Jeopardy game 2.24.2010 Univ Mich FM

Science Jeopardy

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USPSTF update

Antidepressant

What’s new FM Uptodate

ID PotPourri

Final Jeopardy

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©Norman Herr, 2003

QuestionAnswer

A-100• The age, at which USPSTF recommend to start routine mammography.

• 50 yo Screening every other year 50-74yo (grade B) 40-49yo (grade C) teaching self-exam (grade D) clinical breast exam (Grade I)

QuestionAnswer

A-200

• The recommendation level in USPSTF for newborn universal bilirubin screening to prevent chronic bilirubin encephalopathy (kernicterus).

• Grade I (insufficient data).

QuestionAnswer

A-300

• The age, at which USPSTF recommend start screening for obesity.

• 6 yo Jan 2010 recommendation. Obesity is defined as over 95%tile of age-gender specific BMI.

QuestionAnswer

A-400

• The recommendation level of screening for bacterial vaginosis in asymptomatic pregnant women at low/high risk for preterm delivery.

• Grade D/ Grade I

QuestionAnswer

A-500

• Recommended criteria to screen for type2 Diabetes Mellitus in adults.

• BP over 135/80 (Grade B) under 135/80 (Grade I)

QuestionAnswer

• 3 common (specific) side effects of SSRI

• Nausea/vomiting, sexual dysfunction, weight gain, insomnia/agitation, suicidal ideation/behavior, bleeding etc

B-100

QuestionAnswer

B-200

• The response rate for antidepressants (acute depression and maintenance phase).

• 50-60% Remission rate 28% in real world study.

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B-300

• SSRI with least weight gain

• Fluoxetine (Prozac)

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B-400

• The best antidepressant among second generation, regarding symptom improvement & drop out rate.

• None But one meta-analysis showed Escitalopram (Lexapro) and Sertraline(Zoloft) better than other SSRIs, SNRIs, bupropion, Mirtazapine

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B-500

• SSRI with least p450 interaction, comparatively lower side effects, and indication not only for depression but for anxiety.

• Citalopram (Celexa)

QuestionAnswer

C-100

• Interval of ultrasound screening of hepatocelluar carcinoma for patients with hepatitis B.

• 6 months A new guideline from the American Association for

the Study of Liver Diseases

QuestionAnswer

C-200

• The risk known to be increased by Tanning bed (ultraviolet-light emitted).

• Melanoma Tanning beds, sunlamps, and risk of cutaneous

malignant melanoma. Cancer Epidemiol Biomarkers Prev 2005 Mar;14(3):562-6.

QuestionAnswer

C-300

• The recommendation level of neonatal pulse oximetry screening for congenital heart disease.

• Uncertain Role of pulse oximetry in examining newborns

for congenital heart disease: a scientific statement from the AHA and AAP. Pediatrics. 2009 Aug;124(2):823-36. Epub 2009 Jul 6.

QuestionAnswer

C-400

• The announcement by FDA due to use of a new reference standard for unfractionated heparin products manufactured in the United States after October 8, 2009.

• 10% less potent

QuestionAnswer

C-500

• Indications for Propylthiouracil(PTU) as 1st lined drug for hyperthyroidism

• 1st trimester of pregnancy• life-threatening thyrotoxicosis or thyroid storm.

The Role of Propylthiouracil in the Management of Graves' Disease in Adults: report of a meeting jointly sponsored by the American Thyroid Association and the Food and Drug Administration. Thyroid 2009; 19:673

QuestionAnswer

D-100

• Sensitivity of rapid antigen test for Pandemic H1N1 influenza

• 18-69%

QuestionAnswer

D-200• 5 Target groups for pandemic H1N1 influenza vaccination by CDC and ACIP

• Pregnant women• Household contacts and caregivers of child<6mo

• Healthcare and emergency med services personnel

• 6m-24yo• 25yo-64yo w increased risk of flu complication

QuestionAnswer

D-300

• Efficacy of Pneumovax immunization for people over 65yo. (all unimmunized people>65yo are recommended target)

• Decrease all-cause pneumonia (combined relative risk 0.73, 95% CI 0.56-0.94).

• No difference in high quality trials. Does not decrease pneumococcal pneumonia nor mortality.

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D-400

• 4 strains, the novel H1N1 influenza represents

• 2 swine strains, 1 human strain, 1 avian strain.

QuestionAnswer

D-500

• Number of weeks after onset of infectious mononucleosis when athlete can return to sports (non-conact / contact sports)

• Non- contact : 3weeks• Contact : 4weeks or symptom-free, afebrile, normal energy level

QuestionAnswer

E-100

• The most common cause of systolic murmurs in young children.

• Innocent/functional murmur• Present in 50-90% of children at some point between 2-7yo

• Less than 1% attribute to congenital heart disease.

QuestionAnswer

E-200

• Hormone which explains, why women exhibit lower pain threshold, increased pain rating, and respond with 30% less dosage of morphine compared to male.

• Estrogen

QuestionAnswer

E-300

• PPI which can be used safely in combination with Plavix for pt w ACS.

• Pantoprazole (Protonix)

QuestionAnswer

E-400

• Conventional pap testing vs liquid-based testing The test with higher accuracy (detection rates and PPV) for CIN 1,2,3, cervical cancer.

• None• RCT showed, liquid-based cytology is neither more sensitive nor specific.

(Comparision of liquid-based cytology with conventional cytology for detection of cervical cancer precursors. JAMA 2009: 302(16): 1757-1764)

QuestionAnswer

E-500

• Percentage of decreased smoker following brief advice by primary care physician.

• 2.1% = NNT 48 (Cochrane Review 2005)

QuestionAnswer

FINAL JEOPARDY

• 5 criteria of CHADS2 score for A fib

• Congestive Heart Failure (1 point)• Hypertension (1 point)• Age >= 75 years (1 point)• Diabetes Mellitus (1 point)• Stroke symptoms previously or TIA (2 point)