Cardiology
A patient has crushing substernal chest pain and ST elevations in II, III, and aVF. This is the most likely coronary territory involved.
What is the Inferior myocardial infarction (RCA territory)?
A patient with asthma has acute wheezing and dyspnea. After repeated short-acting beta-agonist treatments, persistent symptoms require this additional first-line therapy.
What is Systemic corticosteroids?
A college student has fever, headache, neck stiffness, and photophobia. The empiric treatment for suspected bacterial meningitis in an otherwise healthy adult includes these drugs.
What is Vancomycin + a third-generation cephalosporin (e.g., ceftriaxone)?
A pregnant patient at 34 weeks has painless bright-red vaginal bleeding. The leading diagnosis is this.
What is placenta previa?
A patient has sudden unilateral facial weakness involving the forehead and lower face, without other neurologic deficits. This is the most likely diagnosis.
What is Bell palsy?
A 68-year-old with atrial fibrillation has hypertension, diabetes, and prior stroke. The best long-term strategy to reduce embolic stroke risk is this.
What is anticoagulation with a direct oral anticoagulant (or warfarin when indicated)?
A postoperative patient develops sudden pleuritic chest pain, tachycardia, and hypoxemia. If clinically stable and PE is strongly suspected, the next diagnostic test is this.
What is CT pulmonary angiography?
A patient with fever, flank pain, and pyuria has acute pyelonephritis. This common outpatient antibiotic is appropriate when local resistance patterns permit.
What is an oral fluoroquinolone such as ciprofloxacin (when appropriate locally)?
A pregnant patient has hypertension, proteinuria, headache, and visual changes at 32 weeks. This medication prevents progression to eclampsia.
What is Magnesium sulfate?
A patient presents with sudden-onset aphasia and right-sided weakness 90 minutes after symptom onset. If eligible, the acute treatment is this.
What is IV thrombolysis with alteplase?
A patient with heart failure with reduced EF remains symptomatic despite an ACE inhibitor and beta-blocker. This medication class improves mortality and is especially useful when EF is reduced.
What is a mineralocorticoid receptor antagonist (e.g., spironolactone/eplerenone)?
A smoker has progressive dyspnea, barrel chest, and decreased breath sounds. This pulmonary function pattern is expected.
What is Obstructive pattern: ↓FEV1/FVC?
A patient develops profuse watery diarrhea after receiving clindamycin. The most likely diagnosis is this.
What is Clostridioides difficile infection?
A postpartum patient has heavy bleeding and a boggy uterus. The most likely cause and first-line uterotonic treatment are this.
What is Uterine atony → oxytocin?
A patient has fluctuating fatigable ptosis and diplopia that worsen throughout the day. The most likely diagnosis is this.
What is
Myasthenia gravis?
A young athlete has exertional syncope. Exam reveals a harsh systolic murmur that increases with Valsalva. This is the most likely diagnosis.
What is Hypertrophic obstructive cardiomyopathy?
A patient with severe pneumonia has PaO₂ 55 despite supplemental oxygen and bilateral infiltrates without evidence of left-sided heart failure. This syndrome is present.
What is Acute respiratory distress syndrome (ARDS)?
A patient with HIV has a CD4 count of 180 cells/µL. This prophylaxis is recommended to prevent Pneumocystis jirovecii pneumonia.
What is TMP-SMX?
A 7-week pregnant patient has unilateral pelvic pain, spotting, a positive pregnancy test, and no intrauterine pregnancy on transvaginal ultrasound. This diagnosis should be assumed until proven otherwise.
What is Ectopic pregnancy?
A patient has ascending weakness and areflexia two weeks after a diarrheal illness. This classic postinfectious neurologic syndrome is present.
What is Guillain-Barré syndrome?
A patient on warfarin develops sudden severe headache and focal neurologic deficits. The INR is markedly elevated. The immediate reversal strategy is this.
What is 4-factor PCC plus IV vitamin K?
A patient with COPD has increased dyspnea, sputum volume, and sputum purulence. In addition to bronchodilators and steroids, this treatment is indicated when bacterial exacerbation is suspected.
What is antibiotics?
A patient with a prosthetic valve has fever and positive blood cultures for Staphylococcus aureus. Because prosthetic-valve endocarditis is suspected, this empiric antibiotic coverage is appropriate while cultures are pending.
What is Vancomycin + cefepime (broad empiric coverage, tailored to local guidance/cultures)?
A patient has severe hypertension during pregnancy with platelets 85,000/µL and elevated AST/ALT. This severe preeclampsia variant is diagnosed by this name.
What is HELLP syndrome?
A patient with Parkinson disease develops acute severe rigidity, fever, altered mental status, and autonomic instability after abrupt withdrawal of dopaminergic therapy. This life-threatening complication is called this.
What is Parkinsonism-hyperpyrexia syndrome (aka neuroleptic malignant syndrome–like syndrome)?