October Jeopardy

Cancer Screening

100

Cervical cancer screening in Ethiopia is usually best done with?

VIA and/or VILI

200

Cancer screening should be offered for which of the following populations?

• Patients with signs and symptoms of cancer
• Only elderly patients as they are more likely to have cancers than younger patients
• Asymptomatic patients who meet criteria for age and/or risk exposures
• Patients living in urban areas

Asymptomatic patients who meet criteria for age and/or risk exposures.

300

A 30-year-old male presents to your clinic asking about colorectal cancer screening. He is asymptomatic and has a family history of colon cancer in his father, who was diagnosed at age 47. Which is the appropriate screening for this patient?

Start screening at age 37, ten years before his father was diagnosed with colon cancer.

400

Which is a true statement about prostate cancer screening?

• All males over 50 should be screened for prostate cancer with a PSA and DRE.
• Males over 50 should have a shared decision-making process with their family doctor about whether or not to screen for prostate cancer.
• The prostate specific antigen test (PSA) is a highly sensitive and specific test.
• There are no risks associated with more frequent prostate cancer screening in males

Males over 50 should have a shared decision-making process with their family doctor about whether or not to screen for prostate cancer.

500

Which is a FALSE statement about breast cancer screening?

• Women who are at high risk of breast cancer (genetic syndromes, family history) should follow the same screening guidelines as average-risk women.
• Between ages 40-50, women should have an individualized discussion with their primary care provider about whether or not to screen for breast cancer.
• Breast cancer screening is recommended for all average-risk women every two years between 50-75.
• Routine screening is performed with mammography.

Women who are at high risk of breast cancer (genetic syndromes, family history) should follow the same screening guidelines as average-risk women.

Sexual Health and PreP

100

Name two sexually transmitted infections can NOT found through serological/blood testing?

Gonorrhea and chlamydia

200

Please choose whether each of the following statements is true or false.

1. Sexual health is highly stigmatized, and the physician must always create a safe and non-judgmental environment for the patient to be open and honest
2. If your patient is married, always assume your patient is monogamous (only one partner)
3. Even if your patient is married, never assume your patient is monogamous (only one partner)
4. Never assume your patient’s sexual activities - always ask open-ended questions that allow the patient to elaborate

1. True

2. False

3. True

4. True

300

In which of the following patients, would it be appropriate to prescribe PrEP?

• Patient who had high-risk sexual exposure with an HIV-unknown partner 24 hours ago
• Patient who is having unprotected sexual activity with multiple partners, who requests PrEP
• Patient who is having unprotected sexual activity with multiple partners, who presents with fever, myalgia, and lymphadenopathy
• HIV positive patient who you are seeing for an initial visit

Patient who is having unprotected sexual activity with multiple partners, who requests PrEP

400

In addition to HIV serology, what other blood work test should you order every 3 months in a person on oral PrEP?

Creatinine.

500

Which of the following is NOT an evidence-based PrEP regimen?

• TDF/XTC (e.g., Truvada) once daily
• TAF/FTC (Descovy) once daily
• TDF/XTC (e.g., Truvada) on demand
• TAF/FTC (Descovy) on demand

TAF/FTC (Descovy) on demand

POCUS

100

Name two findings that rule out pneumothorax on lung POCUS.

Lung sliding

Comet tails

200

For each of the following POCUS exams, list a positive clinical finding. For example: Lung POCUS -> pneumothorax.

1. Subxiphoid cardiac view -> ?

2. Aorta ->  ?

3. 1st trimester ultrasound -> ?

1. Subxiphoid cardiac view -> pericardial effusion

2. Aorta -> abdominal aortic aneurysm

3. 1st trimester ultrasound -> ectopic pregnancy

300

On ultrasound, bone reflects all of the ultrasound waves, resulting in what phenomenon?

Anechoic area/acoustic shadowing beyond the bone

400

Choose true or false for each of the following statements:

1. Low frequency probe: penetrates further, lower res

2. High frequency probe: less penetration, lower res

3. Low frequency probe: less penetration, lower res

4. High frequency probe: less penetration, higher res

1. True

2. False

3. False

4. True

500

Name and demonstrate 2 of the 4 cardinal movements that you can use to move the ultrasound probe.

Slide 

Rotate 

Rock/Heel

Sweep/Tilt

Lifestyle modification and chronic disease

100

What do the Ethiopian Primary Health Care Clinical Guidelines say about exercise recommendations?

• 60 minutes per day of vigorous physical activity (dancing, sprinting)
• 30 minutes per day, most days per week, of moderate physical activity (brisk walk)
• 30 minutes twice weekly of moderate physical activity (brisk walk)
• 45 minutes per day, most days per week, of moderate physical activity (brisk walk)

30 minutes per day, most days per week, of moderate physical activity (brisk walk)

200

Which of the following is NOT used to estimate a patient’s cardiovascular disease risk score (by Framingham Risk Score)?

1. Systolic blood pressure
2. BMI
3. Smoking status
4. Age

BMI

300

Which of the following is NOT a component of routine, basic bone health?

1. Treatment with anti-resorptive agents
2. Vitamin D and Calcium supplementation
3. Regular weight-bearing exercises
4. Fall prevention strategies

Treatment with anti-resorptive agents

400

Based on the research by Barbara Starfield, which of the following statements is FALSE regarding primary care/family medicine physicians?

• Areas with higher primary care physician availability (but not specialist availability) have healthier populations
• Greater primary care physician availability reduces the adverse effects of social inequality
• Countries with strong primary care have lower overall costs generally healthier populations
• Primary care physicians create greater health care spending and do not contribute to better population health outcomes

Primary care physicians create greater health care spending and do not contribute to better population health outcomes.

500

Average risk patients should begin screening for diabetes at what age?

Forty

Acute Febrile Illness

100

Which of the following statements about acute febrile illness is FALSE?

1. Fever in a patient who has traveled to a malarious area should be considered malaria until proven otherwise
2. Exposure history is an important piece of history to determine a differential of AFI causes
3. All patients with AFI should be treated with the same antibiotics
4. Both unique travel-related infections and cosmopolitan (common, worldwide) infections can cause AFI

All patients with AFI should be treated with the same antibiotics

200

Name 2 tests should be ordered for ALL travelers returning with an acute febrile illness?

Malaria smears +/- rapid antigen testing

300

Which of the following is true about diagnosis of Dengue Fever?

1. Diagnosis is often clinical due to limitations in currently available microbiologic testing
2. PCR is easily accessible, cheap, and is usually positive for several weeks
3. IgM is positive for life after acute infection
4. There is never a role for serology in diagnosis

Diagnosis is often clinical due to limitations in currently available microbiologic testing.

400

Name the correct exposure to disease. For example: malaria -> mosquito

1. Dengue fever -> ?

2. Rickettsial disease -> ?

3. Typhoid fever -> ?

1. Dengue fever -> mosquitoe

2. Rickettsial disease -> ticks and/or fleas

3. Typhoid fever -> fecal-oral, food/water

500

In the setting of a non-specific acute febrile illness, name the CBC pattern that is 29x more likely to be Dengue Fever than other infectious agent?

Thrombocytopenia + neutropenia + lymphopenia