StudyXing Medicine @USMLEStepStudy
Study 7900 #MedEd "flash-XCreations"- Reminders of topics to do a deeper study-dive. Let's do this! - Zebra hoof-beats? Think Tyrannosaurus 🦖Thanks 51K! 🎉 Earth, WHO jurisdiction Joined November 2009-
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New T wave inversion in lateral leads, potential cardiac abnormalities: myocardial ischemia/infarction, left ventricular hypertrophy, bundle branch blocks, pericarditis, myocarditis, electrolyte abnormalities (hyperkalemia), drug effects, intracranial hemorrhage (see mnemonic)
Ablation Rx for atrial fibrillation - Catheter-based techniques to destroy heart tissue responsible for abnormal electrical signals: Mapping: detailed map of electrical activity & where abnormal signals originate Ablation: targeted energy to disrupt abnormal electrical pathway
Myxoid cyst (aka digital mucous cyst) = ganglion cyst of finger/toe DIPJ likely via small tears in a joint capsule or tendon sheath w/ extravasation of synovial fluid --> fluid gels --> capsulate; s/s: 3-10 mm mass, 2nd/3rd digits MC, solitary or 2-3 group; Benign, Rx: Excision
Myelodysplastic Syndrome - group of disorders caused by poorly formed or dysfunctional blood cells, often characterized by hypercellular marrow with ineffective hematopoiesis in all lineages (RBC, WBC & platelets)
Chronic kidney dz (CKD) = abnormal kidney structure/function >3 mos+; MC risk: DM (MCC), HTN; s/s: fatigue, dry/itchy skin, poor appetite, anemia, acidosis, proteinuria, hyperkalemia, hyperphosphatemia, hypocalcemia, ↓GFR, ↑creatinine; Rx: ACEI/ARB, ↓BP, ↓glucose, ↓weight
Dilated cardiomyopathy - Ventricle enlargement w/ systolic dysfunction & normal or thinned wall thickness; MCC: genetics, autoimmune (RA, sarcoid, scleroderma), infection (Chagas dz, HIV, mycobacteria), infiltrative dz (amyloid), nutritional (Kwashiorkor, low thiamine); Dx: Echo
Intracellular shifts of potassium (K+) can result in hypokalemia - MCC: Medication (insulin, theophylline, β-adrenergic agents like pseudoephedrine, ephedrine, alpha adrenergics), alkalosis, refeeding syndrome, leukemic crisis, familial hypokalemic periodic paralysis, TPP
End-stage renal disease (ESRD) = glomerular filtration rate (GFR) less than 15 mL/min/1.73 m² (milliliters of cleansed blood per min per body surface) --> Kidney function severely diminished, requiring renal replacement Rx (dialysis or transplantation) to sustain life
Cataracts = opacifications of eye lens; s/s: progressive loss of visual acuity, difficulty driving at night, lost red reflex; Risk: smoking, steroid usage, UV radiation exposure, DM, old age (75 y/o+ = 50% occurrence), Wilson disease; Rx: Prevention, Surgery (lens replacement)
Mononeuritis multiplex - asymmetric, peripheral neuropathy affecting 2+ nerves not explained by a single lesion; MCC: autoimmune vasculitides of vasa nervorum in patients with polyarteritis nodosa, Antineutrophil cytoplasmic antibody (ANCA) vasculitis & eosinophilic GPA (EGPA)
Malignant thyroid nodules on ultrasound: Micro-calcifications, solid consistency, > 2cm, hypoechoic, irregular margins, vascular
SGLT2 inhibitors are associated with an increase in hematocrit/hemoglobin after initiation… average increase 2.3% hematocrit and 0.6 g/dL hemoglobin
-White cell casts = renal tubule inflammation or infection, acute pyelonephritis (UTI ascension) -Hyaline casts = MC in NL urine; Benign, concentrated urine, pre-renal -RBC casts = glomerular dz, bleeding, nephritic -Granular casts = tubular damage -Fatty casts = nephrotic
Erdheim-Chester dz - rare excess production & accumulation of histiocytes (Lg phagocytic macrophages) w/in multiple tissues & organs; Sites: long bones, skin, tissues behind eyes, lungs, brain, pituitary gland & other tissues & organs; MCC: Myeloid progenitor cell malignancy
Gastroparesis - delayed gastric emptying in absence of mechanical obstruction; s/s: early satiety, nausea, vomiting, abdominal pain; MCC: DM, Idiopathic; Rx: dietary mod (no fatty, acidic, spicy, Prokinetics (metoclopramide, domperidone), glucose control
Amylin analogues (pramlintide) = adjunct DM Rx to mealtime insulin who have difficulty achieving postprandial glucose control or experience frequent episodes of hypoglycemia despite optimal insulin Rx; MOA: Slow gastric emptying (slowed absorption), inhibit liver glucose release
Endophthalmitis - intraocular vitreous humor infection, aqueous humor, or both; MCC: bacteria or fungi; s/s: severe vision loss (< 20/200) in 20+% of affected eyes; eye surgery, intravitreal injections, penetrating trauma, or keratitis, or it may be endogenous.
