Heme
Endo
USPSTF
GIM
ID
100

M protein below 3 g/dL, clonal plasma cells comprising less than 10% of bone marrow cellularity, and the absence of end-organ damage define this premalignant plasma cell disorder.

What is MGUS (monoclonal gammopathy of undetermined significance)?

100

Two fasting, early-morning total testosterone levels below this threshold — measured between 7 and 10 AM — are required to confirm male hypogonadism.

What is 300 ng/dL?

100

The USPSTF recommends that all persons who plan to or could become pregnant take this daily vitamin supplement to prevent neural tube defects.

What is folic acid?

100

The USPSTF recommends a one-time screening abdominal ultrasound for aortic aneurysm in men within this age range who have ever smoked.

What is 65 to 75 years?

100

This tick-borne intraerythrocytic illness — treated with IV azithromycin plus oral atovaquone for severe disease — may require exchange transfusion when parasitemia exceeds 10% or severe hemolysis or organ failure is present.

What is babesiosis?

200

For isolated deletion of chromosome 5q on karyotype with low-risk MDS, this immunomodulatory drug is the treatment of choice.

What is lenalidomide? (Alt: Revlimid)

200

A 30-year-old woman with a prolactin of 180 µg/L and a 7-mm pituitary microadenoma causing amenorrhea and galactorrhea is best treated with this dopamine agonist, preferred over bromocriptine for superior efficacy and convenience.

What is cabergoline?

200

The USPSTF recommends annual low-dose CT screening for lung cancer in adults aged 50–80 who have at least this many pack-years of smoking history and currently smoke or have quit within the past 15 years.

What is 20 pack-years?

200

Inducible clonus, hyperreflexia, agitation, diaphoresis, and hyperthermia appearing within 24 hours of adding a second serotonergic agent define this toxidrome.

What is serotonin syndrome?

200

In MSSA native valve endocarditis, this antistaphylococcal beta-lactam — or its equivalent oxacillin, with cefazolin as an acceptable alternative — is the treatment of choice because vancomycin is inferior for MSSA.

What is nafcillin? (Accept: oxacillin, cefazolin)

300

When a prolonged clotting time is evaluated by mixing equal parts patient plasma with pooled normal plasma, correction of the clotting time indicates this, while failure to correct indicates this other possibility.

What is a factor deficiency (corrects) vs. a circulating inhibitor (does not correct)? — This is the mixing study.

300

A young woman of Ashkenazi Jewish descent with oligomenorrhea, hirsutism, and a cycle day 5 17-hydroxyprogesterone of 8.2 ng/mL most likely has this diagnosis.

What is nonclassical congenital adrenal hyperplasia (NCCAH) due to 21-hydroxylase deficiency?

300

For women aged 30–65, the USPSTF allows cervical cancer screening every 5 years with this standalone test, as an alternative to Pap smear alone or co-testing.

What is high-risk human papillomavirus (hrHPV) testing?

300

An adult with tinnitus, tachypnea, and a simultaneous respiratory alkalosis plus high anion gap metabolic acidosis has likely ingested this drug in toxic quantities.

What is salicylate (aspirin)?

300

For a non-pregnant patient with primary syphilis and documented severe penicillin allergy (anaphylaxis), this oral antibiotic — given 100 mg twice daily for 14 days — is the CDC-recommended alternative (azithromycin is discouraged due to macrolide resistance).

What is doxycycline?

400

In a patient with heavy menstrual bleeding and severe iron deficiency anemia, a platelet count of 545,000 is best explained by this reactive mechanism.

What is reactive thrombocytosis (secondary to iron deficiency)?

400

In asymptomatic primary hyperparathyroidism, parathyroidectomy is indicated if any one of several criteria is met. Name two criteria involving bone, kidney, or calcium.

Accept any two: BMD T-score ≤−2.5, vertebral fracture on imaging, CrCl <60 mL/min, nephrocalcinosis/nephrolithiasis, 24-hr urine calcium >400 mg/day, serum calcium >1 mg/dL above ULN, or age <50 years.

400

The USPSTF recommends screening ALL pregnant patients for this condition using urine culture, regardless of symptoms.

What is asymptomatic bacteriuria?

400

This validated index uses six factors — high-risk surgery, ischemic heart disease, heart failure, cerebrovascular disease, insulin-dependent diabetes, and creatinine >2 mg/dL — to estimate perioperative cardiac risk.

What is the Revised Cardiac Risk Index (RCRI)? (Alt: Lee index)

400

This human herpesvirus — also associated with Kaposi sarcoma — is the causative agent of multicentric Castleman disease.

What is Human Herpesvirus 8 (HHV-8)?

500

This rare autosomal dominant bleeding disorder — caused by a gain-of-function mutation in the urokinase plasminogen activator gene — causes increased fibrinolysis, a normal platelet count, and bleeding that responds to antifibrinolytic therapy but not to platelets or factor replacement.

What is Quebec platelet disorder?

500

An adrenal mass with unenhanced CT attenuation above this value in Hounsfield units — indicating lipid-poor composition — requires biochemical screening for pheochromocytoma.

What is 10 Hounsfield units (HU > 10)?

500

The USPSTF assigns a Grade A recommendation to screen for this infection in all pregnant persons at their first prenatal visit — and separately recommends screening nonpregnant persons only if at increased risk.

What is syphilis?

500

Fever, diffuse rash, eosinophilia, and internal organ involvement appearing 2–8 weeks after starting allopurinol or an aromatic anticonvulsant define this severe drug reaction.

What is DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms)?

500

In institutions using trough-based vancomycin monitoring for MRSA vertebral osteomyelitis, the target minimum trough is at or above this level. 

[NOTE: Current guidelines favor AUC-guided dosing over trough monitoring — so will also accept target AUC/MIC]

What is ≥15 µg/mL? [Modern guidelines: target AUC/MIC 400–600]