Heme
What is the treatment choice for Polycythemia Vera?
What is phlebotomy
A 47 y/o HIV positive female with CD4 count today of 180 presents with a c/o a nonproductive cough. She is febrile, tachypneic and tachycardic. Lung exam reveals bilateral rales. CXR shows diffuse interstitial infiltrates. What is the recommended treatment in this patient?
What is Trimethoprim-Sulfamethoxazole
A mother brings her 3 y/o to the ER c/o trouble breathing and swallowing. You note the child is drooling and appears toxic. Lungs are clear. Soft tissue neck films show this (pic)....What sign is this and what is the most likely diagnosis?
What is a "thumb sign" and epiglottitis
A 78 y/o man is brought in by his daughter for evaluation of multiple dark, nonpruritic lesions which are all over his back (pic). What is the most likely diagnosis and how would you describe lesions in this?
What is Seborrheic keratoses. Dark brown, slightly raised, greasy looking and slightly "warty" looking.
A 64 y/o plumber, presents with chronic cough which has been worsening in the past couple of weeks. he has a 60 pack year h/o smoking. CXR shows pleural plaques. As a plumber over 40 years ago; he was frequently exposed to asbestos. What is the likely diagnosis based on this info?
What is mesothelioma
A 70 y/o male presents to you office c/o increasing fatigue over the past few months. On PE you note some painless lymphadenopathy. CBC and blood smear reveals leukocytosis, "smudge cells," and increased small mature appearing lymphocytes. What is the most likely diagnosis?
What is CLL
Guttate psoriasis is associated with what type of infection?
What is streptococcal
45 y/o male presents with decreased hearing and ear pressure shortly after scuba diving in Aruba 2 days ago. Pt states on the dive decent he did have some pressure and pain in both ears but felt he was able to equalize his pressures eventually. He denies ear discharge, pain currently, or vertigo. On exam you note a mild conductive hearing loss and a hemorrhagic effusion in the middle ear bilaterally. What does this patient have?
what is hemotympanum d/t barotrauma
This spider's bite can produce a necrotic skin reaction, sometimes described as "red, white, and blue sign".
What is brown recluse
A 17 y/o high school athlete with a history of intermittent wheezing with exercise presents to the ED with SOB. She is having difficulty breathing and has diffuse wheezes throughout both lung fields on auscultation. her pulse ox is 95% on room air. What would be the best next treatment option at this point?
What is albuterol neb treatment
A 45 y/o female presents to your office c/o anorexia, bouts of diarrhea, fatigue, tingling/numbness in her toes, and decreased concentration. On PE, she has mild pallor, glossitis, decreased proprioception and vibratory sense. CBC shows macrocytic anemia. What is best next lab study to obtain next?
What is serum B12 level
Which virus family is responsible for the spread and infection of a verruca vulgaris?
what is HPV
A 22 y/o woman presents to your office after referral from the ophthalmologist after treatment for optic neuritis. She has had episodes of diplopia in the past but no other complaints. Her neurologic exam is normal today. What is the most appropriate next step in her management?
What is an MRI
45y/o M patient is brought to the ED via EMS after being rescued from a house fire. He has several 2nd degree burns on his body including: anterior face and torso, anterior left and right arm, anterior left leg, circumferential right leg. Calculate the body surface area of the injured skin using the rule of nines.
58.5%
(face = 4.5, torso = 18, L. arm = 4.5, R. arm = 4.5, L. leg = 9, R. leg = 18)
A 12 y/o previously healthy female presents with 7 day h/o dry cough, low grade fever, ha, and myalgias. PE reveals normal inspiration and expiration with a few widely scattered rhonchi. CXR shows interstitial patchy infiltrates bilaterally. Cold agglutinins are negative. What is the most likely diagnosis?
What is viral pneumonia
A parent brings their 3 y/o to your clinic stating their child keeps c/o leg and arm pain over the past month and intermittent fever over the past 3 days. Exam is essentially normal. CBC and smear show elevated WBC with pancytopenia and circulating blasts. What is the most likely diagnosis?
What is ALL
What is the most common bacterial pathogen (in adults) that causes AOM?
What is Streptococcus pneumoniae
12 y/o female c/o sore throat x 5 days progressively getting worse. This morning the pts mother noted she appears lethargic and significantly more ill. She also noted the pt was having trouble swallowing her oral secretions. On exam you note nuchal rigidity, trismus, and drooling. She is not having any trouble breathing. What do you need to be worried about and what is the next best step in the evaluation of this patient to confirm your suspicion?
What is a retropharyngeal abscess and CT
What is the major predisposing factor for the development of this skin condition (pic)?
What is chronic venous insufficiency of the lower extremities (eczematous stasis dermatitis)
A 44 y/o male presents with his wife to your primary care office. The pt states his wife made him come because she is tired of listening to him snore. The pt is obese and does c/o not sleeping well and is often tired throughout the day. You order a sleep study which shows the pt does have OSA. What is the best initial education you can give the pt and what is your next step?
What is educate on weight loss and avoidance of ETOH and hypnotic meds. Refer to sleep medicine specialist.
65 y/o male c/o back pain and bilateral leg pain for several months and worsening. Denies injury/trauma or hx of back/leg pain. PE is essentially normal. Blood smear shows rouleaux and protein electrophoresis has positive paraprotein. What is the most likely diagnosis?
What is Multiple/Plasma cell myeloma
KOH prep of a suspected fungal infection on the skin reveals hyphae and yeasts in spaghetti and meatball morphology. What is the suspected organism based on these results?
What is Malassezia furfur
52 y/o male presents with a 4 wk hx of congestion. Pt states symptoms started out like a cold which he has been using OTC meds for since. He saw his PCP 2 wks ago and was put on 10 days of Augmentin. Pt states all his symptoms have resolved and he doesn't feel sick anymore but the congestion just won't go away. Through questioning the patient tells you he has been using oxymetazoline nasal spray multiple times/day the past 4 weeks which worked great at first. What has this pt most likely developed?
What is rhinitis medicamentosa
What is the clinical diagnosis for sharply defined macular hyperpigmentation on a sun-exposed area?
What is melasma
A 64 y/o female teacher presents c/o fever, chills, fatigue, myalgias, ha, and nonproductive cough that started suddenly 3 days ago. Several students in her class have been out for the same symptoms. PE reveals temp of 101, erythematous/edematous nasal mucosa with clear rhinorrhea, pharyngeal injection without exudate, slight tachycardia, and clear lungs. Sars-CoV2 test is negative. What diagnostic study would you do next?
What is a rapid influenza test