Osteomyelitis
What are the two classifications of osteomyelitis based on the mechanism of infection?
Hematogenous and non-hematogenous
What anatomical landmarks define upper GI bleeding?
Mouth to ligament of Treitz
Hepatocellular carcinoma is frequently associated with marked elevations in this biomarker.
What is Alpha-Fetoprotein
Treating VTE at home often produces better outcomes than treating in the hospital.
True or False?
True
List at least 3 major risk factors for developing sepsis.
Age of 65 years or older, malnutrition, chronic illness, immunosuppression, recent surgery or hospitalization, and indwelling devices.
What is the preferred initial imaging modality in the evaluation of suspected osteomyelitis?
Plain film radiography
What 2 risk factors account for 80% of peptic ulcer disease and peptic ulcer bleeding?
NSAID use and H. pylori infection
Even in the setting of significant heart failure, brain natriuretic peptide may be unexpectedly low in patients with this comorbidity.
What is obesity?
In most patients with proximal DVT, the ASH guideline panel suggests anticoagulation therapy alone over thrombolytic therapy in addition to anticoagulation.
True or False?
What serum biomarker is widely used as an indicator for bacterial sepsis?
Procalcitonin
Name at least 3 tests that should be included in the initial laboratory evaluation of suspected osteomyelitis.
CBC, ESR, C-reactive protein, and blood cultures
What is the most common source of lower GI bleeding?
Diverticular disease
This enzyme level is elevated in 75% of untreated patients with sarcoidosis.
What is serum angiotensin converting enzyme (ACE) level?
What type of medication is recommended for the treatment DVT and/or PE?
Direct oral anticoagulants (DOACs) are suggested over vitamin K antagonists (VKAs - warfarin) due to lower risk of major bleeding, and reduced cost by eliminating monitoring requirements.
What are the 4 components of the sepsis bundle that should be completed within 3 hours of presentation?
Fluid resuscitation, antibiotics, lactate measurement, and cultures
What is the most frequently identified pathogen across all types of osteomyelitis?
Methicillin-sensitive Staphylococcus aureus
Current guidelines recommend blood transfusion for patients with upper GI bleeding when hemoglobin is less than _____ g per dL
8 g/dL
This biomarker has been used to screen for cholangio-carcinoma in patients with primary sclerosing cholangitis but is also considered highly specific for pancreatic adenocarcinoma when levels exceed 1000 units/mL
What is CA 19-9?
What is the minimal length of time a patient must be on therapeutic anticoagulation to treat the initial venous thromboembolism (VTE), i.e., primary treatment?
3 to 6 months
As part of fluid resuscitation, patients with sepsis should receive what type of fluid and at what dose?
An intravenous crystalloid (e.g., normal saline, Ringer lactate) at 30 mL per kg
Typically, how long should antibiotic treatment be continued in the treatment of osteomyelitis?
4 – 6 weeks
In a patient with upper GI bleeding, guidelines recommend high-dose treatment post-endoscopy with what kind of medication, for what duration, and why?
High-dose proton pump inhibitor treatment (i.e., esomeprazole [Nexium], 80 mg per day) for the first 72 hours post-endoscopy because this is when rebleeding risk is highest.
14-3-3 Protein is a biomarker that is most frequently elevated in the CSF of patients with this cattle-associated neurodegenerative disease
What is Creutzfeldt Jakob Disease?
After completion of primary treatment for patients with unprovoked DVT and/or PE, the ASH guideline panel suggests continuing antithrombotic therapy for how long?
Indefinitely
__________ is the first-line vasopressor agent for patients with septic shock if initial fluid resuscitation fails to restore mean arterial pressure to _____ mm Hg or greater.
Norepinephrine; 65 mm Hg or greater