JEOPARDY

The Only Thing That Helps My Chest Pain is Morphine

100

Which one of the following is an absolute contraindication to combined oral contraceptives in a 42-year-old female? A) Varicose veins B) Obesity (BMI >30.0 C) Sickle cell disease D) A history of ovarian cancer E) Smoking 1 pack of cigarettes/day

What is Smoking one pack per day?

200

Screening test for abdominal aortic aneurysm recommended by the U.S. Preventive Services Task Force for 70 year old man who has smoked 101 cigarettes in his lifetime.

What is Abdominal Duplex US?

300

A 54-year-old male smoker with a family history of coronary artery disease tells you that he takes B-carotene and vitamin E regularly to help prevent cancer and heart disease. In counseling this patient, you discuss smoking cessation and advise him that A) he should continue both supplements B) he should continue B-carotene and discontinue vitamin E C) he should discontinue B-carotene and continue vitamin E D) he should discontinue both supplements E) evidence is insufficient to assess the risk and benefit of these supplements

What is Discontinue both supplements?

400

The greatest reduction in mortality risk for deep vein thrombosis prophylaxis in a critically ill adult is caused by: A) Anticoagulation therapy B) Antiplatelet therapy C) Mechanical device use (pneumatic compression) D) Inferior vena cava filter use

What is Anticoagulation therapy?

500

A 25-year-old male presents to the emergency department with a complaint of his heart racing for the past 45 minutes. He has no known medical problems. He does have occasional episodes of palpitations, but they usually only last a short period. An EKG shows a narrow QRS complex tachycardia at a rate of 180 beats/min. His condition is not improved by vagal maneuvers and adenosine (Adenocard). He remains hemodynamically stable. Which one of the following would be most appropriate at this point? A) Amiodarone (Cordarone) B) Procainamide C) Sotalol (Betapace) D) Verapamil (Calan, Verelan) E) DC cardioversion

What is Verapamil?

I've cut down to 14 cigarettes A Day

100

A 52-year-old male sees you at the request of his wife because of his snoring and her concerns that he has obstructive sleep apnea. Further evaluation with a sleep study is recommended if the patient reports which one of the following? A) Insomnia B) A history of hypertension C) Snoring that awakens his wife D) Unexplained daytime sleepiness

What is Unexplained Daytime sleepiness?

200

A 2-year-old male is brought to the emergency department by his frightened mother following the sudden onset of nasal stuffiness and a harsh, barking, nonproductive cough. The child does not appear significantly distressed. His temperature is 37.9°C (100.2°F) orally. Mild nasal flaring is present. The nasopharyngeal mucus appears mildly edematous and injected, and upper airway noises are heard, but good air movement is evident on auscultation of his chest. Which one of the following is the most appropriate treatment for this patient? A) A bedside humidifier B) A single dose of oral dexamethasone C) Amoxicillin for 7 days D) Nebulizer treatment with racemic epinephrine E) Tracheal intubation and oxygen administration

What is Oral Dexamethasone?

300

COPD patients who are on OPTIMAL medical management can be referred for this

What is Pulmonary rehab?

400

You see a 5-week-old female for a well child visit in December. She was delivered at 28 weeks gestation because of severe preeclampsia in the mother. Her parents state that she is doing well, feeding well, and growing. The physical examination is normal. At this time, you recommend immunoprophylaxis with A) influenza vaccine B) palivizumab (Synagis) C) pertussis vaccine D) rotavirus vaccine E) intravenous immunoglobulin

What is Palivizumab?

500

A full-term newborn female develops respiratory distress 1 hour after an uncomplicated caesarean delivery. She has a respiratory rate of 70/min, and mild grunting and intercostal retractions are noted on examination. The remainder of the examination is within normal limits. A chest radiograph shows some hyperexpansion and fluid in the fissures. Which one of the following is the most likely cause of her symptoms? A) Respiratory distress syndrome of the newborn B) Transient tachypnea of the newborn C) Pneumothorax D) Meconium aspiration syndrome

What is Transient Tachypnea of the newborn?

It's Bad "Bone on Bone" Arthritis

100

A direct blow to the anterior tibia while the knee is in flexion causes this ligamentous injury to the knee

What is the PCL

200

A 13-year-old baseball pitcher develops pain in the upper arm at the shoulder when throwing and is diagnosed with Little League shoulder. This entity is actually a A) coracoclavicular ligament sprain B) sprain or tear of the acromioclavicular ligament C) deltoid muscle strain D) proximal humeral epiphysitis E) labral tear on the acromion

What is Promximal humeral Epiphysitis?

300

A 6-year-old male is brought to your office by his parents. He describes pain in the right hip for the past month or two, and the parents report that for the past few weeks they have noticed intermittent limping. The history is negative for trauma, injury, and fever. On examination the patient indicates that the pain is over the anterior hip joint, with increased pain on internal rotation, which is limited to 90°. Of the options listed below, which one of the following is the most likely diagnosis in this case? A) Septic arthritis of the hip B) Transient synovitis of the hip C) Osteoarthritis of the hip D) Osteonecrosis of the femoral head (Legg-Calvé-Perthes disease) E) Slipped capital femoral epiphysis

What is Osteonecrosis of the femoral head?

