The following MRI finding is consistent with what recurrent neurologic disease?
Multiple Sclerosis
What is the preferred oral anticoagulant in antiphospholipid antibody syndrome?
Warfarin
Name this condition
Bonus: what is the treatment?
Vitiligo
Topical therapies include high-potency glucocorticoids or immunomodulators (tacrolimus, pimecrolimus). Phototherapy with UV light is also an option and can be the treatment of choice for widespread involvement.
This physical exam finding can be indicative of what disease?
Wilson's Disease
Bonus: Scrubs S07E11
https://www.youtube.com/watch?v=3rXB1Lwg9e0
Treatment is lifelong and involves administration of copper chelators. Trientine is preferred over penicillamine because of a lower rate of adverse effects. Zinc supplements can be administered to decrease intestinal absorption of copper. Urgent liver transplantation is necessary in acute liver failure secondary to Wilson disease.
What is Captain America's shield made of?
Vibranium
What is the most common cause of a thunderclap headache and what is the imaging of choice for initial evaluation?
Subarachnoid Hemorrhage and CT head without contrast
All patients with polycythemia vera should be treated with ________ (medication) and ________ (procedure).
Bonus: tell me what the hematocrit goal is for a patient with polycythemia vera
Low Dose ASA Therapeutic Phlebotomy
Pts who are at high risk for thromboembolic events (prior event or age >60 yo) can be given cytoreduction therapy such as hydroxyurea or interferon alpha or ruxolitinib
HCT <45%
What is the name of this skin condition
Rosacea, Rhinophyma (hyperplastic sebaceous glands and enlargement of the nose, in a patient with long-standing, uncontrolled rosacea).
Tell me the eponymic exam finding and diagnosis
Cholelithiasis/cholecystitis
Murphys Point
Which Avenger cut off Thanos' head
Thor
What are the blood pressure parameters for an acute ischemic stroke and for tPA administration?
Ischemic stroke: blood pressure up to 220/120
tPA Administration: blood pressure should be less than 185/110 mm Hg before treatment
What does the "K" in "Vitamin K" stand for?
Bonus: tell me all of the things that warfarin inhibits the synthesis of
Koagulationsvitamin
The Germanic word for Vitamin K, where it was discovered.
Bonus: Factors 2/7/9/10/C/S
A 44-year-old woman is evaluated for a 4-week history of worsening rash. She used clobetasol cream for 1 week, but the rash worsened. What is the most appropriate diagnostic test?
KOH skin scraping
Tinea corporis is characterized by annular erythematous plaques with scale at the border.
Diagnosis of tinea corporis is made by examination of the scale with potassium hydroxide; the presence of branching hyphae is diagnostic.
29-year-old woman is evaluated at routine follow-up for chronic hepatitis B virus infection. She is asymptomatic, has no other medical conditions, and does not take any medications. She is negative for hepatitis C virus and HIV infections. On physical examination, vital signs and other findings are normal.
Observation, Heb B IG, Antiviral Therapy, Liver Bx?
Treatment of hepatitis B virus (HBV) infection is advised for patients with acute liver failure, chronic infection in the immune-active phase or reactivation phase, or cirrhosis and for selected immunosuppressed patients.
Immune-active chronic HBV infection is defined by presence of hepatitis B core antibody, elevated alanine aminotransferase level, and HBV viral load greater than 2000 U/mL in patients negative for hepatitis B e antigen and greater than 20,000 U/mL in patients positive for hepatitis B e antigen.
What is the Black Widow's real name
Natasha Romanoff
What is the only medication that has been shown to be effective in the prevention of tension type headaches (in controlled trials)
Amitriptyline
What are the 2 confirmatory tests for Von Willebrand Disease?
Reduction in von Willebrand antigen (quantitative analysis) and reduced vWF ristocetin cofactor activity
A 24-year-old woman is evaluated for a 5-year history of atopic dermatitis. She continues to have mild flares every few weeks on her arms. Her only medication is topical clobetasol cream. In addition to topical clobetasol, what other medication could be given to help?
Topical Tacrolimus or Pimecrolimus
Topical tacrolimus and pimecrolimus are immunomodulators (calcineurin inhibitors) that can be effective in treating atopic dermatitis without the risk for skin atrophy, striae, and telangiectasias that can occur with topical glucocorticoid use.
List 3 scoring systems that can be used to identify patients at risk for advanced cirrhosis?
FIB-4, Child Pugh, Na-MELD, NAFLD Fibrosis Score
https://www.mdcalc.com/calc/2200/fibrosis-4-fib-4-index-liver-fibrosis
https://www.mdcalc.com/calc/3081/nafld-non-alcoholic-fatty-liver-disease-fibrosis-score
https://www.mdcalc.com/calc/1754/meldna-meld-na-score-liver-cirrhosis
https://www.mdcalc.com/calc/340/child-pugh-score-cirrhosis-mortality
How many Infinity Stones are there?
Bonus: Name them
6
Mind, Power, Reality, Soul, Space, Time
Inhaling this gas can cause a relative B12 deficiency and result in subacute combined degeneration of the spinal cord.
Nitrous Oxide
What condition is associated with racoon eyes, pinch purpura, yellow periorbital waxy papules/plaques, dystrophic nails, macroglossia
Light Chain Amyloidosis
62-year-old woman is evaluated for a 6-month history of intermittent, painful sores on the back of her hands that worsen with sun exposure. She has no other medical problems and takes no medications. What is the most appropriate diagnostic test?
Bonus: list 2 diseases that are associated with this condition.
Plasma and urine porphyrin levels.
Bonus: HCV, hemochromatosis, alcohol induced liver disease
Porphyria cutanea tarda is a photosensitive disorder that present with scarring and blistering on sun-exposed skin, most commonly on the dorsal hands.
In patients with Autoimmune hepatitis, how long do you keep them on combination immunosuppression (such as azathioprine and prednisone)?
Because autoimmune hepatitis has a high rate of relapse, therapy is recommended for at least 2 to 3 years before discontinuation of the medications.
Biochemical response may occur within 3 to 8 months of treatment in 85% of patients whose disease responds to standard treatment, but histologic response can lag by several months. Therefore, a liver biopsy is recommended to demonstrate absence of active inflammation before cessation of therapy.
In Avengers: Endgame, what food is Scott Lang trying to eat when it's blown out of his hand?
A taco