MDCalc
Stinky!đź’©
So Toxic!
Up or Down
What they got?
100
This score calculates stroke risk for patients with atrial fibrillation
CHAâ‚‚DSâ‚‚-VASc
100
This test can help with the diagnosis of small intestinal bowel overgrowth (SIBO) and carbohydrate intolerance.
Hydrogen breath test
100
Patient in the ED was feeling nauseous. Patient was given medication to help with nausea and now in torsades de pointes. Name the drug that caused this adverse effect
Zofran (Ondansetron)
100
Two diseases that are shared by MEN 2A and MEN 2B.
Pheochromocytoma and Medullary Thyroid Carcinoma
100
Selena Gomez
Lupus
200
This score determines the necessity of anticoagulation in hospitalized patients at risk of VTE
Padua Prediction Score
200
Patient presents with weight loss, vomiting, dysphagia, early satiety, melena, hematemesis, palpable mass in epigastric region, palpable umbilical nodule, and lesions on back (shown in photo below). Most likely diagnosis?
Gastric cancer (with Sister Mary Joseph nodule)
200
Diarrhea, urination, miosis, bradycardia, emesis, lacrimation, lethargy, and salivation. Name the toxicity
Cholinergic toxicity
200
Patient presents with polyuria, nocturia, and polydipsia. Other than BMP, UA and 24 hour urine collection, name one test that will allow you to assess the patient’s capacity to concentrate urine.
Water deprivation test or plasma copeptin test
200
Ashton Kutcher
Vasculitis
300
This score estimates mortality of community-acquired pneumonia to help determine inpatient vs. outpatient treatment
CURB-65
300
This stool test can confirm steatorrhea due to exocrine pancreatic insufficiency.
Fecal elastase
300
Patients with 50 pack years are now presenting with seizures, agitation, tachycardia, hypertension, and hallucinations after initiating new medication to help with smoking cessation.
Bupropion
300
Patient presents with significant weight loss and impaired glucose tolerance. Patient complains of erythema that is spreading on her legs. Patient reported that these areas of redness developed into painful and itchy patches with central areas of bronze-colored induration.
What medication should be initiated for this patient?
Octreotide. The skin rash that the patient is complaining about is necrolytic migratory erythema. This rash is a cutaneous paraneoplastic syndrome mainly associated with pancreatic tumors secreting glucagon, but also can present with hepatitis B, C, and bronchial carcinoma.
300
JJ Watt
Atrial fibrillation
400
This score clears patients from cervical spine fracture clinically, without imaging.
NEXUS Criteria for C-Spine Imaging
400
This is the first thing you should do for a hemodynamically unstable patient presenting with a massive GI bleed… Yes, even before consulting GI.
Adequate IV Access—Two large-bore IV catheters (18 gauge or larger), or a single-lumen central Cordis.
400
Patient ate new fish for the first time, and they are now experiencing nausea, diarrhea, paresthesias, weakness, dizziness, and loss of reflexes. Name the toxin associated with this presentation.
Tetrodotoxin
400
Patient presents with diffusely enlarged thyroid, unintentional weight loss, tachycardia, hyperreflexia, fine postural tremor. ECG shows sinus tachycardia without myocardial ischemia. Labs show low TSH, elevated free thyroxine, positive thyrotropin receptor antibodies. What 2 medications would you want to initiate in this patient.
Methimazole + Beta blocker
400
Lil Wayne
Epilepsy
500
This score predicts prognosis and steroid benefit in alcoholic hepatitis
Maddrey’s Discriminant Function
500
19 F with history of presents with 2 months of persistent epigastric pain, frequent nonbloody stools, and weight loss. She now complains of an itchy rash on her elbows and knees. Exam reveals excoriated erythematous papules and ruptured vesicles on extensor surfaces of knees and elbows. Name the most likely diagnosis.
Celiac’s disease. Patient’s rash is dermatitis herpetiformis, which is closely associated with celiac disease. This rash is not always present, but it strongly suggests celiac disease when it is.
500
Patient who recently traveled out of the country was diagnosed with chloroquine resistant Plasmodium vivax malaria. Treatment was initiated and now the patient is presenting with hearing loss, cognitive impairment, and a constant buzzing in both ears. What drug is responsible for this patient’s presentation?
Quinine
500
For a patient receiving a prolonged course of prednisone, at what dosage per day and length of treatment would you want to initiate PJP prophylaxis?
≤ 20 mg/day prednisone for ≤ 4 weeks
500
Celine Dion
Stiff person syndrome