Catastrophic AntiPhospholipid Syndrome (CAPS) - antiphospholipid antibodies bind to cell surfaces (1st event), activate endothelial cells, monocytes & platelets --> inflammation, complement activation, thrombosis; MC "triggers": infection, cancer, surgery, lupus flare
Bacteria and Yeast Antibiograms released March 2024 based on 2023 data …akiajqrf22xmaqzsiz6q.s3.amazonaws.com/documents/Doct… Susceptibility of bacterial and yeast isolates to various antibiotics and natural substances
Dr Joshua Walinjom @walinjom
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2 Followers 106 Following@USMLEStepStudy Looks like CKD brings a whole menu of symptoms to the table! Agree that taking care of your health is key to keeping those kidneys happy and functioning smoothly. 🥳👩⚕️
@USMLEStepStudy Thank you for sharing your knowledge.
@USMLEStepStudy Ooh, Ooh, Ooh, to touch and feel very good velvet. Such heaven! x.com/buddymed_/stat…
Cranial nerves (picture from Wikipedia) Useful mnemonics: Ooh, Ooh, Ooh, to touch and feel very good velvet. Such heaven! O: olfactory nerve (CN I) O: optic nerve (CN II) O: oculomotor nerve (CN III) T: trochlear nerve (CN IV) T: trigeminal nerve(CN V) A: abducens nerve (CN…
@USMLEStepStudy Dear Sir , loop diuretic cause hypo or hypernatremia ?
@USMLEStepStudy Great example of metaplasia! in this case, the Vitamin A deficiency causes a cylindric to squamous metaplasia in the cornea. Metaplasia is described as a reversible change in which a cellular type is replaced by another capable of resisting an adverse environment.
@USMLEStepStudy A couple of interesting articles about the benefits and the adverse effects of GLP-1 agonists: x.com/buddymed_/stat… x.com/buddymed_/stat…
Interesting article from @JAMA_current on the adverse effects of GLP-1 based medications, check this out! #MedEd #MedTwitter
@USMLEStepStudy Diagnosis Algorithm for Syncope
@USMLEStepStudy Great overview 👍🏻 It’s an interesting condition, because the exact cause of alopecia areata is still unknown, but it may be influenced by genetic and environmental factors. Alopecia areata causes hair loss in patches on the scalp or other parts of the body. It is an autoimmune…
@USMLEStepStudy The bilirubin metabolism is a process that tells us how efficient our body is! x.com/buddymed_/stat…
Bilirubin metabolism: did you know it? Bilirubin (a product of hemoglobin breakdown) metabolism is a very good representation of our body’s efficiency. The process starts in the macrophages of the spleen, liver, and bone marrow, where heme is converted to biliverdin, then to…
@docxusofficial Fifth disease ( erythema infectiosum ) - PVB19 infection <image source: @USMLEStepStudy, tinyurl.com/4jx7bvcp>
Myocardial ischemia manifests in various patterns on the ECG.
@USMLEStepStudy Sjogren’s can present with hypokalemic paralysis or paresis due to dRTA.