The Clot Thickens
Tumor lysis syndrome prophylaxis in high-risk ALL or Burkitt lymphoma patients is best achieved with this drug.
Rasburicase
In a patient with systemic lupus erythematosus who develops proteinuria >500 mg/day or active urinary sediment, the next diagnostic step is this procedure.
Kidney Biopsy
First-line treatment for status epilepticus.
Lorazepam
In septic shock, the first-line vasopressor recommended by the Surviving Sepsis Campaign is this catecholamine.
norepinephrine
The screening test of choice for primary hyperaldosteronism in a patient with resistant hypertension and hypokalemia.
plasma aldosterone-to-renin ratio (ARR)
Patients with sickle cell disease should receive this medication to reduce vaso-occlusive crises and acute chest syndrome.
Hydroxyurea
This renal complication is classically associated with hepatitis C infection.
membranoproliferative glomerulonephritis
Mechanical thrombectomy can be performed up to this many hours after symptom onset in carefully selected patients with large-vessel occlusion.
24 hours
In a mechanically ventilated patient with severe ARDS, the recommended tidal volume is set at this number of mL/kg of predicted body weight.
4-6 mL/kg
In diabetic ketoacidosis, insulin should be withheld until serum potassium is at least this level.
3.3 mEq/L
The presence of CD20 positivity in B-cell lymphomas makes patients eligible for treatment with this monoclonal antibody.
Rituximab
In patients with diabetic CKD and albuminuria, this class of medication reduces progression of kidney disease and cardiovascular mortality beyond ACE inhibitors or ARBs.
SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin)
In myasthenia gravis crisis, this therapy provides more rapid improvement than steroids.
plasmapheresis (or IVIG)
For central line–associated bloodstream infection, this is the minimum duration of catheter-free time recommended before reinsertion at a new site.
48 hours (after documented clearance of bacteremia)
In Graves’ disease, the definitive therapy that provides the highest long-term remission rate is this treatment.
radioactive iodine ablation
In chronic myeloid leukemia, the presence of ≥20% blasts in the blood or bone marrow defines this phase of the disease.
Blast Crisis
The triad of fever, rash, and eosinophilia in the setting of rising creatinine is classic for this cause of AKI.
acute interstitial nephritis (AIN)
The presence of both upper and lower motor neuron signs in different regions of the body is diagnostic of this neurodegenerative disorder.
ALS
This condition, characterized by diffuse symmetric weakness and difficulty weaning from the ventilator, is associated with prolonged critical illness, sepsis, and corticosteroid use.
ICU-acquired weakness (critical illness polyneuropathy/myopathy)
In a prolactin-secreting pituitary adenoma, the first-line treatment is not surgery but this class of medication.
dopamine agonists (e.g., cabergoline, bromocriptine)
These are the expected lab changes seen in DIC (need at least 4)
Platelets decreased, PT/PTT prolonged, fibrinogen decreased, D-Dimer elevated, Hgb/hematocrit decreased, peripheral blood smear showing schistocytes
The most important management strategy for dialysis disequilibrium syndrome is to do this to the dialysis prescription.
reduce the rate and intensity of dialysis (shorter, gentler sessions, slower urea removal)
According to current evidence and society guidelines, placement of a PEG tube in patients with advanced dementia provides no benefit in this outcome.
survival, prevention of aspiration pneumonia, or quality of life
In severe ARDS with refractory hypoxemia despite low tidal volume ventilation, high PEEP, and paralysis, this advanced rescue therapy is indicated when the PaO₂/FiO₂ ratio remains below 80 for more than 6 hours.
venovenous extracorporeal membrane oxygenation (VV-ECMO)
In hyperosmolar hyperglycemic state (HHS), this intervention must be started before insulin therapy.
aggressive IV fluid resuscitation