Sports
What college did Lebron James go to?
Trick question: He did not attend college
A 54-year-old woman is evaluated in the emergency department for a severe, nonpulsatile, bilateral occipital headache accompanied by photophobia and vomiting that suddenly began 3 hours ago during sexual intercourse. She describes the headache as being “different” from her usual migraine. Whereas rizatriptan typically is effective in resolving the migraine, neither rizatriptan nor ibuprofen has relieved her current symptoms.
On physical examination, blood pressure is 144/94 mm Hg; all other vital signs are normal. She appears uncomfortable and prefers a dark room; the remainder of the physical examination is unremarkable.
Results of laboratory studies are within normal limits.
What is the next step in management?
CT head - thunderclap headache which is a medical emergency that warrants immediate diagnostic evaluation
The date St. Patrick's Day is celebrated.
A 63-year-old man is evaluated for easy bruising, worsening edema, and dizziness on standing over the past 9 months. Medical history is otherwise noncontributory; he takes no medications.
On physical examination, blood pressure is 105/60 mm Hg sitting and 80/50 mm Hg standing; pulse rate is 105/min both sitting and standing. Periorbital ecchymoses, macroglossia, and jugular venous distention are present.
Laboratory studies show a normal hemoglobin level, serum albumin level of 2 g/dL (20 g/L), and serum creatinine level of 1.5 mg/dL (133 μmol/L). 24-Hour urine albumin excretion is 3500 mg. Serum protein electrophoresis shows an IgG λ spike of 1.2 mg/dL.
Echocardiogram shows biventricular myocardial hypertrophy with nondilated ventricles and diastolic dysfunction. Left ventricular ejection fraction is 51%.
What is the diagnostic test you should perform next?
Abdominal fat pad biopsy -
What is the name of the horizontal rows on the periodic table?
Periods
What hockey player has the most goals in his game career?
Who is Wayne Gretzky?
A 49-year-old woman is evaluated in the emergency department for sudden-onset severe headache of 24 hours' duration. The headache reached its peak intensity within 1 minute. She is otherwise well and takes no medications.
On physical examination, vital signs are normal. Nuchal rigidity is present. Findings on mental status and funduscopic examinations are normal. There are no cranial nerve deficits.
A CT scan of the head is normal.
What should you order next?
Lumbar puncture - Thunderclap headache is a medical emergency and CT head is normal so with someone suspected to have subarachnoid hemorrhage a LP is indicated (will reveal elevated erythrocyte counts and xanthrochromia)
The National flower of Ireland
What is shamrock?
A 48-year-old woman is evaluated for easy bruising. She has no history of gingival bleeding, menorrhagia, or bleeding following procedures. Medical history is notable only for systemic lupus erythematosus. Medications are prednisone, hydroxychloroquine, and NSAIDs as needed.
On physical examination, vital signs and examination findings are normal.
Laboratory studies show an activated partial thromboplastin time of 38 seconds, platelet count of 190,000/μL (190 × 109/L), and prothrombin time of 12.5 seconds.
What is the diagnostic test you should perform next?
Mixing Study -
What is the atomic number of helium?
2
Who was the women's NCAA champion in 2014?
A 78-year-old man is evaluated for a 4-month history of increasing forgetfulness. He lives alone and maintains independence in all of his instrumental and basic activities of daily living. His daughter reports that he forgets appointments and his home is less organized than before with more clutter, including unopened bills on the dining room table. He does not drink alcohol. There is no history of high-risk sexual behavior. He is otherwise well and takes no medications.
On physical examination, vital signs, general screening, and neurologic examination findings are normal.
He can recall two of three items on the Mini-Cog test but cannot correctly draw a clock face.
What is the next test you should perform?
Meds, alcohol, sleep apnea, depression
Assessment for a reversible cause of cognitive impairment should include consideration of medication adverse effects, alcohol use, sleep apnea, and depression.
The dance that is done to lively Irish music.
What is the Irish jig?
