| Critical Care | GI | Endocrine | Rheumatology | Could be anything |
|---|---|---|---|---|
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What is (3/7 to get points)
Minimizing sedation Early Mobilization Minimizing pooling of supraglottic secretions Scheduled oral care with chlorhexidine Head of bed elevation Minimization of changes of the ventilator circuit Proper hand hygiene
Preventive strategies for ventilator-associated pneumonia
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What is myocardial ischemia (ACS)?
This is why an EKG should be done in older patients with severe GI bleeding.
This is most common cause of death in GI bleeding
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What is measurement of 25-hydroxyvitamin D?
Storage form of vitamin D
Most appropriate test for vitamin D deficiency
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What is the identification of negatively birefringent, needle-like uric acid crystals within neutrophils in fluid obtained by arthrocentesis?
Is the golden standard for the diagnosis of acute gout
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What is peripheral artery disease?
>1.4 - indicated non compressible arteries in the lower extremities and is considered uninterpretable; a toe-brachial index is used for diagnosis of PAD in these patients
Ankle-brachial index of 0.90 or less
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What is hypophosphatemia?
Dextrose stimulates insulin secretion and insulin drives phosphate into cells to be used for oxidative phosphorylation
Patients on total parenteral nutrition are at high risk for
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What is ursodeoxycholic acid?
Most accurate tests: ERCP shows "beading" of the biliary system, anti-smooth antibody, and ANCA
Treatment for primary sclerosis cholangitis
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What is aggressive supportive measures; stress dose glucocorticoids (100mg IV hydrocortisone every 8 hours) are administer empirically before thyroid hormone is initiated to treat possible concomitant adrenal insufficiency?
Myxedema coma
Treatment for life threatening presentation of severe hypothyroidism with hemodynamic compromise; it most often occurs when a systemic illness is superimposed on previously undiagnosed hypothyroidism
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What is Polymyalgia rheumatica?
Associated with pain and profound stiffness of the neck, shoulder, and hip girdle, it responds dramatically to low-dose prednisone
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What is skin cancer?
Did I trick you :)
Most common type of cancer in women in the United States
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What is daily protocoled interruptions of sedation and analgesia?
Have been shown to decrease the incidence of delirium, the need for diagnostic testing, and the amount of time spent on mechanical ventilation and in the ICU
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What is capsule endoscopy?
Preferred test for evaluating stable patients for small-bowel bleeding after normal results on colonoscopy and endoscopy
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What is increased by 30%?
For women with preexisting hypothyroidism, levothyroxine dose adjustment is made emperically when pregnancy is confirmed (percent)
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What is NSAIDs?
PT is most important non pharmacologic intervention
First line treatment for ankylosing spondylitis
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What is thrombosis? Venous 3x more likely then arterial
Best initial dx test: platelet factor 4 antibodies or heparin induced anti platelet antibodies Treatment: STOP the heparin (do not switch to lovenox) use fondaparinux or a NOAC
Heparin-induced thrombocytopenia - reduced platelets a few days after the start of heparin, most common symptom
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What is noninvasive mechanical ventilation?
Immediately after extubation prevents extubation failure in patients at high risk, such as those with heart failure, COPD, and hypercapnia
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What is rectal indomethacin?
Effective in reducing the frequency and severity of pancreatitis after ERCP in high risk patients
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What is gender-affirming hormone therapy?
Criteria - persistent, well documented gender dysphoria, capacity to make a fully informed decision, age of majority in a given country, and if present, control of significant medical or psychological conditions. Treatment includes medications for hirsutism, contraception, abnormal uterine bleeding, menopause, testosterone deficiency, and benign prostatic hyperplasia.
Most common medical intervention sought by transgender people and does not require subspecialty care
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What is tumor necrosis factor alpha inhibitors?
Have been shown to have superior efficacy in the management of joint symptoms and to slow the progression of radiographic damage in severe psoriatic arthritis
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What is Sporotrichosis?
Treatment is itraconazole
Fungus living in soil and plants, acquired from direct inoculation, leads to cutaneous nodules and is diagnosed by culture
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What is Laryngeal edema?
Occurs in up to 30% of patients, with approximately 5% requiring reintubation. RF-Female sex, small tracheal diameter or large ET size, and prolonged intubation Multiple doses of glucocortiocoids prior to extubation can help prevent.
Typically presents with post-extubation stridor and respiratory failure
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What is infection, sedating medications, volume depletion, or GI bleeding; treatment involves addressing the precipitating cause and lactulose?
Precipitating causes of hepatic encephalopathy and treatment
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What is autoantibodies glutamic acid decarboxylase (GAD65) and tyrosine phosphatase IA-2?
These antibodies demonstrate a strong association with immune-mediated type 1 diabetes and should be measured at initial diagnosis to determine etiology
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What is joint involvement, serology, acute phase reactants, and duration?
Six points needed for classification as RA # of joints RF or anti-CCP antibodies CRP or ESR 6 weeks duration
Diagnostic criteria for rheumatoid arthritis
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What is methemoglobinemia?
Blood locked in an oxidized state that cannot pick up oxygen Treatment: Methylene blue
Caused by exposure to drugs such as nitroglycerin, amyl nitrate, nitroprusside, dapsone, or any of the anesthetic drugs that in -caine, brown blood, shortness of breath for no clear reason, clear lungs on exam and normal CXR
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