Could Be Anything
I Hate Bugs
What does Math have to do it?
In Dire Straits
If I only had a Heart
Osler's Advice
100
Two Coronavirus Syndromes Identified Prior to COVID 19?
What are SARS and MERS?
100
Most common infectious cause of Guillain-Barre Syndrome
What is Campylobacter jejune?
100
PCO2 = 1.5(HCO3) + 8 (+/- 2)
What is Winter's Formula?
Determination of expected PCO2 in presence of metabolic acidosis
100
Measure of tendency of lungs to recoil
What is elastance?
Extra 200 points:
What is formula for elastance?
100
Typical maneuver used to differential systolic murmur of hypertrophic cardiomyopathy from other systolic murmurs
What is a Valsalva maneuver?
Anything that decreases filling of the left ventricle, allows the septum to bulge into the LV cavity and increases outflow obstruction ( volume depletion, standing, diuretics, ionotropes)
100
U.S. President who graduated with the first class at Stanford University.
Who is Herbert Hoover?
200
Probability that a patient who has a normal test is actually free of disease?
What is Negative Predictive Value?
200
This gram negative, iron loving bacteria can cause overwhelming sepsis in immunosuppressed patients, as well as in those with alcohol use disorder and asplenia.
What is Capnocytophagia canimorsus?
200
Pplateau - Change in volume/ Compliance is the equation for determine this variable
What is driving pressure?
Compliance = change in volume/change in pressure
compliance = change in volume/ plateau pressure - PEEP
DP = Plateau Pressure - PEEP
200
Factors which shift O2-Hgb dissociation curve to the right
What are acidosis, elevated temperature, and elevated levels of 2,3 DPG?
200
Triad of clinical findings in caridac tamponade, known as Beck's triad
Whats are hypotension, muffled heart sounds, and elevated neck veins?
extra 200 points: name two other finding(exam/imaging) typically associated with cardiac tamponade
200
July 4th was the date of death of these 3 U.S. Presidents
Who are John Adams, Thomas Jefferson, and James Monroe?
Extra 100 points: Which two died the same day?
300
Which of the following is not associated with normal complement levels:
a. TTP
b. HUIDS
c. SLE
d. Goodpasture's
What is SLE?
300
Organism responsible for a rapidly progressive meningoencephalitis after exposure to freshwater?
What is Naegleria fowleri?
300
[(Patmos-PH2O) * FiO2)-(PaCO2/ 0.8)] - PaO2 is used to calculate what value
What is the A-a gradient?
PAO2 = Alveolar pressure
Patmos=m atmospheric pressure
PH20 = water pressure
FiO2 = fraction of inspired oxygen
0.8 = respiratory quotient
300
A 75-year-old male patient with a history of diabetes mellitus, hypertension, and paroxysmal atrial fibrillation is being resuscitated with IV crystalloids for severe sepsis. He initially demonstrated fluid responsiveness with improvements in mean arterial pressure (MAP) and pulse pressure variability. He no longer is responding appropriately to fluid challenge and has a persistently elevated lactate (5 mmol/L) with decreasing urine output.
Which treatment regimen is most appropriate for this patient at this time?
a. Vasopressin to maintain MAP > 70 mmHg
b. Dopamine titrated to MAP > 70 mmHG
c. Norepinephrine titrated to MAP >/= to 65 mmHg
d. Dobutamine titrated to MAP 65 mmHg
What is norepinephrine titrated to MAP >/= to 65 mm Hg?
300
lead misplacement, prior posterior wall MI, RV hypertrophy, RBBB, WPW
What are causes of early, prominent R waves in precordial leads (V1-V3) of ECG?
300
U.S. Presidents Grant(18), Hayes(19), Garfield(20), Benjamin Harrison(23), McKinley(25), Taft(27), and Harding(29) all have one thing in common
What is they were all born in Ohio?
400
Common polygenic endocrine syndrome associated with Addison's Disease, Type 1 Diabetes Mellitus, and chronic thyroiditis
What is Autoimmune Polyendocrine Syndrome Type II?
(HLA DQ2/3 associated)
600 extra points: What constitutes the Type I syndrome?400
In addition to cat scratch disease, Bartonella species can cause what illness in immunocompromised individuals?
What is bacillary angiomatosis?
400
4.6 x (PTpatient - PTcontrol) + Total bilirubin
What is Maddrey's Discriminant score?
What is value at which pharmacologic intervention has demonstrated survival benefit?
400
3 types of airflow seen in pulmonary airways
What are:
a. laminar
b. transitional
c. turbulent
400
Components of typical AV nodal re-entry tachycardia.
What are:
a. two pathways (slow with integrate antegrade conduction, fast with integrate/retrograde conduction)
b. unidirectional block down fast pathway
c. antegrade conduction down slow pathway
d. retrograde conduction via fast pathway
400
Name given to a 4 dimensional square
What is a tesseract?
500
toxic alcohol ingestion, mannitol infusion, ethanol intoxication, Waldenstrom's hypergamaglobulinemia, hypertriglyceridemia
Whats are causes of an elevated osmolar gap?
Csosm = 2(Na) = BUN/2.8 + Glu/18
need to add ethanol/3.7 if ETOH ingestion suspected
Osmolar gap if difference between measured and calculated Sosm > 10
500
Coxiella burnietti, Tropheryma whippeli, Abiotrophia species, fungi, and Chlamydia psittaci
What are causes of culture negative endocarditis?
Different than AACEK group which take longer to grow:
Aggregatibacter aphrophilus, Aggregatibacter actinomycetemcomitans, Cadiobacterium hominus, Eikeinella corrodens, Kingella kingae
500
CO X (SaO2 x Hgb x 1.34) + (PaO2 x .003)
What is oxygen delivery?
CO = cardiac output
1.34 = oxygen binding capacity of Hgb(cc/gm)
.003 = oxygen dissolved in blood per each mmHg of oxygen
500
Conditions which may contraindicate use of permissive hypercarbia in ARDS patients
(at least two needed for full credit)
Whats are:
a. intracranial hypertension/cerebral edema
b. severe metabolic acidosis, especially with hemodynamic compromise
c. severe cor pulmonale
d. presence of significant beta blockade
e. significant hypoxia
500
Cause(s) of prominent A waves ("cannon" A waves) on jugular venous pulsation ( only need one to be correct)
What is/are
a. complete heart block
b. ventricular tachycardia/ectory
c. ventricular pacing
d. junctional rhythm
500
Phase coined by American columnist and newspaper editor to promote annexation of Texas and expansion of US territory in the west.
What is "manifest destiny"?
Extra 2000 points: What was the columnists name?