Have a Heart
Gland Canyon
Swallow your Pride
It's Electric
Don't Bug Me
100
In a patient with a normal baseline EKG and atypical chest pain, this is the appropriate test to rule in/out CAD
Exercise EKG
100
Low TSH, low T4. Diagnosis?
Central hypothyroidism
100
Name the 2 most common causes of peptic ulcer disease
NSAIDs and H. Pylori
100
What’s the rhythm?
Sinus tachycardia
100
Most common pathogen for uncomplicated acute cystitis
E coli (80%)
200
What one finding distinguishes between unstable angina and NSTEMI?
Cardiac biomarkers (troponins)
200
Low plasma renin activity in a patient with hypertension suggests this diagnosis
Primary
(hyper)aldosteronism
Low PRA ->high ARR (aldosterone:renin)
200
49yoM p/w heartburn
Symptoms c/w GERD
Labs normal except mild anemia
Next step?
EGD with biopsy
Anemia = alarm symptom
No alarm symptoms: OK for 4-8 week PPI trial
200
What’s the diagnosis?
Inferior STEMI
200
Patient with AIDS, CD4 <100, with persistent watery diarrhea.
Suspected pathogen?
Cryptosporidium
300
What consultant should you call?
Vascular surgery (“surgery” is fine)
Type A aortic dissection
300
This medication class inhibits resorption of glucose in the proximal renal tubule
SGLT2 inhibitors (flozins)
300
Strep pharyngitis suspected:
(+) subjective fever
(-) cough
(+) tender anterior cervical lymphadenopathy
(-) tonsillar exudates.
What next?
Test for strep (RADT), treat if +
(true for 2-3 Centor criteria)
0-1 don’t test
4 Can test or just treat
300
What’s the rhythm?
Complete heart block
Sinus rhythm at ~75 (p waves)
Ventricular rate ~30 (wide QRS)
300
Risk stratification tool to help determine whether pneumonia should be treated inpatient or outpatient
CURB-65 or PSI or PORT
Confusion, Uremia, Respiratory Rate, SBP, Age
2 criteria, consider inpt; 3 criteria, consider ICU
PSI/PORT: 20 factors predicting mortality
400
On echocardiography, accentuated rate of early diastolic filling is characteristic of this condition
Restrictive cardiomyopathy
(“Restrictive filling”)
400
In a patient with low serum cortisol and low ACTH, suspect this type of adrenal insufficiency
Secondary (or central)
400
Bglu level to diagnose diabetes after 2-hour oral glucose tolerance test
200 mg/dL
400
Why is this patient about to code?
Hyperkalemia (10.5)
400
Virus that causes progressive multifocal leukoencephalopathy (PML)
JC virus
500
Medication list for patient with nonischemic cardiomyopathy, HFrEF (EF 35%), NHYA III…what do you need to add?
Carvedilol
Sacubitril / Valsartan
Dapagliflozin
Furosemide
Spironolactone (or eplerenone) – mineralocorticoid receptor antagonist
Recommended for HFrEF, NHYA class II-IV
500
Pt presents to PCP as post hospital f/u after hip fx after fall from standing
DEXA: T-score -1.5
Diagnosis?
Osteoporosis (fragility fx)
Low bone mass = T score -1 to -2.5
500
Name the syndrome:
Calcium deposits in skin
Raynaud phenomenon
Esophageal dysfunction
Thickened, tight skin on hands/fingers
Visible dilated capillaries (red marks)
CREST syndrome
Subtype of systemic sclerosis
500
85M with DM, TIA
Prior ECGs: sinus rhythm
What med should you start?
This is atrial fib with a normal rate. CHADS2vasc >1
Any reasonable anticoagulant (DOAC preferred)
500
Eponym for septic thrombosis of IJ vein
Lemierre syndrome
600
FINAL JEOPARDY
Describe one thing you saw a NON-PHYSICIAN do during this rotation that impressed you.