Fantasy Fibrosis League
Monday Night Malignancy
Fourth and Goal Flutters
Sarcoid Safeties
First Round Draft Interns
100
Define acute liver failure (3)
<26 weeks onset, no prior liver disease
INR > 1.5
Hepatic encephalopathy
100
Per current USPSTF guidelines recommendations, who should be screened for lung cancer?
Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
“50-80-20-15”
100
What do?
Complete heart block (3rd degree)
TVP -> PPM
100
Define Stage 1 sarcoidosis
Bilateral hilar lymphadenopathy
Often asymptomatic
Can do EBUS for dx, but also ok to just monitor
100
This intern loves videos games and cycling
Juan Cadavid
200
In patients with cirrhosis and varices, what pharmacologic therapy reduces the risk for acute variceal hemorrhage and mortality.
Non-specific BB
Carvedilol > propanalol, nadolol, timolol
OR endovascular variceal ligation
200
What is the definition for Neutropenic Fever?
Sustained temp >100.4 for >1 hour OR single temp > 101 + ANC < 500 OR ANC <1000 with expected decline to <500 within 48 hours
200
Junctional Escape Rhythm
200
What is the preferred modality for the diagnosis of cardiac sarcoidosis in patients with known sarcoidosis?
MRI
If no MRI -> PET
If no PET -> TTE
200
This intern is almost twins with their dogs and is a mixologist at heart.
Grace Kim
300
Name 3 autoantibodies associated with autoimmune hepatitis
Type 1 (often chronic appearing) - ANA, ASMA, anti-SLA
Type 2 (often acute) - Anti-LKM-1, Anti-LC1
P-ANCA (non-specific)
300
How long after initiation of immune checkpoint inhibitors classically present with immune related adverse events (IRAEs)
within 3 months
Delayed = after 1 year
Chronic = persists for >3 months after cessation
300
What do?
Monomorphic Ventricular Tachycardia
What do?
HDUS or pulseless - synchronized cardioversion
HDS - follow ACLS pathway, Amio/lidocaine infusion (usually avoid procainamide + sotalol)
Signs of AV dissociation, with superimposed P waves visible in V1 = VT
300
What is the syndrom that includes fevers, bilateral hilar lymphadenopathy and erythema nodusum?
Lofgren Syndrome - diagnostic of sarcoidosis, does NOT need biopsy for definitive diagnosis per MKSAP + ATS
300
This intern brews elevated teas and is a big sci/fi reader.
Sara Sawicki
400
What will the following antigen/antibodies be in immune immune-tolerant chronic HBV infection?
HBsAg, Anti-HBs, Anti-HBc, HBeAg and Anti-HBe
400
Women with BRCA1 or BRCA2 mutations should start getting annual screening mammograms at this age.
30 - annual mammogram + MRI (often alterate every 6 months)
25 - START annual MRI
400
Brugada Sign
- Coved ST segment elevation >2mm in >1 of V1-V3 followed by a negative T wave.
- This is the only ECG abnormality that is potentially diagnostic.
- It is often referred to as Brugada sign - not syndrome unless clinical findings
400
What is the syndrome that features anterior uveitis, parotid gland enlargement, facial palsy, and fever
Heerfordt Syndrome (uveoparotid fever) - ATS guidelines recommend not to biopsy, as consider this diagnostic.
400
This intern loves fly fishing and makes their own fishing lures
Austin Erben
500
What is the first line therapy for intoxication with amanita phalloides mushrooms
Silibinin (milk thistle extract) - blocks amatoxin uptake into hepatocytes
2nd line - penicillin G + NAC + aggressive supportive care
500
55 y/o F w./ unremarkable PMH was recently diagnosed with metastatic adenocarcinoma of the lung. She has excellent performance status.
There are no molecular alterations (epidermal growth factor receptor, ALK, ROS1). Programmed death ligand-1 expression is negative.
What is first line therapy?
Pembrolizumb + systemic chemotherapy
Shown to improve survival regardless of programmed cell death ligand-1 level.
Pembo can be monotherapy if expression is high
500
Wellen's sign (or Walter)
Deeply inverted or biphasic T waves in V2-3 (may extend to V1-6)
Typically caused by high-grade LAD stenosis. The ST elevations may not meet criteria for a classic STEMI, but these findings are considered a “STEMI equivalent”
500
Whoever correctly names the most baseline tests recommended by ATS for a new diagnosis of sarcoidosis (incorrect will be negative 1).
Occular screen
Cr, CBC, ALP
Ca - Vit D25 + 1-25 if think needs vit D
ECG
500
This intern is a tropical fish breeder and a literal Pokemon master
Alex Todfield
