Doctors Dilemma 10/17/24 Board 1

Cardiology

10

Diagnosis associated with depressed PR segment

Acute pericarditis (accept atrial ischemia)

20

Cause of acute severe mitral regurgitation after STEMI

 Papillary muscle rupture

30

Most common cause of HFpEF

Hypertension

40

Medication that inhibits degradation of atrial and brain natriuretic peptides

Sacubitril (do not accept Entresto, which is a combination of sacubitril and valsartan)

50

 Term for transient myocardial contractile dysfunction following reversal of ischemia  

Myocardial stunning (accept stunned myocardium)

Endocrinology

10

Drug class used before adrenalectomy for pheochromocytoma

α-Receptor blocker

20

Diagnosis suggested by primary amenorrhea, short stature

Turner syndrome

30

Most common cause of acquired hypocalcemia

CKD

40

Adrenal incidentaloma threshold size suspicious for malignancy

> 4 cm

50

Preferred diagnostic test for patients with suspected  diagnosis of familial hypocalciuric hypercalcemia (FHH))

Calcium/creatinine clearance ratio (accept fractional excretion of calcium)

Gastroenterology

10

Initial diagnostic test for achalasia

Barium esophagography

20

First-line therapy for functional dyspepsia

PPI

30

Hematological disorder found in 50% of patients with Budd-Chiari syndrome

Myeloproliferative disorder (accept any: polycythemia vera, essential thrombocythemia, primary myelofibrosis, chronic myeloid leukemia); accept JAK-2 tyrosine kinase mutation

40

Minimum high power field for eosinophilic esophagitis

greater than or equal to 15

50

 Small intestinal bacterial overgrowth syndrome, SIBO diagnostic criteria

 Symptoms plus positive breath test; improvement with empiric treatment

Womens health

10

1st line treatment for vulvovaginal atrophy

Lubricant

20

Virus responsible for oropharyngeal cancer

HPV

30

Class of drugs indicated for initial nonhormonal analgesic treatment for dysmenorrhea

NSAIDs (also accept cyclooxygenase-2 inhibitors)

40

Most common pituitary cause of secondary amenorrhea

Prolactinoma

50

Two most common causes of hyperthyroidism during pregnancy)

Graves disease and human chorionic gonadotropin (hCG)-mediated hyperthyroidism (require both)

ID

10

Indications for treatment of asymptomatic bacteriuria

Invasive urologic procedure and pregnancy

20

What is the antigen used in 4th generation HIV Screening

p24 Antigen

30

Recommended initial antimicrobial therapy for cryptococcal meningitis in patients with HIV infection

Amphotericin B plus flucytosine

40

Name 3 of the 5 requirements to give lyme prophylaxis to a patient with a tick bit

1. Doxycycline is not contraindicated.
2. The attached tick can be identified as an adult or nymphal I. scapularis tick.
3. The estimated time of attachment is ≥36 h based on the degree of tick engorgement with blood or likely time of exposure to the tick.
4. Prophylaxis can be started within 72 h of tick removal.
5. Lyme disease is common in the county or state where the tick bite occurred (i.e., CT, DE, DC, MA, MD, ME, MN, NH, NJ, NY, PA, RI, VA, VT, WI, WV).

50

The 3 most common laboratory abnormalities in patients with human ehrlichia diseases

Leukopenia, thrombocytopenia, elevated aminotransferases