COPD
MAC Attack
Spaced Repitition
Historical Diseases
Medication or Pokemon?
100
What dose and duration of steroids does GOLD recommend for moderate -severe AECOPD?
40 mg prednisone for no more than 5 days.
100
Which populations does the USPSTF recommend screening for HIV in?
Age 15-65
Also all pregnant woman, patients at increased risk (sexual activity, IVDU etc.)
100
What is the most specific and concerning finding on POCUS for cardiac tamponade?
Diastolic right ventricular free wall collapse.
100
This president, famously called "Ike", died from a chronic, debilitating cardiac condition with reduced cardiac output, which is managed by optimizing these guideline-directed medical therapies.
Dwight Eisenhower BB, ARNi/ACE/ARB, SGLT2 and MRA Diuretics only for symptomatic management
100
Rotom
Rotom - Pokemon - a unique Electric/Ghost-type Pokémon known for its ability to possess various electronic appliances, which changes its form
200
What is the most effective treatment regimen for smoking cessation (3)?
Nicotine replacement therapy (patches, lozenges)
Plus
Varenicline or buproprion
Plus
Behavioral counseling
200
Name four infections that can be unmasked by initation of HAART leading to IRIS
TB, MAC, Cryptococcus, CMV, HSV, JCV, Hepatitis B/C, Histoplasma and Toxoplasma
200
In the 2025 American College of Cardiology guidelines, which patient population did the committee recommend empiric treatment with PPI be initiated on?
Patients with high risk of GI bleeding on DAPT or APT + anticoagulation.
*High risk = 1 major or 2 minor criteria.
200
This Spanish leader, known for brutal crackdowns on his people, died of a neurodegenerative disorder that can initially present as new onset restless leg syndrome. 
Francisco Ferdinand
Parkinsons disease
200
Zaltrap
Medication
Ziv-aflibercept
.
300
This should be offered to patients with COPD in symptomatic patients with an FEV1 of less than 50% of predicted and to patients recovering from COPD exacerbation, in addition to medical therapy (especially if hospitalized or treated with systemic steroids).
Pulmonary rehab
Relieves symptoms, improves QOL, decreases frequency of hospitalizations.
300
Which patients with HIV should be on a moderate intensity statin?
Age >40, regardless of ASCVD risk
CI for ASCVD < 5%, AI for 5-20%
Pitavastatin 4 mg once daily (AI)
Atorvastatin 20 mg once daily (AII)
Rosuvastatin 10 mg once daily (AII)
300
What laboratory testing can help differentiate DIC from liver-induced coagulopathy, and what result might be expected?
Factor VIII levels, which are produced by endothelial cells and independent of liver function.
DIC: consumption of all factors - usually low
Liver-induced coagulopathy: endothelial cells increase production to offset coagulopathy - usually high
300
This gangster is thought to have died from a chronic infectious disease best managed with ____ when there is evidence of neurological involvement.
Al Capone
Neurosyphillus
10-14 days of IV penicillin G
300
Geodon
Ziprasidone - atypical antipsychotic
400
Which patients with COPD are expected to benefit from the addition of ICS to LABA/LAMA?
400
Which class of oncology medications can cause IRIS?
Immune Checkpoint Inhibitors (pebmbrolizumab, nivolumab, ipilimumab) - PD-1, PD-L1 and CTLA-4 inhibitors
This is similar to IRIS seen in HIV patients starting ART — the underlying concept is the same:
➡️ Sudden restoration of immune competence → inflammatory response to existing antigen load.
They overactivate the immune system, leading to:
Immune-related adverse events (irAEs) (autoimmune-type toxicities) - can be inflammatory like condition of any organ
400
According to the ACC 2025 concise clinical guideline, what is the preferred treatment option for patients with pericarditis that fail to respond to NSAIDs + colchicine with inflammatory pericarditis?
Anti-IL-1 - rilonacept, anakira or goflikicept
In addition to continuing NSAID + colchicine
400
This author of dystopian fiction who coined the term "big brother", tragically died in his 40's from a chronic active pulmonary infection for which first line treatment is now (duration + meds).
George Orwell
TB
RIPE - isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months
Followed by isoniazid and rifampin are continued daily for 4 - 7 months.
400
Morgrem
Morgrem - Pokemon - humanoid Pokémon, with a magenta upper body and a light green lower body divided by a zig-zag line
500
What three treatment options are recommended by GOLD for reducing frequency of exacerbations in refractory COPD (already on LABA+LAMA +/- ICS)
Dupilumab - eos>300 + chronic bronchitis
Roflumilast - FEV 1<50% + chronic bronchitis
Azithro - 250mg daily or 500mg thrice weekly, usually 6-12 month- everyone else, preferentially former smokers
500
If HAART is started in a patient with HIV with CD4 count 34, what prophylaxis should they be placed on?
Ppx for pneumocystis and toxoplasma. Can consider histo + coccidio
Usually bactrim DS daily
Alt options include dapsone 100 daily
Combinations of sulfasaline/atovaquone (pneumocystis) and pyrimethamine/leucovorin (toxoplasmosis)
Do NOT need MAC ppx with azithro if starting ART
500
70 y/o M w/ CKDII and HTN started on coreg 1 week ago presents w/ dizziness. HR is 47, BP is 101/67 mmHg, Cr is 2.5 and K is 6.2.
What is the diagnosis?
BRASH - bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia
RF - old age, cardiac/renal impairment, ACE/ARBs
Vicious cycle of AV block -> worse renal perfusion -> hyperkalemia -> worse AV block
500
This tragic historical figure sufferred from a chronic autoimmune endocrine disorder associated with hyponatremia and hyperkalemia would have benefitted from firstline treatment with what medication/s?
JFK
Addison's (Primary adrenal insufficiency)
Hydrocortisone BID/TID + fludrocortisone
Generally higher dose hydro in AM to mimic physiologic release
Can substitute pred for hydrocort if BID/TID too hard
500
Valstar
Medication - Topoisomerase II inhibitor
