EKG/Echo/Telemetry
Clinical Images
Visual Learning/Radiology
High Value Care
Miscellaneous
100
Diagnose
Atrial Fibrillation
100
Dx:
Diabetic retinopathy
100
Endoscopic view of the esophagus in a 36-year-old male with dysphagia. Dx?
Eosinophilic Esophagitis
(whitish papules are also visible representing eosinophilic abscesses)
100
Name the medication that Increases smoking cessation rates about 2 times more than control. Avoid with seizure disorder and eating disorder. May be associated with suicidal ideation. Safety in pregnancy is unclear.
Bupropion
100
Dx: 
Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) is a disorder of development of the vasculature characterized by telangiectases and arteriovenous malformations in specific locations. The most common features of the disorder—nosebleeds and telangiectases on the lips, hands, and oral mucosa—are often subtle.
200
Diagnose
This is a classic 12 lead EKG of a patient with Torsade de Pointes. It shows the polymorphic nature of the tachycardia, the long QT interval and the initiation of the tachycardia with a late coupled P.V.C.
Contributed by Michael Rosengarten BEng, MD.McGill (CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0/deed.en)
200
Diagnose: Non tender, multiple lesions. 
Janeway lesions are macular, erythematous, nontender microabscesses in the dermis of the palms and soles caused by septic emboli that are considered pathognomonic for IE.
200
Diagnose the condition. What is the criteria to diagnose? 
- The McDonald criteria for diagnosing multiple sclerosis require symptoms of central nervous system demyelination separated in space and time from a series of clinical relapses or progression, signs on physical examination, distribution of lesions on MRI, and (if necessary) the presence of CSF-unique oligoclonal bands.
- Proper application of diagnostic criteria can prevent unnecessary neurologic testing, referrals, and misdiagnoses in patients suspected of having multiple sclerosis.
200
In patients with cystic fibrosis, what is the recommended age for routine colorectal cancer screening?
40 years (And then rescreening every 5 years)
200
What are the three FDA approved medications for the treatment of opioid use disorder.
300
Diagnose
Pericarditis
300
This patient is at risk of developing?
Squamous Cell Carcinoma
(Image shows actinic keratoses)
300
A 62-year old woman is evaluated for an 8-month history of progressive dyspnea, dry cough, and clubbing. She continues to smoke cigarettes.
Chest CT scan is shown.
This patient's chest CT scan suggests idiopathic pulmonary fibrosis. There are fibrotic cystic changes to the lungs, commonly called "honeycombing" because of their appearance, as shown (arrow). Honeycombing is a pathologic finding and not specific for a single disease, but it is commonly associated with advanced interstitial lung diseases, such as idiopathic pulmonary fibrosis. The presence of honeycombing is associated with a poor prognosis.
300
What is BMI cutoff for bariatric surgery?
Bariatric surgery should be reserved for patients with a BMI of 40 or greater or for those with a BMI of 35 or greater who have obesity-associated comorbid conditions.
300
Define PPV and NPV of a test.
The positive predictive value is the probability that a positive test is a true positive result, and the negative predictive value is the probability that a negative test is a true negative result.
400
Diagnose the condition. 
Hypertrophic Cardiomyopathy
The ECG shows ST-segment depression and deeply inverted T waves (arrows) in the precordial leads, consistent with marked apical hypertrophy.
400
A 60-year-old male presented with fever, fatigue, shortness of breath, and cough. The p smear is given below. What is the most probable Dx?
Acute Myelogenous Leukemia
(Very large, immature myeloblasts with many nucleoli. Linear reddish "Auer rod" composed of crystallized granules is visible in some cells. These findings are typical for acute myelogenous leukemia (AML) most prevalent in young adults)
400
Identify the findings in a HIV patient. 
Kaposi sarcoma, presenting as firm purple nodules on the face and purple palatal nodules, is seen in a patient with AIDS.
400
33 y/o M with PMH of HIV presents with one day of fever, productive cough, and a left-lower-lobe infiltrate on chest radiograph. His CD4 count is 440 cells/mm3. What is the most-likely cause of his pneumonia?
Streptococcus pneumoniae
(pneumocystis jiroveci isn't more common until CD4 is less than 200 cells/mm3)
400
What are BMI cutoffs for Pharmacologic therapy for obesity?
Pharmacologic therapy may be used as an adjunct to lifestyle modifications in patients with a BMI of 30 or greater or in patients with a BMI of 27 or greater who have overweight- or obesity-associated comorbid conditions.
500
Atrial myxoma.
500
A 65-year-old white male presented with the following painless scrotal lesions.
Angiokeratomas
500
Dx?
Pulmonary Embolism
500
Patients age 19-65 with all of the following underlying conditions should receive pneumococcal vaccine except?
A- Alcohol Use Disorder
B- Diabetes Mellitus
C- Essential Hypertension
D- Sickle Cell Disease
C- Essential Hypertension
(Patients age 19-65 with the following clinical conditions should receive pneumococcal vaccine
- Chronic heart disease
- Chronic lung disease
- Chronic liver disease
- Diabetes Mellitus
- Sickle cell disease or other hemoglobinopathies
- Current cigarette smoking
- Alcohol use disorder)
500
Thyroid scan findings are shown.
Which of the following is the most likely diagnosis?
The most likely diagnosis is a multinodular goiter.