STICK THE PIC (IMAGE CHALLENGE)
Feel the TENSION
(HTN)
(HTN)
STRESS MESS (Stress Testing)
ProMOTE the antiDOTE
Syndromic Madness (Endo Syndromes)
100
27 y F with this rash after HSV infection. Dx?
Erythema Multiforme
100
This is the goal BP for nearly all patients regardless of risk factors.
< 130 / < 80
100
This is the preferred stress test across most patient populations as it offers prognostic value - baseline stress test.
EKG + Treadmill
100
Antidote for warfarin induced significant bleeding
PCC (will accept this alone)
plus IV vit K and stop warfarin.
FFP not given much anymore.
100
This inherited endocrine syndrome is characterized by pituitary adenomas, parathyroid adenomas, and pancreatic neuroendocrine tumors.
Men 1
200
50 y AA F - Hilar Adenopathy on CXR - Name this Rash!
Lupus Pernio - Sarcoidosis
200
This class of antihypertensive medications is associated with a high risk of gout
Thiazides.
200
These two classes of meds should be HELD before a treadmill or dobutamine stress test.
BB plus CCB.
200
Suicide attempt. HAGMA, AKI, and these urinary crystals. Antidote?
Fomepizole plus or minus dialysis (accept fomepizole)
200
This inherited disorder causes lifelong mild hypercalcemia, hypocalciuria, and an inappropriately normal or elevated PTH due to an inactivating mutation of the calcium-sensing receptor.
FHH
300
EGD shows this - Dx?
EoE
300
A PREVENT ASCVD Risk score above this value qualifies for pharmacologic anti-hypertensive therapy.
>/= 7.5%
300
In patients with LOW risk for CAD, this alternative imaging study can be done to detect calcified atherosclerotic plaque.
Coronary CTA
Do NOT accept CAC score.
300
A patient with angina develops cyanosis and chocolate-brown blood after receiving a high dose of a nitrate. Pulse oximetry remains around 85% despite supplemental oxygen. Name the antidote.
Methylene Blue
300
This syndrome features medullary thyroid carcinoma, pheochromocytoma, and mucosal neuromas. Name the gene mutated in this condition.
RET
400
Small bowel follow through with barium shows this - whats your Dx?
Crohn's - String Sign
400
This is absolute value of aldosterone, and the ARR that meets diagnostic criteria for hyperaldosteronism using the LC-MS/MS (liquid chromatography–tandem mass spectrometry) lab method.
- LC-MS/MS: aldosterone ≥7.5 ng/dL, PRA ≤1, ARR >15
- Immunoassay: aldosterone ≥10 ng/dL, PRA ≤1, ARR >20
(We actually use LC-MS at Chase - but immunoassay is more common. For your test- still go with 10/20)
400
A 55-year-old woman with exertional chest discomfort needs ischemia testing. She has baseline ST-segment depression of 2 mm on ECG but can exercise adequately. Name TWO types of stress tests that are first line for this patient.
Exercise Echo, Exercise Nuclear.
400
Patient on nitroprusside for HTN emergency - develops aki, lactic acidosis of 14. Antidote?
Hydroxocobalamin
Sodium Thiosulfate (alternative)
400
Name the CONFIRMATORY test used to diagnose this disorder with the following image of the duodenum
(multiple duodenal ulcers) with an indeterminate fasting gastrin level:
Secretin Stimulation test - Zollinger Ellison
Gastrin first, if high youre done - if borderline get SST
500
"Crazy Paving Pattern" on CT Chest - Dx?
Pulmonary Alveolar Proteinosis
CT chest demonstrates bilateral ground-glass opacities with superimposed interlobular septal thickening,
500
This TRIAL compared benazepril + amlodipine vs benazepril + hydrochlorothiazide. Both achieved similar BP control, however, Benazepril + amlodipine reduced cardiovascular events more than benazepril + HCTZ. The trial was stopped early because of the cardiovascular outcome difference. NAME THE TRIAL.
ACCOMPLISH TRIAL
500
This percentage of the age-predicted maximum heart rate should generally be achieved for an exercise treadmill ECG to be considered diagnostically adequate. (Give percent value)
85% of age-predicted maximum heart rate (APMHR) is the classic threshold.
- APMHR = 220 − age
- ≥85% APMHR → generally considered an adequate/diagnostic exercise stress test
- <85% → submaximal/nondiagnostic for ruling out ischemia, especially if stopped before achieving adequate workload
500
This methylxanthine is used to reverse severe bronchospasm caused by adenosine during cardiac stress testing.
Aminophylline
500
This syndrome classically presents with chronic mucocutaneous candidiasis, hypoparathyroidism, and adrenal insufficiency.
Autoimmune polyglandular syndrome type 1
- APS-1 = Candidiasis + Hypoparathyroidism + Addison
- APS-2 = Addison + Thyroid disease ± T1DM
APS-1 = “3 C’s”
Candida
Calcium low (hypoparathyroidism)
Cortisol low (Addison)
APS-2 = “A + T + D”
Addison
- Thyroid autoimmune disease
- Diabetes type 1