Heart Throb
Who runs the world? GIRLS!
Do you even lift bro? (MSK)
Bugs not drugs
Dealer's Choice
100
Name 2 absolute contraindications to exercise stress testing?
Severe CHF, significant aortic stenosis, myocarditis, unstable angina, acute MI within 2 days, recent PE, BP >200/120
100
late decelerations on FHT represent
placental insufficiency
100
McMurray test most commonly tests for ?
meniscal tears
100
CURB - 65 criteria
Confusion
Uremia (BUN >19)
Respiratory rate (RR>30)
BP (SBP <90 or DBP <60)
Age >65
100
What year was family medicine formally recognized as a speciality
Feb 1969
200
22yoF with h/o palpitations, currently in office denies dizziness or palpitations. EKG in office shows the below. Otherwise healthy and no medications. No FHx. Next step in management?
No treatment unless symptomatic. A betablocker like metoprolol may help to reduce symptomatic PACs
200
Who gets an endometrial biopsy ?
EMT >4mm postmenopausal (or >45yo)
If >35yo with risk factors for endometrial hyperplasia (obesity, diabetes).
200
Tearing this ligament causes a positive Lachman's test
ACL
200
HIV Prophylaxis: CD4 less than 50-100/mm3.
Name the Bug and Drug
Mycobacterium avium complex (MAC), weekly azithromycin
- DC when CD4 is >100 for more than 3 months
200
Dr. Halle Dillon, most famously known to be what?
The first FEMALE physician in Alabama. She was also the first African American.
- Board Certified in Montgomery in 1891. worked at Tuskegee as a Resident physician with Booker T Washington.
- died 1901 of dysentery and childbirth at the age of 37
300
300
What OB complication is NOT negatively associated with cigarette smoking?
IUGR, low birth weight, PreE, placental abruption
PreE
300
45yoF house cleaner with left shoulder pain. Exam shows pain and relative weakness when pushing toward the midline against resistance while the shoulder is adducted and elbow is bent to 90 degrees. With elbow at 90 deg she is unable to keep left hand away from her body when positioning hand behind her back.
Name tendon most consistent with this injury.
Subscapularis
weakness with internal rotation
- positive internal lag test (inability to keep hand away from her body when placed behind her back)
300
10yoM with 8mm induration after 2 days tuberculin skin test. Shares bedroom with 18yo brother who was diagnosed with TB. No PE or Sxs to suggest active infection. CXR is normal.
Next step?
A. monitor with annual TB skin test
B. Observe and repeat test in 3 weeks
C. Rifampin daily for 4 months
D. Isoniazid daily for 9 months
E. Once-weekly isoniazid and rifampin for 3 months
Positive test in exposed individuals 5mm. (also XR evidence prior infxn, HIV or immune suppressed)
Kids 2-11yo, tx isoniazid 10-20mg/kg daily OR 20-40mg/kg twice weekly for 9 months. Shorter 6 months for adults is not recommended in pediatrics. Not recommended to use rifampin alone or in combo with isoniazid in kids under 12yo.
300
This compound, AKA folinic acid, can "rescue" a patient from methotrexate toxicity.
Leucovorin
400
What is Heyde syndrome?
triad of aortic stenosis, GI bleeding and acquired von willebrand syndrome
Commonly seen in the elderly; due to increased circulatory shear forces ---> cleavage of large von Willebrand multimers.
400
Which of the following bacterial infections are NOT generally associated with preterm labor?
A. ureaplasma urealyticum
B. mycloplasma hominis
C. Gardnerella vaginalis
D. Bacteroides species
E. All are associated with preterm labor
E. all are associated with preterm labor
400
Name the injury:
Boxer fracture
- fracture of 5th metacarpal head
Tx: closed reduction and ulnar gutter splint
400
Previously treated c. difficile colitis with oral vancomycin 2 weeks prior presents with recurrent watery diarrhea for the past 3 days. Recurrent infection is confirmed. What is appropriate treatment?
Fidaxomicin 200mg BID for 10 days
If available, a prolonged tapered course of vancomycin could be used if a 10-day course was prescribed initially (weak recommendation, low quality of evidence). Vancomycin is only recommended for a first recurrent episode if metronidazole was used initially (weak recommendation, low quality of evidence).
400
Name all the features associated with CHARGE syndrome
coloboma, heart defects, atresia choanae (choanal atresia), growth retardation, and ear abnormalities.
500
Name 3 out of 5 terrible T's of congenital cyanotic heart disease
Tetralogy of Fallot, Transposition of great vessels, total anomalous venous return, tricuspid atresia, persistent truncus arteriosus
500
Who is this?
Elizabeth Blackwell
First woman to be granted an MD
- attended Geneva Medical College in NY, co-founded New York Infirmary for Indigent Women and Children
500
Ottawa Ankle Rules (must name all 4)
1. Posterior edge or tip of lateral malleolus
2. Posterior edge or tip of medial malleolus
3. Base of 5th metatarsal
4. Navicular
500
65yoM admitted for sepsis found to be growing bacterioides fragilis on 2/2 blood cultures. what is the likely source associated with this bug and what screening did he likely not receive?
Colonoscopy; likely secondary to GI malignancy.
Piperacillin/tazobactam, meropenem, and metronidazole have high susceptibility rates.
500
Name that Syndrome:
SGA infant with normal mental development. Large fontanels, triangular face (petite face with relatively large head), forehead nevus flammeus, Blue sclera, precocious sexual development, asymmetric arms and/or legs.
BONUS 200 points if can name the abnormality in the gene
Russell-Silver Syndrome
- gene: methylation abnormalities in IGF2