What is the likely diagnosis in a sexually active college
student with the rash below? It is painful and associated
with low-grade fever.
Herpetic whitlow (secondary to HSV infection)
Viêm bàn tay do HSV
What is the recommended treatment fo
What is the first-line treatment for patients with bullous
herpetiformis?
pemphigoid?
dapsone (acute relief) and a gluten-fre
High-potency topical glucocorticoids (e.g. clobetasol)
term relief)
What is the likely diagnosis in a young adult patient that
presents with the foot rash below? The lesions are
painful with walking and standing.
Plantar warts (due to HPV infection)
Mục cóc
What is the suggested treatment to
Do cherry hemangiomas typically regress complications of proliferative-tăng s
spontaneously? retinopathy?
No Argon laser photocoagulati
laser quang đông
What is the likely diagnosis in a patient that presents with
sudden onset flashes of light-chớp sáng and floaters in
the left eye? The patient felt like "a curtain came down" What is the likely underlying etiology of anemia in an
over her eye. Ophthalmoscopy reveals a grayish- elderly patient with fatigue, lymphadenopathy, and Pica (thèm ăn non-food), espec
appearing retina. splenomegaly? ice (pagophagia), may be indicativ
deficiency anemia
Retinal detachment Bone marrow infiltration (e.g. lymphoma, leukemia)
Bong võng mạc
What is the first-line treatment for most patients with What enzyme is typically elevated in patients What is the recommended treatment t
chronic myeloid leukemia (CML)? with hemolytic anemia? effects of heparin?
Tyrosine kinase inhibitors (e.g. imatinib) Lactate dehydrogenase (LDH) Protamine sulfate
, What is the recommended management for What is the recommended screening
What is the recommended management for
a hemodynamically unstable Wolff-Parkinson-White abdominal aortic aneurysm
costochondritis?
syndrome patient with atrial fibrillation?
One-time abdominal ultrasound for m
Reassurance and symptomatic pain management
Electrical cardioversion or former smokers aged 65-75
Ascending aortic aneurysms are most often due Ascending aortic aneurysms are most often due Patients with beta blocker overdose
to cystic medial necrosis-hoại tử (due to aging) and to cystic medial necrosis-hoại tử (due to aging) and refractory hypotension (e.g. to atropi
connective tissue disorders connective tissue disorders should be started on IV gluca
In addition to history and physical, pat
What is the most common cause of sudden cardiac diagnosed with hypertension shoul
What is the likely diagnosis in a systemic
arrest in the immediate post-infarction period in patients following basic testing:
sclerosis patient that presents with renal
with acute MI?
failure and malignant hypertension?
1. Urinalysis (for occult hematuria and
Re-entrant ventricular arrhythmias (e.g. ventricular protein/creatinine ratio)
Scleroderma renal crisis
fibrillation) 2. Chemistry panel
Khủng hoảng thận xơ cứng bì
Nhịp nhanh thất 3. Lipid profile
4. Baseline ECG
In addition to history and physical, patients initially In addition to history and physical, patients initially In addition to history and physical, pat
diagnosed with hypertension should have the following diagnosed with hypertension should have the following diagnosed with hypertension shoul
basic testing: basic testing: following basic testing:
1. Urinalysis (for occult hematuria and urine 1. Urinalysis (for occult hematuria and urine 1. Urinalysis (for occult hematuria and
protein/creatinine ratio) protein/creatinine ratio) protein/creatinine ratio)
2. Chemistry panel 2. Chemistry panel 2. Chemistry panel
3. Lipid profile 3. Lipid profile 3. Lipid profile
4. Baseline ECG 4. Baseline ECG 4. Baseline ECG
What intervention is most likely to improve
What valvular defect is associate
cardiovascular and overall long-term mortality in
hyperdynamic pulse (e.g. bounding
Diagnosis of amyloidosis is confirmed using tissue patients with acute STEMI?
hammer" pulses)?
biopsy (e.g. abdominal fat pad)
Restoration of coronary blood flow (e.g. PCI,
Aortic regurgitation
fibrinolysis)
What is the likely diagnosis in a patient with ST What is the recommended treatm
elevations in leads II, III, and aVF with JVD, hemodynamically unstable patient w
The strongest predictors of abdominal aortic aneurysm hypotension and clear lungs on auscultation? tamponade?
rupture are large aneurysm diameter, rapid rate of
expansion, and current cigarette smoking Right ventricular MI Emergency pericardiocente
chọc dò màng tim cấp cứu
,What is the preferred diagnostic study for patients with
renal insufficiency or hemodynamic instability with
suspected aortic dissection?
