BOARD STUDY RELAY

BOARD STUDY RELAY

Divide into your Y week cohort groups!!!!!!!
With ONE Team Lead/Phone holder

ROUND 1

Squat and stand maneuver

Auscultate your partner 5 times while they squat and stand

Multiple Choice

A 14-year-old adolescent boy is seen for a preparticipation physical examination to play soccer. He is healthy with no concerns voiced by him or his parents. His physical examination findings are normal except for a systolic ejection click heard best at the right upper sternal border. Further inquiry reveals that the boy’s paternal grandfather had aortic valve surgery at age 55 years. The boy is referred to a pediatric cardiologist. 

Of the following, the boy’s MOST likely diagnosis is

• bicuspid aortic valve

• partial anomalous venous return

• pulmonary valve stenosis

• ventricular septal defect

Multiple Choice

A 57-year-old man is evaluated for a 6-month history of stable chest pain. He experiences chest pressure that occurs after walking 1 mile and resolves promptly with rest. He has no symptoms at rest. His history includes aspirin allergy manifesting as hives and difficulty breathing after taking 325 mg of aspirin as a teenager. He is a never smoker. He has hyperlipidemia. His only medication is atorvastatin.

On physical examination, vital signs are normal. BMI is 30. The remainder of the examination is normal.

Resting ECG is normal, and an exercise ECG is scheduled. The patient receives counseling on lifestyle interventions to reduce his risk for disease progression. Antianginal medications will be initiated.

Which of the following is the most appropriate additional therapy to add?

• Clopidogrel

• Low-dose aspirin

• Prasugrel

• Ticagrelor

Round 2

(Timed) Up and Go Test

EACH team member must start from a sitted position, stand, and walk three feet and sit back time
THREE TIMES EACH TEAMMEMBER

Multiple Choice

An 81-year-old woman is evaluated for dyspnea that has slowly worsened over the past 3 months. She has a history of severe COPD and has been on continuous oxygen therapy for 6 years. She has a minimal cough productive of scant sputum. Two weeks ago, she finished pulmonary rehabilitation, which provided some improvement in symptoms. Her medications are inhaled vilanterol trifenatate, umeclidinium bromide, and fluticasone furoate.

On physical examination, vital signs are normal. Breath sounds are diminished bilaterally.

Which of the following is the most appropriate treatment?

• Chest physiotherapy

• Handheld fan

• Levofloxacin

• Pulmonary rehabilitation

Multiple Choice

A 10-year-old girl is seen for a health supervision visit. Her parents are concerned because their daughter can bend backward at the elbows and knees to a degree that seems unnatural and she is “double-jointed.” They want to make sure that it is safe for her to participate in sports. The girl is active in both soccer and gymnastics without pain or limitations. On physical examination, the girl demonstrates 15 degrees of elbow extension and 15 degrees of knee extension bilaterally. She is able to touch her palms to the floor without bending her knees but does not have signs of increased joint mobility in her hands or wrists. The remainder of her physical examination findings are normal. 

Of the following, the BEST next step in this girl’s evaluation and management is to

• reassure the family about her physical examination findings

• recommend that she discontinue gymnastics due to risk of joint injury

• refer her to a geneticist for evaluation for a connective tissue disorder

• refer her to a physical therapist for generalized strengthening

ROUND 3 (Final Round)

DUCK WALK

YOUR TEAM MUST NEGOTIATE FOUR LAPS OF DUCK WALK
(one person can do all of them, split between two people, each do 1 lap, etc)

Multiple Choice

A 50-year-old woman is evaluated for a 6-month history of pain and swelling in the hands, knees, and feet. She reports 1 hour of joint stiffness in the morning.

On physical examination, vital signs are normal. The thumb and second and third fingers on the right hand are diffusely swollen, with tenderness and swelling at the metacarpophalangeal and proximal and distal interphalangeal joints. There are similar findings on the thumb and second finger on the left hand. Several of the affected proximal interphalangeal joints have a slight purple discoloration. There is a right knee effusion. The second and fourth toes on the right foot are diffusely swollen, as are the first and third toes on the left foot. Two small psoriatic plaques—one in the umbilicus and one on the scalp—are noted.

Laboratory evaluation reveals a negative rheumatoid factor result.

Which of the following is the most likely diagnosis?

• Osteoarthritis

• Psoriatic arthritis

• Seronegative rheumatoid arthritis

• Systemic lupus erythematosus

Multiple Choice

A 5-year-old boy is brought to the clinic for evaluation. He has had difficulty walking for the past 2 days. He has bilateral calf pain and prefers not to walk; when he does walk, he does so with a stiff-legged gait. Three days ago, the boy had a fever and cough, both of which have resolved. There is no history of trauma or initiation of a new physical activity. The boy’s physical examination findings are normal except for tenderness to palpation in both calves.

Of the following, the BEST next step in this boy’s evaluation is to order

• antinuclear antibody and double-stranded DNA testing

• antistreptolysin O testing

• a creatinine phosphokinase level

• a respiratory viral panel for influenza A/B