Hallelujah Hematology!
Santa's Nephrons
Holiday Heart
GIngle Bells
Holiday Hits
200
Treatment for acute ischemic stroke in patients with sickle cell disease
Exchange transfusion and aspirin (accept exchange transfusion)
*Exchange transfusion also used in treatment of severe acute chest syndrome
200
A 40 year old morbidly obese male with no significant past medical history or recent infection presents with bilateral edema. Labs reveal hypoalbuminemia and profound hyperlipidemia. 24 hr urine reveals 3.8 g protein. What is the most likely etiology of his renal disease?
FSGS
*Nephrotic syndrome associations:
FSGS: HIV, morbid obesity
Membranous Nephropathy: Hep B, C, syphillis, SLE, drugs, cancers
Minimal change: Post infection
DM renal disease: slowly progressive with long standing DM
200
The most effective drug for intermittent claudication
Cilostazol
200
This CT and analogous food item represent which disease?
Autoimmune pancreatitis
*Sausage shaped pancreas
Type 1 AIP associated with IgG4-related diseases: Sjögren syndrome, PSC, bile duct strictures, autoimmune thyroiditis, retroperitoneal fibrosis, sclerosing sialoadenitis, interstitial nephritis.
Type 2 AIP: associated with chronic pancreatitis and IBD, less likely to include elevated IgG4 levels
200
According the the song “Santa Clause is Coming to Town,” how many times does Santa check his list?
Twice
400
Pre-op hemoglobin transfusion goal in patients with sickle cell disease
10
400
This elective surgery is associated with a high risk of calcium oxalate stones
Roux-en-y gastric bypass
(Accept bariatric surgery, short gut syndrome, bowel resection)
400
"Funny" channel inhibitor used in patients with an EF <35% who are in sinus rhythm with a heart rate >70 despite maximal beta blocker therapy
Ivabradine
400
Name 2 indications for cholecystectomy in patients with a gallbladder polyp
Polyp >/= 1 cm
Polyp >/= 8 mm with primary sclerosing cholangitis
Polyp of any size in the presence of gallstones or biliary colic
400
In a rather morbid song written in the 70s, which family member gets run over by a reindeer?
Grandma
600
A 25 year old male presents with fatigue, yellow skin and a palpable spleen. Labs reveal anemia, reticulocytosis, elevated LD, indirect hyperbilirubinemia and spherocytes on peripheral smear. Which test should you order to differentiate between 2 likely diagnoses?
Direct antiglobulin test
(Accept coombs test, DAT test)
*Need to differentiate between hereditary spherocytosis and autoimmune hemolytic anemia
600
This disorder is often responsible for neurological symptoms after or during dialysis and is thought to be due to osmotic shifts causing transient cerebral edema
Dialysis disequilibrium syndrome
600
Name one cardiac condition with paradoxical splitting (split S2 with expiration)
LBBB, HCM and severe AS
600
Order this diagnostic test for a patient with cirrhosis who becomes dyspneic and hypoxemic sitting up with symptom relief when lying down
Transthoracic contrast echocardiogram (accept contrast echo)
*Patient has hepatopulmonary syndrome and symptoms are consistent with platypnea-orthodeoxea syndrome
600
This song, released in 1994, is the most digitally downloaded/streamed Christmas song of all time
All I Want for Christmas is You
800
A 30 year old female with easy bruising and epistaxis is found to have an prolonged PTT and normal PT on labs. What is the next test to order?
A mixing study
*Missing factor vs factor inhibitor
800
Likely etiology for the following labs in a hypovolemic patient:
Serum Sodium: 128
Serum Osms: LOW
Urine Sodium: LOW
Negative urine anion gap
GI Losses (Diarrhea)
Urine anion gap = Na + K - Cl
NEGATIVE in GI LOSSES
POSITIVE in RENAL LOSSES
800
Syndrome associated with a pseudo-RBB pattern and ST elevations in V1-V3
Brugada syndrome
800
A patient with primary biliary cholangitis requires a liver biopsy if these 2 criteria are met
Alkaline phosphatase level ≥1.5× ULN
Positive antimitochondrial antibody titer OR positive sp100 or gp210 if antimitochondrial antibody is negative
(Accept elevated Alk phos and positive AMA)
800
In 1965, this became the first song played in space when it was broadcast during NASA's Gemini 6A space flight
Jingle Bells
1000
An 88 year old presents with fatigue, fever, night sweats and weight loss. Labs reveal anemia, thrombocytopenia, leukocytosis and the following peripheral smear. What is the most likely diagnosis?
Primary myelofibrosis
1000
Bone mineral disorder seen in chronic kidney disease that results from abnormal bone turnover due to secondary hyperparathyroidism or complications of hyperparathyroidism treatment
Renal osteodystrophy
Osteitis fibrosa cystica: inadequate tx of secondary hyperPTH
Adymanic bone disease: excess tx of secondary hyperPTH
1000
The 2 most common structural heart diseases associated with syncope
Aortic stenosis and hypertrophic cardiomyopathy
1000
What are the 2 indications to screen for hepatocellular carcinoma in patients with primary biliary cholangitis?
Male sex and presence of cirrhosis
1000
Written in the 1940s, critics say the lyrics of this popular jingle are suggestive of harassment while others argue that it represents breaking the cultural expectations of the songs time
Baby it's Cold Outside