Cardiology
GI
ID
Endo
Miscellaneous
100

28-year-old woman with a history of lupus presents with pleuritic chest pain that improves when leaning forward. EKG shows diffuse ST elevation and PR depression. What is the treatment?

What is NSAIDs (e.g., ibuprofen) for pericarditis?

100

35-year-old woman presents with jaundice, pruritus, and elevated alkaline phosphatase. Imaging shows bile duct strictures and a beaded appearance

Diagnosis 

What is primary sclerosing cholangitis?

100

A 70-year-old patient with diabetes presents with black eschar on the hard palate and facial pain. 

Diagnosis

What is mucormycosis?

100

35-year-old woman with longstanding type 1 diabetes presents with nausea, orthostatic hypotension, and hyperkalemia. Labs reveal a cortisol level of 2 µg/dL.

What is Addison’s disease (autoimmune adrenal insufficiency)?

100

A 39-year-old man is evaluated for a chronic pruritic skin condition involving the flexural surfaces of his wrist, arms, and legs.

Diagnosis

What is atopic dermatitis?

200

What is the name of this EKG finding, and what condition is it most commonly associated with?

What is electrical alternans, most commonly associated with pericardial effusion and cardiac tamponade?

200

A 40-year-old man presents with watery diarrhea, flushing, and wheezing. Labs show elevated urinary 5-HIAA.

Diagnosis

What is carcinoid syndrome?

200

A 50-year-old HIV-positive patient presents with headache, photophobia, and fever. Lumbar puncture shows opening pressure > 20 cm H₂O and positive India ink stain. 

Diagnosis

Cryptococcal meningitis

200

Worldwide primary cause of adrenal insufficiency

What is TB?

200

A 25-year-old woman presents with vaginal discharge and itching and dysuria.

A vaginal wet mount is shown.

What is Trichomoniasis ?

300

A 60-year-old man in cardiac arrest is found to have pulseless electrical activity (PEA) on the monitor. During CPR, the team works to identify and treat reversible causes. What could be at least 5 causes that should be considered in this scenario?

What are the reversible causes of PEA, including:

  • H’s: Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hyperkalemia/Hypokalemia, Hypothermia.
  • T’s: Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary embolism), Thrombosis (myocardial infarction)?
300

A 55-year-old woman presents with pruritus, fatigue, and elevated alkaline phosphatase. AMA is positive. What is the next best step in management?

What is ursodeoxycholic acid (for primary biliary cholangitis)?

300

25-year-old man presents with 3 days of fever, abdominal cramping, and watery diarrhea, which turned bloody on the second day. He reports eating undercooked chicken at a barbecue 4 days ago. Stool cultures reveals Campylobacter. 

what is the first-line treatment for severe cases?

Azithromycin


300

A 45-year-old man with a history of a non-functioning pituitary macroadenoma presents with sudden onset of severe headache, visual disturbances, and confusion. On examination, he has bitemporal hemianopsia and hypotension. MRI of the brain reveals hemorrhage within the pituitary gland. 

What is the diagnosis, and what is the initial step in management?

What is pituitary apoplexy, and the initial step is IV glucocorticoids (e.g., hydrocortisone) to prevent adrenal crisis?

300

A 23-year-old woman has a 7-month history of a pruritic rash on the flexural surfaces of her wrists, arms, and legs. The patient was recently diagnosed with hepatitis C virus infection.

What is lichen planus?

-pruritic, purple, polygonal papule; these papules are usually distributed symmetrically on the wrists, flexural aspects of the arms and legs, lower back, and genitals

400

What are the criteria for reducing apixaban to 2.5 mg BID in atrial fibrillation?

What are:

  • Age ≥ 80 years.
  • Weight ≤ 60 kg.
  • Serum creatinine ≥ 1.5 mg/dL (requires 2 of the 3 criteria)?
400

Mention 2 indications to start SBP prophylaxis?

1. Ascitic protein < 1.5 g/dL AND one of the following:

  • Serum creatinine ≥ 1.2 mg/dL.
  • Blood urea nitrogen (BUN) ≥ 25 mg/dL.
  • Serum sodium ≤ 130 mEq/L.
  • Child-Pugh score ≥ 9 with bilirubin ≥ 3 mg/dL.

2. Variceal bleeding

3. Previous Episode of SBP

400

A 62-year-old woman is evaluated in the emergency department with a self-diagnosis of shingles. Medical history is notable for chickenpox as a child and breast cancer; she is receiving chemotherapy with doxorubicin, cyclophosphamide, and paclitaxel.

Which transmission-based precautions should be initiated?

What is airborne and contact precautions?


  • Disseminated herpes zoster is diagnosed in immunocompromised patients when only one dermatome is involved.
  • Because disseminated herpes zoster may involve the respiratory tract, contact and airborne precautions are necessary to prevent the spread of disease.
  • In immunocompetent patients, contact precautions alone (Option C) would be appropriate with only one involved dermatome. However, this patient is immunocompromised, and therefore requires contact and airborne precautions.

 

400

Initial treatment for prolactinoma

what is dopamine agonist (e.g., cabergoline or bromocriptine)?

400

medication can be considered to slow disease progression in ADPKD.

What is tolvaptan?

500

A 28-year-old woman with lupus presents with a fever and new-onset mitral regurgitation. TEE w/ vegetation. Blood cultures are negative. 

Diagnosis

What is Libman-Sacks endocarditis?

500

Prophylaxis in Variceal Bleeding

  • Ceftriaxone: 1 g IV daily for 7 days (preferred in high-risk settings).
  • Norfloxacin: 400 mg orally twice daily for 7 days (alternative in low-risk settings).
500

 treatment for secondary syphilis

single dose of intramuscular benzathine penicillin.

- Doxycycline is an alternate therapy for all forms of syphilis with the exception of neurosyphilis, and a 14-day course would be appropriate for management of secondary syphilis; however, doxycycline should only be used in patients with a penicillin allergy or if benzathine penicillin is unavailable.

500

Pituitary tumors, parathyroid hyperplasia, pancreatic tumors

Diagnosis

What is MEN1?

500

A 58-year-old woman with septic shock is admitted to the ICU. A central venous catheter is placed. Follow-up chest radiography is performed.

What is R pneumothorax?