Favorite Pimping Questions

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jojo14

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This past year, I swear I got pimped on some concepts more than others. And then, of course, some crazy crazy questions that I had no clue at all.

Thought it might be fun to go over "favorite pimping questions!" Yeah, I'm a dork. Here's some to get started.

What is the most common EKG finding in pulmonary embolism?

What are the causes of pancreatitis?

What is the sensitivity and specificity of Abd CT for appendicitis?

Treatment of C. Difficile?

What causes an R wave in V1 on an EKG?

Sensitivity and specificity of RUQ U/S for gallbladder disease?

How much should a serum B-HCG level increase by in 48 hrs in normal early pregnancy?

Most common cause of pediatric bowel obstruction?

You get the idea...
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MY FAVORITE!!!!

Name the four rivers that border the state of Missouri. :oops: :eek:


:laugh: :laugh: :laugh: :laugh:
 
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What is the resting pressure of the Sphincter of Oddi?

What is the size of a bile caniculi cell?
 
15 mmHg

I think the bile caniculi cell is 2 microns
 
Ok, I'll do my best to remember these off the top of my head. Other people, chime in if I mess something up.


jojo14 said:
This past year, I swear I got pimped on some concepts more than others. And then, of course, some crazy crazy questions that I had no clue at all.

Thought it might be fun to go over "favorite pimping questions!" Yeah, I'm a dork. Here's some to get started.

What is the most common EKG finding in pulmonary embolism?
Sinus Tachycardia

What are the causes of pancreatitis?
Gallstones, alcohol (together these make up the vast majority of cases), hypertriglycerdemia, hypercalcemia, trauma, ERCP, Drugs (thiazides, diuretics, steroids, antiretrovirals), tumor, anorexia, viral, ESRD, ischemia, and my favorite...scorpion bites

What is the sensitivity and specificity of Abd CT for appendicitis?
I think it is 90-95% sensitive...actually don't remember specificity

Treatment of C. Difficile?
Metronidazole or Vancomycin PO. I think Vanco can be given IV as well to treat it but po is the traditional.

What causes an R wave in V1 on an EKG?
1. Posterior Infarct 2. RV Strain (from something like pulmonary hypertension) 3. RVH 4. RBBB

Sensitivity and specificity of RUQ U/S for gallbladder disease?
Again, only remember sens which I have heard as being 95-97%

How much should a serum B-HCG level increase by in 48 hrs in normal early pregnancy?
Classically, 66%

Most common cause of pediatric bowel obstruction?
2mos-5 years- Intussusception. My surgery chief told me it is Meckels after that, but I've never heard anyone else say that.

You get the idea...
Click to expand...
 
At the expense of being proven an idiot, I'll venture some answers:

What is the most common EKG finding in pulmonary embolism?
Sinus tachycardia (although S1Q3T3 is frequently pimped)

What are the causes of pancreatitis?
Alcohol and gallstones are the big 2; others include hypertriglyceridemia, hypercalcemia, drugs (classically antiretrovirals), trauma, idiopathic, ERCP, infection and scorpion sting

What is the sensitivity and specificity of Abd CT for appendicitis?
Around 95% for both I think

Treatment of C. Difficile?
Metronidazole

What causes an R wave in V1 on an EKG?
Posterior MI (I have been pimped on treatment also: Dopamine and fluids)

Sensitivity and specificity of RUQ U/S for gallbladder disease?
~85% and 99% for gallstones, more sensitive/less specific for acute cholecystitis

How much should a serum B-HCG level increase by in 48 hrs in normal early pregnancy?
It should double (approximately)

Most common cause of pediatric bowel obstruction?
I'm going with intussusception, but it probably varies by age group

Good luck to all the newly minted 3rd years.
 
Nah, we were both just super pimped
 
What was John Milton's profession (besides poet)? What religion did he practice?
Clergy, Anglican.

In what year did Constantiople become Istanbul?
No idea.

Heard from a friend:
What year was the Bovie invented?
No idea.
 
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My favorites:

"Describe the pathophysiology of anemia of chronic disease. Be brief."

