Cancer signs and syndromes
Name that mAb
Good for Heart,
Bad for Body
Bad for Body
Rash & Burn
Bite Me
Near 100% Fatality
100
Name the cancer syndrome associated with the development of thousands of polyps throughout the colon, often starting at a young age
Familial adenomatous polyposis (FAP), autosomal dominant mutation of APC gene on chromosome 5q.
100
This monoclonal antibody targets CD20+ and is used in the treatment of numerous lymphomas?
Rituximab
100
Baseline tests to measure for patients on chronic amiodarone therapy (name 1)
Thyroid Function Test (hyper or hypothyroid)
Liver Function Test (hepatotoxicity)
Pulmonary Function Tests (pulmonary fibrosis)
100
Name & first line treatment for this often misdiagnosed condition
Hidradenitis suppurativa
Tx = hibiclens (chlorhexidine) wash, PO doxycycline 100 mg BID
100
Monotherapy antibiotic of choice for a clenched fist injury requiring prophylaxis.
Augmentin 875-125 BID for 3-5 days
100
This Lyssavirus is nearly 100% fatal is prompt antibiotics are not administered post exposure
Rabies
200
This cancer syndrome is the most common cause of hereditary colorectal (colon) cancer and is also associated with increased risk of endometrial and ovarian cancer
hereditary nonpolyposis colorectal cancer or Lynch syndrome - in these patients colon cancer occurs at a younger age (before age 50)
200
Tocilizumab, a monoclonal antibody used in cytokine release syndrome, acts against what receptor?
Anti-IL6 (IL-6 has pleotropic effects on inflammation)
200
We love SGLT2s, but they can have these dangerous side effects (name 3)
Hypotension, AKI, genitourinary infections (yeast infections - candida vulvovaginitis or balanitis; Fournier's gangrene, UTI), euglycemic DKA
200
Your patient gets a "new" mattress on Buy Nothing Graduate Hospital and then develops this rash. Name the cause + treatment
Bed Bugs!
Tx - If very pruritic, can do low- or medium-potency topical corticosteroid (eg, triamcinolone acetonide 0.1%), an oral antihistamine, or both
Exterminator
200
How long after removal of a tick is antibiotic prophylaxis still warranted?
Up to 72 hours of tick removal
200
Case fatality of this thermophilic ameboflagellate protozoan is nearly 99%.
Naegleria Fowleri
300
Name the paraneoplastic sign associated with an abrupt eruption of multiple seborrheic keratoses that is a sign of an internal malignancy
sign of Leser-Trelat (both the neoplastic and paraneoplastic process began concurrently and the skin involvement resolves as the neoplastic process is treated.
300
Humira or Adalimumab targets what cytokine in the management of numerous autoimmune conditions?
TNF-alpha
300
Your patient with asthma gets started on a medication to help with his tremors. He then calls in with wheezing. Name the medication and mechanism of this side effect
Propranolol
Nonselective beta blockers can cause bronchospasm through smooth muscle constriction via antagonism of beta 2 receptors
More common with asthma than COPD
300
Name & maintenance treatment of this common skin condition
Sebhorrheic dermatitis
Maintenance (face) - Ketoconazole 1-2x/day
Flares (face) - topical hydrocortisone 2.5%
300
60-80% of all pasturella multocida infections come from this animal’s bite?
Cat
300
A patient with this disease can present to clinic with rapidly progressive dementia, aphasia, sleep disturbances and myoclonus (especially provoked by startle)
Creutzfeldt-Jakob Disease
400
Name the syndrome associated with a mutation in the tumor suppressor gene known as TP53.
Li-Fraumeni Syndrome; those with the mutation are susceptible to developing several cancers, most notably soft-tissue and bone sarcomas, breast cancer, brain tumors, adrenocortical carcinoma and acute leukemia
400
This monoclonal antibody targets CTLA-4, a negative modulator of T cell activity, and is used in the treatment of many solid malignancies?
Ipilimumab (yervoy)
400
This antiplatelet agent can cause dyspnea
Ticagrelor
400
Name the top 2 causative organisms for this crusty rash
Impetigo - rash of superficial epidermis, usually starts as vesicle with yellow "honey" crusting
Staph aureus
Group A beta hemolytic strep
400
Name 1 of the 2 venomous snake species found in Eastern Pennsylvania that require hospitalization if bitten?
Copperhead, Timber Rattlesnake
400
This gram positive rod is nearly 85% fatal, notably in the pulmonary form.
Anthrax
500
Name the cancer syndrome associated with the development of hemangioblastomas in the brain, spinal cord and retina, among other parts of the body. Patients with this syndrome are also are higher risk of RCC and pheochromocytoma.
Von Hippel-Lindau disease (VHL disease is an autosomal dominant disorder resulting from a deletion or mutation in the VHL gene, The normal VHL gene acts as a tumor-suppressor gene, with the function of preventing the formation of tumors)
500
Donanemab, a new monoclonal antibody that recently gained FDA approval for Alzheimer's disease, targets what epitope?
amyloid-beta (Abeta) peptide
500
Statin myopathy? Switch to one of these 3 statins with lower risk (name all 3)
pravastatin, fluvastatin, pitavastatin
500
Your patient presents to clinic with a 3 month history of cellulitis that just won't get better with antibiotics. It began after she hit her shin on her dining room table.
On exam, you see this.
Name the condition and at least 2 associated systemic diseases.
Pyoderma Gangrenosum
>50% have an associated systemic disease
146 patients (41 percent) with inflammatory bowel disease
●73 patients (21 percent) with inflammatory arthritis
●23 patients (7 percent) with solid organ malignant neoplasms
●21 patients (6 percent) with hematologic malignant neoplasms
●17 patients (5 percent) with hematologic disorders (monoclonal gammopathy of undetermined significance, myelodysplastic syndrome, or polycythemia vera)
500
A researcher working in the primate lab at Penn suffered a macaque monkey bite that required stitches. She presents post ED visit to clinic. What postexposure prophylaxis should be started on her?
Valacyclovir (or acyclovir)
500
This 100% autosomal dominant disease resulting from a missense mutation of the PRNP gene results in progressive insomnia, hallucinations, and personality changes.
Fatal Familial Insomnia