Electrolyte Delight
This is the first-line IV treatment for severe symptomatic hyponatremia with seizures.
What is 3% hypertonic saline?
Unlike loop diuretics, this class of diuretics decreases urinary calcium excretion and is therefore useful in patients with recurrent calcium nephrolithiasis.
What are thiazide diuretics?
A traveler returns from sub-Saharan Africa with fever, chills, thrombocytopenia, and intravascular hemolysis. This potentially fatal infection must be ruled out urgently.
What is Plasmodium falciparum malaria?
A patient with infective endocarditis develops acute severe aortic regurgitation, pulmonary edema, and heart failure symptomatology. This is the next step in management.
CT Surg
This single laboratory test supports adult-onset Still disease in a patient with quotidian fevers, an evanescent salmon-colored rash, and arthralgias.
Ferritin
This electrolyte abnormality should be corrected before hypokalemia can be fully corrected.
What is hypomagnesemia?
This diuretic is used to treat idiopathic intracranial hypertension by reducing cerebrospinal fluid production.
What is acetazolamide?
A traveler returns from India with prolonged fever, relative bradycardia, and abdominal discomfort with diarrhea. Blood cultures are obtained to diagnose this systemic infection.
What is enteric fever caused by Salmonella Typhi?
A patient with new-onset atrial fibrillation has hypotension, altered mental status, and signs of shock. This is the next step.
What is immediate synchronized electrical cardioversion?
This is the most useful biochemical marker for distinguishing vitamin B12 deficiency from folate deficiency.
Elevated methylmalonic acid.
This is the preferred initial treatment for severe hypercalcemia of malignancy, in addition to addressing the underlying cause.
What is IV isotonic fluid resuscitation?
A patient with cirrhotic ascites is started on diuretics. This is the usual initial spironolactone-to-furosemide dose ratio used to maintain potassium balance.
What is 100 mg of spironolactone to 40 mg of furosemide? (5:2)
Name the suspected diagnosis for a traveler returning from the Caribbean with fever, severe myalgias, and retro-orbital pain.
What is dengue fever?
A patient with suspected thrombotic thrombocytopenic purpura has thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, and normal coagulation studies. ADAMTS13 testing is pending. This treatment must not be delayed.
What is therapeutic plasma exchange plus glucocorticoids?
This is the most specific cerebrospinal fluid finding for Guillain-Barré syndrome after the first week of illness.
Albuminocytologic dissociation.
This is the classic electrolyte disturbance associated with refeeding syndrome that can cause respiratory depression.
What is hypophosphatemia?
This diuretic acts on the epithelial sodium channel (ENaC) and can be used to treat lithium induced nephrogenic diabetes insipidus.
Amiloride
A traveler returns from West Africa with fever, a rapidly progressive hemorrhagic syndrome, and multisystem organ dysfunction. This filovirus causes severe viral hemorrhagic fever.
What is Ebola virus disease?
A patient with cirrhosis presents with hematemesis and suspected acute esophageal variceal bleeding. In addition to resuscitation, this vasoactive medication and prophylactic antibiotic should be initiated.
What are octreotide and ceftriaxone?
This is the single most predictive laboratory marker of mortality in acute pancreatitis.
BUN
A patient with hypertension, hypokalemia, and metabolic alkalosis has suppressed renin and suppressed aldosterone. This is a classic diagnosis.
What is Liddle syndrome?
This inherited tubulopathy causes hypokalemic metabolic alkalosis, hypomagnesemia, hypocalciuria, and normal or low blood pressure.
Gitelman Syndrome
A traveler returns from Central or South America with fever, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia due to intracellular protozoa in macrophages.
What is visceral leishmaniasis (kala-azar)?
A patient with Clostridioides difficile infection develops hypotension, ileus, megacolon, and rising lactate. In addition to a surgical consultation, what is the next best step?
PO Vanc, IV Flagyl, Vanc Enema
This is the single most important prognostic biomarker used to identify high-risk tumor lysis syndrome.
Elevated LDH.