Thicc Hearts
Have You Tried Motrin?
Protein Gone Wild
My Belly Hurts
DWTS 35
100
Initiate any three of these beta blockers for first-line treatment of symptomatic obstructive HCM.
What are nonvasodilating beta blockers (e.g. metoprolol, propanolol, nadolol, bisoprolol, atenolol)?
Avoid vasodilating beta blockers (e.g. carvedilol, labetalol, nebivolol)
100
Consider this infection as the most common etiology of acute pericarditis in regions where it is endemic.
What is tuberculosis?
Tuberculosis accounts for ~70% of acute pericarditis cases in endemic areas.
100
Consider this diagnosis in patient with ascitic fluid studies revealing SAAG>1.1 and protein>2.5.
What is heart failure?
100
This contestant serves as Jimmy Kimme's sidekick and regularly interviews celebrities on the red carpet.
Who is Guillermo Rodriguez?
200
Perform any one of these manuevers to decrease preload and make the obstructive HCM murmur louder.
What are Valsalva and standing?
Valsalva and standing decrease preload and make the murmur louder, while squatting and handgrip increase preload or afterload and make the murmur softer.
200
Diagnose acute pericarditis by identifying at least two of these four criteria.
What are
1) pleuritic/positional chest pain
2) pericardial friction rub
3) new widespread ST elevation or PR depression
4) new/worsening pericardial effusion?
200
Consider this type of cardiac amyloidosis in patients with bilateral carpal tunnel syndrome, lumbar spinal stenosis, and spontaneous biceps tendon rupture.
What is ATTR amyloidosis?
200
Consider this diagnosis in patient with ascitic fluid studies revealing SAAG<1.1 and protein>2.5.
What are peritoneal carcinomatosis, tuberculous peritonitis, pancreatic ascites, nephrotic syndrome?
200
This contestant played a Shakespeare-loving teenager opposite Heath Ledger in 10 Things I Hate About You.
Who is Julia Stiles?
300
DAILY DOUBLE!!!!
Avoid any three of these medications in symptomatic obstructive HCM.
Hint: Think about how preload, afterload, and contractility affect LVOT obstruction.
What are vasodilators (dihydropyridine CCBs, ACE inhibitors, ARBs, nitrates), high-dose diuretics, and positive inotropic agents?
Remember that decreased preload, decreased afterload, and increased contractility worsen LVOT obstruction.
300
DAILY DOUBLE!!!!
Avoid this medication class as first-line treatment for acute idiopathic pericarditis, as it can promote recurrence and dependence.
What are corticosteroids?
Remember that first-line treatment consists of NSAIDs/aspirin PLUS colchicine.
300
This transthyretin stabilizer reduces cardiovascular morbidity and mortality in patients with ATTR amyloidosis.
What is tafamidis?
300
Implement this management for patient with ascitic fluid studies revealing PMN count 300 but negative culture.
What is ceftriaxone (and albumin)?
Remember that ascitic fluid cultures are positive in only 40-50% of cases. A negative culture does not exclude SBP if PMN count is elevated.
300
This contestant appead on the UK version of Love Island as well on Traitors alongside DWTS dancer Mark Ballas.
Who is Maura Higgins?
400
Evaluate for any two of these echocardiogaphic findings in HCM, as they are major risk markers for SCD.
What are maximal LV wall thickness >30 mm, LV apical aneurysm, and LVEF <50%?
400
Evaluate for this specific echocardiographic finding if concerned for development of cardiac tamponade.
What is early diastolic RV collapse?
Diastolic RA collapse has 50-100% sensitivity, 33-100% specificity
RA collapse >1/3 cardiac cycle has 90% sensitivity, 100% specificity
Diastolic RV collapse has 48-100% sensitivity, 72-100% specificity
400
Exclude AL amyloidosis with these three laboratory tests before interpreting positive PYP scan as diagnostic of ATTR amyloidosis.
What are serum FLC, serum IFE, and serum IFE?
400
***DOUBLE***
Suspect secondary bacterial peritonitis in patients with three of these findings.
What are:
- Polymicrobital ascitic fluid culture
- Very or rising PMN count
- No clinical improvement after ~48 hours of appropriate antibiotics
- Persistent abdominal pain or peritoneal sign
- Free air or other concerning findings on imaging
400
This contestant worked as a back-up dancer for Beyonce before playing a high school student on Glee.
Who is Harry Shum Jr?
500
Determine the peak LVOT gradient in HCM, as this lower peak gradient defines the presence of obstruction and this higher peak gradient (at rest or with provocation) defines hemodynamically significant obstruction.
What are >30 mm Hg and >50 mm Hg?
500
Evaluate for this echocardiographic finding when differentiating constrictive pericarditis from restrictive cardiomyopathy.
What is exaggerated ventricular interdependence?
The rigid pericardium prevents transmission of intrathoracic pressure changes and fixes cardiac volume, forcing the ventricles to compete for space (increased filling of one reduces filling of the other).
500
Initiate ciprofloxacin for long-term primary SBP prophylaxis in patients with these findings.
What is low ascitic protein (<1.5) AND renal dysfunction (Cr >1.2, BUN >25, Na <130) or liver failure (Child Pugh >9, total bilirubin >3)?
500
This contestant danced alongside Channing Tatum in Step Up before marrying (and later divorcing) him.
Who is Jenna Dewan?