Liver Let Die
Gut Feelings
Shaken, not Stirred
Blood Flow
Gran-tastic
Radicals
Heme Flow
double double vision
100
This diagnosis is made by finding a neutrophil count greater than 250 cells/µL in ascitic fluid.
What is Spontaneous Bacterial Peritonitis (SBP)?
100
What is the recommended first-line therapy for uncomplicated diverticulitis?
Observation and pain control.
100
What is the first-line medication class for alcohol withdrawal syndrome?
Benzodiazepines
100
A patient on warfarin for atrial fibrillation is scheduled for a low-bleeding-risk procedure. How many days before the procedure should warfarin be stopped?
5 days
100
What is the classic chest x-ray finding in a patient with sarcoidosis?
Bilateral hilar lymphadenopathy.
100
This is the cardinal rule of radiation side effects: (Radiation causes toxicity in this area)
the area that was treated
100
What is the maximum serum M-protein concentration for a diagnosis of MGUS?
Less than 3 g/dL
100
Identify the first critical distinction when evaluating a patient with diplopia.
Binocular diplopia resolves when either eye is covered and indicates ocular misalignment from neurologic, neuromuscular, or mechanical causes
Monocular diplopia persists when the unaffected eye is covered and typically indicates an ocular problem (such as refractive error, cataracts, or corneal irregularities)
200
This first-line therapy for pruritus in cirrhosis is a bile acid sequestrant.
What is cholestyramine?
200
What is the recommended diagnostic test for acute diverticulitis?
A contrast-enhanced abdominal and pelvic computed tomography (CT) scan.
200
what is the typical timeframe for the peak of delirium tremens symptoms?
48-72 hours
200
A patient taking apixaban for atrial fibrillation is scheduled for a low-bleeding-risk surgery. How long should the medication be held before the procedure?
24-48 hours
200
What is the pathognomonic finding on a tissue biopsy for sarcoidosis?
Non-caseating granulomas.
200
his common acute side effect of radiation to the breast or skin can be managed with various creams, ointments, or even honey dressings.
radiation dermatitis
200
According to Dr. Jacocks, these are the 3 important questions to ask/answer when it comes to an abnormal CBC.
1. Trend - is that a pattern to the change over time?
2. Tempo - rapidly changing counts matter more than absolute numbers
3. Smear - does it suggest an acute problem
200
Which patients with acute binocular diplopia require urgent neuroimaging?
CNIII palsy requires urgent brain CTA to rule out compressive aneurysmal lesions
brainstem symptoms (vertigo, ataxia, dysarthria) should have urgent brain MRI
multiple CN palsies require imaging with attention on cavernous sinus (CT venogram)
diplopia + HA or diplopia + pupillary involvement require same-day urgent imaging
300
What is the recommended screening for Hepatocellular Carcinoma (HCC) in a patient with cirrhosis?
Biannual abdominal ultrasound and serum α-fetoprotein.
300
Name two of the appropriate oral antibiotic regimens for a patient with uncomplicated diverticulitis who requires them.
Amoxicillin-clavulanate; Cefalexin + metronidazole; Ciprofloxacin + metronidazole; OR Trimethoprim-sulfamethoxazole + metronidazole.
300
This treatment for AUD focuses on identifying and unlearning patterns, thoughts, and feelings associated with substance use.
Cognitive Behavioral Therapy (CBT)
300
A patient on warfarin presents to the ED with a life-threatening hemorrhage. What two agents should be administered for rapid reversal?
Prothrombin Complex Concentrate (PCC) and Vitamin K
300
This enzyme is often elevated in sarcoidosis and can be used to monitor disease activity, although it has low specificity.
What is Angiotensin-Converting Enzyme (ACE)?
300
Radiation pneumonitis generally occurs in this period following lung radiation.
dry cough and dyspnea 3-6 months after lung radiation
300
list 2 characteristics/factors associated with a blood clot that would lead to a high value heme consult.
