All in the family(Choosing wisely)
"Don’t do imaging for low back pain within the first _________, unless red flags are present."
"Don’t do imaging for low back pain within the first six weeks, unless
red flags are present."
Two antibodies associated with autoimmune hepatitis
ANA, Smooth muscle, LKM, SLA
Histological cause of renal artery stenosis in persons <40
Fibromuscular dysplasia
Two beta blockers approved for treatment of heart failure
Metoprolol succinate and carvedilol
What is winter's formula
PC02= 1.5(HC03) +8 +/- 2
"Don’t screen women _________ for cervical cancer who have had adequate prior screening and are not otherwise at high risk for cervical cancer"
"Don’t screen women older than 65 years of age for cervical cancer who have had adequate prior screening and are not otherwise at high risk for cervical cancer"
Condition associated with intestinal bacterial overgrowth
Scleroderma
Autoimmune diseases are likely to be associated with which type of RTA
Type 1
EKG often shows an usual RBBB in this genetic syndrome that predisposes to sudden cardiac death
Brugada syndrome
Using a normal albumin as 4, this is the corrected calcium for a serum Calcium of 7.4 and albumin of 2
9
***Corrected Calcium = (0.8 * (Normal Albumin - Pt's Albumin)) + Serum Ca
" Don’t order a _______ when assessing levothyroxine (T4) dose in hypothyroid patients."
"Don’t order a total or free T3 level when assessing levothyroxine (T4) dose in hypothyroid patients."
Treatment of scleroderma renal crisis in pregnancy
ACE-inhibitor
Use of TMP-SMX is likely to cause this type of RTA
Type 4
The epsilon wave has been classically decried in patients with this congenital syndrome
Arrhymogenic right ventricular dysplasia
This is the number needed to treat with a relative risk reduction of 50% and absolute risk reduction of 12.5 %
8
***(1/Absolute Risk Reduction)
" Don’t recommend CEA for _____________"
" Don’t recommend CEA for asymptomatic carotid stenosis unless the complication rate is low (<3%)."
Diagnostic test for suspected IgG4-related disease
Biopsy of involved tissue
Obesity drug associated with acute oxalate nephropathy
Orlistat
Blood pressure greater in legs vs arms in aortic regurgitation known as this sign
Hill sign
Positive liklihood ratio with a sensitivity of 0.8 and a specificity of 0.2
1
*****Positive Likelihood Ratio= (sensitivity)/(1-specificity)
" Don’t use parenteral nutrition in adequately nourished critically ill patients within _____________."
"Don’t use parenteral nutrition in adequately nourished critically ill patients within the first seven days of an ICU stay."
Cause of dyspnea and wheezing in relapsing polychondritis
Tracheal ring and bronchial stenosis
Two diagnostic laboratory abnormalities common to beer potomania, tea and toast syndrome, and primary polydipsia
Hyponatremia and inappropriately dilute urine
LV EF and systolic LV internal diameter used as an indication for surgical intervention in severe mitral regurgitation
LVEF <60%
LVID in systole >45 mm
This is the LDL cholesterol in a patient with total cholesterol of 190, HDL of 90 and TG of 50
90
Friedewald (1972) Formula: LDL = TC - HDL - TG/5.0
" For patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, don’t ________________"
"For patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, don’t renew the prescription without assessing the patient for ongoing hypoxemia"
Arm claudication and valve regurgitation in young patient
Takayasu arteritis
Glomerular diseases associated with low complement
Lupus nephritis, IRGN, MPGN, cryoglobulinemia GN
Name the components of the tetralogy of Fallot
RV outflow obstruction, VSD, RVH, aortic override of VSD
Stool osmotic gap with a stool osmolality of 300, stool sodium of 20 and potassium of 80
100
300(or stool osmolality) − 2 *(stool Na + stool K)
>100 suggests osmotic (celiac, lactase deficiency, chronic pancreatitis