Medical Jeopardy

NephMadness™

100

In the diagnosis of SIADH, these two conditions must be excluded first

Hypothyroidism and Adrenal Insufficiency

200

Acute hypertensive condition in which ACEi are strongly preferred over ARBs

Sclerodermic Renal Crisis

300

Only medication FDA approved to slow progression of ADPKD

Tolvaptan

400

Expected decrease in pH for every 10 mmHg rise in pCO2 for both acute and chronic hypercapnea

Acute: 0.08 decrease in pH for every 10 increase

Chronic: 0.03 decrease in pH for every 10 increase

*Look at your hypercapnic patient's ABGs closely, a pH of 7.24 with a pCO2 of 60 should concern you more than a pH of 7.25 with a pCO2 of 90

500

A patient on peritoneal dialysis presents with recurrent small-bowel obstructions and this is found on CT, what is the diagnosis?

Encapsulating Peritoneal Sclerosis (EPS)

*1 year mortality of ~50% from time of diagnosis

Make Some Rheum

100

Most specific antibody for Rheumatoid Arthritis

Anti-CCP (cyclic citrullinated peptide)

* Citrulline is a non-essential amino acid and the word dervies from "citrillus" for watermelon

200

Most common cause of death in patients with Rheumatoid Arthritis

Cardiovascular Disease

300

Malignancy associated with Sjögren's Syndrome

Non-Hodgkin's Lymphoma

*15-20x times risk compared to general population

400

Auto-immune condition associated with these nail findings

Psoriatic Arthritis (PsA)

500

Antibody associated with Inclusion Body Myositis

Anti-NT5C1A (anti-cytosolic 5'-nucleotidase 1A)

Magician's Favorite Physician

100

What is the answer to the category's title?

"Card"iologist because magicians like using card tricks

200

Minimum duration of anticoagulation after cardioversion for AF (even with CHA₂DS₂-VASc score of 0)

4 weeks

* Primarily due to increased risk of recurrence of AF and atrial-stunning in the first 30 days post cardioversion, Class I recommendation

300

Criteria for Class I indication for CRT-D in patients with HFrEF?

LBBB with QRS > 150 ms

LVEF < 35% with NYHA II-IV symptomatology

Sinus rhythm

*Class IIa recommendation made for non-LBBB between > 150 ms and LBBB between 120-150 ms

400

Diffuse T wave inversion throughout the precordial lead in an unconscious patient raises concern for what?

Increased ICP or massive ischemic CVA 

*Cerebral T Waves

500

Which types of Myocardial Infarctions are caused by procedures?

Types 4 and 5 (PCI and CABG, respectively)

Viruses, Bacteria, and Fungi, oh my!

100

Two types of meningitis that corticosteroids are indicated for continued management once pathogen has been identified with mortality benefit

Streptococcus Pneumoniae and Tuberculosis Meningitis

* Listeria in particular in observational studies had increase mortality when treated with steroids

*Haemophilus Influenza has hearing loss-benefits in pediatric populations, benefit not preserved in adults and no mortality benefit

200

Enterobacter cloacae, Klebsiella aerogenes and Citrobacter freundii all have this inducible gene that can lead to production of enzymes that  cause resistance to beta-lactam antibiotics (even when in vitro susceptibilities are present)

AmpC

300

Management of asymptomatic candiduria in neutropenic patient?

Treat as disseminated candidemia (caspofungin, micafungin, ampho B, etc.)

400

Virus associated with multicentric Castleman's Disease

HHV-6

500

Candidal species with intrinsic activity against fluconazole

Candida Krusei 

(do NOT accept Candida Glabrata or Candida Auris)

Don't Do Drugs (except these)

100

Loading and maintenance doses for Apixaban when treating VTE

10 mg BID x7 days --> 5 mg BID

200

Vitamin deficiency associated with chronic furosemide use

Vitamin B1

300

Class Ib anti-arrhythmic that is also an anti-epileptic agent

Phenytoin

400

Name 3 medications that induce Cytochrome P450

Accept 3 of: 

Phenytoin, Phenobarbital, Rifampin, Modafinil, Carbamazepine, Griseofulvin St. John's Wart

500

Cephalosporin that has true cross-reactivity with amoxicillin

Accept any of:

Cephalexin, Cefaclor, Cefadroxil 

*Shares an identical R₁ side-chain

I See You (ICU)

100

Method of cardiac-resuscitation involving the use of VA-ECMO

ECPR (Extracorporeal cardiopulmonary resuscitation)

200

2009 Landmark trial that found a 2.6% absolute risk reduction in 90-day mortality with tight glucose control of 140 - 180 mg/dL

NICE-SUGAR 

(Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation)

300

Preferred route of administration for pulmonary vasodilators (e.g., epoprostenol) in acute pulmonary hypertension NOT due to PAH

Inhaled

* IV is preferred to inhaled in WHO group 1 pHTN since there's no issue with poorly ventilated areas and concern for shunting

400

Goal plateau and driving pressures in ARDS

P_plat < 30 cm H2O

P_driv < 15 cm H2O

* P_driv = P_plat - PEEP

500

Preferred vasopressor in patients with HOCM

Phenylephrine