Transesophageal echocardiography The presence of a continuous abdominal bruit has a
high specificity for the presence of renovascular
What is the recommended lipid-l
hypertension therapy for patients < 75 that have
significant atherosclerotic dis
High-intensity statin
What is the recommended therapy for patients > 75 that
have clinically significant atherosclerotic disease? Patients with an LDL > 190 mg/dL are recommended to Patients with an LDL > 190 mg/
begin high-intensity statin therapy recommended to begin high-intens
Moderate-intensity statin therapy
What is the recommended pharmaceutical therapy to
Patients with an estimated 10-year ASCVD risk reduce overall cardiovascular mortality in patients with What is the most common mode of in
> 7.5% should be started on a moderate- to high- peripheral arterial disease? hereditary spherocytosis
intensity statin
antiplatelet agent (e.g. aspirin) and a statin Autosomal dominant (75%
, What is the recommended treatment for immune
thrombocytopenic purpura in adults with platelet counts What is the likely diagnosis in a patient with acute
< 30,000/uL or bleeding? lymphoblastic leukemia that develops premature
ventricular beats and acute kidney injury after What is an appropriate prophylactic
IVIG or corticosteroids initiating chemotherapy? help prevent tumor lysis syndr
Tumor lysis syndrome IV fluids + allopurinol or rasbu
Diagnosis of paroxysmal nocturnal hemoglobinuria- The major risk factor for developmen
tiểu Hb kịch phát về đêm may be made with flow keratosis (dày sừng) is chronic sun
What is the recommended treatment for thrombotic cytometry, which can detect the absence of the proteins
thrombocytopenic purpura (TTP)? CD55 and CD59
Emergent plasma exchange +/- corticosteroids
Thay huyết tương
What is the likely diagnosis in a patient with Marfan
syndrome that presents with sudden-onset tearing chest
pain?
Aortic dissection
What is the most common location
Management of acute decompensated heart failure foci that cause atrial fibrillat
includes supplemental O2, IV loop diuretics, and
possibly a vasodilator/vasopressor Pulmonary veins
, Autoimmune hemolytic anemia is differentiated from What is the first-line
hereditary spherocytosis by a positive Coombs test treatment for mild inflammatory acn
benzoyl peroxide + topical reti
What is the likely diagnosis in a male with a history of
SLE (lupus) that presents with epigastric burning
provoked by exertion (gắng sức) and relieved by rest?
Atypical angina
What is the likely diagnosis in a patient that presents with
pruritus and the rash below? A punch biopsy shows
linear IgG and C3 deposits at the dermal-epidermal
junction.
