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Doctor\'s Dilemma Maryland ACP Scientific Meeting Heat 3 February 09, 2008. Qualifying Round. FINAL. Final Jeopardy. Doctor’s Dilemma. Pulm/Critical Care. My Blood. My Belly. Radiology. Endocrine. Preventive Medicine. 100. 100. 100. 100. 100. 100. 200. 200. 200. 200. 200.

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Presentation Transcript
slide1

Doctor\'s Dilemma Maryland ACP Scientific Meeting

Heat 3

February 09, 2008

Qualifying Round

FINAL

slide2

Final

Jeopardy

Doctor’s Dilemma

Pulm/Critical

Care

My Blood

My Belly

Radiology

Endocrine

Preventive

Medicine

100

100

100

100

100

100

200

200

200

200

200

200

300

300

300

300

300

300

400

400

400

400

400

400

500

500

500

500

500

500

pul critical care 100q
Pul/Critical Care 100Q

The optimal tidal volume and plateau pressure strategy in the management of ARDS

Topic I

100

Question

pul critical care 100a
Pul/Critical Care 100A

What are tidal volume of 6 cc/kg & plateau pressure below 30 mmHg?

Go To Single

Quizitor

Topic I

100

Answer

pul critical care 200q
Pul/Critical Care 200Q

This is the outcome of the most recent published study on the effects of corticosteroid in sepsis as published in the NEJM

Topic I

200

Question

pul critical care 200a
Pul/Critical Care 200A

Hydrocortisone did not improve survival or reversal of shock in patients with septic shock, either overall or inpatients who did not have a response to corticotropin.

NEJM 2007;358:111-124

Go To Single

Quizitor

Topic I

200

Answer

pul critical care 300q
Pul/Critical Care 300Q

Name the 3 classes of drugs used in the treatment of Pulmonary HTN

Topic I

300

Question

pul critical care 300a
Pul/Critical Care 300A

What are

High-dose calcium channel blockers

Phosphodiesterase-5 inhibitorsProstacyclin analogues?

Go To Single

Quizitor

Topic I

300

Answer

pul critical care 400q
Pul/Critical Care 400Q

A young male cigarette smoker has diffuse parenchymal lung disease with large lung volumes, recurrent pneumothorax and irregular cystic lesions on HRCT

Topic I

400

Question

pul critical care 400a
Pul/Critical Care 400A

What is Langerhan’s Cell granulomatosis/pulmonary histiocytosis-x eosinophilic granuloma?

Go To Single

Quizitor

Topic I

400

Answer

pul critical care 500q
Pul/Critical Care 500Q

Topic I

500

Question

This equation represents

PAO2= FIO2 (PB-PH2O)-PACO2 {FIO2- 1-FIO2/R}

pul critical care 500a
Pul/Critical Care 500A

What are COPD exacerbation,

cardiogenic pulmonary edema,

acute respiratory failure in immunosuppressed patients &

early extubation of patients with COPD who require intubation initially?

Go To Single

Quizitor

Topic I

500

Answer

my blood 100q
My Blood 100Q
  • The 2 immunochemistry markers that are deficient in patients with Paroxysmal Nocturnal Hemoglobinuria?

Topic II

100

Question

my blood 100a
My Blood 100A

What are CD55 & CD59?

Go To Single

Quizitor

Topic II

100

Answer

my blood 200q
My Blood 200Q
  • This protein is useful in the management of Idiopathic Thrombocytopenic Purpura (ITP) if patient is unresponsive to corticosteroid. It requires an intact spleen and can only be given to Rh+ patient.

Topic II

200

Question

my blood 200a
My Blood 200A

What is anti D immune globulin?

Go To Single

Quizitor

Topic II

200

Answer

my blood 300q
My Blood 300Q

The risks of post transplant lymphoproliferative disorder can be estimated by measuring this

Topic II

300

Question

my blood 300a
My Blood 300A

What is EBV DNA load?

