October Jeopardy

Ow My Liver

100

What lab can help determine if ALP is from a hepatobiliary source?

GGT

5'-nUCLEOTIDASE

200

An R value >5 indicates what kind of Liver Injury Pattern?

Hepatocellular

300

What is the common AST:ALT ratio in those with Alcoholic Hepatitis?

2:1 or greater

400

How many grades of Hepatic Encephalopathy are there?

4

500

What are traditional diagnostic criteria for Acute Liver Failure

•Hepatic Encephalopathy

•AST/ALT elevation

•Increased INR (> 1.5)

Peeing Protein

100

What is the argument for using Bumex for Diuresis in Nephrotic Syndrome patients?

Not a Protein Bound Loop Diuretic

200

Why does Vitamin D Deficiency occur in Nephrotic Syndrome?

- Body is dumping Vitamin D Binding Protein

300

What are the findings of Minimal Change Disease on Light Microscopy?

Normal

400

What are the 3 diagnostic criteria for Nephrotic Syndrome?

- Proteinuria > 3.5 g/day or spot urine protein to creatinine ratio > 3-3.5g/g

- Peripheral Edema on Physical Exam

- Hypoalbuminemia

500

Which class of Lupus Nephritis is most associated with the nephrotic syndrome?

- Type 5 

All Backed Up

100

What is this gentle, bulk forming laxative formed from the Plantago Ovata plant?

Psyllium

200

What are 2 examples of an Osmotic Laxative?

- Polyethylene Glycol

- Lactulose

- Sorbitol

- MagOH

- Mag Citrate

300

What is an example of a Stimulant Laxative?

- Senna 

- Bisacodyl

400

What is an example of a Prosecretory Agent used for Constipation?

- Linaclotide (Linzess)

- Plecanatide

- Lubiprostone

500

What is an example of a Mu-Opioid antagonist used for Opioid Induced Constipation?

- Methylnaltrexone (Relistor)

- Naloxegol (Movantik)

- Alvimopan (Entereg)

- Naldemidine (symproic)

Hospital Acquired Friends

100

TRUE OR FALSE

You only need the 3 following criteria to clinch a diagnosis of CAUTI: 

- Bacteriuria

- Indwelling catheter for >2 days

- No other identified source of infection

False 

200

What is the most common Healthcare Associated PATHOGEN?

C. difficile

300

What is an empiric treatment for VAP?

Empiric treatment should cover: 

MRSA (if >10%–20% of isolates are methicillin resistant) 

     • Vancomycin or linezolid 

GNR (including Pseudomonas aeruginosa) 

     • Cefepime, ceftazidime, piperacillin/tazobactam or meropenem 

Consider 2nd agent – aminoglycoside, FQ

 • If risk factors, or >10% of gram-negative isolates are resistant to an agent

400

What Genus is the most common cause of CLABSIs in both Hospital Wards and in ICUs?

Staphylococcus

500

What is first line treatment for initial non severe C. Diff Infection?

Oral Fidaxomicin (IDSA 2021)

Oral Vancomycin (ACG 2021)

Miscellaneous

100

Which of these forms of insulin is the Shortest lasting?

- NPH

- Detemir (Levemir)

- Lispro (Humalog)

- Glargine (Lantus)

- Degludec (Tresiba)

Lispro

200

If a patient is on Torsemide 40 daily at home and admitted for ADHF, what dose of Lasix should be given based on the DOSE trial?

Lasix 200

300

What is the only Oral Inotrope?

Digoxin

400

Every CD4% of 7 is equal to a CD4 count of approximately _____.

100

500

These are the 3 Evidence based Indications for Albumin Administration

1. During Treatment of SBP

2. Diagnosis and Treatment of Hepatorenal Syndrome

3. After Large Volume Paracentesis