internal medicine jeopardy game - utdl.edu · jeopardy game ziad mattar, m.d. chief medical...

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Internal MedicineJeopardy Game

Ziad Mattar, M.D. Chief Medical Resident

University of Toledo

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TBHIV

ADISEndo

carditisEye

InfectionEye Pain

Single Quiz

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FinalQuiz

I 100Q

Topic I 100 Question

High risk group or PPD > 5mm, treat regardless in:

a) IV drug user

b) Silicosis

c) Foreign-born resident

d) Close contact

Go To SingleQuiz

I 200Q


Asymptomatic 42 yo M comes to you with history that his wife has been found to have active TB. You do his PPD and it 5mm. CXR normal. What Next?

a) Give a second PPD with 250 TU

b) Begin INH

c) No action required

d) Start 4 antiTB meds

Go To SingleQuiz

I 300Q


31 yo M visiting NY from Pakistan is found to have PPD of 12 mm. Asymptomatic and CXR normal. What next?

a) INH for 9 monthsb) No treatmentc) INH, RIF, EMB, PZD

Go To SingleQuiz

I 400Q


42 yo M with PPD 17mm. One year ago 5mm. He comes from an area with <4 % MDR TB. His HIV test is negative and the CXR normal. Which of the following is the best for prophylaxis?

a) INH & RIF for 6 mos

b) INH for 9 mos

c) INH for 12 mos

d) No prophylaxis

Go To SingleQuiz

I 500Q

Topic I 500 QuestionGo To Single

Quiz

PPD >10mm in a 47 yo patient with DM requires no treatment

a) Trueb) False

II 100Q

Topic II 100 QuestionGo To Single

Quiz

Which of the following vaccine cannot be given in immunocompromised host?

a) DTP

b) Oral polio

c) MMR

d) HBV

II 200Q


Quiz

Can a patient with AIDS be vaccinated with Measles vaccine?

a) Yes

b) No

II 300Q


Quiz

An ER doctor sticks himself accidentally with a needle used for a patient with HIV+. What is your advice?

a) Observation

b) Obtain blood test for HIV and wait for the result

c) Obtain blood test for HIV and begin HIV prophylaxis using 3 drugs

d) Begin HIV prophylaxis immediately without any blood test

II 400Q


Quiz

What blood test would you do to determine if patient has been immunized effectively against HBV?

a) Hep B surface antibody

b) Hep B core antibody

c) Both

II 500Q


Quiz

26 yo resident is stuck with a needle that was used on a patient with ac HBV. His work-up reveals + HB Ag and – HB sAb. What is your next step management?

a) Hep B vaccine and Hep B Ig

b) Hep B Ig

c) Hep B vaccine

d) No treatment

III 100Q

Topic III 100 QuestionGo To Single

Quiz

Cardiac lesions for which endocarditis prophylaxis is recommended?

a) Isolated secundum septal defect

b) CABG

c) MVP without murmur

d) Pacemaker

e) HCM

III 200Q


Quiz

Procedures for which prophylaxis for bacterial endocarditis is indicated?

a) Dental filling cavities

b) Esophageal stricture dilatation

c) Flexible Bronchoscopy

d) Cesarean section

III 300Q


Quiz

Procedures for which prophylaxis for bacterial endocarditis is NOT indicated?

a) Dental extraction

b) Rigid Bronchoscopy

c) Cystoscopy

d) TEE

III 400Q


Quiz

Endocarditis prophylaxis is indicated in a patient with?

a) Bicuspid valve undergoing dental cleaning

b) Ostium secundum defect undergoing vaginal hysterectomy

c) Bioprosthetic valve undergoing TEE

d) MVP without murmur undergoing colonoscopy

III 500Q


Quiz

A urine culture shows VRE. Patient is transferred to ICU. What precautions would you take?

a) Hand washing of personnelb) Private room with contact isolation

c) Private room with air isolation

d) Semiprivate room with negative pressure

IV 100Q

Topic IV 100 QuestionGo To Single

Quiz

Which of the following is most commonly associated with viral conjonctivitis?

a) Rubeola

b) Rubella

c) Adenovirus

d) Rotavirus

IV 200Q


Quiz

A 42 yo M Gardner with injury to the eye the previous day, wakes up with severe photophobia, injected conjunctiva around cornea in the right eye. Pupil is normal. She has not responded to the OTC eye drops. What is the possible diagnosis?

a) Conjonctivitis c) Uveitis

b) Keratitis d) Scleritis

IV 300Q


Quiz

A 23 yo F having ocular lenses, is obsessed with cleaning the lenses with a lens solution repeatedly. He develops eye infection with pain and photophobia. What is the organism involved?

• Streptococcus

• Rickettsia

• Pseudomonas

• Candida

IV 400Q


Quiz

53 yo M is referred to you for pink eye that is not responding to ABx. Patient c/o eye dryness with gritty sensations under the eyelids for months. A fluoresceintest is negative. What is the diagnosis?

a) Viral Keratitis

b) Sjogren syndrome

c) Viral conjonctivitis

d) Scleritis

IV 500Q


Quiz

21 yo M presents with pain and swelling of the right eye with photophobia. O/E there is edema, erythema and tiny vesicles are seen on the periorbital skin. On slit lamp examination, there is dendritic ulcer. What is your diagnosis?

a) Herpes simplex keratitis

b) Uveitis

c) Iritis

d) Fungal keratitis

V 100Q

Topic V 100 QuestionGo To Single

Quiz

54 yo F has well controlled diabetes mellitus for 5 years. Urine is normal. What would be the findings in the fundus examination?

