Odd one out:
Poison ivy
Nickel,
Hair dye
NSAIDS
what is NSAIDS
70 Y old M with new onset Afib, HR 116 to 126/m. PMH is significant for HTN and HLD. TTE 1 week ago showed EF 45%. He has not been started on medications yet. What is the best antiarrythmic agent for this Pt?
What is Toprol
Pt with HIV must be tested prior to initiating this medication
What is Abacavir
28 Y old F with recurrent episodes of fever, polyserositis, arthritis, erysipeloid rash around the ankles. Attacks last 1 to 3 days and are self-limited Her husband thinks she is being dramatic. Next time she has an attack, what is the treatment of choice?
What is Colchicine
•Target INR for antiphospholipid syndrome
What is 2.5 to 3.5, same for mechanical heart valves
•45 y old RN who just started working in the hospital this morning develops hives. What test will confirm your suspicion
• Skin test for allergy to latex
• RAST for allergy to latex
• CH 50
•Patch test
What is RAST for latex allergy
Two beta blockers approved for the treatment of heart failure
What are Toprol and Carvedilol
31 Y old M who arrived from Sri lanka 5 days ago presents with abd pain, diarrhea, nausea and vomiting.There are blanching erythematous macules on the lower chest and upper abdominal wall. He has scleral icterus and injected conjunctivae. Temp is 102F, HR64, BP is 102/65, wbc is 14k, AST 114, ALT 214. Blood cultures show gram-negative bacilli in 2 bottles. what is the diagnosis?
What is Typhoid fever
45 Y old M diagnosed with SLE 10 years ago now has increasing difficulty using her hands due to joint deformities.
Exam: subluxation and ulnar deviation of the MCP joints on both hands, swan neck deformity of fingers on both hands, flexion and subluxation of the MCP joint of both thumbs, and hallux valgus of the 1st MCP joints bilaterally.
Hand radiographs: no deformities or evidence of erosions
What is Jaccoud arthropathy
Type 2 DM pt recently diagnosed with CHF. Name 1 class of diabetic medications to avoid
What is Thiazolidinediones
3 receptors that opioid agents bind
What are Mu, kappa and delta
Pt with EF 15%, in the ED after he passed out while watching TV this morning. Discharge summary a week ago states that Pt is on maximal medical therapy. Pt will benefit from..
What is CRT-D
A 29-year-old woman is here for a 5-day hx of nodules over her lower extremities. She reports that she regularly visits a local spa that uses whirlpool footbaths during her pedicure procedures; she always shaves her legs with a razor before these visits. Medical history is unremarkable, and she takes no medications. Punch biopsy of a lesion reveals a necrotizing granulomatous dermatitis, and tissue culture grows a mycobacterial species within 4 days. What is the diagnosis?
What is Mycobacterium fortuitum furunculosis.
30 Y old F presents with a 4-month hx of increasing foot pain. She also has a 2-month hx of increasing pain and swelling in her fingers and right wrist as well as morning stiffness for >1 hour. No PMH, no home meds
Exam: VS wnl. There are tenderness and swelling of the 2nd and 5th PIP joints and the 2nd and 3rd metatarsophalangeal joints of the feet bilaterally, and tenderness with movement and swelling of the right wrist.
Radiographs of the hands and wrists are normal. Which test confirms your diagnosis?
What is anti CCP antibodies
30 Y old M who did not respond to full-dose antidepressant monotherapy for 6 weeks. Next step in mgnt
Dc current antidepressant, switch to another medication from the same class or from a different class
•2009 trial that showed tight glycemic control increased mortality in ICU patients.
What is the NICE SUGAR TRIAL
A low pitched rumbling diastolic murmur best heard at the apex, no snap available
What is Aortic regurgitation
31 Y old M who arrived from Sri lanka 5 days ago presents with abd pain, diarrhea, nausea and vomiting.There are blanching erythematous macules on the lower chest and upper abdominal wall. He has scleral icterus and injected conjunctivae. Temp is 102F, HR64, BP is 102/65, wbc is 14k, AST 114, ALT 214. Blood cultures show gram-negative bacilli in 2 bottles. what is the diagnosis?
What is typhoid fever
27 Y old M here with a 4 day hx of bilateral ankle stiffness ,swelling and pain. He has had a dry cough for that past 2 weeks. Yesterday he noticed a red painful pimple below his right knee. Pt is afebrile. CBC and BMP are wnl. ESR is 38. Chest xray shows bilateral hilar lymphadenopathy. What is the diagnosis and the most appropriate treatment
What is Löfgren syndrome , and NSAIDs
35 Y old F planning to start a family soon sees you in the clinic. She is on Lisinopril, Lipitor, Metformin, Sertraline and Folic acid. Pregnancy test is negative. Which of the medications will you stop today?
What are Lisinopril and Lipitor. Sertraline should be stopped by the Psychiatrist, not you! Never stop antidepressants suddenly.
I can mimic any other disease because i affect almost all organ systems. As a matter of fact I am known to cause false positive pregnancy tests.
What is SLE
36 Y old F presented after a syncopal episode while shopping. She is totally fine, but her cousin died suddenly last year at age 25. Her Mum died in an accident 5 years ago, but she remembers seeing her Mum faint a lot.EKG showed RBBB.
What is Brugada syndrome. autosomal dominant pattern.
A 60-year-old woman is admitted to the hospital for a 2-week history of confusion and change in personality. Her symptoms began acutely and have progressed steadily since onset. CBC, BMP,CRP and ESR unremarkable. CSF is clear, glucose, protein and cells are wnl, protein 14-3-3 is elevated CT head is negative. MRI shows focal cortical hyperintensity.What is the diagnosis?
What is Sporadic Creutzfeldt-Jakob disease
27-year-old man is evaluated for a 2-year history of ankylosing spondylitis. Symptoms were initially responsive to physical therapy and naproxen; however, for the past 6 months he has experienced increasing back and buttock pain and stiffness. 1 week ago, he was switched to Indomethacin but his symptoms remain unchanged. Next class of medications to try and the specific med.
What are TNF alpha inhibitors. what is Adalimumab. Rituximab is NOT approved for AS, it is for RA.
Screening test of choice for Atrial fibrillation
What is peripheral pulse palpation. Duhhh!!