UPDATE to lung screening guidelines 2021: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative. The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. 10 year or 40 whatever comes first. mammogram- 40 every 2 year Quick note (Unsure if this was mentioned elsewhere) for the pap smear screening, it is every 3 years with just isolated pap but every 5 years with pap + hpv which can be started at age 30. Also for the ASCUS workup, if the patient is between the ages of 21-24 with ASCUS, we don't work that up and just repeat the pap next year with the assumption that it will probably resolve on its own at that age.

56:15 IBS 1:04:50 chronic PPI 1:05:00 meningitis 1:05:35 small pox vs chickenpox, rashes 1:07:00 breast screening, cysts 1:08:25 diabetes, back pain 1:11:00 essential tremor, tourettes, huntingtons 1:11:40 Asthma 1:12:20 asthma vs copd 1:13:30 sleep apnea, osteoporosis, pain management, chronic venous insufficiency 1:14:43 ear diseases 1:15:32 umbilical hernia, colon cancer screening (villous is worst) 49:00 50:50 hip 12:45 kid 15:00 allergies, diarrhea 19:23 msk, hematuria 22:22 thyroid ctd, ob 26:09 hyperca, hypona, k 29:10 bronchitis, ear 30:55 MI 34:40 ckd, GI 36:45 lung, depression 39:00 ob 40:18 CHF 41:53 OCPs 42:30 HTN 43:44 intussusception. Colicky 46:35 44:20 mid gut volvulus. Constant. Double bubble or corkscrew. 45:20 jejunal atresia. Maternal cocaine. Triple bubble. Duodenal atresia. Double bubble, Down’s syndrome. 45:40 pneumomediastinum. Borhaave. No endoscopy. 46:53 dementia, weight loss, PCOS, migraine 48:40 statins

Minor error at 1:15:05 mark; the Dix-Hallpike Test is used for the diagnosis of BPPV, whilst the Epley Manoeuvre can be used for its treatment once BPPV is diagnosed. Awesome videos, thank you for posting!

Lung Cancer screening with low dose CT is now 50-80 with a 20 pk year who quit withing 15 yrs.

1:40 per 2021 - Colorectal screening at age 45 is a grade B recommendation: The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. See the "Practice Considerations" section and Table 1 for details about screening strategies.

updated Lung CA screen (as of March 2021) - 20 pack year (remember 2ppd for 10y is considered 20 pack-year) for 50-80 yo and that 15 year bit

Straight to the point, no bs, high yield. You're a lifesaver. Listened to this video in its entirety about 4 times now driving to and from rotations because I'm a slow learner.

Minor note on the first fact regarding AAA, the screening is only for men 65-75 (not women) who have ever smoked Thank you for doing these!! They're very helpful

Binge watching all your videos the day before my step2 exam, you are a life saver 👏🏼👍🏼👍🏼

Whos watching in 2021 right before their FM final? yes me

Thank you! Another thing to add if it hasnt been mentioned already: The new annual LDCT guidelines from the USPSTF now reccomend screening for ages 50-75 in pts with a 20 pack year history (or who have quit in the past 15 years). Ugh so many changes

I was doing pretty badly on my uworld fam med practice questions in anticipation of my shelf (rotation was 6 mos ago) but after watching this vid and reading USPSTF’s A & B guidelines I’m getting 80%s. Thank you so much!!

UPDATE to lung screening guidelines 2021: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

Age 50 years or older: 2-dose series RZV (Shingrix) 2-6 months apart (minimum interval: 4 weeks; repeat dose if administered too soon), regardless of previous herpes zoster or history of zoster vaccine live (ZVL, Zostavax) vaccination (administer RZV at least 2 months after ZVL)

New guidelines for HFrEF are to add on an SLGT-2 inhibitor in addition to the ACEi, MRA, and beta blocker

02:34 The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. Not at 40 years old

Colon Cancer screening now starts at 45yo. Thanks for the great vid!

This has been the best video…straight to the point no extra “talking” between straight educational facts! Thank you!

The reason herniated disc is more symptomatic in flexion is because the herniated disc herniates anteriorly into the spinal canal to cause compressive symptoms. The reason spinal stenosis is more symptomatic in extension is because the facets will close down more on spinal roots

Quick note (Unsure if this was mentioned elsewhere) for the pap smear screening, it is every 3 years with just isolated pap but every 5 years with pap + hpv which can be started at age 30. Also for the ASCUS workup, if the patient is between the ages of 21-24 with ASCUS, we don't work that up and just repeat the pap next year with the assumption that it will probably resolve on its own at that age.

