Cardiology
A patient with PE decompensates into shock on therapeutic heparin. What is the appropriate next step?
What is high-risk (massive) PE, requiring systemic thrombolysis?
A 29-year-old woman has fever, bilateral ankle arthritis, and tender red nodules on her shins. CXR shows bilateral hilar lymphadenopathy.
What is Löfgren syndrome (acute sarcoidosis)?
This diagnosis needs no biopsy, has an excellent prognosis, and usually resolves with supportive care and NSAIDs alone.
This is the maximum blood pressure threshold for tnk ?
What is 185/110 mmHg?
Indications for urgent renal replacement therapy?
What is AEIOU?
Refractory Acidosis
Electrolyte derangement (refractory hyperkalemia)
Intoxications (dialyzable toxins)
Overload (refractory volume overload/pulmonary edema)
Uremia (encephalopathy, pericarditis, pleuritis)
No specific eGFR threshold mandates initiation.
This resident almost had a rapid called and is permanently banned from PetSmart.
Who is Haya?
Name 3 drugs causing QTc prolongation.
What are:
Antiarrhythmics Ia and III — quinidine, procainamide, amiodarone, dofetilide, sotalol
Antibiotics — macrolides and fluoroquinolones
Antipsychotics — haloperidol, olanzapine
Antidepressants — citalopram, escitalopram, TCAs
Antiemetics — ondansetron
Antifungals — fluconazole
Antimalarials, methadone?
A 68-year-old man with severe COPD quit smoking two years ago. His resting SpO₂ is 87% on room air and his PaO₂ is 54 mmHg. Only two interventions are proven to improve survival in COPD. Smoking cessation is one. This is the other.
What is long-term oxygen therapy for ≥15 hours/day?
A 34-year-old woman with myasthenia gravis on home medications develops progressive dyspnea and bulbar weakness after starting a new antibiotic for a UTI. This specific antibiotic class is classically implicated in precipitating myasthenic crisis.
What are fluoroquinolones or aminoglycosides?
Winters' formula for metabolic acidosis compensation?
What is expected pCO2 = 1.5 × HCO3⁻ + 8 (± 2)?
This resident had police called on him by Foreman?
Who is Carnahan ?
A hypovolemic trauma patient with a pericardial effusion has only a modest rise in JVP and no obvious Beck's triad, yet has pulsus paradoxus and hypotension. On right heart catheterization, this specific hemodynamic finding confirms tamponade physiology despite the atypical ('low-pressure tamponade') exam.
What is equalization of diastolic pressures across all four cardiac chambers?
A patient with pneumonia develops a pleural effusion. This is the type of effusion it most commonly is, and these are the criteria used to classify it.
What is an exudate (parapneumonic effusion), classified by Light’s criteria?
A 62-year-old woman has recurrent, unilateral, electric shock–like paroxysms in the V2/V3 distribution triggered by chewing and light touch. What is the first-line treatment?
What is carbamazepine (~200–1200 mg/day) or oxcarbazepine (300–1800 mg/day)? Watch out for Stevens-Johnson syndrome.
Rapidly progressive glomerulonephritis with linear IgG deposition along the glomerular basement membrane, often with concurrent hemoptysis, describes this disease.
What is Goodpasture syndrome (anti-GBM disease)?
Which attending had a food bolus removed mid rounds?
Who is Dr. Rosel?
A patient with a CHA2DS2-VA score of 0 undergoes successful catheter ablation for symptomatic paroxysmal AF. Regardless of her low thromboembolic risk, current guidance mandates continuing oral anticoagulation for this minimum duration post-ablation.
What is at least 2 months?
Because the procedure itself creates a short-term prothrombotic state independent of baseline risk.
Mandatory early OAC: minimum 2 months under ESC 2024 ("irrespective of estimated thromboembolic risk"), 3 months under ACC/AHA 2023.
Beyond that window: continue OAC based on baseline stroke risk (CHA2DS2-VA or CHA2DS2-VASc), not how successful the ablation seemed.
ALONE-AF (and OCEAN): CHA2DS2-VASc <3 and arrhythmia-free for a year → can stop OAC.
A patient on HFNC/NIV has a P/F ratio of 140 and persistently high respiratory effort. This tool helps predict NIV failure.
What is the HACOR score? (Applied about 60 minutes after starting NIV, it predicts NIV failure in hypoxemic patients.)
Identifies stroke-related PFO in patients with cryptogenic stroke?
What is the ROPE score?
A non-diabetic patient has eGFR 35 and UACR 450 mg/g. Is an SGLT2i indicated?
Yes (1A). SGLT2i are recommended in T2D with eGFR ≥20, and in non-diabetic CKD with UACR >200 mg/g or heart failure. Suggested (2B) for eGFR 20–45 even without albuminuria.
Which attending as a resident broke their leg on residency retreat?
Who is Mery Mezher?
What scoring system estimates risk of infective endocarditis (IE) and determines priority for echocardiography?
What is VIRSTA?
A patient with sarcoidosis has fatigue and daytime hypersomnolence out of proportion to her disease. This common comorbidity must be excluded before blaming the sarcoidosis. It is also a reason to keep her steroid dose as low as possible.
What is obstructive sleep apnea?
Corticosteroids can worsen OSA through weight gain and upper-airway fat deposition. Use the lowest effective dose and consider steroid-sparing agents early.
A 19-year-old develops an oculogyric crisis and torticollis hours after a dose of haloperidol. What is the immediate treatment?
What is diphenhydramine or benztropine?
Scoring system to assess severity for rhabdomyolysis?
What is the McMahon score?
This attending had a bronch secondary to choking on a chocolate covered peanut? and by who?
Who are Dr. Ginsburgh and Dr. Gunther?