Set 2: AY2019 Block 5

Osteoarthritis

100

The leading cause of physical disability in industrialized countries?

Osteoarthritis

200

Predisposing factors leading to early osteoarthritis

Trauma

300

Type of pain: Morning stiffness lasting >60 minutes, better with activity.

Inflammatory Arhtritis

400

Diagnosis: Hook or beak shaped osteophytes affecting the second and third metacarpal heads?

Hemochromatosis

500

Diagnosis: Confluent flowing ossification of at least 4 contiguous vertebral levels, more commonly seen on the right side of the spine?

Diffuse idiopathic skeletal hyperostosis (DISH)

Osteoporosis

100

Screening age to start OP screening for post menopauseal females?

Age 65.

200

T score below which Osteoporosis is diagnosed?

Less than -2.5.

300

Time past which a drug holiday should be considered for oral and for IV bisphosphonate therapy?

5 year for oral, 3 year for IV.

400

Factors for which you would continue bisphosphonate therapy after 5 years?

Patients who remain high risk (T score less than -2.5, Frax hip >3%, Any osteoporotic >20%)

500

Briefly explain the available data guiding treatment decisions after 5-10 years of bisphosphonate therapy. (Dr. Pribich excluded from answering).

Its complicated and incomplete. 

(Melanie's team gets credit too)

Potassium

100

What percentage of potassium is intracellular?

98%

200

6 Treatment options for hyperkalemia?

Calcium Gluconate (1-3 minutes), Insulin (30 min), Albuterol (30 minutes), Kayexalate (1-2 hours), Lasix (2-4 hours? Guessing here), Dialysis (Immediate)

300

22 yo M with hypertension, hypokalemia and a bicarbonate of 34.

Liddle syndrome (he's got a "Liddle" bit of everything--Thanks Dan!)

400

Residents have previously been warned about using this fluid in patients with hyperkalemia ______. How much of this fluid would you have to give to equal a 40meq dose of oral potassium?

LR, 10L

500

Describe progression of EKG Changes with hyperkalemia?

6-7= Peaked T waves

7-8= Flattened P waves, prolonged PR, ST Depression, Peaked T waves

8-9Atrial Stand still, >9 Sine Wave

Erythrocyte Disorders

100

ANEMIA: Low MCV, High RDW

Iron Deficiency

200

Serum test useful in confirming Cobalamin deficiency when elevated.

Serum Methylmalonic Acid (Elevated in B12 Def).

300

Low MCV, Normal RDW. Normal Iron Panel.

Alphal Thal

400

Normal Hemoglobin Electrophoresis: Alpha or Beta Thal?

Alpha Thal

500

An Index, Defined as the MCV/RBC count, that, when greater than 13 can help differentiate Iron Deficiency Anemia from Alphal Thalassemia

Mentzer Indez 

>13= IDA, <13=Alpha Thal

San Diego Trivia

100

Home ported at NAS North Island, this Nuclear Powered Aircraft Carrier goes by call sign "Rough Rider" and is know as "The Big Stick" (CVN-71).

USS Theodore Roosevelt

200

This was the first Naval Aviations weapon school and was founded at this base in San Diego as a result of excessive Air to Air losses sustained by the US in Vietnam?

(Need: School and Base)

 

Top Gun, MCAS Miramar

300

Known as the Silent Service, this San Diego Park houses a memorial to the 52 "boats" lost during World War II. 

(Need 2 answers: Service and park in San Diego)

Submarine Service, Liberty Station

400

This hall of fame baseball player has his own beer called .394 IPA. Ill bet he wishes he could call it .400

Tony Gwenn

500

Currently a registered historic land mark, this location on Naval Base Point Loma was a prior site where whaling ships would burn their whale blubber and is now the name for a popular San Diego Brewery?

Ballast Point