ECGs
Cirrhosis
Dialysis
Pancreatitis
Wizarding World
100
how many miliseconds is 1 big box on an ECG?
0.20s, or 200ms.
100
What is the most common cause of cirrhosis in north america?
NAFLD/MASLD metabolic dysfunction-associated steatotic liver disease (MASLD)
100
What are the indications for acute dialysis?
AEIOU
•Acidosis: pH < 7.1 refractory (active acidosis, AKI with rapid accumulation of acid, DKA if refractory)
•Electrolytes: K ≥ 6.5 OR any K+ elevation with ECG changes and refractory to Rx. Severe hypercalcemia refractory. Severe hyperphosphatemia causing symptomatic hypocalcemia or
•Intoxications: methanol, lithium, salicylates, Ethylene glycol, valproate, phenobarbital
•Overload refractory to diuretics (CRRT if hemodynamically unstable)
•Uremia: encephalopathy, pericarditis, bleeding or platelet dysfunction, intractable nausea and vomiting from uremia.
100
How do you diagnosis pancreatitis?
(1) typical abdominal pain, (2) amylase/lipase ≥3× ULN, (3) imaging evidence
100
Who put harry potter's name in the goblet of fire?
Barty Crough Jr - impersonating mad eye moody
200
What ECGs findings do you see in a pulmonary emoblus?
S1Q3T3
200
List 4 complications of decompensated cirrhosis
VIBES
Volume - ascites - diuresis or large volume paracentesis.
Infection - SBP
Bleeding - Varices
Encephalopathy
Screening- HCC
HRS
HPS
200
what is sodium thiosulfate used for?
calciphylaxis
First-line medication given IV after dialysis to chelate calcium and dissolve vascular deposits.
200
How high do TG need to be to cause pancreatitis?
>11.3
200
who is the griffindor ghost?
Sir Nicholas/ nearly headless nick
300
A 47-Year-Old Man with Chest Pain
- Acute anterior myocardial infarction
300
When are steroids indicated in alcoholic hepatitis?
Maddrey DF ≥32 or MELD ≥20 and no active infection/bleed/renal failure/pancreatitis
300
If I want to remove more potassium from the blood, what should I do with the diasylate during dialysis?
Decrease the concentration of potassium in the diasylate.
300
How do you treat pancreatitis due to hypertriglyceremia?
insulin, fluids, fenofibrates, statin.
300
What kind of spider is Aragog?
Acromantula
400
What's the abnormality?
- Sinus rhythm with premature ventricular complexes in a pattern of bigeminy.
- Ventricular rate 92/min
- Left ventricular hypertrophy with repolarization abnormality
400
First step in variceal hemorrhage management?
→ Resuscitate + IV octreotide + ceftriaxone → urgent endoscopy (banding)
400
How do you diagnosis PD Peritonitis?
At least two of the following
Clinical features consistent with peritonitis - abdomen pain, and/or cloudy effluent
effluent WBC>100 with >50% PMN
effluent Positive culture
400
What type of pancreatitis responds to steroids?
Type 1 IgG4-related autoimmune pancreatitis.
400
What is the creature that can transform itself into a person’s biggest fear?
Boggart
500
75 year old male after PCI. Name the rhythm.
AIVR - Accelerated idioventricular rhythm
ECG Interpretation
- Broad complex rhythm, rate 90/min
- No P waves
- Marked left axis deviation
- Positive QRS in AVR
- QRS complex duration 160 ms
- All chest leads show a downward QRS complex (concordance)
500
A 60-year-old man with decompensated cirrhosis and tense ascites is admitted with mild abdominal pain, low-grade fever, and worsening renal function. Paracentesis shows SAAG 14, and PMN count 260 cells/µL. Culture pending.
SBP - ceftriaxone
500
Patient during hemodialysis suddenly became altered, GCS 13/15, with headache and vomiting. What is going on?
Dialysis disequilibrium syndrome
Acute cerebral edema due to rapid extraction of osmotically active substances (urea and NaCl)
Increased ICP – HA, vomiting, papilledema, AMS
Clinical Dx
Use hemofiltration over HD in patients with risk factors
If HD – do slow, regular sessions
Adjust dialysate
500
A patient with acute pancreatitis continues to spike fevers after 7–10 days, with rising WBC and clinical deterioration. What complication should you suspect?
Infected pancreatic necrosis.
500
What does Dumbledore leave for Harry, Ron, Hermione in his will?
Harry - sword of griffindor and the snitch
Ron - delluminator
Hermione - book, tales of beedle the bard.