My achy breaky heart
At what ejection fraction should an ICD be considered? Assuming patient has been receiving chronic optimized medical therapy
What is EF < 30-35%
Kusumoto, F. M., Calkins, H., Boehmer, J., Buxton, A. E., Chung, M. K., Gold, M. R., Hohnloser, S. H., Indik, J., Lee, R., Mehra, M. R., Menon, V., Page, R. L., Shen, W. K., Slotwiner, D. J., Stevenson, L. W., Varosy, P. D., & Welikovitch, L. (2014). HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials. Circulation, 130(1), 94–125. https://doi.org/10.1161/cir.0000000000000056
A 3 year old patient presents to the clinic with 1 month of perianal itching worse at night. What infection should you suspect?
What is a pinworm infection
What anatomic landmark delineates the upper GI from the lower GI?
What is the ligament of traits
What does the Spurling's test evaluate for?
what is Cervical radiculopathy caused by nerve root compression
Which part of the urine stream should be collected when evaluating for gonorrhea/chlamydia?
What is the first catch
What medications/therapies are recommended as part of GDMT ( guideline directed medical therapy)?
Four pillars:
What are ...
1. RAAS-I/ARNI (renin-angiotensin-aldosterone- inhibitor/ angiotensin receptor-neprilysin inhibitor)
2. B-blocker
3. MRA ( mineralocorticoid receptor antagonist)
4. SGLT2- Inhibitors
Dixit, N. M., Shah, S., Ziaeian, B., Fonarow, G. C., & Hsu, J. J. (2021). Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization. US Cardiology Review, 15. https://doi.org/10.15420/usc.2020.29
During which timeframe should Lyme disease post-exposure prophylaxis be started?
What is within 72 hours of tick removal?
https://www.cdc.gov/lyme/resources/FS-Guidance-for-Clinicians-Patients-after-TickBite-508.pdf
Of all the h. pylori tests, which is the most sensitive?
what is the urea breath test
The ACG states that the urea breath test has the highest sensitivity and specificity overall but, in a low-prevalence population (around 20%), stool antigen testing also performs well. The ACG does not recommend serology testing in a low-prevalence population because of a high false-positive rate.
Where would you x-ray to evaluate a patient for Sever's disease?
what is the heel/calcaneus
Achilles tendon tension causing apophysitis
What is the recommended regimen for the treatment of late latent syphilis per the CDC ( dose, frequency/duration) assuming the patient has no antibiotic allergies?
What is benzathine penicillin G 2.4 million units weekly for 3 weeks
https://www.cdc.gov/std/treatment-guidelines/latent-syphilis.htm
What is the recommended INR range for patients who have had a mechanical mitral valve replacement?
What is INR 2.5 - 3.5?
mechanical mitral valve replacement INR 2.5- 3.5
mechanical aortic valve replacement INR 2.0 - 3.0
What is the vector for endemic (murine) typhus?
What is the flea
Besides gastric cancer, what other cancer is associated with h pylori infection?
What is MALT
Name the unhappy triad
What is
- rupture of the MCL
- damage to the medial meniscus
-rupture of the ACL
A 14 year old patient is starting her HPV vaccination series. What many doses of the HPV vaccine does she need in total?
What is 2
Patients who start their HPV vaccination on or after their 15th birthday need the full 3 doses.
For patients with moderate asymptomatic aortic stenosis, how often should they have a TTE completed?
What is every 1-2 years
mild aortic stenosis q3-5 years
moderate aortic stenosis q1-2 years
severe aortic stenosis q1 years
Name one of the recommended malarial chemoprophylaxis most malaria- endemic regions
What are:
1. Atovaquone/Proguanil
2. doxycycline
3. mefloquine
4. Chloroquine
5. Primaquine
What is one of the two recommended outpatient antibiotic regimens recommended by the AGA for acute diverticulitis?
what is metronidazole + fluoroquinolone or Augmentin mono therapy for 4-7 days
AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review- December 2020
What is the location of a Colles fracture?
What is a Distal radial fracture ( broken end of radius tilts upward)
What is the first line regimen recommended for treatment of chlamydia as of 2021?
What is Doxycycline 100mg orally BID x 7 days
CDC STI Treatment Guidelines 2021https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm
Regardless of other risk factors, at what CAC score (coronary artery calcium score), should a statin be started?
A patient who recently immigrated from Guatemala 3 months ago, presents to the clinic with a large skin ulcer on the abdomen. Initially the the lesion started as a painless nodule that has gradually increased in size. What is the vector in this cutaneous parasitic infection?
What is the sand fly in cutaneous leishmaniasis
During a routine colonoscopy, dark pigmentation was noted in the otherwise normal appearing colon mucosa. Patient has history of chronic constipation. What is benign finding called?
what is melanosis coli
In a patient with osteopenia, at what FRAX 10 year risk score for hip fracture should treatment with bisphosphonate considered?
what are scores => 3%
Your patient is admitted for neurosyphilis. He does not have penicillin allergy. 1 hour after administration of penicillin, the floor nurse calls you stating the patient is febrile and tachycardia and complaining of chills and myalgia. What potential reaction is the patient having?
What is the Jarisch-Herxheimer Reaction