Should I Tap That?
Heart Breaker
Breast (Cancer)
Drinks (-> Cirrhosis)
Do you know your intern?
100
What empiric antibiotics should patients with a community aquired empyema be on?
Aerobic + anaerobic coverage
Ceftriaxone + metronidazole
100
For how long should patients with ACS with a low bleeding risk be kept on DAPT?
12 months
100
At what age should breast cancer screening start and how often should it occurf according to USPSTF?
40, every TWO years
American college of radiology recommends annual screening
10-year cumulative false-positive rates are 42% with biennial screening and 61% with annual screening
100
What is the definition of acute liver failure?
INR > 1.5, neurologic dysfunction and no prior hx of liver disease
Important because expedites liver transplant workup
100
This intern dabbles in Latin Dance
Koushick
200
What are Light's Criteria?
LDH > 2/3 or 0.6 serum LDH
LDH > 0.5 UNL
Prot - serum prot > 0.5
200
Name the 3 main etiologies of MINOCA
Embolism, vasospasm and spontaneous coronoary artery dissection
200
What is this sign and what does it make you concerned about?
Peau d'orange - orange peel sign
Inflammatory brest cancer
200
What can you use to treat HRS on the floor?
Midodrine + octreotide
Inferior to norepi or terlipressin, but generally unavailable on floor at both sites.
200
This intern has enjoyed being a part of jazz and rock bands
Dario - look up Borderline Empire on Spotify/Apple Music
300
What 3 values classify a parapneumonic pleural effusion as complicated?
pH < 7.2
Gluc < 60
Gram stain positive
(Also, LDH > 1000)
300
What medications are recommended for Dressler Syndrome?
High dose aspirin (325-1000) and colchicine.
NOT glucocorticoids or nonsteroidal anti-inflammatory drugs (besides aspirin) as they may increase the risk of recurrent myocardial infarction or impaired myocardial healing and risk of rupture.
300
In what patient population should SERM be avoided?
Those with hx of DVT
300
What medication is associated with an increased risk of SBP in patients with cirrhosis and ascites?
PPI
300
This intern is a big fan of Sci-Fi/Fantasy books
Sara
400
What are these signs?
Plankton sign - floaty bits of exudate
Hematocrit sign - layering of hyperechoic fluid
400
What medication should all patients with ACS started on DAPT and a high bleeding risk be started on?
PPI
400
What is recommended for patients with all subtypes of breast cancer with known bone metastasis?
Zoledronic acid (bisphosphonates) or denosumab - decreases fractures, pain, and need for radiation.
400
Which patient population should always get a paracentesis in the ED and what outcomes does it affect
ANY patient with ascites and known or suspected cirrhosis
Para within 12 hours is associated with improved mortality compared to within 72 hours
400
This intern enjoys reading about post-colonialism and is an outdoor enthusiast
Mahdi
500
Name two values that can help you determine if an exudative effusion is a pseudoexudate
25% of exudates = transudate
BNP > 1500 in pleural fluid
Serum pleural protein gap > 3.0
Serum pleural albumin gap > 1.2
500
Define MINOCA
Rise in tropinin with evidence of ischemia (EKG changes, WMA, etc) with <50% stenosis on LHC NOT due to myocarditis or takotsubo.
500
In patients with a known BRCA mutation, at what age and by what modality should they be screened for breast cancer?
25 and with MRI annually
By age 30 they should start having mammogram + MRI annually
500
Define hepatorenal syndrome
Cr increase of 0.3 or more within 48 hours or >50% in 7 days with NO response to IV alb + cessation of diuretics after 48 hours not related to shock/NSAID/intrinsic kidney pathology
500
This intern restores vintage bicycles with his father
Stefano
