Doctor's Dilemma

Cardiology

100

MI location most commonly associated with papillary muscle rupture

Inferior wall

200

Characteristic auscultatory finding in atrial septal defect.

Fixed split S2

300

First line drug for treatment of long QT syndrome

Beta blockers

400

Characteristic wave seen in ECG of arrhythmogenic right ventricular dysplasia

Epsilon wave

500

Treatment of refractory angina (refractory to medical therapy, angioplasty, and coronary artery bypass surgery)

Enhanced external counterpulsation

Infectious Disease

100

Two most common bacterial pathogen associated with bronchiectesis

Pseudomonas and Staphyloccus

200

Diagnosis suggested by severe community acquired pneumonia with pancytopenia in a setting of bird exposure

Psittacosis

300

This disease presents as dementia, cerebellar and spinocerebellar disease findings, and startle myoclonus

Creutzfeldt-Jakob disease

400

Organism thought to be pathogenic in posttransplantation lymphoproliferative disease

Epstein-Barr Virus

500

What is the treatment of babesiosis?

Clindamycin + Quinine or Azithromycin + Atovaquone

Gastroenterology

100

Rash associated with celiac disease

Dermatitis herpetiformis

200

Score to predict short term survival in acute alcoholic hepatitis

Discriminant function

300

The gold standard for diagnosing chronic pancreatitis

Endoscopic Retrograde Cholangiopancreatography (ERCP)

400

Eponym for obstruction of proximal duodenum by a gallstone

Bouveret's syndrome

500

Name of syndrome due to external compression of common hepatic duct resulting from a large stone lodged in cystic duct

Mirizzi's syndrome

Nephrology

100

Target blood pressure goal in chronic kidney disease patient with >1g/24hr proteinuria

125/75

200

This non anion gap metabolic acidosis has predisposition to renal stones

Type 1 distal renal tubular acidosis

300

Cause of serum osmolal gap without metabolic acidosis

Isopropyl alcohol poisoning

400

Nephrotic syndrome seen in hodgkin's lymphoma

Minimal change disease

500

Autosomal dominant syndrome associated with hypertension and hypokalemic metabolic alkalosis

Liddle's syndrome

Randomized Control Trial

100

In ALLHAT (anti HTN and lipid lowering treatment to prevent heart attack trial), this thiazide diuretic was compared against amlodipine and lisinopril

Chlorthalidone

200

RALES trial showed addition of which medication to standard therapy reduced mortality and risk of sudden cardiac death in patient with severe CHF

Spironolactone

300

This trial showed that addition of fixed dose isosorbide dinitrate - hydralazine to standard therapy for heart failure decrease mortality among black patient with advanced heart failure

A-HeFT (African-American Heart Failure Trial)

400

This trial analyzed effectiveness of rosuvastatin in the primary prevention of cardiovascular disease

JUPITER trial (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin trial)

500

This RCT showed that lifestyle intervention decreased the incidence of type 2 diabetes mellitus by 58% compared with 31% in the metformin treated group

DPP (Diabetes prevention program)