Heme
In immune TTP (iTTP), a level below 10% of this enzyme — the von Willebrand factor–cleaving protease — confirms the diagnosis.
What is ADAMTS13 activity?
In diffuse cutaneous systemic sclerosis, this short-acting ACE inhibitor — titrated aggressively — is the first-line treatment when a patient develops sudden hypertension, rising creatinine, and thrombotic microangiopathy.
What is captopril?
A diabetic patient with malignant otitis externa due to skull-base osteomyelitis is infected by an oxidase-positive, blue-green pigmented organism. This is its characteristic smell.
What is a grape-like odor? (Organism: Pseudomonas aeruginosa)
This eponymous syndrome describes obstruction of the common hepatic duct by extrinsic compression from an impacted gallstone in the cystic duct or infundibulum of the gallbladder.
What is Mirizzi syndrome?
Empagliflozin, canagliflozin, and dapagliflozin belong to this class of oral antidiabetic agents, which also reduces hospitalizations for heart failure.
What are SGLT-2 inhibitors?
In polycythemia vera, the CYTO-PV trial established that maintaining hematocrit below this target significantly reduces cardiovascular death and major thrombotic events.
What is <45%?
When new edema, rising creatinine, active urinary sediment with RBC casts, and rising anti-dsDNA develop in a patient with SLE, this is the single most important next diagnostic step.
What is renal biopsy?
In this tick-borne illness, a painless eschar forms at the site of the bite, followed by a maculopapular rash that spreads centripetally from the extremities to the trunk.
What is Rocky Mountain Spotted Fever? (Organism: Rickettsia rickettsii)
In primary biliary cholangitis, this is the most common extrahepatic autoimmune association — that requires periodic serum bloodwork.
What is autoimmune thyroid disease?
Annual TSH measurement is part of routine co-screening
Transition from IV to subcutaneous insulin in DKA requires blood glucose below 200 mg/dL, anion gap below 12, and a serum bicarbonate that has risen above this threshold (in mEq/L).
What is 15 mEq/L?
Accept: 15–18
Excess supplementation of this mineral causes copper deficiency by upregulating intestinal metallothionein, leading to pancytopenia and a myeloneuropathy syndrome.
What is zinc?
In antiphospholipid syndrome, anticardiolipin antibodies are one of three laboratory criteria. Name either of the other two antibody tests.
What is lupus anticoagulant OR anti-β2 glycoprotein I antibodies? (Accept either)
A painless black eschar with a Gram stain showing large boxcar-shaped Gram-positive rods in chains is the presentation of this cutaneous infection.
What is cutaneous anthrax? (Organism: Bacillus anthracis)
A 68-year-old with chronic pancreatitis and foul-smelling, floating steatorrhea has a fecal elastase-1 of 45 µg/g, confirming severe exocrine pancreatic insufficiency. This is the first-line treatment.
What is pancreatic enzyme replacement therapy (PERT)?
Accept: pancrelipase, Creon
In the standard high-dose cosyntropin stimulation test, a serum cortisol exceeding this value at 60 minutes is a normal response, ruling out primary adrenal insufficiency and chronic secondary AI.
What is 18 µg/dL?
AML is diagnosed when myeloid blasts reach or exceed this percentage in the bone marrow or peripheral blood — though this threshold does not apply when AML-defining cytogenetics such as t(8;21) or t(15;17) are present.
What is 20%?
Palpable purpura, arthralgias, abdominal pain, and glomerulonephritis form the classic tetrad of this IgA-mediated small-vessel vasculitis.
What is IgA vasculitis? (Alt: Henoch-Schönlein purpura, HSP)
Enlarged, oval-shaped red blood cells with ameboid trophozoites on peripheral smear, 10 months after travel to Papua New Guinea, reflect reactivation of dormant liver hypnozoites from this malaria species.
What is Plasmodium vivax?
A patient with known IBD has 6 months of watery, non-bloody diarrhea (6–8 episodes/day). Colonoscopy is grossly normal, but colonic biopsies show colonic lymphocytosis. This is the first-line treatment.
What is budesonide?
NOTE: also discontinue NSAIDs/PPIs if possible
A fasting 6–8 AM serum cortisol at or below this level (in µg/dL) is highly suggestive of adrenal insufficiency, while a value of 15 µg/dL or above effectively rules it out.
What is 3 µg/dL?
In a patient with HbSS disease and acute chest syndrome whose baseline hemoglobin is ≥10 g/dL, simple transfusion would cause hyperviscosity — making this procedure the preferred intervention to reduce HbS to below 30%.
What is exchange transfusion?
Before initiating any anti-TNF biologic, clinicians screen for Mycobacterium tuberculosis via TST or IGRA. Name the other infection requiring serologic screening prior to starting anti-TNF therapy.
What is hepatitis B? (Screen for HBsAg, anti-HBs, and anti-HBc)
This filarial infection — unlike Wuchereria bancrofti — causes peak microfilaremia between 10 AM and 2 PM (diurnal periodicity) and is endemic to Central Africa.
What is loa loa (loiasis)?
When evaluating isolated gastric fundal varices along the greater curvature, this imaging modality — rather than EGD alone — best delineates splanchnic vascular anatomy to guide treatment decisions.
What is CT of the abdomen with contrast?
A score of 45 or above on this assessment tool — which incorporates temperature, heart rate, atrial fibrillation, CHF, and CNS effects — is highly suggestive of thyroid storm.
What is the Burch-Wartofsky Point Scale?