Super helpful for the test. But this is why a lot of doctors suck. This is just straight regurgitation of facts. I wouldn't want my doctor to only know how a bunch of words fit together. Things in the real world dont work like this most of the time.

min 7:40 you mean respiratory alkalosis

new update for croup; all patients regardless of severity get steroids, and then add epi if in mod/severe distress

Herpes zoster vaccine can be given starting age 50yo! 2 doses

I thought if someone was hypovolemic, you always correct their fluid levels before you correct their sodium levels so we would give isotonic saline to someone who is hypotonic and hyponatremic first?

was burnt out, last 5 days only watched your videos on repeat. Got a very good score .Truly thank you for all these videos

taking step 2 tomorrow and you have made my favorite videos/resources to use for step 1, shelf exams, and now step 2. your videos are soooo good. best of luck with everything!

Thank you so much, you're literally so amazing!! Really appreciate everything you do!

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Updated USPSTF Guidelines (that were mentioned) as of August 2024: 1. Abdominal Aortic Aneurysm Screening: One time abdominal ultrasound in men 65-75 years of age who have ever smoked. 2. Lung Cancer Screening: Annual low-dose CT chest in adults aged 50-80 with at least 20 pack year history of smoking and are currently smoking or quit within the last 15 years. Keep screening annually till they have quit for at least 15 years. 3. Colon Cancer Screening: Q10year colonoscopy in adults aged 45 and older OR 10 years prior to diagnosis of 1st degree relative with colon cancer (whichever is earlier). Alternate screening options accepted by USPSTF - Q5year flexible sigmoidoscopy OR Q10year flexible sigmoidoscopy with Qannual FIT OR CT colonography Q5years OR Annual FIT or FOBT. 4. Cervical Cancer Screening: Q3year PAP smear (cytology only) in women aged 21-65. Q5year PAP + HPV co-testing in women aged 30-65. 5. Breast Cancer Screening: Q2year Mammogram in women aged 40 to 74. 6. Osteoporosis Screening: DEXA scan for all women aged 65 or above.

you're the best!

Great effort untiring

Is the new recommended treatment for Tourette’s VMAT inhibitors?

Amazing review, thank you!!

