Oncologic Madness
Tap that Joint
Endocrine Showdown
100

Used in tumor lysis syndrome, this drug inhibits formation of new uric acid crystals, and also excretes existing uric acid crystals.

Rasburicase

100

This is the normal synovial fluid white blood cell count

<200

100

These two classes of drugs have been shown to reduce cardiovascular mortality in type 2 diabetics.

GLP1 and SGLT2

200

This is the class of drugs that reduces recurrence of estrogen receptor positive breast cancer in post menopausal females.

Aromatase inhibitors

200

This type of shoulder pathology is characterized by pain with passive and active range of motion, has less than 30 minutes of morning stiffness, and gets worse throughout the day.

What is glenohumeral osteoarthritis?

200

This is the primary lab value measured in secondary hypothyroidism to track progression of disease.

Free T4

300

This mutation predicts response to PARP inhibitors in certain breast, ovarian, pancreatic, and prostate cancers.

What are BRCA1/BRCA2 mutations?

300

This is the most common joint affected by gout.

What is the first metatarsophalangeal joint (podagra)?

300

After maximally tolerated ACE/ARB, and SGLT2 inhibitor, this drug may be added to further reduce progression of diabetic nephropathy.

Finerenone

400

This is the screening interval for patients who undergo colonoscopy and are found to have a tubular adenoma of villous histology.

3 years.

400

This destructive shoulder arthropathy is characterized by hydroxyapatite crystal deposition, massive rotator cuff tears, and a large, often bloody, noninflammatory joint effusion.

Milwaukee shoulder syndrome

400

These are three antibodies associated with T1DM

Anti GAD 65

Anti insulin

Anti Zn Transporter8

Anti Islet Cell

500

What are the criteria for cessation of cervical cancer screening in women at age 65 who are average risk?

1) At least two negative consecutive cytology+HrHPV in last 10 years, most recent test within last 5 years

OR

2) At least three negative consecutive cytology in last 10 years, most recent test within last 3 years.

500

This shoulder joint pathology is characterized by a positive apprehension test.

Anterior glenohumeral instability (anterior subluxation or dislocation).

500

This is the single best lab test used to distinguish between euthyroid sick syndrome, and true hyperthyroidism in a hospitalized patient.

Total T3

  • Euthyroid sick: T3 is low. It’s the earliest and most consistent change.
  • True hyperthyroidism: T3 is high, even in a sick patient.

(will accept Free t3 - Free T3 drops in nonthyroidal illness too, so both point the same way. Free T3 assays are just less reliable in sick inpatients (binding protein changes, heparin, drug interference), so total T3 is what’s typically ordered and tested. Either way, a low T3 argues against hyperthyroidism. )

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