1. BNP 
- Things that elevate: female sex, old age, renal failure
- Things that depress: obesity
- BNP < 100 = unlikely to have acute HF
2. Coronary artery calcification score: not indicated in routine testing, but helpful to risk-stratify people with intermediate 10-year risk of CAD (10-20% risk) into less vs more aggressive medical management.
3. Cryptogenic organizing pneumonia: 
- Symptoms suggestive of lower respiratory tract infection (dyspnea, cough, fever, chills, night sweats, weight loss)
- Acute to subacute course (weeks to months) vs IPF tends to be slower
- Alveolar opacities on CXR (vs interstitial reticulnodular pattern for IPF)
- CXR findings can migrate -- involving different lung fields on different exams.
4. Asbestosis
- Clinically like IPF
- PFTs with restrictive picture (and decreased DLCO) -- sarcoid looks similar
- History with exposure lasting at least 10-15 years
- CXR with calcified pleural plaques,
5. Lung disease and eosinophilia: 
- Acute eosinophilic pneumonitis: acute course (days to 3 weeks), fever, sputum, eosinophilia, peripherally distributed infiltrate
- Drug-induced lung toxicity: subacute course (months), hypersensitivity clinical picture (low grade fever, cough, fatigue). +/- eosinophilia
6. DVT prophylaxis and renal function
- Heparin: no adjustment
- Lovenox: Dose reduction and/or interval prolongation for GFR <30
- Fonda: contraindicated if GFR<30
7. Polymyalgia rheumatica
- Get symptom control with low dose steroids (10-20mg) and then taper downwards. If you get a flare, then increase steroids to the minimum amount needed to control symptoms again, and then taper more slowly. If you fail tapering multiple times, add a steroid sparing agent (methotrexate)
- Goal is symptom control with the lowest possible steroid dose
- Infliximab has not been shown to be effective in PMR
8. Colchicine in acute gout: If given in first 24 hours, can abort an attack. Administer at first sign of attack 2-3 times a day until the patient experiences symptomatic relief, develops GI toxicity, or hits the maximum dose (6mg/attack)
9. Maintenance therapy for gout
- Indicated in people with recurrent attacks (>2), tophi or kidney stones, and decreasing time between attacks
- Goal to lower serum uric acid <6, because at that point urate crystals are reabsorbed
- Stop drugs that cause uric acid retention like salicylates and thiazides
- Low dose colchicine or NSAID (like indomethacin) prevent attacks but don't lower uric acid
- Apply low dose steroids (10mg), colchicine, or NSAID 1 week before beginnng/changing uric acid lowering therapy to prevent triggering acute attack
10. Osteoarthritis
- Diagnosed with knee pain + 3 of the following: Age > 50, morning stiffness < 30 mins (>1 hr think RA), crepitus, bony enlargement, bony tenderness, no warmth
- Osteoarthritis in someone with CPPD = pseudoosteoarthritis. Treated the same way as OA (PT/OT, pain control, joint replacement)
- First NSAIDs, then joint steroid injections.
Hand x-ray findings in various kinds of arthritis: {source in BMJ-- excellent review of literature presenting evidence-based recommendations for diagnosis of hand OA}