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

For lung cancer, its 20 pack history

Breast cancer screening starts at 40 years old, every year. - HPV vaccine is given between ages 9 and 26. - Herpes zoster vaccine is given at age 60. - Pneumococcal vaccine is given at age 65. - Meningococcal vaccine is given at college age. - Pap smear for HIV patients is done every year; for normal population, start at age 21, every three years, and stop at age 65. - Hypothyroidism, prolactinoma, and pregnancy can cause galactorrhea. - Hypothyroidism increases TSH, which stimulates prolactin, leading to increased breast milk and osteoporosis. - Pregnancy increases beta-HCG, which stimulates prolactin, leading to increased breast milk. - Prolactinoma suppresses GnRH, causing low estrogen and osteoporosis. - Hypothyroidism suppresses LH and FSH, leading to low estrogen and osteoporosis. - Female athlete triad includes low BMI, excessive exercise, and eating disorders, leading to osteoporosis. - Hypogonadotropic hypogonadism due to low BMI or excessive exercise can cause osteoporosis. - Stress fractures are associated with low BMI. - Prevent osteoporosis with weight-bearing exercises, calcium, and vitamin D. - Secondary amenorrhea should first be evaluated for pregnancy with urine beta-HCG, then check prolactin and TSH. - Most effective emergency contraception is a copper IUD. - Copper IUD risks include increased pelvic inflammatory disease and menorrhagia. - Post-op fever causes include wind (pneumonia), water (UTI), walking (DVT), wound (infection), and wonder drugs and (abscess). - Stress incontinence is caused by pelvic floor issues; diagnose with Q-tip test- URETHRAL HYPERMOBILITY. In SUI, INT URETHRAL SPHINCTER BELOW PELVIC FLOOR - Kegel exercises are the first-line treatment for stress incontinence; pessary is second-line.THIRD- MID URETHRAL SLING - Urge incontinence is caused by an overactive bladder; treat with bladder training exercises or oxybutynin - Overflow incontinence is often due to diabetic neuropathy or post-anesthesia; treat with intermittent catheterization. OR BETHANECHOL. OVER 100 ML POST VOID - Pelvic organ prolapse types include cystocele (bladder herniation), rectocele (rectum herniation), and enterocele (uterine prolapse). BULGING SMOOTH MASS - Rectocele causes constipation relieved by digital rectal exam; differentiate from uterine fibroids and endometriosis(NO CONSTIPATION BUT DYSCHEZIA). - Post-c-section complications include evisceration, wound dehiscence, and wound infection. - Evisceration treatment: cover with sterile sponge, go to OR. - Wound dehiscence treatment: abdominal binder, go to OR. - Wound infection treatment: open wound, clean, and administer antibiotics. - Pelvic inflammatory disease- RED TENDER CERVIX, UTERINE, ADNEXAL TENDERNESS,FEVER, WBC, DYSPAREUNIA- is commonly caused by chlamydia and gonorrhea; can lead to tubo-ovarian abscess(MASS) and Fitz-Hugh-Curtis syndrome. - Vaginal infections include trichomoniasis (green frothy discharge, strawberry cervix), GARDNERELLA- bacterial vaginosis (thin white discharge, clue cells), and candidiasis (thick cheesy discharge). - Trichomoniasis is sexually transmitted; treat both partners. ADENOMYOSIS- PAINFUL, TX- OCP, NSAID ENDOMETRIOSIS- DYSMENORRHEA, DYSCHEZIA, DYSPAREUNIA. ON DRE- ODD TISSUE. A/W INFERTILITY BCZ DISRUPTS CYCLE IF PAIN RELIEVED WITH URINATION AND UTI RULED OUT- INTERSTITIAL CYSTITIS GROSS PAINFUL- KIDNEY STONE GROSS PAINLESS HEMATURIA- BLADDER CANCER, RCC Leiomyomas (fibroids) present as non-tender, midline masses; treat with NSAIDs, progestins, or hysterectomy. - Threatened abortion involves closed cervix with bleeding; inevitable abortion involves an open cervix. - Incomplete abortion has retained products; complete abortion has expelled all products. - Missed abortion has no bleeding or cramping but a non-viable fetus. - Ectopic pregnancy diagnosis requires ultrasound if HCG > 1500; treat with methotrexate IF <3CM, , IF>3CM- SALPINGOSTOMY OR SALPINGECTOMY, surgery. IF HYPOTENSIVE- EMERGENCY- SALPINGECTOMY - Molar pregnancies may progress to choriocarcinoma;A/W HYPEREMSESIS, PREECLAMPS, track beta-HCG and use OCPs post-D&C. - Septic abortion may lead to retained products and infection; treat with antibiotics CLINDA AND GENTA, IV fluids, and possible repeat D&C Molar pregnancies (complete/incomplete mole) present with elevated beta-HCG; complete moles have 46 chromosomes, incomplete moles have 69. - After D&C for molar pregnancy, track beta-HCG and use OCPs to avoid masking cancer development. - Retained products from an incomplete abortion can lead to sepsis; treat with antibiotics and possibly repeat D&C. - Septic abortion can lead to necrotizing endometritis; treat with hysterectomy if necessary. - Listeria can cause chorioamnionitis with intact membranes; treat with ampicillin. - Chorioamnionitis from ruptured membranes requires immediate delivery. - Benign breast masses include fibroadenomas and fibrocystic changes; follow standard diagnostic algorithms. Fibroadenoma is a firm, mobile, non-tender nodule in young females. Fibrocystic changes involve fluctuating masses; usually painful. - In females under 30 with a breast mass, perform ultrasound; over 30, perform mammography; biopsy all masses. - Most common breast cancer is invasive ductal carcinoma. - Intraductal papillary carcinoma presents with bloody or copper-colored discharge. - Cysts with fluid are drained; bloody cysts are biopsied. - Inflammatory breast cancer shows erythema, skin dimpling (Peau d'orange).DUE TO LN OBSTRUCTION - Paget's disease of the breast presents as a scab or rash over the nipple.UNDERLYING CANCER - BRCA testing is for individuals with strong family history; start breast MRI at age 25. - Triple-negative breast cancer has a poor prognosis; lacks estrogen, progesterone, and HER2 receptors. - Asherman syndrome results from D&C; diagnosed with hysterosalpingogram.- AMENORRHEA - Necrotizing endometritis treatment includes hysterectomy. - Sheehan syndrome: hypotension, pituitary necrosis, hormone replacement - Sertoli-Leydig cell tumors(ABRUPT): virilism, sudden onset, androgens, VS PCOS(GRADUAL, NO VIRILISM ONLY HIRSUITISM) granulosa cell tumors, precocious puberty - Ovarian torsion: severe pain, nausea, ultrasound, Doppler, surgery OVARIAN MASS- TORSION- OR - Congenital adrenal hyperplasia: 21-hydroxylase, 11-hydroxylase, 17-hydroxylase deficiencies - Turner syndrome: 45,X, OR 46 XY(TAKE OUT STREAK OVARIES) webbed neck, streak ovaries- LOW estrogen, GIVE FSH, LH growth hormone - Müllerian agenesis(XX) vs. androgen insensitivity(XY- EXCESS TESTOSTERONE GETS CONVERTED TO ESTROGEN): Müllerian agenesis results in the absence of the uterus and upper vagina, while androgen insensitivity syndrome (46,X,Y) results in female external genitalia and internal testes. Both lack a uterus but differ in testosterone levels and secondary sexual characteristics. - Kallman syndrome: GnRH neurons, anosmia, hypogonadism, infertility - Endometrial cancer: PRECEDED BY hyperplasia, TVS, ultrasound,- biopsy IF <45 Y, obesity. TX- HYSTERECTOMY a pap smear that shows up with atypical squamous cells or atypical glandular cells so like glandular cells remember that the uterus has glandular cells Pap smear results showing atypical squamous or glandular cells(ENDOMTERIUM) require follow-up with colposcopy, HPV testing for ASC-US, endometrial sampling for glandular cells, with post-coital bleeding being suspicious for cervical cancer, and HPV (strains 6, 11 for warts; 16, 18 for CERVICAL cancer) and HIV as risk factors for cervical cancer. - Ovarian cancer: mass, weight loss, ascites, DX- ultrasound, NOOOOO biopsy BCZ SEEDING - Vulvar cancer: itching, ulceration, biopsy- SCC - Lichen sclerosus: white skin, itching, topical steroids- SCC - Atrophic vaginitis: dryness, topical estrogen - Hirsutism in pregnancy: luteinized theca cell cyst - Toxic shock syndrome: hypotension, Macular rash, tampon use, antibiotics - Magnesium sulphate toxicity: calcium gluconate - Down syndrome screening: beta-HCG, nuchal translucency, quad screen,confirm with chorionic villus sampling(10-12 week), amniocentesis(15 week) - Child abuse: spiral fractures, bruises, milestones, CPS, hospital admission before child protection - Elder abuse: caretaker, legal reporting - Medications: endometritis (clindamycin, gentamicin), chorioamnionitis (ampicillin, gentamicin), tubo-ovarian abscess (clindamycin, metronidazole), septic abortion (clindamycin, gentamicin), magnesium overdose (calcium gluconate), UTI (amoxicillin, cephalosporins, nitrofurantoin, TMP-SMX in non preggo), chlamydia (azithromycin), gonorrhea (ceftriaxone, azithromycin)