Zoster recombinant (Shingrix) starts at age 50, not 60 I believe :)

This definitely got me a few points on my FM shelf!! Such a great review even 4 yrs later

Good differentiation between IV bisphosphonates (Zoledronate) and oral (Alendronate) is Barrett's esophagus and CKD....give IV in those cases

Love this guy’s vids. Very helpful. And he’s nice to look at so that helps haha 😉

Now SGLT-2 inhibitors also decrease mortality in HF!

Errata at 41:10, CHF is not diagnosed on echocardiogram, it is a clinical diagnosis based on Framingham criteria. HF with reduced vs preserved ejection fraction is diagnosed on echo.

you are a beast bro, thanks for compiling all this for us

I learned from UWorld actually that only symptomatic vaginosis (malodorous discharge or pelvic pain) is treated with metronidazole and asymptomatic is not treated.

who is watching 2020 ... gra8 video yaar

The most informative and helpful video to watch before Family Med EOR, thank you!!! - from a PA student.

Always watch the morning of my shelf! So helpful!

Bro, this is gold for shelf!

I'm always amazed how some guy with a webcam does more in 1 hour than my school has done in 2 years. US education system is busted top to bottom, y'all

=)) still a gold-standard reviews for Step 2ck 😊

I just wanted to say this video was extremely helpful for my FM shelf and I definitely got multiple questions right just off of watching this. Thank you!

Letrozole: First line for ovulation induction for PCOS with clomiphene as alternative. (Source: Amboss)

1:06:44 I thought you treat Measles --> SPPE with Vitamin A, not B6?

I've seen a lot of questions regarding acute otitis media (AOM) vs. otitis media with effusion. Note, AOM has a (+) fever and effusion DOES NOT have a fever.

Thank you for sharing this! I thought that the Dix Hallpike Test was used to *diagnose* BPPV, while the Epley Maneuver is used to *treat* BPPV.

watching this the night before my shelf and this is GOLD, thanks bro!

What are the USPSTF's new recommendations? In short, the task force now recommends women: Start breast cancer screening at age 40 instead of the previously recommended starting age of 50. Get screening mammograms every other year from ages 40 to 74.

No more prophylaxis for MAC when CD4+ is below 50. We now only treat with azithro if they get it.

Great lec! Small comment... you can't admit a child to inpt service to remove them from the abusers against their parents will. Only CPS or a judge can do it; therefore, contacting CPS immediately would be the right answer on the test 50:25

Little side note on the non-stress test, if it is reactive then it falls within the "15 in 15, 2 in 20" guidelines

These videos are incredibly helpful. Thank you so much for making these! You're awesome :)

Most cold thyroid nodules are not malignant but when compared to hot nodules cold are more likely to be malignant.

taking my family medicine shelf this friday! has anyone taken their shelf and can attest to how helpful/High Yield this is?! love the video and the content, just want to make sure i don't skim through it super quickly! thank you so much!

courvosiers sign can also be a cholangiocarcinoma along with pancreatic tumor. Great video!

It's 2019, Emma Holliday is so out, Doctor High Yield, MD is in

So helpful morning of my FM exam, thank you!

This is so so helpful, thank you for making this! You are amazing!! :)

At the very end, colonoscopy is every 5 (not 3) years if a polyp is found. If normal then 10 year intervals

God bless you man. I think I learn more hear than Uworld lol

Update: We don’t give MAC prophylaxis (Azithromycin) for CD4 count < 50 in HIV anymore. Simply treat if patient develops MAC with Azithro.

Excellent video, MAC prophylaxis is no longer recommended.

Recent update: HPV vaccine you can now give up to 45 years old.

Watching it at 2x speed the morning of my shelf 😅

Thank you for making this extremely helpful high-yield video!! FM ITE coming up soon. 2021

May I ask ,do u have any written notes for your lectures? I listen to it every nights when i am making my babies sleep,but at times I miss something. Hope to get a note to read together.

Watching this the morning of my FM shelf let’s go!

