COPD
The diagnosis of COPD is... (spirometry findings)
Spirometry results FeV1/FVC < 0.70 or LLN post-bronchodilator
Name 3 causes of upper GI bleeding?
esophageal varices
gastritis / esophagitis / duodenitis
ulcers
H. pylori
Mallory-Weiss tear
PHG
malignancy
What is the SADMANS mnemonic and what is it used for?
used to help prevent adverse drug reactions and acute kidney injury.
S: ulfonylureas
A: CE inhibitors
D: iuretics
M: etformin
A: ngiotensin receptor blockers (ARBs)
N: onsteroidal anti-inflammatory drugs (NSAIDs)
S: GLT2 inhibitors
What is the hormone that stimulates hunger?
Ghrelin
What is the name of the Canadian team in the NBA?
Toronto Raptors
What 3 things have mortality benefits in COPD?
Smoking Cessation
Pulmonary Rehab
Home Oxygen for Resting Hypoxemia
Name 2 common medications that can increase the risk of GI bleeds?
steroids
antiplatelets
NSAIDS
anticoagulants
What are 3 lab findings for rabdomyolysis?
elevated CK
RBC positive on dipstick
hyperkalemia / hyperphosphatemia
metabolic acidosis
Name 3 ways to diagnose Diabetes.
Fasting Blood Glucose >7.0 mmol/L
Hemoglobin A1C ≥ 6.5%
2hPG in a 75g OGTT ≥ 11.1 mmol/L
Random PG ≥ 11.1 mmol/L
How many games are in a NBA season?
82 games
< 55 mmHg or PaO2 < 60 mmHg with cor pulmonale or polycythemia with a hematocrit of > 56%
What is the rebleeding risk associated with Ia of Forrest Classification?
60-100%
A 36-year-old man has had stable ulcerative colitis for 5 years. He is being treated with sulfasalazine 1000 mg three times daily. On routine follow-up, he is found to have an ALT of 250 IU/L, an AST of 225 IU/L, an alkaline phosphatase of 450 IU/L, and a bilirubin of 2 μmol/L. Ultrasound of the abdomen reveals no bile duct dilatation or gallstones. Endoscopic retrograde cholangiopancreatography (ERCP) reveals multifocal strictures and dilatations of both the intrahepatic and extrahepatic bile ducts. What is the MOST likely diagnosis?
a. Primary Sclerosing cholangitis
b. Common bile duct stone
c. Primary biliary cirrhosis
d. Drug-induced hepatitis
Primary Sclerosing cholangitis (PSC)
This patient has elevated liver enzymes with an ERCP characteristic of sclerosing cholangitis. The ERCP rules out biliary stones. Whereas sulfa drugs can cause hepatitis, this would not account for the findings on the ERCP.
Spontaneous Bacterial Peritonitis (SBP) include:
a positive ascitic fluid bacterial culture and an elevated absolute polymorphonuclear leukocyte (PMN) count in the ascitic fluid, typically exceeding 250 cells/mm3
Which city used to have an NBA team in Canada other than Toronto? What was their name?
Vancouver - Grizzlies
What is very severe COPD defined by?
FeV1 < 30% predicted
What are the 3 principles of management of suspected variceal bleeds prior to endoscopy?
IV PPI
Antibiotics
Octreotide
A 23-year-old man who is being treated for depression is brought to the emergency department in a confused state by his mother, who found him with several empty, unlabeled pill bottles. He has been depressed since his fiancée left him 3 weeks ago. His mother does not know what medications he has been taking.
An electrocardiogram shows sinus tachycardia, a QRS complex width of 160 msec, and a corrected QT interval of 550 msec. A comparison electrocardiogram obtained one month ago was normal.
Which intravenous therapy is most appropriate for this patient?
a. metoprolol
b. physostigmine
c. procainamide
d. Sodium bicarbonate
Sodium bicarbonate
Name 3 causes of Hepatocellular Liver Enzymes in the 1000's
•Toxins/Drugs (acetaminophen, cocaine –associated with ischemic injury)
•Viral (Acute Hep A, B, D, or E)
•Vascular: Shock, Budd Chiari
•Acute stone w/ in 24 hours
•Autoimmune hepatitis
•Wilson’s (rare)
Who is the All-Time Leading Scorer in the NBA?
LeBron James
When should you consider BIPAP for respiratory failure?
1. pH ≤ 7.35 with a pCO2 ≥ 45
2. severe dyspnea (impending resp failure)
3. persistent hypoxemia despite supplemental oxygen
Which Forrest Classifications require endoscopic interventions?
Ia
Ib
IIa
IIb
A 56yo male is brought to the ED by EMS with frank hematemesis. He has a history of an NSTEMI with previous PCI to the LAD 2 years ago. He also has T2DM, hypertension, dyslipidemia and is on ASA, metformin, empagliflozin, bisoprolol, candesartan, and rosuvastatin. He has been adherent to all of his medications. His vitals on presentation are: HR 124, BP 88/56, O2 95%, T 36.8, RR 16. He is lethargic and confused but does respond to verbal commands. His initial blood work shows: Hgb 62, MCV 103, WBC 8.2, Plt 118.
Which of the following is not part of your initial management?
a) Administer 1g tranexamic acid
b) Cross match, group & screen, and transfuse packed red blood cells
c) Start IV pantoprazole, octreotide, and ceftriaxone
d) Consult ICU for consideration of airway protection and admission to monitored bed
Administer 1g tranexamic acid
What are 3 contraindications of prednisolone to treat Alcoholic Hepatitis?
Uncontrolled GI Bleed
AKI
Acute Pancreatitis
Infection
Psychosis
Who has won the most MVPs in NBA history?
Kareem Abdul-Jabbar