Endocrine
When do you start off with a lower dose of levothyroxine (less than 1.6 ug/kg lean body weight) in a patient with hypothyroidism?
Older adults and CVD
What type of antibiotic treatment is appropriate for MSSA bacteremia?
IV penicillin (oxacillin) or 1st generation cephalosporin (cefazolin)
What is the classic presentation of acute cholangitis?
fever, jaundice, and RUQ pain- Charcot's triad
What is fulminant Clostridoides difficile infection treated with?
oral vancomycin + IV metronidazole
What should patients at high risk for sexually transmitted infections be screened for? (4)
chlamydia, gonorrhea, HIV, syphilis
What is the treatment for hypogonadism secondary to chronic opioid use in men?
testosterone therapy
What screening test should be performed in a patient with a history of recurrent Neisseria infections?
total hemolytic complement (CH50) levels
What is the treatment for malignant hyperthermia caused by succinylcholine?
dc trigger agent, active cooling, and dantrolene
What are the classic imaging findings of HSV encephelitis?
unilateral temporal lobe enhancement
How do you treat severe Campylobacter?
azithromycin
A patient has hypothyroidism and elevated prolactin level. What is the next best step?
Treat hypothyroidism
(before getting pituitary MRI)
What test should you get in a patient with suspected CVID?
IgG subset (IgG 1-4) levels
What is central sleep apnea most commonly associated with?
heart failure
How do you treat "hot tub" folliculitis?
Patient lives in Northeast bit by a tick, has encephelitis, Borrelia burgdorferi serology is negative- Diagnosis?
Powassan virus infection
When is screening for pheochromcytoma indicated in a patient with incidentally noted adrenal mass?
When the mass is greater than 10 Hounsfield units
What is HIV pre-exposure prophylaxis (PrEP)?
tenofovir fumarate and emtricitabine
What is the most appropriate treatment for venous thromboembolism in pregnancy?
low molecular weight heparin
What does a positive treponemal test with a negative nontreponemal test suggest?
previous treatment for syphilis
A patient with a febrile illness, tremors, parkinsonism, myoclonus, and a maculopapular rash. MRI shows basal ganglia involvement. How is diagnosis made?
West Nile Virus IgM measurement
What should be measured annually in patients receiving long term metformin therapy?
B12 level
What is the most commonly diagnosed trigger of Guillain-Barre syndrome?
Campylobacter
What are the typical thresholds for transferrin saturation and ferritin level that indicate a trial of oral iron in CKD?
Transferrin saturation ≤30% or ferritin level ≤500 ng/mL.
A patient has erythematous vesciular rash on ear with peripheral nerve palsy: diagnosis?
Ramsay Hunt syndrome
A patient has symptoms consistent of Ehrlichiosis but is not improving with doxycycline after 48 hours- diagnosis?
Heartland virus