Love Hurts (Cardiology)
A 65-year-old with crushing substernal chest pain, ST elevations in II, III, aVF.
What is an inferior STEMI?
Most common cause of upper GI bleed overall.
What is peptic ulcer disease?
Most common cause of community-acquired pneumonia.
What is Streptococcus pneumoniae?
Most common cause of nephrotic syndrome in adults.
What is focal segmental glomerulosclerosis (FSGS)?
Most common cause of hyperthyroidism in the U.S.
What is Graves disease?
Post-MI patient develops acute pulmonary edema and a new holosystolic murmur at the apex radiating to axilla.
What is papillary muscle rupture?
Cirrhotic with hematemesis and hypotension. First medication to give.
What is octreotide?
HIV patient with CD4 <200 and dyspnea, dry cough, diffuse ground-glass opacities.
What is Pneumocystis jirovecii pneumonia?
Hyperkalemia with peaked T waves. First medication.
What is IV calcium gluconate?
Patient on chronic steroids who presents with hypotension and hyponatremia after stopping meds.
What is adrenal insufficiency?
Young patient with syncope during exertion and a systolic murmur that increases with Valsalva.
What is hypertrophic obstructive cardiomyopathy?
Iron deficiency anemia in an older man with no obvious bleeding. Next best step.
What is colonoscopy (and EGD)?
Patient with prosthetic valve and persistent fevers. Best initial test.
What is transesophageal echocardiogram (TEE)?
Urine sodium <20 in a hypotensive patient with AKI. What is dx?
What is prerenal azotemia?
Best initial test for suspected Cushing syndrome.
What is overnight dexamethasone suppression test?
Name the treatment for A-fib patient with CHA₂DS₂-VASc of 4 and no contraindications. GIVE DOSE TOO!
What is anticoagulation with a DOAC (e.g., apixaban)?
Elevated AST > ALT (2:1 ratio) in heavy alcohol use.
What is alcoholic hepatitis?
Treatment for latent TB in a patient starting a TNF-alpha inhibitor.
What is isoniazid (or rifampin-based therapy)?
Hyponatremia with low serum osmolality and euvolemia. What is dx?
What is SIADH?
Diabetic with anion gap metabolic acidosis and glucose 450. First step in management.
What is IV fluids?
Patient with chest pain relieved by leaning forward, diffuse ST elevations, and PR depressions.
What is acute pericarditis?
Severe acute pancreatitis marker that predicts worse prognosis at 48 hours.
What is elevated BUN (or rising hematocrit)?
Septic shock patient after fluids still hypotensive. First-line vasopressor.
What is norepinephrine?
Rapidly progressive glomerulonephritis with hemoptysis. What is dx?
What is Goodpasture syndrome (anti-GBM disease)?
MEN2 is associated with this thyroid cancer.
What is medullary thyroid carcinoma?