Leningitis
From Each According to the Tumor
Seize the Means of Coagulation
The People's Cholesterol
The Red Carpet
100
Name 4 reasons to get a CT head prior to LP
Your attending PANICS when you get an LP without a CTH
Papilledema, AMS, (F)ND, Immunosuppressed, CNS structural dis, new onset Seizure within the past week.
100
What is the classic antibody seen in autoimmune encephalitis?
anti-N-methyl-D-aspartate receptor (NMDAR)
Also accept anti-Hu [SCLC], anti-Ma2 [testicular], anti-CRMP5 [SCLC/thymoma], anti-NMDA receptor [ovarian teratoma, idiopathic]
100
The updated PE guidelines recommend that patients with newly diagnosed PE who require initial parenteral anticoagulant therapy should be treated with this anticoagulant when possible, instead of this anticoagulant.
Low-molecular-weight heparin (lovenox)
Over
Heparin ggt
Advantages
It offers a more predictable anticoagulant response
Does not require routine laboratory monitoring (aPTT)
Is associated with fewer bleeding complications
Some studies show reduced mortality over 3-6 mo follow up
Disadvantages
Weight-based dosing – make sure you have an accurate weight
Caution in ESRD
100
The 2018 guidelines on cholesterol recommended a cutoff of what percentage 10 year ASCVD risk for the initiation of moderate intensity statins for primary prevention?
Bonus - what do the new guidelines recommend for iniation of statins for primary prevention 10 year PREVENT score
>7.5% discuss initiation of statin
PREVENT
>5% start statin, consider starting if 3-5%
100
Which oscar nominee received public backlash after saying they "didn’t want to work in areas like ballet or opera who no one cares about anymore"?
Timothy Chalamet - thank god he lost to Michael B Jordan
200
What is the empiric treatment for bacterial meningitis in a 55-year-old immunocompetent man?
Dexamethasone followed by vanc + ceftriaxone + ampicillin
200
What is this sign called, and what is it associated with? 
Leser-Trelat Sign -Sudden eruption of seborrheic keratoses
Associated with gastrointestinal malignancies.
200
After 6 months of treatment with anticoagulation for a new first DVT/PE, if extension of treatment is indicated for irreversible/no identified RF, treatment should continue with what dose of eliquis?
2.5 mg BID
Unless very high recurrence risk (e.g., *active cancer*, recurrent VTE on therapy) or concern that reduced dose may be insufficient
200
The new lipid guidelines from the ACC recommend that everyone have this screening lab sent at least once in their lifetime.
Lp (a) - a highly genetic, "sticky" type of LDL cholesterol particle that significantly increases the risk of heart attack, stroke, and aortic valve disease. It is relatively stable across time, so a one time measurement is adequate to predict risk.
200
What is the first K-pop song to win an Oscar?
Golden - Kpop Demon Hunters
300
78M evaluated in the ED for a 1-week history of fever, confusion, and altered speech. Medical history is otherwise unremarkable. Temperature 103.1F, rest of vitals normal. Patient is difficult to rouse, is disoriented, and does not follow commands. The neuro exam is nonfocal and the remainder of the exam is normal. Empiric IV vancomycin + ampicillin + ceftriaxone + acyclovir are initiated. CSF studies are obtained
WBC: 60 with 88% lymphocytes
Glucose: 42
Protein: 113
Gram Stain + Culture: Negative
PCR assay of the CSF for viruses and bacteria is negative. MRI of the brain is shown.
Which of the following is the most appropriate IV treatment?
Continue antibiotics + acyclovir
Continue antibiotics and stop acyclovir
Continue acyclovir and stop antibiotics
Discontinue current medications and start IVIG and glucocorticoids
Continue acyclovir and stop antibiotics
Especially early in HSV meningitis PCR can be negative. If concerned for false negative and have high suspicion for HSV, continue acyclovir and repeat PCR within 1 week
300
In a patient with SIADH 2/2 SCLC, what might you expect the urine sodim and urine osmolality to be?
Uosm >100 - ADH is on
UrNa >30 - RAAS is off (as long as patient has adequate sodium intake)
300
What can be used to decide if a patient with cancer should be placed on prophylactic anticoagulation?
Khorona Score - anticoagulation indicated if >=2 and low bleeding risk - VTE rate at 2.5 mo 2% if score is 2
300
Patients with what comorbidities should be started on statin therapy empirically at age 40 - 3
TIIDM and HIV regardless of LDL, CKDIII+ as long as >70
Class 1 indication
300
How many Oscars was Sinners nominated for?
16 - beating the previous record of 14 (though notably was nominated for casting, which was only added this year)
Picture, director, actor, supporting actor, suporting acress, original screenplay, casting, cinematography, film editing, costume design, makeup, score, song, production, sound, visual effects
400
What patients, if any, should have serum cryptococcal screening?
HIV with CD4 < 100 planned to start on ART - high risk for developing CNS IRIS
Some guidelines suggest < 200
400
What are the milan criteria for transplant in HCC?
400
Which patients does the American College of Cardiology recommend be started on PPI?
On SAPT/DAPT and anticoagulant
On DAPT and "high" GIB risk
Prior GI bleed
Prior peptic ulcer disease
Age ≥65
Helicobacter pylori infection
Concomitant NSAIDs
Steroid use
AKA everyone in the CCU
400
What is the first line treatment (medication) for hypertriglyceridemia when it is
- 300
- 600
Lifestyle always first line haha
Statins 150-500
Modest TG lowering (10–30%) for statins, reduce ASCVD is the goal
Fibrates > 500
400
For the cold open of the Oscars, host Conan O'Brien dressed up as the main antagonist of which film?
Weapons - Aunt Gladys
Amy Madigan won best actress for playing the role
500
What are the three stages of treatment for cryptococcal meningitis, and which medications are included in each stage?
Induction - Amphotericin B + flucoytosine 2 weeks
Consolidation - high dose fluconazole for 8 weeks
Maintenance - low dose fluconazole for 6-12 months
500
What two malignancies make up the majority of cases of paraneoplastic encephalitis?
SCLC - 0.5-3% - represents 40-60% of paraneoplastic encephalitis
Ovarian teratome 1-4% - 20% of paraneoplastic encephalitis
Thymoma 1-2%
Testicular germ cell tumors <1%
Breast 0.1-0.5%
500
For how long do we continue anticoagulation in a newly diagnosed first PE/DVT with
1 Major reversible RF
2 Minor reversible RF
3 No identified reversible RF
4 Irreversible major RF identified
1 Major reversible RF - 3-6 month anticaog
2 Minor reversible RF - SDM - either 3-6 mo or indefinite
3 No identified reversible RF - indefinite
4 Irreversible major RF identified - indefinite
500
Other than a lipid panel, what lab can be measured serially to help guide statin titration?
ApoB
500
For 97 years, this Oscar category had never been won by a woman - a streak that ended on Sunday
Cinematography
Autumn Durald Arkapaw won for Sinners
Only 3 women have been nominated in 98 years