With over 100 pearls posted, I thought it would be fun to take a quiz on topics covered to date!

Multiple choice questions

1. Your patient with hypertensive crisis is admitted with yellow discoloration of skin but not sclera. Which of the following might explain your finding?
   1. Hypothyroidism
   2. Excessive ingestion of squash or carrots
   3. Liver disease
   4. Nephrotic syndrome
   5. All of the above
2. Your patient with COPD is admitted with acute exacerbation of his disease without a clear trigger or explanation.  Based on published literature, his risk of concurrent pulmonary embolism is approximately…
   1. 0-10%
   2. 15-20%
   3. 30-40%
   4. 50%
   5. > 60%
3. Your diabetic patient has developed hypoglycemia while being treated with trimethoprim-sulfamethoxazole for a urinary tract infection. A potential explanation for this finding include:
   1. Trimethoprim serving as an insulin secretagogue
   2. Sulfamethoxazole serving as an insulin secretagogue
   3. Reduction of insulin renal clearance by sulfamethoxazole
   4. Increased renal excretion of glucose due to sulfamethoxaole
   5. All of the above
4. Your patient with urosepsis and E.coli bacteremia presents with new-onset direct hyperbilirubinemia (4.0 mg/dl). His ultrasound of the liver and biliary tree is normal. The most likely explanation for his hyperbilirubinemia  is…
   1. Hemolysis due to sepsis
   2. Gilbert’s syndrome
   3. Common bile duct obstruction due to stone
   4. Cholestasis due to sepsis-induced cytokines
   5. None of the above
5. Your 55 y old patient is admitted for alcohol withdrawal. You note “Frank’s sign” on his exam. All of the following is true of this sign except…
   1. It was first discovered by a surgeon
   2. It describes a diagonal earlobe crease
   3. It may be a potential marker of coronary artery disease, especially in those 60 y of age or younger
   4. It is associated with alcoholic cirrhosis
   5. It’s pathogenesis may be related to the breakdown of type I collagen due to oxidative stress in atherosclerosis

 

True or false questions

1. Patients with reported shellfish allergy have a significantly higher rate of allergic reactions to iodinated contrast media than those without shellfish allergy.     T              F

2. The new AABB guidelines recommend using a hemoglobin threshold of 7.0 g/DL for all hospitalized patients in the absence of active hemorrhage.    T             F

3. Vitamin D deficiency may present as proximal muscle weakness before any biochemical signs such as hypocalcemia develop.  T         F

4. “SPICE” organisms include multi-drug resistant Staphylococcus aureus and  Pseudomonas aeruginosa.   T            F

5. Prophylactic subcutaneous heparin can be associated with hyperkalemia.

T             F

 

For answers: Scroll down past the bonus picture quiz below….

What condition may benefit from an active compound isolated from these peppers?

 

Answer key

Multiple choice questions

1:5; 2:2;3:2;4:4;5:4. 

True or False 

1:F; 2:F; 3:T; 4:F;5:T

For further discussion of the answers, please refer to the actual pearls by typing in a keyword

Guide to the interpretation of quiz results

10 correct answers: You are the “Duke of Pearl”!

7-9 correct answers: You have “Pearl vision”!

5-6 correct answers: You are “Pearly good” at this quiz!

<5 correct answers: I am “Pearly proud” of you for taking the quiz!

 

Bonus picture quiz answer:

Post-herpetic neuralgia, due to capsaicin in hot peppers!