Jeopardy from block 2

1. Jeopardy!
Block 2
August 21, 2018

2. Case Reports Specialty Talks Clinic Didactic Inpatient Curriculum Grab Bag
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3. Answer
Describe Nikolsky’s sign and state a disease it
appears in.
Jacob (MS3) - DRESS

4. Nikolsky’s sign = epidermal detachment with
pressure adjacent to a bullae
Appears in SJS and TEN, Staph scalded skin
syndrome, pemphigus vulgaris.

5. Answer
What are the temperature and neutrophil
count criteria for diagnosing neutropenic
fever per IDSA guidelines?
Travis Baker – Neutropenic Fever

6. Single temperature > 38.3 C (101 F)
or
Temperature > 38.0 C for more than 1 hour
ANC < 500 cells/mm3
or
Expected to decrease < 500 in the next 48 hr
IDSA Guidelines

7. Answer
Name 2 antibiotics which are considered 1st
or 2nd line for treatment of infection with
Mycoplasma.
Evan Yount – Mycoplasma

8. Azithromycin
Doxycycline
Fluoroquinolones

9. Answer
What lab finding is most indicative of an
exudative pleural effusion?
Michio Taya – Pleural Effusions

10. Pleural LDH > 200

11. Answer
Which organ, if affected, has the highest
diagnostic yield on biopsy for GPA?
Di Yan – GPA

12. Kidney

13. Answer
What's an isomolar urine specific gravity?
Dr. Cryst- Tests of Renal Function

14. 1.010

15. Answer
A patient presents with erythema and
swelling around their right eye with vision
loss, pain with eye movements, and fevers.
What is an appropriate antibiotic regimen for
this patient?
Dr. Woolston – SSTI

16. Vancomycin
+
Ceftriaxone/cefotaxime/
amp-sulbactam/pip-tazobactam

17. Answer
What is the most
likely diagnosis
based on this
EKG?
Dr. Hwang - ACS

18. Acute pericarditis

19. Answer
A patient is admitted for ACS and 3 days into
their admission develops pneumonia
requiring intubation.
Name all 5 appropriate anti-pseudomonal
antibiotics that this patient could receive.
Dr. Parker – Parker Power Hour

20. Levofloxacin
Cefepime
Piperacillin-tazobactam
Meropenem
Imipenem

21. Answer
90 – 95% of chronic cough is due to these
three conditions
Dr. Gerbino – Chronic Cough

22. 1. Upper Airway Cough Syndrome
2. Asthma (Eosinophilic Bronchitis)
3. Reflux Disease

23. Answer
Alcohol misuse affects what percent of the
population (+/- 10%)
Dr. Bucher– Alcohol Abuse

24. 30%

25. Answer
Name the four muscles that make up the
rotator cuff (double points for their function)
Dr. Smith– The Shoulder

26. Supraspinatus (abduction)
Infraspinatus (external rotation)
Teres minor (external rotation)
Subscapularis (internal rotation).

27. Answer
What treatment for acute non-specific low
back pain has high quality treatment
evidence?
Dr. Horwitch– Back Pain

28. None!

29. Answer
What diabetes medication carries a risk of
euglycemic DKA (double points - what class is
it from?)
Dr. Smith – Non-insulin T2DM

30. Empagliflozin (SGLT-2)

31. Answer
38 year old man whose mother had colon
cancer at age 49. No other FH colon CA.
What do you recommend for CRC screening?
Dr. Soung – Colorectal Cancer

32. Colonoscopy every 5 years, starting at age 39
(10y younger than index family member)

33. Answer
In what setting should normal saline be used
as initial fluid management over lactated
ringers for pancreatitis?
Chad – Acute Pancreatitis

34. If hypercalcemia is the cause of acute
pancreatitis.
Otherwise, use LR over NS as there is a
decreased rate of SIRS with LR.

35. Answer
Name 2 diagnostic criteria for diabetes.
Zack – Diabetes

36. A1c > 6.5%
Fasting glucose > 126
Oral glucose tolerance test > 200
Random plasma glucose > 200

37. Answer
What are 2 of the 3 most likely etiologies of
acute sustained anuria?
Jackie – AKI

38. Urinary obstruction
Rapidly progressive glomerulonephritis
Mechanical occlusion of renal blood flow

39. Answer
A patient
presents with
syncope with this
EKG.
What is the
treatment?
Meriah – Syncope

40. Pacemaker
This patient has
complete heart
block.

41. Answer
In what 2 settings is FeNa NOT an accurate
predictor of pre-renal vs intrinsic renal AKI?
Jackie – AKI

42. When using diuretics
In CKD – tubules are damaged and can’t
absorb sodium efficiently

43. Answer
Chai Tea is served on what day, time and
location?
Wellness

44. Wednesday @ 3pm in Doctors Dining Room

45. Answer
A study enrolls 100
smokers and 100 non-
smokers and follows
them for lung cancer.
Based on the results
shown, what is the
relative risk of
developing lung cancer
in smokers?
Lung Cancer No Lung Cancer
Smoker 30 70
Non-Smoker 10 90
Morning Report – EBM Math

46. Relative risk =
Risk of lung cancer in smokers = 30/100
Risk of lung cancer in non-smokers = 10/100
Relative risk = (30/100) / (10/100)
= 3.0

47. Answer
What are the criteria for placement of a
biventricular pacer in a patient with systolic
heart failure?
Dr. Parker – Own the Boards

48. On guideline-directed medical therapy
EF < 35%
QRS > 150 ms with LBBB
NYHA class III-IV symptoms

49. Answer
A 44 year old smoker presents to your clinic
asking about Pneumococcal vaccinations.
Which Pneumococcal vaccines should they
receive and at what ages during their lifetime?
Morning Report – High Value Care

50. PPSV23 at age 44 (any age 19-64)
PCV13 at age 65
PPSV23 at age 66

51. Answer
Identify the following
intern’s self-portrait.
Intern to Intern Session

52. Aaron Cheung