COPD 🫁
What is the PFT measurement defined by the maximum volume of air exhaled in the first second of a forced maneuver?
FEV1
What cardiac imaging modality do we use to evaluate patients with staph aureus bacteremia and no determined source?
TTE and/or TEE
What does VIBES stand for (the management aspect for each letter) when managing liver disease?
V - Volume
I - Infection
B - Bleeding
E - Encephalopathy
S - Screening
A 70‑year‑old woman presents with sudden, painless hematochezia. Vital signs are stable. Which is the most common cause of this presentation?
A. Colon cancer
B. Diverticulosis
C. Ischemic colitis
D. Inflammatory bowel disease
Diverticulosis
What type of bleed ccurs proximal (above) the ligament of Treitz and typically present with hematemesis or melena?
Upper GI bleed
What PFT pattern is identified by a reduced total lung capacity (TLC) under 80% of the predictive value.
Restrictive pattern
What is the most likely bug in a non-purulent cellulitis?
Group A Streptococcus >>> Staphylococcus
A 60‑year‑old man with cirrhosis presents with hematemesis and hypotension. After airway protection and IV access, which medication should be started immediately?
A. Carvedilol
B. IV octreotide
C. Propranolol
D. Tranexamic acid
IV octreotide
A patient with cirrhosis and upper GI bleeding should receive which additional therapy to reduce infectious complications and mortality?
A. Metronidazole
B. Vancomycin
C. Ceftriaxone
D. Azithromycin
Ceftriaxone
What PFT pattern shows a reduce FEV1/FVC ration with a normal or reduced FVC?
Obstructive
Forced Vital Capacity (FVC)
What two medications can you pick to cover a MRSA pneumonia?
Vancomycin and Linezolid
What key blood protein drops in liver failure, leading to fluid leaking out into tissues?
Albumin
A 68‑year‑old man on warfarin presents with brisk hematochezia and hypotension. After initial resuscitation, which study is most appropriate to localize the bleeding source?
A. Colonoscopy after bowel prep
B. Flexible sigmoidoscopy
C. Tagged RBC scan
D. CT angiography
CT angiography
What is the patient positioning that is commonly used by patients with COPD to ease severe shortness of breath, fix trapped air, and helpings expand?
Tripoding
What is a rare, inherited genetic condition can cause COPD even in non-smokers due to a lack of protective lung protein.
Alpha-1 antitrypsin deficiency
Which carbapenem does not have pseudomonal activity?
ertapenem
Which cirrhotic patient population should get secondary prophylaxis for SBP?
All patients with prior SBP (treat with PO cipro or PO bactrim)
A patient presents with melena. Which laboratory finding most strongly suggests an upper GI source?
A. Elevated INR
B. Low albumin
C. Elevated BUN with normal creatinine
D. Elevated alkaline phosphatase
Elevated BUN with normal creatinine
What is the PFT term that describes the volume of air remaining in the lungs after a normal, quiet expiration?
Functional residual capacity (FRC)
What are essential routine immunizations recommended for patients with COPD to prevent deadly lung infections?
Influenza accise and pneumococcal vaccine
What two cardiac complication can occur with fluoroquinolones?
Aortic aneurysm
QTc prolongation/Torsades
How do lactulose and rifaximin work pathophysiologically to manage HE?
Lactulose: changes the acid levels making the bowels more "acidic" making ammonia less "absorbable" and also acts as a laxative
Rifaximin: Targets bacteria that make ammonia, reduces the number of bacteria that use urease to turn waste into ammonia.
Because of its severe gastrointestinal side effects, this macrolide antibiotic is often administered IV before an endoscopy to clear blood or debris from the stomach.
Erythromycin
What is the criteria used for secondary bacterial peritonitis?
Runyon criteria
- Total protein > 1 g/dL
- glucose < 50 mg/dL
- LDH > upper limit of normal for serum