Cardiac PathoPhys
Lungs... Sure
More than Vanco/Zosyn
Time to GrO-OVER some Endo
G... I... Oughta
100
Why CCBs should be avoided in patients with pre-excited atrial fibrillation (WPW)
AV-node blockade promotes conduction via accessory pathway
100
Compliance is _____ in ARDS, but ______ in Pulmonary Edema?
Reduced, preserved
100
Which tick-borne disease can mimic thrombotic thrombocytopenic purpura (TTP)?
Babesia
100
1,25-(OH)₂ vitamin D will be elevated in what?
Granulomatous diseases or Lymphoma
100
What is the primary mechanism by which lactulose improves encephalopathy?
Conversion of ammonia to non-absorbable ammonium in the gut and promoting ammonia excretion.
200
Which coronary artery is most often involved in causing bifascicular block on ECG (RBBB + LAFB)?
LAD — it supplies both bundle branches
200
In obstructive sleep apnea, what is the primary mechanism driving systemic hypertension?
Recurrent Hypoxia --> Sympathetic Surges --> Increased Vascular Tone
200
What distinguishes disseminated gonococcal infection (DGI) arthritis-dermatitis syndrome from reactive arthritis clinically?
Timing and Sampling. Also migratory pattern of the tenosynovitis.
200
What is the most sensitive diagnostic test for primary hyperaldosteronism
Plasma Ald/Renin >20
200
A patient presents with jaundice, dark urine, and elevated ALP and GGT. Imaging shows intrahepatic biliary strictures and cirrhosis. Which autoimmune disease is most likely?
Primary sclerosing cholangitis.
300
In a patient with severe aortic stenosis, why is preload dependence clinically important when giving diuretics or nitrates?
Reduced LV compliance requires high preload to maintain cardiac output
300
What is this specific pattern called, commonly see in PAP, Some ILDs, PCP Pna, Sarcoid, etc.
300
Which fungal infection presents with broad-based budding yeast in the Midwest?
Blastomyces
300
A patient with hyperthyroidism develops fever, rash, and elevated liver enzymes after initiating therapy. What is the most concerning complication, and how should it be managed?
What is the likely agent and what is happening?
Methimazole Agranulocytosis/hepatoxicity
300
A patient with chronic pancreatitis develops diabetes and fat-soluble vitamin deficiencies. You order an A1c which confirms endocrine dysfunction, but what exocrine testing can confirm the diagnosis of pancreatic insufficiency?
1. Exocrine: Fecal Elastase
400
A patient with hypertrophic obstructive cardiomyopathy (HOCM) becomes hypotensive after diuresis. Explain the physiologic mechanism.
Decreased preload increases LV outflow tract obstruction due to greater anterior motion of the mitral valve
400
On bronchoalveolar lavage, you find hemosiderin-laden macrophages. What does this finding indicate?
Alveolar Hemorrhage
400
What is the Jarisch-Herxheimer reaction, and which cytokines mediate it?
Constitutional Symptoms
after Spirochete treatment
TNFAlpha, IL6,8
400
What biochemical test differentiates factitious thyrotoxicosis from Graves’ disease?
Thyroglobulin
400
A patient with longstanding ulcerative colitis undergoes surveillance colonoscopy, revealing a flat lesion with high-grade dysplasia. What is the preferred management?
ProctoColectomy
500
38 year old male admitted with hypertensive urgency, AKI, and CHF
Amyloid CMP
500
In status asthmaticus , why is a normal PaCO₂ concerning?
It indicates impending respiratory failure — patient is tiring, losing compensatory hyperventilation
500
40 year old patient with AIDS. CD4 <20. This is not Mulloscum?
Disseminated Crypto
500
A patient has episodic flushing, diarrhea, and a markedly elevated 24-hour urine 5-HIAA. Which type of tumor should be suspected, and where is it most commonly located?
Carcinoid, Small Intestine
500
A patient with chronic pancreatitis develops a pancreatic pseudocyst causing biliary obstruction. What intervention strategy is preferred?
Cystogastro or cystojejunostomy