Bullous pemphigoid The CHA2DS2-VASc score is useful for
The CHA2DS2-VASc score is us
assessing thromboembolic risk in patients with non-
valvular atrial fibrillation: assessing thromboembolic risk in
with non-valvular atrial fibrill
C: Congestive heart failure
H: Hypertension C: Congestive heart failur
A2: Age > 75* (2 points) H: Hypertension
A2: Age > 75* (2 points)
D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism* (2 points) D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism*
V: Vascular disease (prior MI, PAD, or aortic plaque)
A: Age 65-74 V: Vascular disease (prior MI, PAD
Sc: Sex category (female) plaque)
A: Age 65-74
Sc: Sex category (female)
, The CHA2DS2-VASc score is useful for The CHA2DS2-VASc score is useful for
The CHA2DS2-VASc score is us
assessing thromboembolic risk in patients with non- assessing thromboembolic risk in patients with non-
valvular atrial fibrillation: valvular atrial fibrillation: assessing thromboembolic risk in
with non-valvular atrial fibrill
C: Congestive heart failure C: Congestive heart failure
H: Hypertension H: Hypertension C: Congestive heart failur
A2: Age > 75* (2 points) A2: Age > 75* (2 points) H: Hypertension
A2: Age > 75* (2 points)
D: Diabetes mellitus D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism* (2 points) S2: Stroke/TIA/thromboembolism* (2 points) D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism*
V: Vascular disease (prior MI, PAD, or aortic plaque) V: Vascular disease (prior MI, PAD, or aortic plaque)
A: Age 65-74 A: Age 65-74 V: Vascular disease (prior MI, PAD
Sc: Sex category (female) Sc: Sex category (female) plaque)
A: Age 65-74
Sc: Sex category (female)
The CHA2DS2-VASc score is useful for The CHA2DS2-VASc score is useful for
The CHA2DS2-VASc score is us
assessing thromboembolic risk in patients with non- assessing thromboembolic risk in patients with non-
valvular atrial fibrillation: valvular atrial fibrillation: assessing thromboembolic risk in
with non-valvular atrial fibrill
C: Congestive heart failure C: Congestive heart failure
H: Hypertension H: Hypertension C: Congestive heart failur
A2: Age > 75* (2 points) A2: Age > 75* (2 points) H: Hypertension
A2: Age > 75* (2 points)
D: Diabetes mellitus D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism* (2 points) S2: Stroke/TIA/thromboembolism* (2 points) D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism*
V: Vascular disease (prior MI, PAD, or aortic plaque) V: Vascular disease (prior MI, PAD, or aortic plaque)
A: Age 65-74 A: Age 65-74 V: Vascular disease (prior MI, PAD
Sc: Sex category (female) Sc: Sex category (female) plaque)
A: Age 65-74
Sc: Sex category (female)
student with the rash below? It is painful and associated
with low-grade fever.
Herpetic whitlow (secondary to HSV infection)
Viêm bàn tay do HSV
What is the recommended treatment fo
What is the first-line treatment for patients with bullous
herpetiformis?
pemphigoid?
dapsone (acute relief) and a gluten-fre
High-potency topical glucocorticoids (e.g. clobetasol)
term relief)
What is the likely diagnosis in a young adult patient that
presents with the foot rash below? The lesions are
painful with walking and standing.
Plantar warts (due to HPV infection)
Mục cóc
What is the suggested treatment to
Do cherry hemangiomas typically regress complications of proliferative-tăng s
spontaneously? retinopathy?
No Argon laser photocoagulati
laser quang đông
What is the likely diagnosis in a patient that presents with
sudden onset flashes of light-chớp sáng and floaters in
the left eye? The patient felt like "a curtain came down" What is the likely underlying etiology of anemia in an
over her eye. Ophthalmoscopy reveals a grayish- elderly patient with fatigue, lymphadenopathy, and Pica (thèm ăn non-food), espec
appearing retina. splenomegaly? ice (pagophagia), may be indicativ
deficiency anemia
Retinal detachment Bone marrow infiltration (e.g. lymphoma, leukemia)
Bong võng mạc
What is the first-line treatment for most patients with What enzyme is typically elevated in patients What is the recommended treatment t
chronic myeloid leukemia (CML)? with hemolytic anemia? effects of heparin?
Tyrosine kinase inhibitors (e.g. imatinib) Lactate dehydrogenase (LDH) Protamine sulfate
, What is the recommended management for What is the recommended screening
What is the recommended management for
a hemodynamically unstable Wolff-Parkinson-White abdominal aortic aneurysm
costochondritis?
syndrome patient with atrial fibrillation?
