≈ 12 → ΔAG (Delta) = 27 – 12 = 15
ΔHCO₃⁻ = 24 – 9 = 15 → ΔAG ≈ ΔHCO₃⁻
No other metabolic process present.
Concomitant AGMA and Resp alkalosis
300
What is the first line therapy for h pylori infection, and when can you test for erradication of h pylori?
PPI BID, bismuth 300mg QID, tetracycline 500mg QID (alternative: doxy 100mg BID), metronidazole 500 QID x 14d
confirm for all pts w/ stool Ag, urea breath test, or EGD >4 wks after completion of abx and off PPI for 2w
300
These two medications confer the HIGHEST risk of developing drug-induced lupus
Procainamide (15-20% incidence/year)
Hydralazine (5-10% incidence per year)
.
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
What is the name of Dr. Fanning’s cat?
Moriarty
400
What is the definition of AKI (3) per Kidney Disease: Improving Global Outcomes (KDIGO)
↑Cr ≥ 0.3 within 48hrs
↑Cr ≥ 1.5x baseline within 7 days
Uo ≤ 0.5cc/kg/hr for 6 hours
400
For high risk peptic ulcer disease, what is the recommended treatment for secondary prevention of UGIB, including duration and administration method.
IV PPI BID x72 hours (reduce re-bleeds and need for repeat EGD)
PO PPI BID x2-8 weeks
400
What is this imaging finding in calcium pyrophosphate deposition disease? Name two conditions all patients with CPPD should be screened for?
Chondrocalcinosis
Hyperparathyroid and hemochromatosis. Also hypomagnesmia.
400
What testing is recommended for all patients with orthostatic hypotension?
B12, BMP, CBC, ECG, TSH
Screening for supine hypertension - about 50% of neuogenic OH, changes diagnostic criteria (30 mm Hg or more), most pharm therapy can worsen supine HTN
140 mm Hg or higher systolic or 90 mm Hg or higher diastolic after five minutes in the supine position
400
This Princeton Medicine Physicians doctor was also trained as a lawyer
Kevin Skole
500
What 3 medication classes should all patients with confirmed nephrotic syndrome be on; need all 3
RAAS-blocker, statin, loop diuretic
Often need sequential nephron blockade, may need to discuss AC
500
Which populations did the SCCM suggest empiric stress ulcer prophylaxis be given to in their 2024 guidelines (3)?
Critically ill patients with
Coagulopathy (inc risk 4.8%)
Shock (inc risk 2.6%)
Chronic liver disease (inc risk 7.6%)
Mechanical ventilation alone probably is not a risk factor and does not necessitate SUP.
500
What is first line treatment for polymyalgia rheumatica?
Second line?
Moderate dose prednisone 12.5 - 20 mg
Methotrexate can be used as a weak glucocorticoid-sparing agent
Sarilumab (IL-6 inibitor) can be used for refractory PMR patients who relapse during taper.
500
What patient populations does the endocrine society recommend vitamin D supplementation for regardless of vitamin D level?
11
persons aged 75 years and older, pregnant persons, and persons with high-risk prediabetes
(2/3 impaired fasting glucose, HbA1c, or 2-hour glucose and/or impaired glucose tolerance. )
Diseases including - bone mineral disorder, CKDIII or higher, malabsorption disorder, chronic liver disease, hyperparathyroid, medications, obesity, institutionalized/homebound
500
Which Princeton MTS attending has 5 kids?
Dr. Hogshire
