Mast Confusion
Axis Denied
Failure Is Not An Option
Hot Topics
Commercials
100
The PEN-FAST score can only be applied to this hypersensitivity reaction.
What is type 1 hypersensitivity reaction (IgE mediated)?
Ask about prior reaction timing! Type 1 hypersensitivity reactions typically occur quickly (<1 hour)
100
These are the two best leads to evaluate P waves when confirming sinus rhythm.
What are leads II and aVR?
Observing p wave followed by QRS complex is helpful but can also be seen in atrial tachycardias, etc.
100
This physical exam finding has the highest likelihood for heart failure.
What is S3?
+LR of 11
100
These three co-infections should be tested for in a patient with babesia infection.
What is lyme, erlichia, anaplasma?
Test for co-infections in all tickborne illness as many pathogens are carried within the same vector (ie. Ixodes tick)
100
The commercial jingle for this diabetes medication was based off the following song.
What is Ozempic?
200
Desensitization protocols must be repeated if this amount of time lapses between drug doses.
What is 4 half lives?
If patient is rechallenged without first densensitizing following lapse of 4 half lives, anaphylaxis will result!
200
This is the voltage criteria definition of an ST depression.
What is 0.5 mm (half of a small box)?
This is in contrast to voltage criteria definition for an ST elevation criteria (1 mm).
200
DAILY DOUBLE
These two diuretics are sometimes used acutely to augment loop diuretic efficacy through a method known as sequential nephron blockade.
What is metolazone and chlorothiazide (Diuril)?
200
This is the amount of FiO2 that a patient on 3L nasal cannula is recieving.
What is 30-33%?
3-4% FiO2 above 21% atomospheric for every 1 lpm delivered via nasal cannula.
This is why at 40 LPM/40% FiO2 of high flow nasal cannula, we often step down to 6L regular nasal cannula.
200
The commercial for this PDE5 inhibitor displayed the following image.
What is Cialis?
300
These are two 1st generation cephalosporins that cross react with penicillins due to a similar R1 side chain.
What are cephalexin, cefadroxil, cefatrizine, and cephradine?
300
The treatment for this EKG finding.
What is treat the underlying cause?
Multifocal atrial tachycardia is often precipitated by exacerbation of respiratory disorders
300
Name two non cardiac conditions/situations that can raise pro-BNP and one that often falsely lower pro-BNP.
Raise: renal failure/CKD, PE, pulm HTN, sepsis, anemia, stroke, entresto (should check NT-proBNP)
Lower: obesity (clearance receptors on adipose tissue), pericardial constriction
BNP production increases with age.
300
These three objective measures are needed to accurately risk stratify pulmonary embolism.
What are troponin, pro-BNP, and transthoracic echocardiogram?
300
The slogan for this dermatologic medication is "nothing is everything."
What is Skyrizi?
400
This cephalosporin has cross reactivity with a monobactam that has significant gram negative resistance rates and is therefore infrequently used.
What is ceftazidime?
Otherwise, aztreonam does not cross react with other beta lactams.
400
The name for this STEMI equivalent.
What is De Winter Sign - often seen in hyperacute phase of MI?
Anterior STEMI equivalent - STEMI morphology usually follows this finding
400
This is the correct method to measure JVD (draw or demonstrate).
400
DAILY DOUBLE
This is how to build an isotonic bicarbonate drip with the IV fluid builder (using sodium bicarbonate amps and an IVF base).
What is putting 150 mEq of NaHCO3 in 1L of D5W.
This creates a solution with 150 mOsm Na and 150 mOsm HCO3 in a 1L base of free water that carries no tonicity, resulting in a 1L solution with an isotonic concentration of approximately 300 mOsm.
Isotonic bicarbonate drips can be used to temporize acidosis while repleting volume (ie. patient with severe AKI and metabolic acidosis from diarrhea)
400
The commercial jingle for this medication with cardiac, renal, and anti-diabetic benefits is:
**Jay plays jingle**
What is Jardiance?
500
These two immunoglobulins mediate a hypersensitivity reaction is characterized by fever, arthralgias, and vasculitis.
What is type III hypersensitivity reaction (also known as serum sickness)?
This is IgG and IgM mediated. It involves formation of immune complexes that deposit in small blood vessels.
500
Name the classic cause of this rhythm.
What is reperfusion?
AIVR is classically caused by reperfusion following PCI or ROSC.
500
This physiologic mechanism is responsible for a drop in blood pressure when inotropes are given to a patient with this ultrasound and LV gram finding
What is left ventricular outflow obstruction?
Patient's with classic takotsubo pattern have akinetic apical to mid segments with a hyperdynamic base, this leads to systolic anterior motion of the mitral valve in states with further increased contractility (ie. addition of an inotrope)
500
Name the 3 common pyrogenic cytokines and one medication that directly acts on each.
What are
IL 1- anakinra, rilonacept, canakinumab
IL 6- tocilizumab, sarilumab
TNF alpha- etanercept, adalimumab (humira), infliximab (remicade)
500
The slogan "so easy a caveman could do it" is for the following insurance company.
What is Geico?