One-time abdominal ultrasound for m
Reassurance and symptomatic pain management
Electrical cardioversion or former smokers aged 65-75
Ascending aortic aneurysms are most often due Ascending aortic aneurysms are most often due Patients with beta blocker overdose
to cystic medial necrosis-hoại tử (due to aging) and to cystic medial necrosis-hoại tử (due to aging) and refractory hypotension (e.g. to atropi
connective tissue disorders connective tissue disorders should be started on IV gluca
In addition to history and physical, pat
What is the most common cause of sudden cardiac diagnosed with hypertension shoul
What is the likely diagnosis in a systemic
arrest in the immediate post-infarction period in patients following basic testing:
sclerosis patient that presents with renal
with acute MI?
failure and malignant hypertension?
1. Urinalysis (for occult hematuria and
Re-entrant ventricular arrhythmias (e.g. ventricular protein/creatinine ratio)
Scleroderma renal crisis
fibrillation) 2. Chemistry panel
Khủng hoảng thận xơ cứng bì
Nhịp nhanh thất 3. Lipid profile
4. Baseline ECG
In addition to history and physical, patients initially In addition to history and physical, patients initially In addition to history and physical, pat
diagnosed with hypertension should have the following diagnosed with hypertension should have the following diagnosed with hypertension shoul
basic testing: basic testing: following basic testing:
1. Urinalysis (for occult hematuria and urine 1. Urinalysis (for occult hematuria and urine 1. Urinalysis (for occult hematuria and
protein/creatinine ratio) protein/creatinine ratio) protein/creatinine ratio)
2. Chemistry panel 2. Chemistry panel 2. Chemistry panel
3. Lipid profile 3. Lipid profile 3. Lipid profile
4. Baseline ECG 4. Baseline ECG 4. Baseline ECG
What intervention is most likely to improve
What valvular defect is associate
cardiovascular and overall long-term mortality in
hyperdynamic pulse (e.g. bounding
Diagnosis of amyloidosis is confirmed using tissue patients with acute STEMI?
hammer" pulses)?
biopsy (e.g. abdominal fat pad)
Restoration of coronary blood flow (e.g. PCI,
Aortic regurgitation
fibrinolysis)
What is the likely diagnosis in a patient with ST What is the recommended treatm
elevations in leads II, III, and aVF with JVD, hemodynamically unstable patient w
The strongest predictors of abdominal aortic aneurysm hypotension and clear lungs on auscultation? tamponade?
rupture are large aneurysm diameter, rapid rate of
expansion, and current cigarette smoking Right ventricular MI Emergency pericardiocente
chọc dò màng tim cấp cứu
,What is the preferred diagnostic study for patients with
renal insufficiency or hemodynamic instability with
suspected aortic dissection?
Transesophageal echocardiography The presence of a continuous abdominal bruit has a
high specificity for the presence of renovascular
What is the recommended lipid-l
hypertension therapy for patients < 75 that have
significant atherosclerotic dis
High-intensity statin
What is the recommended therapy for patients > 75 that
have clinically significant atherosclerotic disease? Patients with an LDL > 190 mg/dL are recommended to Patients with an LDL > 190 mg/
begin high-intensity statin therapy recommended to begin high-intens
Moderate-intensity statin therapy
What is the recommended pharmaceutical therapy to
Patients with an estimated 10-year ASCVD risk reduce overall cardiovascular mortality in patients with What is the most common mode of in
> 7.5% should be started on a moderate- to high- peripheral arterial disease? hereditary spherocytosis
intensity statin
antiplatelet agent (e.g. aspirin) and a statin Autosomal dominant (75%
, What is the recommended treatment for immune
thrombocytopenic purpura in adults with platelet counts What is the likely diagnosis in a patient with acute
< 30,000/uL or bleeding? lymphoblastic leukemia that develops premature
ventricular beats and acute kidney injury after What is an appropriate prophylactic
IVIG or corticosteroids initiating chemotherapy? help prevent tumor lysis syndr
Tumor lysis syndrome IV fluids + allopurinol or rasbu
Diagnosis of paroxysmal nocturnal hemoglobinuria- The major risk factor for developmen
tiểu Hb kịch phát về đêm may be made with flow keratosis (dày sừng) is chronic sun
What is the recommended treatment for thrombotic cytometry, which can detect the absence of the proteins
thrombocytopenic purpura (TTP)? CD55 and CD59
Emergent plasma exchange +/- corticosteroids
Thay huyết tương
What is the likely diagnosis in a patient with Marfan
syndrome that presents with sudden-onset tearing chest
pain?