•Unusual clot location (splanchnic, cerebral) = high value
•Recurrent thrombosis on anticoagulation = consult now
•Anticoagulation decisions that affect procedures or discharge disposition
•Hypercoagulable testing rarely changes inpatient management
300
This should be suspected when eye misalignment does not fit a pattern for any cranial nerve palsy.
Ocular myasthenia
(diplopia in myasthenia is typically variable, worsening with sustained gaze or fatigue, and may be accompanied by ptosis that worsens throughout the day)
400
In a patient with cirrhosis and portal hypertension, what is the preferred non-selective beta-blocker, and at what optimal daily dose?
Carvedilol, 12.5 mg daily.
400
This term describes diverticular inflammation associated with an abscess, phlegmon, fistula, perforation, or stricture.
What is complicated diverticulitis?
400
This FDA-approved medication for AUD is safe in Child-Pugh Class A/B cirrhosis but should not be used in patients on opioids.
naltrexone
400
Although proton treatments are more difficult to plan and often less accurate, what is the primary benefit of proton treatment?
no exit dose
400
What is the first-line treatment for symptomatic or progressive pulmonary sarcoidosis?
Corticosteroids (e.g., prednisone).
400
A patient develops difficulty with memory and high-level functioning months to years after whole-brain radiation. Is this considered a normal or abnormal side effect?
Normal (an expected late effect)
400
What is the minimum percentage of clonal bone marrow plasma cells required for a diagnosis of multiple myeloma?
10% or a biopsy-proven plasmacytoma
400
What additional testing should be performed in patients over 50 years old presenting with recent-onset diplopia?
Inflammatory markers should be obtained to rule out giant cell arteritis in any patient over 50 years with a recent (within 1 month) history of diplopia, new headache, temporal artery abnormalities, or jaw claudication
500
In a patient with cirrhosis and a greater than 1.0-cm mass on screening ultrasound, what are the two imaging features on a multiphasic contrast-enhanced CT or MRI that can diagnose hepatocellular carcinoma without a biopsy?
Arterial-phase hyperenhancement and portal venous phase washout.
500
For a patient with complicated diverticulitis and a diverticular abscess, what is the size threshold at which antibiotic therapy alone is associated with a higher treatment failure rate?
> 4 cm
500
This medication for AUD should be avoided in patients with severe chronic kidney disease
acamprosate
500
For a patient taking clopidogrel, how many days should it be held before a high-bleeding-risk surgery?
5 days
500
This syndrome is an acute form of sarcoidosis characterized by fever, bilateral hilar lymphadenopathy, erythema nodosum, and arthralgia.
What is Löfgren's syndrome?
500
After receiving external beam radiation, a patient asks if they are radioactive and can be around their pregnant daughter. What is your advice?
You are not radioactive, and it is safe to be around anyone, including pregnant women and children.
500
What percentage of bone marrow plasma cells is characteristic of smoldering myeloma?
Between 10% and 60%
600
A patient with compensated cirrhosis and small esophageal varices (<5 mm) without red wale marks is found on endoscopy. He cannot tolerate BB therapy. What is the recommended management?
Repeat upper endoscopy in 2 years
600
According to ASAM guidelines, what is the preferred benzodiazepine dosing method for alcohol withdrawal in a setting with continuous monitoring?
Symptom-triggered treatment
600
Any one of the following findings, even in the absence of serum calcium > 11.5 mg/dL, renal dysfunction, anemia, and bone lesions would be enough for MM diagnosis.
SliM criteria
clonal bone marrow plasma cells ≥60%
serum free light chain ratio ≥100
>1 focal lesion on MRI
600
This medication is a commonly used steroid-sparing agent for patients with chronic or refractory sarcoidosis.
What is Methotrexate?
600
A patient with a serum M-protein of 2 g/dL and 5% clonal bone marrow plasma cells would be diagnosed with which condition?
Monoclonal Gammopathy of Undetermined Significance (MGUS)