Heart of Hearts
Live Er Die
Guns, Germs & Meals
Kidney Beans
We Get Sick Too
100
In 2021, the USPSTF recommended daily ASA 81mg at 12 weeks gestation in patients with one of these six major risk factors to prevent pre-eclampsia.
One of the following: History of preeclampsia, Multifetal gestation, Chronic hypertension, Pregestational type 1 or 2 diabetes, Renal disease, Autoimmune disease (SLE, APLA)
Or two or more of the following: nulliparity, BMI > 30, age > 35, IVF pregnancy, greater than 10 yrs since last pregnancy, Black race, first deg relative with pre-E
100
In 2020, USPSTF updated HCV screening guidelines to this.
Since Hep C has tripled since 2010, the USPSTF recommends screening for HCV infection in adults ages 18 to 79.
Opioid use increased from 1995 to 2016, now declining due to the Turn the Tide Campaign.
100
Since 2019, this is the number one cause of pediatric death in the US
Firearm injury
100
These are the recommended monotherapy abx regimens for mild to moderate pyelonephritis in pregnancy.
IV Rocephin or IV Cefepime
100
SJD loved PSC so much that she couldn’t quite pull the trigger on leaving. Especially because she needed this procedure to cure her affliction.
Steroid injection for trigger finger
200
According to the 2018 AHA ASCVD guidelines, a coronary calcium scan may be beneficial in these patients.
5-7.5%: consider statin; can offer CACS; if CACS = 0, statin not recommended; if CACS > 100, recommend statin
ASCVD risk >7.5-20%: recommend statin; if patient declines statin, offer CACS; CACS = 0 statin not recommended; if CACS >100, recommend statin
200
When LFTs are mildly elevated (< 5x ULN), we should consider these tests for a comprehensive evaluation.
CBC, ferritin, hep panel, RUQ sono
200
This syndrome is characterized by symmetrical ascending weakness and can be a rare side-effect of the flu vaccine.
Guillain Barre Syndrome
200
This causes urinary obstruction in neonatal males, usually presenting with irritability and a dribbling urinary stream.
Posterior urethral valves
200
CWIV used this as first line treatment to clear his namesaked lesions as a teenager.
tretinoin/adapalene
300
The 2019 ACC/AHA statin guidelines recommend moderate intensity statins for primary prevention of ASCVD if the 10 yr ASCVD risk is in this range in non-diabetic patients ages 40-75.
AHA: 7.5% - 20%
USPSTF: 10% or greater PLUS at least 1 CV risk factor
300
In Oct 2023, AGA updated MASLD screening guidelines: Check LFTs once a year to screen for MASLD in these populations
Patients with one or more of the following: overweight, obese, diabetes, HTN, HLD
300
The name, dosing schedule and efficacy of this shiny rooftop vaccine should be discussed with our quinquagenarians.
Shingrix
300
These are indications for nephrology referral
Electrolyte disturbance, GFR < 30, rapid decline of GFR, anemia of CKD, macroalbuminuria
300
TDHKN had this small pouch which was discovered after Xe swallowed an alkaline earth metal.
Zenker diverticulum - seen on barium (Xe6s2) swallow
400
High intensity statins should be considered for primary prevention of ASCVD if the 10-year risk is 7.5 – 20% when these risk enhancers are present.
Non-diabetic patient risk enhancers: South Asian race, GFR < 60, inflamm dz (RA, SLE), LDL > 160
Diabetic patient risk enhancers: retinopathy, diabetic cataracts, nephropathy, neuropathy, ABI < 0.9, DM > 10 years
400
In 2022, ACIP recommended universal vaccination of hepatitis B in this age group
Since hepatitis B has increased by 114% since 2006, ACIP recommends universal hep B vaccination in the 19-59 yo age group
400
Please encourage your at-risk patients to RSVP for one of these three products to prevent SOB, wheezing and even hospitalization
Beyfortus, Abrysvo, Arexvy
400
In poker, 4 of these is a good hand. In CKD, it’s the mainstay of treatment. In ARF, you might want to stop it.
ACEs/ARBs
400
SEH wakes up at 5am, runs 3 miles every morning and doesn't appear to be emotionally stressed. But she has suffered a few physical breaks...If she has a pre-65 FRAX score of this, she'll need a DEXA scan when she's postmenopausal.
8.4%
500
In 2021, the ACC/AHA identified this blood test as an independent marker for ASCVD. In 2023, they recommended checking it one time in patients with elevated cardiac risk.
Lp(a) 
500
If a patient is found to have MASLD on US, fibrosis screening should be done by one of these non-invasive tests
FIB-4 (age, AST, ALT, platelets) with reflex to ELF or fibrosis panel
500
74% of the US population is overweight or obese.
GS is a 38 yo M. He is 6’1 and 400 lbs. How much weight will he lose with Wegovy vs Zepbound vs gastric sleeve?
BMI: 52, IBW: 191 lbs
Wegovy: 40 – 60 lbs
Zepbound: 60 – 80 lbs
Gastric Sleeve: 100 – 110 lbs
500
Volume expansion to prevent contrast induced nephropathy should only be considered in patients with GFR less than this.
30
500
SC-MW loves to travel. He’s been to Niagara and Yosemite to see their beautiful waterfalls. Little did he know, he was looking through this similar condition every day.
Cataracts
Cataracta in Latin = waterfall