NHMC Residency

Cardiology

100

This arrhythmia causes an irregularly irregular rhythm and increases stroke risk via left atrial appendage thrombus

Atrial Fibrillation

200

ST elevation in leads II, III, aVF suggests infarction of which coronary artery

Right Coronary Artery

300

Name the 4 drug classes that are part of GDMT in the management of HFrEF

- ACE-inhibitors/ARBs/ARNI

- SGLT2 inhibitors

- MRAs

- Beta-blocker

400

Which medications are contraindicated in AFib with RVR in patients with decompensated HFrEF?

- CCBs, BBs

500

What mechanical complication shortly after MI can cause acute pulmonary edema and hypotension

Papillary muscle rupture -> severe mitral regurgitation

Pulmonology

100

Which bacteria is the most common cause of community-acquired pneumonia?

Streptococcus pneumoniae

200

COPD is a lung disease defined by what post-bronchodilator FEV1/FVC ratio?

<0.70

300

What are the specific details of Light's criteria to differentiate exudative and transudative pleural effusions?

- pleural fluid/serum protein ratio >0.5

- pleural fluid/serum LDH ratio >0.6

- pleural fluid LDH >2/3 of upper limit of normal

400

A patient develops sudden hypoxia and hypotension after central line placement. What complication does this suggest?

Tension pneumothorax

500

Which antibiotic cannot be used in MRSA pneumonia and why?

1. Daptomycin

2. Inactivated by lung surfactant

GI

100

This antibiotic is first-line for uncomplicated C. diff

Oral Vancomycin

200

What LFT ratio is suggestive of alcoholic liver disease?

AST:ALT >2

300

The first medication that should be started in suspected variceal bleeding, even before endoscopy?

Vasoactive drugs (somatostatin, terlipressin, or octreotide)

400

Why do we give aggressive fluids in acute pancreatitis?

Prevention of pancreatic hypoperfusion and necrosis

500

What is Type 3C Diabetes?

Occurs due to pancreatic damage from conditions like pancreatitis, cystic fibrosis, pancreatic cancer, or pancreas removal, leading to impaired insulin production

Renal/Electrolytes

100

pH 7.34, serum bicarbonate 18 mEq/L, pCO2 30 indicates what abnormality?

Metabolic Acidosis

200

Which protein causes the tubular injury seen in rhabdomyolysis?

Myoglobin

300

Detail the two lab abnormality criteria that defines an AKI

- rise in creatinine > 0.3 mg/dL

- or > 1.5x baseline

400

Which medication is used to protect the heart during hyperkalemia?

IV calcium gluconate

500

Thiazide diuretic mechanism of action is inhibiting the ____ symporter in the ____ tubule of the kidney

1. Na+/Cl-

2. distal

Other Systems

100

A patient with acute focal neurologic deficit and normal head CT should undergo this next study.

MR Brain with diffusion-weighted imaging

200

What type of crystals are seen in pseudogout?

CCPD (calcium pyrophosphate dihydrate)

300

____ LDH and _____ haptoglobin strongly support a diagnosis of hemolytic anemia

1. elevated

2. low

400

A patient with new-onset seizure, fever, and temporal lobe abnormalities on MRI should receive this empiric therapy immediately

IV Acyclovir (concern for Herpes Simplex Encephalitis)

500

A patient on chronic steroids with acute hip pain and normal XR should be evaluated for this diagnosis

Avascular necrosis of the femoral head