Aortic dissection
What is the most common location
Management of acute decompensated heart failure foci that cause atrial fibrillat
includes supplemental O2, IV loop diuretics, and
possibly a vasodilator/vasopressor Pulmonary veins
, Autoimmune hemolytic anemia is differentiated from What is the first-line
hereditary spherocytosis by a positive Coombs test treatment for mild inflammatory acn
benzoyl peroxide + topical reti
What is the likely diagnosis in a male with a history of
SLE (lupus) that presents with epigastric burning
provoked by exertion (gắng sức) and relieved by rest?
Atypical angina
What is the likely diagnosis in a patient that presents with
pruritus and the rash below? A punch biopsy shows
linear IgG and C3 deposits at the dermal-epidermal
junction.
Bullous pemphigoid The CHA2DS2-VASc score is useful for
The CHA2DS2-VASc score is us
assessing thromboembolic risk in patients with non-
valvular atrial fibrillation: assessing thromboembolic risk in
with non-valvular atrial fibrill
C: Congestive heart failure
H: Hypertension C: Congestive heart failur
A2: Age > 75* (2 points) H: Hypertension
A2: Age > 75* (2 points)
D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism* (2 points) D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism*
V: Vascular disease (prior MI, PAD, or aortic plaque)
A: Age 65-74 V: Vascular disease (prior MI, PAD
Sc: Sex category (female) plaque)
A: Age 65-74
Sc: Sex category (female)
, The CHA2DS2-VASc score is useful for The CHA2DS2-VASc score is useful for
The CHA2DS2-VASc score is us
assessing thromboembolic risk in patients with non- assessing thromboembolic risk in patients with non-
valvular atrial fibrillation: valvular atrial fibrillation: assessing thromboembolic risk in
with non-valvular atrial fibrill
C: Congestive heart failure C: Congestive heart failure
H: Hypertension H: Hypertension C: Congestive heart failur
A2: Age > 75* (2 points) A2: Age > 75* (2 points) H: Hypertension
A2: Age > 75* (2 points)
D: Diabetes mellitus D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism* (2 points) S2: Stroke/TIA/thromboembolism* (2 points) D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism*
V: Vascular disease (prior MI, PAD, or aortic plaque) V: Vascular disease (prior MI, PAD, or aortic plaque)
A: Age 65-74 A: Age 65-74 V: Vascular disease (prior MI, PAD
Sc: Sex category (female) Sc: Sex category (female) plaque)
A: Age 65-74
Sc: Sex category (female)
The CHA2DS2-VASc score is useful for The CHA2DS2-VASc score is useful for
The CHA2DS2-VASc score is us
assessing thromboembolic risk in patients with non- assessing thromboembolic risk in patients with non-
valvular atrial fibrillation: valvular atrial fibrillation: assessing thromboembolic risk in
with non-valvular atrial fibrill
C: Congestive heart failure C: Congestive heart failure
H: Hypertension H: Hypertension C: Congestive heart failur
A2: Age > 75* (2 points) A2: Age > 75* (2 points) H: Hypertension
A2: Age > 75* (2 points)
D: Diabetes mellitus D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism* (2 points) S2: Stroke/TIA/thromboembolism* (2 points) D: Diabetes mellitus
S2: Stroke/TIA/thromboembolism*
V: Vascular disease (prior MI, PAD, or aortic plaque) V: Vascular disease (prior MI, PAD, or aortic plaque)
A: Age 65-74 A: Age 65-74 V: Vascular disease (prior MI, PAD
Sc: Sex category (female) Sc: Sex category (female) plaque)
A: Age 65-74
Sc: Sex category (female)
