Let’s (not) stick together
The Mush and the Push
Who you gonna call?
Doc, can the patient eat?
Misc.
100

In a patient with CKD, this thrice daily medication and route is used to prevent VTE.

What is Heparin, subQ?

100

These classes of medications constitute the “mush” and the “push” that underpins a good bowel regimen.

What are bulk forming laxatives/osmotic laxatives, and stimulant laxatives?

100

At our illustrious veteran’s hospital, an admission isn’t complete without this document.

What is an LST or life-sustaining treatment note?

100

These characteristics signal that it is time to trial a diet in a patient admitted for DKA.

What is a closed anion gap, and normo-glycemia

100

The primary pharmacologic class used for stress ulcer prophylaxis in critically ill patients, especially in those with risk factors such as mechanical ventilation or coagulopathy.

What is a Proton pump inhibitory or PPI?

200

Complete the phrase: “Platelets are less than ______ – hold chemical DVT prophylaxis"

What is 50k or 50,000?

200

This is first-line therapy for a patient with fecal impaction (and why the 100 pt question is so important).

What is DRE?

200

This written document details a patient’s wishes for their medical care should they become incapacitated.

What is a living will or advanced directive?

200

In which GI condition (recently discussed by one Prisca Pungwe) should you avoid a stepwise reintroduction of food consistencies?

What is pancreatitis?

200

This type of facility is commonly used for patients who need subacute care, and provides rehabilitation, physical therapy, or post-surgical recovery, but not  continuous medical supervision.

What is a SNF or skilled nursing facility?

300

These two medications, commonly prescribed after a visit to the CCU, are not generally considered adequate for DVT prophylaxis

What is aspirin and an antiplatelet?


Also acceptable for antiplatelet: clopidogrel, ticagrelor

300

These three are the most concerning potential side effects when using sodium phosphate (Fleet enema) in the inpatient setting, particularly in patients with renal or cardiac comorbidities.

What is hyperphosphatemia, hypocalcemia and hyperkalemia?

300

True or false: a diagnosis of cognitive impairment excludes a patient from determining their own code status.

What is False?

300

There is evidence that "NPO at midnight" may be unnecessary for all patients- this fasting period may become more common in the future.

What is 6 hours?

300

This type of facility is designed for patients who require extended hospital-level care, often for conditions like chronic respiratory failure, complex wound care, or multi-organ failure, but do not need the intensive services of an ICU.

What is an LTAC or long-term acute care hospital?

400

This daily oral anticoagulation may be continued during hospitalization but must be given with food for best absorption.

What is rivaroxaban?

400

While not technically part of a bowel regimen, this class of medications is used when traditional laxatives fail in opioid-induced constipation.

What is a peripherally-acting mu opioidR antagonist?

400

List the first 4 steps of the Surrogate Decision-Maker Hierarchy in Texas.

What are spouse, adult child, parent, sibling?

400

A CKD diet is low in these 3 elements.

What are sodium, potassium, and phosphorous?
400

This is one of the most common electrolyte side effects of proton pump inhibitors (PPIs), particularly when used long-term in the inpatient setting for GI ulcer prophylaxis.

What is hypomagnesemia?

500

The best option for DVT prevention in a person with active bleeding, with a caveat.

What are SCDs that are properly applied?
500

This element-containing laxative should be avoided in people with advanced CKD due to retention of said element.

What is magnesium citrate?

500

A living will or advanced direct can be reversed at this time.

What is anytime?

500

There was a recent change to guidelines from the American Gastroenterological Association and the American Society of Anesthesiologists on holding this miracle medication prior to surgery or endoscopy- no word yet from the American College of Gastroenterology.

What are glp-1 agonists?

500

LTACH admission involves a requirement that the patient has been in the hospital for at least this many days and requires continued intensive services, typically after the initial acute phase of their illness has stabilized.

What is 25 days?