Shelf Review Round 2

GI

100

Pt presents with hepatitis, diabetes, bronze skin, elevated LFTs and iron

Hemochromatosis 

HFE gene mutation - Autosomal recessive 

200

Dx in an older male patient presenting with dysphagia and bad breath 

Zenker's diverticulum

Not a true diverticulum - only includes mucosa, not all layers of organ wall 

300

Cause of bloody vomiting in a pt with cirrhosis AND 1 management step (any order) 

Gastric varices

Two large bore IV, EGD, IVF, octreotide, PPI, ABCs, balloon tamponade, etc. 

400

Autoimmune disease with antimitochondrial antibody positive, associated with IBD

Primary biliary cirrhosis 

500

Infectious cause of achalasia 

Chagas disease 

Cardiology 2

100

Time to balloon if STEMI presents to ED 

90 min

Thrombolytics if PCI >2 hours away and if no other contraindication 

200

Aspirin and clopidogrel or ticagrelor should be taken for ____ months after PCI with drug eluting stent

6 months if DES (prevent vascular tissue overgrowth) 

1 month if bare metal stent (higher risk of ISR)

300

Name one cause of hypertension that can be treated surgically 

Coarctation of the aorta 

Pheochromocytoma 

Renal artery stenosis 

Fibromuscular dysplasia 

400

Diastolic murmur associated with widened pulse pressure

Aortic regurgitation 

Associated with connective tissue disease (Marfan's, vascular EDS), syphilis, ankylosing spondylitis

500

Name 2 causes of dilated cardiomyopathy 

MI, alcohol, postviral, doxorubicin, postradiation, Chagas disease 

Misc

100

Fasting blood sugar level that is required for diagnosis of diabetes 

126

Random glucose >200 with symptoms is also diagnostic 

200

Polyuria, polydipsia, dehydration, confusion/coma, blood glucose > 1000 in known diabetic with pH 7.39

 HHS

Hyperosmolar hyperglycemic syndrome 

Serum osm usually > 320

300

Needle-shaped, negatively birefringent crystals on joint aspiration is consistent with 

gout 

400

Two physical exam findings that can suggest hypocalcemia 

Chvostek and Trousseau signs 

Chvostek - Facial muscles twitch when tapping cheek 

Trousseau - hand spasm when inflating BP cuff

500

Sudden onset of numerous seborrheic keratoses should raise concern for 

GI malignancy, usually stomach cancer 

Neurology

100

First imaging study that should be done in stroke workup

Non-con head CT 

200

Unilateral headache with vision changes and jaw claudication 

Temporal arteritis 

300

First medication used for seizure abortive in the hospital 

Benzodiazepine 

400

Can't miss dx in IVDU with back pain and LE weakness

Epidural abscess or other infection of spinal cord/peripheral nerve roots 

500

Triphasic bursts on EEG in the setting of dementia and myoclonus

Creutzfeldt Jakob disease (prion disease)

ID

100

Name one bacterial cause of meningitis in adults 

Strep pneumo 

H flu

Neisseria Meningitidis 

Lysteria 

Staph 

200

Post-influenza pneumonia is often caused by

S aureus

300

You should prescribe this drug/supplement to be taken with isoniazid to prevent peripheral neuropathy and sideroblastic anemia 

Vitamin B6 (pyridoxine) 

400

Most common bacterial cause of endocarditis 

S aureus 

500

Treatment for an HIV+ patient who is presenting with CD4 54, dyspnea, cough, fever, and chest pain with elevated LDH on labs? 

Trimethoprim-sulfa

Dapsone + Trim-sulfa

Primaquine + clindamycin

Pentamidine