"Which state is the shape of a perfect square?"
 
which beta-blocker to avoid with renal failure?

ans-atenolol. it is cleared by the kidneys.

welcome 4th year.
 
What's the molecular weight of beta-HCG?

I didn't even listen to the answer. Man I hated ObGyn.
 
1. Name the 10 layeres of the bowel wall

2. Why doesn't TB respect the metaphysis in septic arthritis secondary to osteomyelitis
 
What are the five mechanisms of anemia in renal failure?
 
What are the 3 auscultatory signs of CRITICAL aortic stenosis?

1. late-peaking systolic murmur.
2. paradoxically split S2.
3. I can't remember the last one.
 
DHMO said:
What's the molecular weight of beta-HCG?

I didn't even listen to the answer. Man I hated ObGyn.
Click to expand...

i think about 40K daltons (dont ask me how i remember)
 
toofache32 said:
My favorites:

a - "Describe the pathophysiology of anemia of chronic disease. Be brief."

b - "Which state is the shape of a perfect square?"
Click to expand...

a - I believe this is when there is impaired use of iron b/c the body "hides" it from the offending agent.

b - I guess a perfect square is in a state of total harmony and equilibrium? (no idea)
 
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dentate_gyrus said:
What was John Milton's profession (besides poet)? What religion did he practice?
Clergy, Anglican.

In what year did Constantiople become Istanbul?
No idea.

Heard from a friend:
What year was the Bovie invented?
No idea.
Click to expand...

Milton was actually never ordained and didn't believe in the Trinity - he was a very weird Christian. I would have answered diplomat/government functionary in the Cromwellian government. (sorry to intrude - I wrote my thesis on John Milton and I really hope I get a couple questions like this when I get to medical school... :) )
 
dentate_gyrus said:
Heard from a friend:
What year was the Bovie invented?
No idea.
Click to expand...

1920, right? I think Bovie was an engineer who helped develop electrocautery with Dr. Cushing.
 
s42brown said:
MY FAVORITE!!!!

Name the four rivers that border the state of Missouri. :oops: :eek:


:laugh: :laugh: :laugh: :laugh:
Click to expand...
Missouri, Mississippi, St. Francis (west side of the bootheel), Fox River (north east corner before it joins into the Mississippi)
 
how do you measure zero degrees temperature?

apparently mmHg wasn't good enough . . .
 
Blade28 said:
1920, right? I think Bovie was an engineer who helped develop electrocautery with Dr. Cushing.
Click to expand...

Harvey Cushing first used the device developed by Harvard biophysicist William Bovie on Oct. 1, 1927, to remove a large sarcoma from the skull. Cushing had abandoned surgery on this patient 3 days earlier because of uncontrollable hemorrhage. They had to run electricity into the OR. Several days later, Cushing used the device on a similar tumor in a 12-year-old girl.

Cushing H: Electro-surgery as an aid to the removal of intracranial tumors. With a preliminary note on a new surgical-current generator by W.T. Bovie, Ph.D., Chicago. Surg Gynecol Obstet 47: 751–784, 1928.
 
"What is the daily volume of salivary secretions?"
Followup: "What is the daily volume of gastric secretions? Biliary secretions? etc."

Turns out most of these are actually in Maxwell's, though the amounts vary so widely I can't imagine it would be useful to know.

Biliary: 50-800
Diarrheal: "varies"
Gastric: 100-4000
Ileal: 100-9000
Pancreatic: 100-800
Salivary: 500-2000
 
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DHMO said:
What's the molecular weight of beta-HCG?

I didn't even listen to the answer. Man I hated ObGyn.
Click to expand...

Perfect answer: Who gives a flying ****?

I hated OB/GYN too.
 
Currently on Neurosurgery

- What is the amount of intracranial CSF? Pressure?

- What is the normal CVP?

- Define medial hippocampal sclerosis

- Describe the neurocutaneous syndromes

- Describe the histology of oligodendrocytomas

- Is radiosurgery effective in the treatment of cavernous haemangiomas?

- what other vascular anomaly is associated with cavernous haemangiomas?

- Is it necessary to close the dura after cranial surgery? Why or why not?

- Causes of diffusely inverted T waves?

