Headaches
Las Drugas
HFrEF
Spaced Repetition
2 Facts, 1 Flummery
100
What is the preferred neuroimaging modality for non-emergent evaluation of outpatient headaches, when indicated
MRI
CT ONLY in emergent settings, particularly when brain bleed is on the ddx. MRI has better sensitivity/specificity for 2nd headache causes.
100
What testing can be sent to evaluate if a patient has been drinking alcohol over the weeks
Phosphatidylethanol - PEth takes over a week to result
Single binge / occasional use → may be detectable for ~3–7 days.
Regular/moderate-heavy use → typically detectable for 2–3 weeks.
Chronic heavy use → can sometimes remain positive for up to 4 weeks.
100
As of this fall, the CDC now considers this cause of cardiomyopathy to be endemic to the United States (Texas)
Kissing bug
Chaga's disease
100
What changed in the IDSA guideline definition of complicated UTI in the 2025 guidelines?
Redefined by where the infection is and how systemic it is, not by who the patient is
Any infection extending beyond the bladder is complicated
Male, pregnant, diabetics, immunocompromised patients are no longer automatically complicated
100
1) I fostered cats with my neighbors
2) I had a German Shepherd and a Labrador growing up
3) I had 2 guinea pigs in high school
2) I had a German Shepherd and a Labrador growing up
200
Name 4 reasons to get a CT head prior to LP
If you don’t order a CT head before doing an LP on certain patients, your attending PANICS
Papilledema, Altered mental status, (focal) Neurologic deficits, Immunocompromised states, CNS disease in the past (structural lesion), new Seizures
200
What medication/medications is/are first line for moderate-severe alcohol use disorder?
1st line: Naltrexone ↓reward/cravings (CI in opiod use)
Acamprosate ↓cravings (CI if GFR<30)
2nd line - Disulfarim
Off-label - topiramate/gabapentin
200
Which patient population with HF should be screened for iron deficiency?
All patients with HF.
Improvements in exercise performance, CHF symptoms and health‐related quality of life. May even reduce hospitalizations.
Regardless of anemia.
200
What should be used first to screen for suspected HIT?
4T score
200
1) I have been to more European countries than US states
2) I am deathly afraid of heights, but LOVE roller coasters
3) I was born in Champaign, Illinois
1) I have been to more European countries than US states
300
What is first and second line for the treatment of idiopathic intracranial hypertension (formerly pseudotumor cerebri)
1st line: Acetazolamide - "Champagne blues"
2nd line: Topiramate
300
What are the FDA-approved medication is approved for anorexia associated with weight loss in patients with AIDS and chemotherapy induced nausea and vomiting in patients who have not responded to conventional antiemetics?
Dronabinol
Cannabinoid
300
Name 3 situations in which the BNP may be falsely low.
HFpEF, Obesity, flash pulm edema
Also constrictive, mitral stenosis, higher GFR, meds - diuretics, BB, ACE/ARB
300
What is the process for punting admissions to ADS?
Send a chat message with the patient to the attending on call, explaining the presentation and why you think it is appropriate for the Attending Directed Service (not NTS)
Call the admitting attending if they do not respond in a timely manner (1/2 hour)
If they agree, they will add the attending on ADS to admit.
300
1) I am a dual Australian citizen
2) I have broken all of my extremity bones (aka wrists and ankles)
3) I was born in Boston
2) I have broken all of my extremity bones (aka wrists and ankles)
400
List 8 features of headaches that suggest a secondary cause, warranting evaluation with neuroimaging
400
What can beta blockers cause false positives for on drug screening?
Amphetamines (particularly labetalol and metoprolol, which are structurally similar)
Also buproprion + trazadone
400
What are the 4 most common causes of non-ischemic cardiomyopathy
HTN
Valvular
Tachyarythmia
Substances
Less common amyloid, sarcoid, thyroid, anemia, rheumatic etc.
400
What is the empiric treatment for bacterial meningitis in a 55-year-old immunocompetent man?
Dexamethasone followed by vanc + ceftriaxone + ampicillin
Ampicillin for age > 50, immunocompromised
NNT for mortality 10 for dexamethasone, on subgroup analysis efficacy only seen in strep pneumo
400
1) My favorite fast food place is Taco Bell.
2) I have gone bowling inside the White House
3) I have travelled to 10 countries
3) I have travelled to 10 countries
500
What are the diagnostic criteria for idiopathic intracranial hypertension (formerly pseudotumor cerebri)?
6 total, whichever team/teams get the most
Papilledema OR CNVI palsy present
Normal neurological examination except for cranial nerve abnormalities
Normal CSF composition
Elevated lumbar puncture opening pressure > 25 cm of water
No hydrocephalus, mass or structural lesion, and no meningeal enhancement on MRI of the brain with gadolinium
No venous sinus thrombosis on MRV
500
These illicit/commonly abused substances are associated with erectile dysfunction - team with the most correct will get points.
Cocaine, meth/amphetamines, MDMA, heroin, canabis, alcohol, benzos, barbituates + nicotine
500
Which patients with HFrEF have a Class 1 indication for Cardiac Resynchronization Therapy?
NYHA II-III or ambulatory IV + LVEF ≤35% + Normal Sinus Rhythm + QRS >150ms w/ LBBB
Class II if non-LBBB QRS > 150 or LBBB+ QRS 120-150
500
The team that lists the most appropriate reasons to screen for 2nd HTN (max 12) according to the most up to date ACC guidelines gets points.
500
1) I love Disney World. I just traveled there for the 20th time
2) One of my cats has asthma, and he uses an inhaler
3) I used to sleep with a plastic knife when I was a child
1) I love Disney World. I just traveled there for the 20th time