a) Dot and blot hemorrhages

b) Proliferative changes

c) Papilledema

d) Normal

V 200Q


Quiz

A picture of fundus shows a bright cherry red spot in the region of macula. Which of the following is a possible diagnosis?

a) Proliferative retinopathy of diabetes mellitus

b) Central retinal artery occlusion

c) Normal

d) CMV retinitis

V 300Q


Quiz

72 yo M is on IV hyperalimentation for a very long time. He develops endophthalmitis. What is the organism involved?

a) Bacteria

b) Disseminated Candida

c) Virus

d) None

V 400Q


Quiz

A patient has macular edema that is affecting his vision. What will you advice?

a) Adjust glasses

b) Laser photocoagulation

c) Magnifier

d) Trabeculectomy

V 500Q


Quiz

A 31 yo M bus driver has yearly rhinitis with congestion. There is no improvement with OTC meds. What is your next step?

a) Intranasal glucocorticoids

b) Oral cromolyn

c) Non-sedating antihistamine

d) Refer to an allergist

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Achy Joints

Doc Fix Me

Guess Me Imaging Trivia

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Double Quiz

FinalQuiz

VI 200Q

Topic VI 200 QuestionGo To Double

Quiz

Heberden’s nodes and Bouchard nodes in a 71 yo patient with joint pains. What is the initial treatment for this patient arthritis?

a) Tylenol

b) NSAID

c) Aspirin

d) Colchicine

VI 400Q


Quiz

62 yo patient has pain in the hip due to arthritis. Where would the pain radiate?

a) Buttocks

b) Groin

c) Lateral thigh

d) Foot/toes

VI 600Q


Quiz

A 72 yo patient c/o pain in the back and legs when walking downhill. The pain improves on stopping or when doing uphill. What is the possible diagnosis.

a) Peripheral arterial disease

b) Spinal stenosis

c) Osteoarthritis

d) L5-S1 disc disease

VI 800Q


Quiz

What is the most suggestive feature of AnkylosingSpondylitis?

a) HLA B27

b) Ao Regurgitation

c) Pulmonary apical fibrosis

d) Loss of spinal mobility

VI 1000Q


Quiz

A 21 yo man has 6-week h/o intermittent diarrhea and urethral discharge. He c/o itchy eyes and pain in the left heel. O/E there are several painless ulcers in his mouth. Gram stain and cultures of the urethral discharge are negative. RF –

What is the diagnosis?

a) Reiter’s c) Psoriatic arthritis

b) Gonococcal arthritis d) Behcet’s syndrome

VII 200Q

Topic VII 200 Question

A 74 yo F has arthralgia in the hands. O/E she has swollen MCP and PIP. What is your next step.

a) Check RF

b) Check uric acid level

c) Check ANA

d) Begin treatment

VII 400Q

Topic VII 400 QuestionGo To Double

Quiz

A 43 yo F with moderate RA is started on ASA as initial therapy. She develops allergic reaction to it. Which of the following medications should be prescribed for RA?

a) Ibuprofen

b) Tylenol

c) Methotrexate

d) Desensitization + Cox inhibitor

VII 600Q


Quiz

33 yo F with active and advanced RA, does not improve with NSAID’s and low dose of oral steroids. What is your next step?

a) Tylenol with codeineb) Steroids in higher dosesc) MTXd) Doxy

VII 800Q


Quiz

43 yo F with acute RA, who has already been on NSAID, MTX, and Hydroxychloroquine, continues to have symptoms of synovitis. Next step?

a) Minocyclineb) D-Penicillinc) Cyclosporined) Fish capsules

VII 1000Q


Quiz

Which medication is a a disease modifying agent:

a) Azathioprine

b) Methotrexate

c) Cyclophosphamide

d) Cyclosporine

VIII 200Q

Topic VIII 200 QuestionGo To Double

Quiz

Which condition is NOT associated with + RF:

a) Sjogren’s

b) Cryoglobulinemia

c) Behcet’s

d) Ankylosing Arthritis

e) SLE

VIII 400Q


Quiz

A 73 yo M with RA and frequent occipital headaches, develops acute cholecystitis. You are called to clear her for surgery. What is your next step?

a) CX-ray

b) RF and ESR

c) C spine X-ray

d) CT brain

VIII 600Q


Quiz

Which disease affects distal interphalangeal joints?

a) RAb) Osteoarthritisc) SLEd) Scleroderma

VIII 800Q


Quiz

A 42 yo F with patches of skin disorder on the extensor surface of elbows has bilateral arthritis of the PIP and DIP joints with pitting of the nails. What is the diagnosis?

a) RAb) Psoriatic arthritisc) Reiter’sd) Osteoarthritis

VIII 1000Q


Quiz

A 54 yo F with HTN has been on HCTZ. She feels fine and comes for BP check up. BP is normal, a routine blood work shows a uric acid of 13.5 mg/dl. What is your next step?

a) Stop HCTZ and order 24 hr urine for uric acidb) Begin a uricosuric agentc) Allopurinol 300 mg po dailyd) Do nothing

IX 200Q

Topic IX 200 QuestionGo To Double

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IX 400Q


Quiz

This 36 year old woman developed asymptomatic brown papules on her elbows. Physical examination also revealed lacrimal gland hypertrophy

IX 600Q


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IX 800Q


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IX 1000Q


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X 200Q

Topic X 200 QuestionGo To Double

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X 400Q


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X 600Q


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X 800Q


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X 1000Q


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Final Quiz

Both Wegener and Goodpasturecause hemoptysis.True or False?

Question

What is the pathophysiology of Hemoptysis in Goodpasture vs Wegener?

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internal medicine jeopardy game - utdl.edu · jeopardy game ziad mattar, m.d. chief medical...

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