- What are the two greatest factors that predispose to SAH?

- What nerve could be damaged during insertion of an internal jugular line

oh and obviously all the pimping of hydrocephalus communicating vs non communicating, obstructive/non obstructive
 
Purifyer said:
Currently on Neurosurgery

- What is the amount of intracranial CSF? Pressure?

- What is the normal CVP?

- Define medial hippocampal sclerosis

- Describe the neurocutaneous syndromes

- Describe the histology of oligodendrocytomas

- Is radiosurgery effective in the treatment of cavernous haemangiomas?

- what other vascular anomaly is associated with cavernous haemangiomas?

- Is it necessary to close the dura after cranial surgery? Why or why not?

- Causes of diffusely inverted T waves?

- What are the two greatest factors that predispose to SAH?

- What nerve could be damaged during insertion of an internal jugular line

oh and obviously all the pimping of hydrocephalus communicating vs non communicating, obstructive/non obstructive
Click to expand...

Amount of CSF in ventricles - 150mL
Intracranial pressure? - ~15mmHg

Factors predisposing to SAH? - aneurysms & malformations

ok.. a bit hazy about the rest :sleep:
 
My favorite pimp question to ask

"Who was APGAR? - and what did they do to deserve having the scoring system named after them?"

In neonatology, here are some med student level common pimp Q (these questions are for NICU level 2 rotations, not well-baby questions - of which there are a million):

Trace the path of the umbilical artery and vein

Why do we fortifiy breast milk for premature babies?

Why do premature babies have apnea?

What are the stages of ROP?

What weight defines a VLBW and a ELBW infant?

How much weight does a full-term or preterm baby NORMALLY lose after delivery and why do they lose it?

There are more, but this should keep the future neonatologists here ready to go!

Regards

OBP
 
oldbearprofessor said:
My favorite pimp question to ask

"Who was APGAR? - and what did they do to deserve having the scoring system named after them?" - Named after an anesthesiologist, Virginia Apgar who developed a scoring system of wellness for newborns.

In neonatology, here are some med student level common pimp Q (these questions are for NICU level 2 rotations, not well-baby questions - of which there are a million):

Trace the path of the umbilical artery and vein - Don't know. Placenta to baby, that's my best guess. LOL

Why do we fortifiy breast milk for premature babies? - They need more calories than full term infants, especially since they don't have any/much brown fat stores.

Why do premature babies have apnea? - Lung development?

What are the stages of ROP? - Yikes, I should totally know this. I can tell you what a typical labor looks like in a ROP baby. PROM, no contractions for several hours, slow/no descent, persistent back pain, leg numbness at times, long 2nd stage, etc. Man I hate attending those, those mamas suffer.

What weight defines a VLBW and a ELBW infant? - Very large birth weight, extremely large birth weight- is that what those terms mean? Macrosomic is 9+# right?

How much weight does a full-term or preterm baby NORMALLY lose after delivery and why do they lose it? - 10% is the max that docs like to see lost, I think it has something to do with the burning off of brown fat as the baby adjusts to breathing, breastfeeding, etc.
Click to expand...

Ooh can I steal these and see if some of my doula colleagues can answer? ;)

I want to try to answer even tho my knowledge level is purely lay and not based on a medical education yet.

I can't wait to do my OB/GYN rotation....... *drooling*
 
etf said:
wasn't this the interview question in harold and kumar? or was it about the symptoms?
Click to expand...

it was the presentation (symptoms)

man that movie was funny :laugh:
 
Doula-2-OB said:
Ooh can I steal these and see if some of my doula colleagues can answer? ;)

I want to try to answer even tho my knowledge level is purely lay and not based on a medical education yet.

I can't wait to do my OB/GYN rotation....... *drooling*
Click to expand...

You got Apgar basically correct, although her life story is very interesting. What did she do later in life??

Sorry - by ROP I meant retinopathy of prematurity, not what you thought - we neo's don't care much about how the babies present in labor!

The rest of the answers are a bit off - but I'll let you work on them...hint, calories aren't the main reason we fortify human milk for premies, it's one reason but not really the primary one.

