Science Jeopardy

USPSTF update Antidepressant What’s new FM ID PotPourri

Uptodate

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Final Jeopardy
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©Norman Herr, 2003

 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)

Answer Question
 A-200

• The recommendation level in USPSTF for

newborn universal bilirubin screening to
prevent chronic bilirubin encephalopathy
(kernicterus).

• Grade I (insufficient data).

Answer Question
 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.

Answer Question
 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

Answer Question
 A-500

• Recommended criteria to screen for type2

Diabetes Mellitus in adults.

• BP over 135/80 (Grade B)

under 135/80 (Grade I)

Answer Question
 B-100

• 3 common (specific) side effects of SSRI

• Nausea/vomiting, sexual dysfunction,

weight gain, insomnia/agitation, suicidal
ideation/behavior, bleeding etc

Answer Question
 B-200

• The response rate for antidepressants

(acute depression and maintenance phase).

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

Answer Question
 B-300

• SSRI with least weight gain

• Fluoxetine (Prozac)

Answer Question
 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

Answer Question
 B-500

• SSRI with least p450 interaction,

comparatively lower side effects, and
indication not only for depression but for
anxiety.

• Citalopram (Celexa)

Answer Question
 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

Answer Question
 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.

Answer Question
 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.

Answer Question
 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

Answer Question
 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

Answer Question
 D-100

• Sensitivity of rapid antigen test for

Pandemic H1N1 influenza

• 18-69%

Answer Question
 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

Answer Question
 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.

Answer Question
 D-400

• 4 strains, the novel H1N1 influenza

represents

• 2 swine strains, 1 human strain, 1 avian

strain.

Answer Question
 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

Answer Question
 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.

Answer Question
 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

Answer Question
 E-300

• PPI which can be used safely in

combination with Plavix for pt w ACS.

• Pantoprazole (Protonix)

Answer Question
 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)

Answer Question
 E-500

• Percentage of decreased smoker following

brief advice by primary care physician.

• 2.1% = NNT 48 (Cochrane Review 2005)

Answer Question
 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)

Answer Question