Thank you so much ! You're amazing :)

USPTF recommends mammogram screening for all women beginning at age 50.

just read the USPSTF a & B guidelines because they're constantly changing

i'm writing fam med tomorrow i'm glad i found this

You never discussed transient synovitis lol FOR AOM: STRAIGHT FROM UWORLD: Acute otitis media (AOM) is common in children age 6-18 months because their eustachian tubes are straight and drain poorly. Risk factors include day care attendance, cigarette smoke exposure, and recent upper respiratory infection. Breastfed children have lower rates of AOM due to a relative decrease in bacterial colonization of the nasopharynx. Common pathogens include Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis. Diagnosis is confirmed on otoscopy by visualization of a bulging tympanic membrane (TM) and/or the presence of middle ear effusion (indicated by poor TM mobility on insufflation) with TM inflammation (eg, erythema). Treatment with oral antibiotics is recommended in specific situations: First-line therapy with amoxicillin is indicated for infants age 39 C [102.2 F]), severe pain, or bilateral disease. Second-line therapy with amoxicillin-clavulanate is indicated for refractory symptoms after 2-3 days of antibiotic therapy or recurrent AOM (within 30 days) after antibiotic therapy. Therefore, this patient with high fever and recurrent, bilateral AOM after recent antibiotics warrants a course of oral amoxicillin-clavulanate. Ototopical antibiotic drops are used to treat otitis externa. Presentation includes ear pain and discharge with edema and inflammation of the external auditory canal. Otitis media with effusion (middle ear fluid without TM inflammation) can be observed for resolution. Unilateral AOM accompanied by low-grade fever and mild pain can also be treated supportively and observed in patients age >6 months. This patient has bilateral AOM with a high fever, warranting treatment. Thank you so much for the video

I don't know how his voice doesn't sound in 2x

Dr. HY dropping heat again.

This is awesome! Thank you for taking the time to make this!

WOW THIS IS BY FAR THE BEST VIDEO ON KZfaq CHANNEL! KEEP UP THE GOOD WORK. I WOULD BY YOUR BOOK BUT IM AN AUDITORY LEARNER, CAN YOU MAKE VIDEOS FOR SALE LIKE MP3. ILL BE HAPPY TO SUPPORT YOU.

I wish there was a review like this based on the Canadian system! :p I might use this as a base though - to see what topics to cover.

Such great videos...thankyou fellow human

i thought Dx of asthma was made through spirometry first, then if that's normal you move to methacholine challenge

Amazing video, Doc! 🙏

atypical pneumonias have Bilateral interstitial infiltrates whereas typical pneumonias have lobar consolidation on CXR

Excellent review!! You are amazing.

newest guidelines recommend Colonoscopy screenings starting at 45 years old

Its the asthma has different flavors for me!😅. Thanks for this review! God bless you!!

homeboy just spat facts for 1h 20 at 200 WPM. Bless up 💯

Ultrasound has higher sensitivity for intraductal non calcified lesions such as intraductal papilloma. Question stem will say unilateral nipple bleeding, mammogram was inconclusive what is next best step? Answer is US

This video would have been even better if you: - turned off your phone. The dinging is super distracting - made a simple PPT. Those who learn by hearing comprise the smallest percentage of learners. Good chunk of us are mixed learners, visuals help big time

Thank you so much for this awesome video!

Tip = When driving at 1.45X At rest 2X

You give shingles vaccine after 50 not 60 yo *

you're a beast man, thanks a bunch for the nice review!

Thank you for making this!

would you consider this a good review for Family Medicine for CK because Uworld doesn't have FM in detail? (for IMGs who don't have family medicine shelf)

Very helpful. Thanks for the review!

This is so solid, thanks for making it!

Thank you for saving me on my shelf

Very helpful videos! Thank you!

Why is this so EPIC?

This is super helpful!! Thank you so much!

Good one. Thank you for this!!

Nice video! hope it turns out useful. Covered some good topics. quick errata (52:25): 5HT syndrome presents with clonus and hyper-reflexia not rigidity

Absolutely awesome! Thank you

rash in parvovirus also starts after the fever goes away like HHV6

The pap section of this video is really outdated, would recommend a more updated reference for anyone watching in 2022

bravo , it was like a marathon.

2021: Mammograms are Biannual.

Fantastic job, thank-you so much!!