Go To Single

Quizitor

Topic II

300

Answer

my blood 400q
My Blood 400Q

The measurement of this enzyme is essential in the diagnosis of primary polycythemia vera. Mutation of this substance is due to amino acid substitution

Topic II

400

Question

my blood 400a
My Blood 400A

What is JAK 2 (JANUS KINASE 2)? Mutation is a valine to phenylalanine substitution @ position 617

Go To Single

Quizitor

Topic II

400

Answer

my blood 500q
My Blood 500Q
  • This hematological entity is characterized by the following in an asymptomatic 70-year-old man: IgG monoclonal protein of 2.5g/dL; Bence Jones proteinuria of 0.8g/24 hour & 5% Bone Marrow clonal plasma cells

Topic II

500

Question

my blood 500a
My Blood 500A

What is Monoclonal Gammopathy of Unknown Significance?

Go To Single

Quizitor

Topic II

500

Answer

my belly 100q
My Belly 100Q

The finding of this antibody alone in the serum indicates prior HBV vaccination

Topic III

100

Question

my belly 100a
My Belly 100A

What is hepatitis B surface antibody (HbsAb)?

Go To Single

Quizitor

Topic III

100

Answer

my belly 200q
My Belly 200Q

This pharmacotherapy have been found to reduce mortality in patients with alcoholic hepatitis whose Maddrey discrimination function is >32

Topic III

200

Question

my belly 200a
My Belly 200A

What is Corticosteroid?

(DF = 4.6 [PTpatient − PTcontrol] + serum bilirubin [mg/dL]). A DF score of >32 identifies patients with a 50% mortality rate within 30 days.

Go To Single

Quizitor

Topic III

200

Answer

my belly 300q
My Belly 300Q

Radiographic findings of submucosal hemorrhage and edema (thumbprinting) of the colon is seen in this condition.

Topic III

300

Question

my belly 300a
My Belly 300A

What is mesenteric ischemia?

Go To Single

Quizitor

Topic III

300

Answer

my belly 400q
My Belly 400Q

The treatment of ulcerative colitis with high grade dysplasia

Topic III

400

Question

my belly 400a
My Belly 400A

What is Procto-colectomy?

Go To Single

Quizitor

Topic III

400

Answer

my belly 500q
My Belly 500Q

The implicated microorganism in a patient with hemochromatosis who develops acute abdominal pain, diarrhea and low grade fever.

Microscopic exam of the stool shows WBCs and RBCs.

Topic III

500

Question

my belly 500a
My Belly 500A

What is Yersinia enterocolitica?

Go To Single

Quizitor

Topic III

500

Answer

radiology 100q
Radiology 100Q

This diagnosis is compatible with the bone changes in this xray

Topic IV

100

Question

radiology 100a
Radiology 100A

What is coarctation of the aorta?

(xray shows rib notching)

Go To Single

Quizitor

Topic IV

100

Answer

radiology 200q
Radiology 200Q

Identify the pathology

Topic IV

200

Question

radiology 200a
Radiology 200A

Go To Single

Quizitor

Topic IV

200

Answer

What is meningioma?

radiology 300q
Radiology 300Q
  • A 64 year old asymptomatic woman had a routine x-ray which showed a benign pathology which was further worked up by CT. What is the diagnosis, based on these imaging findings?

Topic IV

300

Question

radiology 300a
Radiology 300A

What is Morgagni’s Hernia?

Go To Single

Quizitor

Topic IV

300

Answer

radiology 400q
Radiology 400Q
  • The diagnosis in this 66-year-old man with Stage IV heart failure with h/o old pulmonary TB.

Topic IV

400

Question

radiology 400a
Radiology 400A

What is Constrictive Pericarditis?

Go To Single

Quizitor

Topic IV

400

Answer

radiology 500q
Radiology 500Q

A 21-year-old female with IVDA , HIV with CD4 count of 400 cells per cubic millimeter presenting with fever, chest pain, hemoptysis and a murmur on physical examination.

