Hot + Heavy Cardio
A 68 yo male with a PMH of HLD presents to his PCP for pain in his calves after walking his dog that is relieved by rest. This is the gold standard diagnostic test for his likely condition.
Lower Extremity Angiography (ABI is 1st line but not GS) for Intermittent claudication secondary to Peripheral Artery Dz
This is the tx of choice for a symptomatic non-traumatic pneumothroax that is 16% of the thoracic cavity
What is a chest tube
This symptom completes a common pentad seen with severe ascending cholangitis: RUQ pain, fever, jaundice, hypotension, and _______.
What is altered mental status?
DAILY DOUBLEEEEEE!!!!!!
WHAT IS THIS PENTAD CALLED???
"mouse/rat bite" "punched-out" erosions on an x-ray of the big toe is likely associated with what finding on synovial fluid analysis?
negatively birefringent and needle-shaped monosodium urate crystals (Gout)
(note: radiodensity/Chondrocalcinosis is indicative of pseudogout)
A patient who presents with fatigue, pruritus, Kussmaul respirations, asterixis, muscle wasting, and a UA reveals broad waxy casts should make you think of this diagnosis.
Chronic Renal disease
This medication used for diabetes is one of the only 4 medications shown to reduce mortality in dilated cardiomyopathy
SGLT2is (empagliflozin/dapagliflozin)
This ABG result is most likely given a patient with COPD
Respiratory Acidosis with elevated PCO2
Treatment of choice for acute esophageal varices incudes what combination
Therapeutic endoscopy – endoscopic band ligation and IV octreotide + Ceftriaxone
Elevated Creatinine Kinase and anti-jo antibodies indicates what condition?
Polymyositis
This is the best pharmacological treatment for a diabetic patient who experiences nocturnal hypoglycemia but wakes with hyperglycemia.
Somogyi Effect: Give less nighttime NPH
ps. could also just give nightime snackie
A 60 y/o male with a PMH of longstanding CAD presents to his second visit with elevated BP. This therapeutic combination is best suited for a patient with this history.
Beta Blocker and ACEi/ARB
A 38 yo female presents with a chronic dry cough. your attending is super extra and orders tests that reveal elevated ACE levels, elevated calcium, and bilateral hilar lymphadenopathy. this condition is the likely cause.
What is Sarcoidosis?
Intermittent solid-food only dysphagia and steakhouse syndrome is unique to what cause of dysphagia?
Schatzki rings
A patient with labs significant for +ANA, anti-dsDNA, anti-Smith, low complement (C3/C4) should be treated with this medication for maintenance therapy.
Hydroxychloroquine (SLE)
A patient with a PMH of osteoarthritis treated with ibuprofen and was recently treated for syphilis presents with blood in his urine. UA reveals eosinophils and WBC casts. what is the best next step?
D/C offending agent -> stop ibuprofen and PCN (Acute Interstitial Nephritis)
This medication is an absolute contraindication to the heart condition that causes a harsh mid-systolic murmur at the LLSB that increases with valsalva and decreases with squatting.
Digoxin (HOCM) but nitrates, diuretics, and ACEi/ARBs are not recommended as well
A patient presents with JVD, peripheral edema, hepatomegaly, loud P2/right ventricular heave, hypoxemia, and chronic pulmonary disease. This symptomatic treatment given for HF is contraindicated in this patient
What is a diuretic?
An elderly patient presents with dysphagia, regurgitation of undigested food, halitosis, cough/aspiration, and a neck mass. Where is the abnormality most likely located?
Killian's triangle (between the oblique and transverse fibers of the inferior pharyngeal constrictor)
(Zenker's diverticulum)
This is the treatment of choice for a pt with a PMH of IV drug use who presents with a painful swollen left knee with a WBC >50,000 with PMN predominance.
Levofloxacin or ciprofloxacin
(Septic arthritis with a risk of pseudomonas)
A patient who presents with fatigue, weight loss, and recurrent nausea and vomiting. On physical exam, he appears weak and has skin that appears abnormally tan. Blood pressure is 90/70. A basic metabolic panel reveals hyponatremia and hyperkalemia. This is the gold standard test to diagnose the likely dx.
Cosyntropin (ACTH) Stimulation Test (No cortisol rise = AI).
DAILY DOUBLE NO WAYYYY!!
WHAT IS THE INITIAL SCREENING TEST FOR THIS DISORDER???
A 60 year old patient with a PMH only significant for HLD presents with crushing chest pain. EKG reveals "bunny ears" in V4, V5, and V6 and a widened QRS in V1, V2, V3. EMS reports that the patient waited almost 2 hours to call since onset. This next step is the definitive therapeutic choice for this patient.
Fibrinolytic therapy (ex. tPA)- Patient has a new onset LBBB, but PCI is not an option because it has been more than 90 minutes. Pt only has hx of HLD, no contraindications for tPA
A patient presents with dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough with pink frothy sputum. A PCWP shows 22%. This is the likely cause of this pulmonary edema.
What is cardiogenic pulmonary edema?
The first line diagnostic test for the condition associated with Hamman sign (crunch): mediastinal crackling heard on auscultation synchronous with the heartbeat and is induced by forceful vomiting is known as?
What is Water-soluble contrast esophagram (Gastrografin)?
(Borhaave syndrome)
A patient presents with a reddish-purple (violaceous) discoloration of the eyelids and flat-topped, red/purple bumps on the knuckles likely has what autoimmune condition?
What is Dermatomyositis (heliotrope rash and Gottron papules)
A 48 yo male with a hx of HIV presents with headache, neck stiffness, and confusion. LP shows increased intracranial pressure and a CSF sample shows India Ink and CrAg positive. What could have been done to prevent this condition?
Prophylaxis w/ fluconazole starting at CD4 count <100
(Cryptococcus)