Regards

OBP
 
oldbearprofessor said:
You got Apgar basically correct, although her life story is very interesting. What did she do later in life??

Sorry - by ROP I meant retinopathy of prematurity, not what you thought - we neo's don't care much about how the babies present in labor!

The rest of the answers are a bit off - but I'll let you work on them...hint, calories aren't the main reason we fortify human milk for premies, it's one reason but not really the primary one.

Regards

OBP
Click to expand...

Well I've asked the questions to my doula friends so we'll see if anyone has any good guesses.

On the ROP question- duh. I should have guessed you weren't talking about fetal positioning! :laughy

Thanks, this is fun. :)
 
Why do premature babies have apnea?

Because of the lack of lecithin palmitoyl (ie. surfactant made by the alveolar cells) secretion in their lungs. I believe one can give corticosteroids to enhance the secretion.

this right? @_@
 
I still remember some psychiatry pimp questions:

1. What are the only antipsychotics approved for use in children?

2. What is the mechanism of action of waxy flexibility?

3. Which antibiotic is chemically closely related to an MAOI, disallowing the patient to eat foods containing tyramine?
 
pwanda said:
Why do premature babies have apnea?

Because of the lack of lecithin palmitoyl (ie. surfactant made by the alveolar cells) secretion in their lungs. I believe one can give corticosteroids to enhance the secretion.

this right? @_@
Click to expand...

surfactant deficiency explains respiratory distress syndrome (hyaline membrane disease), but not apnea of prematurity.

Regards

OBP
 
oldbearprofessor said:
surfactant deficiency explains respiratory distress syndrome (hyaline membrane disease), but not apnea of prematurity.

Regards

OBP
Click to expand...

ok, well, they're premature, right? so perhaps the brainstem isn't fully mature yet?
 
oldbearprofessor said:
correct - then rationally, what's the treatment?

OBP
Click to expand...

My guess would be supportive (i.e. CPAP, caffeine, etc.) until the tincture of time takes over
 
SexPanther said:
My guess would be supportive (i.e. CPAP, caffeine, etc.) until the tincture of time takes over
Click to expand...

One of my colleagues is fond of saying "Time for the baby's morning cup of coffee." Of course, it is a VERY expensive cup of coffee since it is pharmaceutically produced caffeine. In fairness, some premies also have a significant component of obstructive apnea (CPAP treats both central and obstructive apnea) which is also treated with positioning. Finally, to complete this one so you really sound smart on rounds, the big controversy now is the role of reflux in apnea - and what to do about it. Most premies have reflux and apnea and desaturations can be associated with it (although causality has not been shown and a recent study cast real doubt on the association). The problem is that we don't have any good meds for use in preterm babies for reflux anyway.

Don't mean to turn SDN into a medical ed site, but since people seem interested, I'll continue...as these ARE common pimp questions for clinical med students on rounds in pedi when they are doing baby rounds.

OBP
 
Purifyer said:
Currently on Neurosurgery
- What is the normal CVP?

0-5 cm H20

- Define medial hippocampal sclerosis

Neuron loss, gliosis, and atrophy of the hippocampus. Is a cause or maybe result of temporal lobe epilepsy. If you're hip, you use the term "mesial" instead of "medial".

- Describe the neurocutaneous syndromes

Congenital diosrders that predispose to tumors in the nervous system, skin, and other organs.

- Describe the histology of oligodendrocytomas

Fired eggs

- Is radiosurgery effective in the treatment of cavernous haemangiomas?

Yes, for selected patients.

- what other vascular anomaly is associated with cavernous haemangiomas?

Venous malformation

- Is it necessary to close the dura after cranial surgery? Why or why not?

Yes, directly or with graft, to prevent CSF leak and infection

- Causes of diffusely inverted T waves?

NS resident holding strip upside down

- What are the two greatest factors that predispose to SAH?

Age and family history or smoking and ethanol

- What nerve could be damaged during insertion of an internal jugular line

CN X
Click to expand...
.
 
oldbearprofessor said:
correct - then rationally, what's the treatment?

OBP
Click to expand...

in addition to cpap/caffeine as mentioned, what about drugs to increase respiratory drive? surely they exist.
 
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