Steroids
Your Daily Renal Chem 10
Medicine Pearls on the Wards
Landmark Trials of the Past 10 Years
Medical Puns by Mason - Continued
100

This steroid has the least mineralocorticoid activity and the most glucocorticoid activity; you might have seen it used in COVID or ARDS.

What is dexamethasone?

100

Your patient is given IV regular insulin instead of the subcutaneous insulin you ordered. This would be the expected electrolyte abnormality if you got a renal chem 10 one hour later. 

What is hypokalemia?

100

This serum marker has a sensitivity for acute aortic syndrome of about 96%, which is similar to the sensitivity for the condition it is moreso known to be used to rule out. 

What is the D-Dimer?

100

This trial, published in 2014, found sacubitril-valsartan to be superior to enalapril in heart failure patients with EF 40% or less. 

What is the PARADIGM-HF trial?

100

A nocturnist Dr. Gowen, or the Adult Swim of Nickelodeon programming.

What is Nick at Night?

200

Patients on the equivalent of 20 mg of prednisone or more daily for >1 month typically are started on prophylaxis against this organism.

What is Pneumocystis jirovecii?

200

This electrolyte abnormality is the strongest one that is associated with chronic PPI use. 

What is hypomagnesemia?

200

Serum and urine studies still have you confused? This serum study is typically low in SIADH.. and typically normal/elevated in all other causes of hyponatremia.

What is uric acid?

200
Published in 2015, this trial found that patients with Afib on warfarin did just as well, with significantly less bleeding risk, when they weren't bridged with low-molecular weight heparin, compared to the patients that were bridged.

What is the BRIDGE trial?

200

This IV fluid has all of the liquid portion of your blood without the extra calories.

What is Plasma Lyte?

300

You might use this scoring system to further risk stratify patients on chronic glucocorticoids in a patient who doesn't meet criteria for bisphosphonates by bone mineral density alone.

What is the FRAX (Fracture Risk Assessment) tool?

300

You admit a patient with a calcium of 13.2, a low PTH and a low 25OH-Vit D. Other studies are pending but the patient is diagnosed with sarcoidosis. What is the most likely mechanism of hypercalcemia?

What is 1,25OHVitD production?

300

This serum study is likely a better marker for EGFR than creatinine, especially if your patient has very high/low muscle mass. 

What is Cystatin C?

300

Published in 2018, this trial found among critically ill adults in the ICU, use of balanced IV fluids compared to normal saline resulted in lower rate of the composite outcome of death, new renal-replacement therapy, or persistent renal dysfunction.

What is the SMART trial?

300

This addition to a patient's bowel regimen is also how someone may describe Dr. Clausen when he's lying or stealing.

What is a senna?

400

Your patient might develop this condition if they have been on long-term glucocorticoid therapy and abruptly stop or wean too quickly. 

What is (Tertiary) adrenal insufficiency?

400

Your patient is admitted with toxic alcohol poisoning. The anion gap is 9. What is the most likely toxic alcohol?

What is isopropyl alcohol?

400

This antibiotic, compared to counterparts in its class, is often said to have a PEA sized hole. Name the antibiotic and the PEA sized hole. 

What is ertapenem and "Pseudomonas, Acinetobacter, and Enterococcus?"
400

Published in 2022, this trial found that, among patients with severe ischemic LV Systolic Dysfunction who received optimal medical therapy, revascularization by PCI did not result in a lower incidence of death from any cause or hospitalization for heart failure.

What is the REVIVED Trial?

400

This hidden-camera reality TV show is getting a new fungal spinoff.

What is Candida Camera?

500

This is the glucocorticoid used in the "CAPE COD" trial.... where, among patient's with severe community-acquired pneumonia, patient's receiving this steroid had a lower risk of death at Day 28 of enrollment.

What is hydrocortisone?

500

A 54 y.o. female patient on HCTZ is found to have a calcium of 10.8. PTH is 90. What electrolyte will most likely be low?

What is phosphorous?

500

Hives and hypotension? Give epinephrine but also draw this lab to confirm the diagnosis in a couple of days.

What is tryptase?

500

This study, published in April 2024, found that patients that were fully vaccinated against COVID-19 with at least one risk factor, as well as non-vaccinated patients without such risk factors, found no difference (Time to alleviation of symptoms) between nirmatrelvir-ritonavir (Paxlovid) compared to placebo.

What is the EPIC-SR trial?

500

<0.05 in a positive study, or your patient's urine output.

What is the pee value?