Topic IV

500

Question

radiology 500a
Radiology 500A

What are multiple septic emboli or multiple pulmonary bacterial abscesses due to tricuspid endocarditis?

Go To Single

Quizitor

Topic IV

500

Answer

endocrine 100q
Endocrine 100Q

The three most common endocrine conditions that can cause carpal tunnel syndrome

Topic V

100

Question

endocrine 100a
Endocrine 100A

What are acromegaly, diabetes mellitus & hypothyroidism?

Go To Single

Quizitor

Topic V

100

Answer

endocrine 200q
Endocrine 200Q
  • This long-acting, intravenous nitrogen-containing biphosphonate is indicated for the treatment of hypercalcemia of Malignancy

Topic V

200

Question

endocrine 200a
Endocrine 200A
  • What is zoledronate?

Go To Single

Quizitor

Topic V

200

Answer

endocrine 300q
Endocrine 300Q
  • This anabolic agent is recommended for women with severe osteoporosis or osteoporosis unresponsive to conventional antiresorptive agents

Topic V

300

Question

endocrine 300a
Endocrine 300A
  • What is teriparatide (recombinant injectable human PTH)

Go To Single

Quizitor

Topic V

300

Answer

endocrine 400q
Endocrine 400Q

Most likely diagnosis in this man who presents with hypoglycemia. C-peptide level parallels insulin level; urinary/plasma sulfonylurea is negative; proinsulin level is more than 20%.

Topic V

400

Question

endocrine 400a
Endocrine 400A

What is Insulinoma?

Go To Single

Quizitor

Topic V

400

Answer

endocrine 500q
Endocrine 500Q

A new calcimimetic agent that increases the sensitivity of the calcium sensing receptor to ECF calcium approved to reduce PTH concentration in patients with secondary hyperparathyrodisim or parathyroid cancer

Topic V

500

Question

endocrine 500a
Endocrine 500A

What is Cinacalet?

Go To Single

Quizitor

Topic V

500

Answer

preventive medicine 100q
Preventive Medicine 100Q

The recommended age for pneumococcal vaccine for all adults

100

Topic VI

Question

preventive medicine 100a
Preventive Medicine 100A

What is 65?

Go To Single

Quizitor

100

Answer

Topic VI

preventive medicine 200q
Preventive Medicine 200Q

A 35 year-old with 1st degree relative with colorectal cancer at age 55 should begin screening at this age

Topic VI

200

Question

preventive medicine 200a
Preventive Medicine 200A

What is 40?

Go To Single

Quizitor

Topic VI

200

Answer

preventive medicine 300q
Preventive Medicine 300Q

The USPSTF recommendation for screening ultrasound for abdominal aortic aneurysm

Topic VI

300

Question

preventive medicine 300a
Preventive Medicine 300A

What are men 65-75 years old who smoke?

Go To Single

Quizitor

Topic VI

300

Answer

preventive medicine 400q
Preventive Medicine 400Q

These two medications were approved in 1998 & 2007 respectively for reduction of invasive breast cancer in high risk patients and postmenopausal women with osteoporosis

Topic VI

400

Question

preventive medicine 400a
Preventive Medicine 400A

What are tamoxifen & raloxifen?

Go To Single

Quizitor

Topic VI

400

Answer

preventive medicine 500q
Preventive Medicine 500Q

This medication has been shown to reduce the risk (incidence) of prostate cancer in men over the age of 55

Topic VI

500

Question

preventive medicine 500a
Preventive Medicine 500A

What is Finasteride?

Go To Double

Quizitor

Topic VI

500

Answer

final jeopardy
FINAL JEOPARDY

TOPIC:

Endocrinology

slide64

FINAL JEOPARDY

The associated skin manifestation is characterized by necrolytic migratory erythema and 50% of patients would have metastasis at presentation. Diarrhea is a prominent feature

final jeopardy1
FINAL JEOPARDY

What is glucagonoma?

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