400

35-year-old female presents to your office with a 2-week history of pain, mild swelling, and point tenderness in the midportion of her anterior tibia. She has recently increased her jogging from 6 miles per week to 30 miles per week. She is unable to hop on the involved leg, as this induces significant pain at the site. A plain radiograph reveals a faint lucency at the same location. This patient would most likely benefit from this treatment initially.

What is a Walker Boot/Immobilization

500

A 16-year-old male presents to your office with a 1-month history of paresthesias in the ring finger and little finger of his left hand. He is the catcher on his high school baseball team. The physical examination reveals no abnormalities of his neck, shoulder, or elbow. His hand grip is normal, but maximal flexion of the wrist elicits paresthesias in the fourth and fifth digits. Which one of the following is the most likely diagnosis? A) Carpal tunnel syndrome B) Ulnar entrapment C) Flexor carpi ulnaris tendinitis D) De Quervain’s tenosynovitis E) Stress fracture of the scaphoid

What is Ulnar entrapment?

I'm pretty sure all this fatigue is coming from my thyroid

100

Which one of the following outcomes is seen with intensive glycemic control in patients with type 2 diabetes mellitus? A) Fewer hypoglycemic events B) Improved blood pressure control C) A delay in the development of macroalbuminuria D) A reduced need for dialysis E) Lower all-cause mortality rates

What is a delay in the development of microalbuminuria?

200

A 35-year-old white male who has had type 1 diabetes mellitus for 20 years begins having episodes of hypoglycemia. His glucose levels had previously been stable and well controlled, and he has not recently changed his diet or insulin regimen. Which one of the following is the most likely cause of the hypoglycemia? A) Spontaneous improvement of CA 35-year-old white male who has had type 1 diabetes mellitus for 20 years begins having episodes of hypoglycemia. His glucose levels had previously been stable and well controlled, and he has not recently changed his diet or insulin regimen. Which one of the following is the most likely cause of the hypoglycemia? A) Spontaneous improvement of B-cell function B) Renal disease C) Reduced physical activity D) Insulin antibodies

What is Renal Disease?

300

A 42-year-old female continues to have elevated blood pressure while on three antihypertensive agents. You are concerned that she may have idiopathic adrenal hyperplasia or an aldosterone-producing adenoma. You should order this test

What is Renin/Aldosterone ratio?

400

Long-term treatment with which one of the following is known to reduce serum vitamin D levels? A) Estrogen replacement B) Isoniazid C) Phenytoin D) Statins E) Thiazide diuretics

What is Phenytoin?

500

Pioglitazone (Actos) has been found to be associated with which one of the following adverse effects? A) Steatohepatitis B) Fluid retention C) Cognitive dysfunction D) Increased stroke risk E) Increased all-cause mortality

What is Fluid Retention?

Numbskull

100

A 63-year-old female presents with a complaint of a painful, red right eye. She says that her vision has also been blurry. She has also noted a discharge. The patient wears contact lenses. When you examine the patient you note photophobia. The pupils are equal, round, and reactive to light. You also note unilateral diffuse injection. Fluorescein staining reveals focal corneal uptake. Which one of the following is the most likely diagnosis? A) Corneal abrasion B) Subconjunctival hemorrhage C) Uveitis D) Acute angle-closure glaucoma E) Herpes zoster ophthalmicus

What is Corneal Abrasion?

200

An 18-year-old male comes to your office because of the recent onset of recurrent, unpredictable episodes of palpitations, sweating, dyspnea, gastrointestinal distress, dizziness, and paresthesias. He says he is always concerned about when the next attack will occur. His physical examination is unremarkable except for moderate obesity. Laboratory findings, including a CBC, blood chemistry profile, and TSH level, reveal no abnormalities. This is the most likely diagnosis.

What is Panic Disorder?

300

A 19-year-old female high school student is brought to your office by a friend who is concerned about the patient cutting herself on the wrists. The patient denies that she was trying to kill herself, and states that she did this because she “just got so angry” at her boyfriend when she caught him sending a text message to another woman. She denies having a depressed mood or anhedonia, and blames her fluctuating mood on everyone who “keeps deserting her,” making her feel like she’s “nothing.” She admits that she has difficulty controlling her anger. Her sleep quality and pattern appear normal, as does her appetite. She denies hallucinations or delusions. The wounds on her wrists appear superficial and there is evidence of previous cutting behavior on her forearms. Her vital signs are stable. Which one of the following would be most beneficial for this patient? A) Clonazepam (Klonopin) B) Fluoxetine (Prozac) C) Quetiapine (Seroquel) D) Inpatient psychiatric admission E) Psychotherapy

What is Psychotherapy?

400

. A 44-year-old male complains of feeling tired and sad for the last few months. He has a past medical history of obesity, diabetes mellitus with painful peripheral neuropathy, and seizure disorder. He has also noticed that he is not as interested in his usual hobbies and is eating more than usual. You diagnose depression. Which one of the following would be the most appropriate agent for this patient, considering his comorbidities and symptoms? A) Bupropion (Wellbutrin) B) Citalopram (Celexa) C) Duloxetine (Cymbalta) D) Nortriptyline (Pamelor)

What is Duloxetine?

500

Which one of the following medications blocks dopamine stimulation in the chemoreceptor trigger zone, making it an effective antiemetic for patients with gastroenteritis? A) Diphenhydramine (Benadryl) B) Meclizine (Antivert) C) Metoclopramide (Reglan) D) Ondansetron (Zofran) E) Scopolamine (Transderm Scop)

What is Metoclopramide?