A 68-year-old man is evaluated for a transfusion reaction. He was hospitalized for acute upper gastrointestinal bleeding. While receiving his first unit of packed red blood cells, he developed fever, dyspnea, and flank pain 15 minutes into the transfusion. The transfusion was stopped by the nursing staff. His only medication is omeprazole.
On physical examination, temperature is 38.3 °C (100.9 °F), blood pressure is 80/40 mm Hg, pulse rate is 120/min, and respiration rate is 18/min. Oxygen saturation is 96% breathing ambient air. Cardiopulmonary examination reveals clear lungs, normal heart sounds, and low central venous pressure.
Inspection of a collected urine specimen reveals a pink coloration.
What is the diagnosis?
Acute hemolytic transfusion reaction -
These are the only two elements that are liquid at room temperature.
Bromine and Mercury
Where is the college football hall of fame?
Atlanta, GA
A 65-year-old man is evaluated in the emergency department for a 24-hour history of difficulty walking and inability to urinate. He has hypertension treated with amlodipine.
On physical examination, vital signs are normal. Muscle strength is 4/5 for both hip flexors. Patellar reflexes are 3+ bilaterally. There are bilateral extensor plantar responses in the toes, decreased sensation to pinprick below the nipple line bilaterally, and a palpable bladder. Upper extremity reflexes are 2+ in both biceps. Arm strength is normal. Gait is ataxic.
What is the next step to perform to make the diagnosis?
MRI of thoracic spine - Myelopathy may result in spastic paresis or paralysis, with weakness, hyperreflexia, muscle spasticity, extensor plantar responses, and often loss of sensation at or below the site of injury.
This patient has signs of thoracic myelopathy on examination, with bilateral patellar hyperreflexia, extensor plantar responses, and a sensory level at approximately T3 (below the nipple line).
A vegetable with eyes that tastes great mashed or fried.
What are potatoes
A 19-year-old woman is evaluated following a recent diagnosis of hereditary spherocytosis. She is asymptomatic. She takes no medications.
On physical examination, vital signs are normal. The spleen tip is palpable.
Laboratory studies show a hemoglobin level of 11.7 g/dL (117 g/L), mean corpuscular hemoglobin concentration of 40 g/dL (400 g/L), and reticulocyte count of 6% of erythrocytes.
Peripheral blood smear shows frequent spherocytes and polychromasia of the erythrocytes and reticulocytosis.
What is the most appropriate treatment?
Folate
This is the name for P2O5.
What is diphosphorous pentoxide
How many gymnastics events do women compete for in the Olympics?
4
A 66-year-old man is evaluated for abnormal behavior during sleep. His wife reports he has a prolonged history of nocturnal flailing and jerking movements and of shouting, punching, and jumping out of bed. The patient does not recall these movements and reports no discomfort. He also has a history of urinary incontinence and falls. He takes no medications.
On physical examination, vital signs are normal. He has reduced facial expression and bilateral rigidity. His gait is unsteady, with postural imbalance during turns, and he cannot walk in tandem. Other neurologic examination findings are unremarkable.
A polysomnogram reveals complex movements associated with preserved muscle tone during rapid-eye-movement sleep.
What is the diagnosis?
Rapid eye movement sleep behavior disorder - strong association with neurodegenerative disorders; patient's are often unaware of the movements. This patient has evidence of parkinsonian disorder
A special type of meat eaten especially on St. Patrick's Day.
What is corned beef
A 68-year-old woman is seen in consultation regarding recently diagnosed JAK2 V617F mutation–positive essential thrombocythemia. She is asymptomatic, has no other medical problems, and takes no medications.
On physical examination, vital signs are normal. The spleen is palpable 2 cm below the left costal margin.
Laboratory studies show a hemoglobin level of 13.5 g/dL (135 g/L), leukocyte count of 6000/μL (6 × 109/L), and platelet count of 685,000/μL (685 × 109/L).
What medication should you give to treat this patient?
Hydroxyurea and aspirin -
This is the rarest element that occurs naturally in the earth's crust.
What is astatine?