Jeopardy: Are you smarter than a med student?

Endo

100

For primary prevention of ASCVD, above this LDL we give high intensity statins regardless of age 

190

200

1st line treatment of prolactinoma (name & mech of action)

cabergoline (or bromocriptine) = dopamine agonist

300

Screening test for primary hyperaldosteronism

Aldosterone : renin ratio (ARR)

400

Initial treatment options for diabetic neuropathy (need 3 of 4) (classes of medications or examples from each class)

1. Gabapentinoids

2. serotonin-norepinephrine reuptake inhibitors

3. tricyclic antidepressants 

4. sodium channel blockers (e.g. lidocaine)

500

Indications for parathyroidectomy in primary hyperparathyroidism (need 5/7)

1. Age < 50

2. Hypercalcemia > 1 mg/dl above ULN

3. BMD by DEXA < t 2.5 at any site

4. vertebral fracture

5. GFR < 60

6. hypercalciuria

7. nephrolithiasis / nephrocalcinosis

Rheum

100

Classic X-ray finding of the lumbar spine for young adult male with ankylosing spondylitis

Bamboo spine

200

Treatment of Kawasaki disease (2/2)

IVIG & high dose aspirin

300

Classic triad of Reiter's Syndrome (reactive arthritis)

1. Can't see (conjunctivitis / uveitis)

2. Can't pee (urethritis)

3. Can't climb a tree (arthralgia / arthritis, enthesitis, dactylitis, sacroiliitis)

Related infections: chlamydia or GI (salmonella, shigella, yersinia, campylobacter)

400

Name the vasculitis:

abdominal pain, mononeuritis multiplex

ANCA negative, ANA negative

associated with hep B and hep C

arteriography can help suggest diagnosis

 

Polyarteritis nodosa (PAN)

bonus points: what is the specific serological test for PAN?

500

name DMARDs, their MOA, and adverse effect (need at least 3)

1. methotrexate (folate antimetabolite) hepatotoxicity, cytopenias, stomatitis

2. leflunomide (pyrimidine synthesis inhibitor) hepatotoxicity, cytopenias

3. hydroxychloroquine (TNF & IL-1 suppressor) retinopathy

4. sulfasalazine (TNF & IL-1 suppressor) hepatotoxicity, hemolytic anemia, stomatitis

5. TNF inhibitors (adalimumab, certolizumab, etanercept, golimumab, infliximab) infection, demyelination, CHF, malignancy

Heme/Onc

100

USPSTF recommendation for breast cancer screening (age & frequency)

age 40-74, biennial

200

Hepatitis C screening age

adults age 18-79

300

Lung cancer screening (age & pack years & within how many years of quitting)

50-80 year olds, 20+ pack year hx, smoke currently or within the past 15 years

400

medical treatments of severe hypercalcemia of malignancy (need 4/5)

1. isotonic saline volume expansion

2. loop diuretics if kidney or heart failure

3. IV bisphosphonate

4. denosumab

5. calcitonin

500

Indications for adrenalectomy (need 3/3)

1. Size > 4cm or suspicious abnormality of imaging

2. Growth on serial imaging

3. Hormone-producing tumors (except mild hypercortisolism)

Pharm

100

Which medication class for HFrEF increases risk of euglycemic DKA?

SGLT2i

200

Antipsychotic medication that can cause hypothyroidism

Lithium

300

GFR at which Metformin is contraindicated

below 30 ml/min/1.72m^2

(generally not started below 45)

400

pulmonary drug for pulmonary arterial hypertension that causes elevated liver enzymes and requires monitoring of LFTs

bosentan - endothelin receptor antagonist

500

Conditions/medications that can reduce PO levothyroxine levels (need at least 4)

1. underlying malabsorption d/o (e.g. celiac)

2. binders (iron, calcium, cholestyramine)

3. increase metabolism (phenytoin, carbamazepine, rifampin)

4. obese

5. pregnant

6. proteinuria