Lyte the way
My pee is weird :(
Why so yellow?
Up top
Down low
100
65 year old with end-stage renal disease presents with peaked T waves on EKG. What is the immediate next step?
IV calcium
100
5 year old boy with foamy urine, leg swelling, periorbital edema. What is the treatment?
Steroids
100
28 year old man with cirrhosis, schizophrenia, and Kayser-Fleischer rings on slit-lamp exam. What lab would confirm the diagnosis?
Low ceruloplasmin
100
33 year old man with heartburn and regurgitation, improved on PPIs. What is the underlying pathophysiology?
Transient lower esophageal sphincter relaxation
100
55 year old woman has watery diarrhea after recent hospitalization. What is the treatment?
Oral vancomycin or fidaxomicin
200
70 year old woman with recent brain tumor and hypernatremia. What test would confirm the diagnosis?
ddAVP challenge with >50% rise in urine osmolality
200
12 year old boy with sensorineural hearing loss and microscopic hematuria. What is the defect?
Type IV collagen
200
68 year woman with recent hypovolemic shock, now with AST and ALT in the 1000s. Which area is most likely to be affected?
Zone 3
200
28 year old man with asthma and eczema, now with difficulty swallowing. What makes the diagnosis on biopsy?
>15 eosinophils per hpf
200
28 year old man with chronic diarrhea and bloating with positive IgA to TTG. What might you see on his skin?
Dermatitis herpetiformis
300
3 causes of euvolemic hypotonic hyponatremia
SIADH, adrenal insufficiency, and hypothyroidism
300
13 year old girl with recent sore throat develops bloody urine. What would you see on EM?
Hump-like immune complex deposits
300
35 year old woman with jaundice and pruritis, found to have positive anti-mitochondrial antibodies. What would you see on histology?
Granulomatous destruction of lobular bile ducts
300
35 year old woman with difficulty swallowing both liquids and solids, and a "bird beak" appearance on barium swallow. What cells are missing?
Inhibitory ganglion cells (in the myenteric plexus)
300
68 year old woman with chronic constipation with left lower quadrant pain, found to have diverticulosis. Where do the diverticula form?
Weak spots in the muscle wall where nerves and arterial vasa recta penetrate
400
32 year old presents with elevated Cr after a surgery where they became hypotensive. What would the FENa be?
<1-2%
400
50 year old woman with sinusitis, hemoptysis and increased Cr. What test would confirm the diagnosis?
ANCA
400
55 year old man with a history of Hep C, with new onset ascites and tender hepatomegaly. The elevation of what serum marker would suggest the diagnosis?
Alpha-fetoprotein
400
58 year old man with severe epigastric pain radiating to the back, both lipase and amylase are elevated. What are 5 causes of this?
400
65 year old man with atherosclerotic disease presents with severe abdominal pain, found to have dark and dusky bowels. What are 2 areas of the GI tract at highest risk?
Splenic flexure and rectosigmoid junction
500
6 year old girl presents with hypomagnesemia, hypokalemia, and hypocalciuria. Where is the defect?
Distal convoluted tubule
500
Diagnosis?
Diabetic nephropathy
500
68 year old man with chronic alcohol use found to have a nodular liver on ultrasound. What are 5 physical exam findings the patient might have?
Ascites, jaundice, asterixis, spider angiomas, palmar erythema, caput medusae, gynecomastia
500
24 year old woman from India with nausea and 3 months of epigastric pain found to have multiple ulcers. If left untreated what (2) complications is she at risk for?
Gastric adenocarcinoma and MALT lymphoma
500
36 year old woman with 8 months of diarrhea and abdominal pain, with suspected IBD. What are 4 differences to make the final diagnosis?
