Pulmonification
Herbs
Critter Control
Cornucopia
Feline Frenzy
200
Phosphodiesterase inhibitor used occasionally in the treatment of end stage COPD refractory to conventional therapies, use is limited by its narrow therapeutic window and nasty side effect profile (nausea, diarrhea, tachycardia, seizures, etc). Toxicity can be treated with beta blockers
Theophylline.
**ALMOST NEVER THE BOARD ANSWER :)
200
Common adverse effect of the following herbal remedies: Ginseng, Tumeric, Gingko Biloba
Bleeding
200
68 year old male from Tent City presents with acute confusion and asymmetric flaccid paralysis. His girlfriend at bedside reveals he has had multiple falls and rigid movements over the past few weeks. CSF analysis reveals lymphocytosis. What is the likely diagnosis?
West Nile Encephalitis
200
First line anticoagulation for a pregnant female with a DVT and minimal bleeding risk
Subcutaneous low molecular weight heparin (accept lovenox, enoxaparin)
200
Garfields Favorite Food
Lasagna
400
Initial diagnostic test to evaluate a patient with chronic dyspnea and a history of multiple PEs and increased RV pressure on echocardiogram
V/Q scan
**Evaluate for CTEPH
400
Alternative herbal remedy used for treatment of hyperlipidemia in the anti-statin folks
Red Yeast Rice
400
A 42 year old fresh water diver returns from a trip to Sub-Saharan Africa and presents 1 week later with fever, chills, myalgias and an urticarial rash. She was compliant with antimalarial prophylaxis. Labs show eosinophila. Which neoplasm can occur if untreated?
Squamous cell carcinoma of the bladder
**patient has schistosomiasis. Treatment is steroids followed by praziquantel after resolution of acute phase. Long term complications include bladder cancer and hydronephriosis
400
Suspect this diagnosis in a compliant diabetic with A1c of 6.2% and unilateral severe proximal muscle pain followed by weakness that progresses to the contralateral leg.
Diabetic Amyotrophy
** Due to ischemia from nonsystemic microvasculitis
400
A famous fictional character created by the Japanese company Sanrio
Hello Kitty
600
Chronic lower respiratory illness seen in patients with asthma and cystic fibrosis, labs show eosinophilia and imaging shows central bronchiectasis
Allergic bronchopulmonary aspergillosis
600
Used as an alternative treatment for BPH as it is noted to contain anti 5-alpha-reductase properties
Saw Palmetto
600
Management of post infectious symptoms of Lyme Disease after treatment with doxycycline
Supportive care
600
Feared complication of this toxic alcohol is blindness due to retinal toxicity
Methanol
600
North American Cougar native to Collier County as well as other rural and wildlife communities of Southern Florida
Florida Panther
800
Name the diagnosis: A 55 year old male with chronic dyspnea on exertion, physical examination notable for velcro rales and clubbing without any other systemic manifestations. PFTs show FEV1/FVC ratio 86%
Idiopathic pulmonary fibrosis
800
Banned by the FDA in 2004, this evergreen shrub has been used for weight loss and as a cold remedy, but carries increased risk of hypertension, MI and stroke
Ephedra
800
A healthy 35 year old male presents with fever, shortness of breath, neck pain and progressively worsening sore throat and odynophagia despite a course of amoxicillin. He is found to have gram negative bacteremia and a segmental pulmonary embolism. What is the diagnosis?
Lemierre's Syndrome
Infectious thrombophlebitis of the internal jugular vein often resulting from oropharyngeal infection, commonly the anaerobe Fusobacterium necrophorum
800
Treatment of disabling essential tremor in an otherwise healthy 58 year old male chemist that is refractory to beta blockers, benzos and anticonvulsants
Deep Brain Stimulation
800
Grumpy Cats real name (RIP 🙁 )
Tardar Sauce
1000
53 year old female with fever, arthralgias and dry cough x 1 month. CT of the chest shows hilar adenopathy. She shows you the following skin lesions. What is the diagnosis?
Loeffgren's Syndrome, a manifestation of acute sarcoidosis, particularly in females. Diagnosis is clinical, no biopsy needed! Treatment is supportive care.
1000
Root of the plant Glycyrrhizia glabra, thought to treat stomach ulcers and viral infections but can cause hypertension and hypokalemia via apparent mineralocorticoid excess
Liquorice
1000
A 45 year old traveler from Southeast asia presents with epigastric pain worse with meals, wheezing and hemoptysis x 8 weeks. He is started on systemic steroids for a presumed COPD exacerbation. He decompensates overnight and is intubated and started on pressors and empiric antibiotics. Blood cultures are positive for gram negative rods. What is the likely overall diagnosis?
Strongyloides infection.
**Larvae dissemination in multiple organ systems can cause shock and gram negative bacteremia due to seeding of organisms from the GI tract.
**DO NOT GIVE STEROIDS
1000
Autosomal Dominant genetic disorder characterized by frequent epistaxis, recurrent GI bleeds, seizures, cerebral aneurysms, and hemorrhagic strokes
Hereditary Hemorrhagic Telangiectasias (Osler-Weber-Rendu Syndrome)
1000
Number of Cats owned by Dr. Rasnake
4