Risk Factors: The two greatest risk factors for stroke are age and hypertension. TIA is basically a stroke that lasts for less than 24 hours, and symptoms resolve within 24 hours. TIA is reversible because there is no actual infarction of the brain cells. A clot resolves, or there's collateral circulation that perfuses the brain enough to save it in time. A key sign for TIA on board exams is amaurosis fugax, which is transient curtain-like blindness from a cholesterol plaque embolizing to the ophthalmic artery. To work up a stroke, the first step is a head CT without contrast. You do a CT without contrast to rule out hemorrhage because contrast is white, and blood in the brain is also white. This helps avoid camouflaging blood with the contrast. The main treatment for an ischemic stroke is TPA, which dissolves the clot but increases the risk of bleeding. A head CT without contrast is done to determine if the stroke is hemorrhagic, which would contraindicate TPA. 85% of strokes are ischemic, and the other 15% are hemorrhagic. The most common place for a stroke is the MCA. TIA- SHOWN BY AMAUROSIS FUGAX NCCT- STROKE(R/O HMG- IF NOT HMG- GIVE TPA), KIDNEY STONE Remember the homunculus: middle parts of the brain along the sagittal suture control the lower extremities, and outer parts control the upper extremities. If there's ischemia in the outer parts of the brain, there will be upper limb paralysis and sensory loss. The left MCA also supplies the language areas of the brain, including Broca's and Wernicke's areas. Broca's area is in the left inferior frontal lobe. Wernicke's area is in the temporal lobe. Left MCA strokes can cause language deficits: Broca's aphasia (expressive aphasia) or Wernicke's aphasia (receptive aphasia). A classic left MCA stroke will present with language deficits and right arm weakness and sensory loss, hyerreflex. Hemorrhagic strokes are often caused by trauma, ruptured berry aneurysm, or arteriovenous malformation. Subarachnoid hemorrhage is associated with the worst headache of someone's life and symptoms of increased intracranial pressure (ICP) like papilledema, nausea, and projectile vomiting. Berry aneurysms -autosomal dominant polycystic kidney disease- surgical clipping. If a subarachnoid hemorrhage is unclear on CT, the next best step is a lumbar puncture, which will show red blood cells (xanthochromia). After diagnosing a stroke, you should work up the source with a carotid Doppler, echo, and EKG. Carotid stenosis can lead to thrombosis, and an echo can reveal wall motion abnormalities predisposing to thrombus formation. An EKG can reveal atrial fibrillation, which increases the risk of thrombus formation and stroke. For atrial fibrillation, the CHADS2 score is used to determine the need for anticoagulation. If chadvas 0 or 1= aspirin, if >=2- warfarin Lacunar strokes affect deep subcortical parts of the brain (basal ganglia, internal capsule, thalamus) and are often caused by hypertension.Lacunar strokes can cause pure motor strokes (internal capsule) or pure sensory strokes (thalamus- VPL). Pure motor strokes cause complete hemiparesis, indicating a lacunar stroke in the internal capsule. The left hemisphere controls language (aphasia), and the right parietal hemisphere controls spatial awareness (hemineglect) Increased ICP can be lowered with hyperventilation(METABOLITES GET WASHED OUT- ARTERIES VASOCONSTRICT- REDUCED ICP), mannitol, and elevating the head of the bed. For ischemic strokes within three hours, TPA is administered. Outside the three-hour window, aspirin is used. For symptomatic carotid stenosis with >70% occlusion, carotid endarterectomy is performed. For <70% occlusion, aspirin is the mainstay treatment. Hypertensive emergency first-line medications are nitroprusside, labetalol, and hydralazine. Essential tremor, also known as familial intention tremor, worsens with movement and improves with alcohol. Treat essential tremor with beta-blockers. Friedreich's ataxia features scoliosis, hypertrophic cardiomyopathy, and dorsal column problems. It's a trinucleotide repeat disorder (GAA). Dorsal column issues cause decreased pressure, proprioception, vibration, and touch. Hypertrophic cardiomyopathy (HOCM) in Friedreich's ataxia can cause sudden cardiac death in young athletes. Delirium is common in the elderly, often caused by infection or polypharmacy. Benzodiazepines and antimuscarinics can cause delirium.Delirium presents with fluctuating consciousness(SLEEPY AND AGITTAED) and worsens at night (sundowning). Treat AGITATED delirium with haloperidol. Multiple sclerosis is an autoimmune condition affecting the upper motor neurons and is characterized by symptoms spread out in space and time. MRI showing periventricular plaques and lumbar puncture showing oligoclonal bands. Treat- interferon and steroids for acute flares. TRIAD- CHARCOT- SCANNING SPEECH , INO, INTENTIONAL TREMOR, NYSTAGMUS= SIIN Guillain-Barré syndrome is an autoimmune condition affecting the peripheral nervous system, often following an infection. ascending paralysis - IVIG or plasmapheresis. Myasthenia gravis - FEMALE LIBRARIAN- PTOSIS, WEAKNESS SWALLOWING- worsens throughout the day. Diagnose myasthenia gravis with the edrophonium test and treat with pyridostigmine. Myasthenia gravis- associated with thymoma, so a CT of the thorax is recommended. Duchenne(5 YO) and Becker(18-20 Y) muscular dystrophy are X-linked recessive disorders causing muscle weakness, with Duchenne presenting earlier than Becker. Dystrophin is missing in these conditions. Tuberous sclerosis is characterized by Ashleaf spots, cardiac rhabdomyomas, epilepsy, angiomyolipomas of the kidneys, and facial fibromas. Sturge-Weber syndrome presents with port-wine stains on the face and intellectual disability. Von Hippel-Lindau disease is associated with renal cell carcinoma, pheochromocytoma, and cavernous hemangiomas of the brain. Arnold-Chiari malformation features myelomeningocele, syringomyelia, and tonsillar herniation. Syringomyelia causes loss of pain and temperature sensation in a cape-like distribution. Brown-Séquard syndrome is caused by a hemisection of the spinal cord, often from a stab wound. corticospinal, spinothalamic, and dorsal column is key in Brown-Séquard syndrome. Brown-Séquard Syndrome: Ipsilateral paralysis and loss of touch with contralateral loss of pain and temperature. Corticospinal Tract: Two-neuron pathway controlling motor function from the cortex to the anterior horn. Dorsal Column Tract: Three-neuron pathway for touch, pressure, and proprioception that decussates at the medulla. Spinothalamic Tract: Three-neuron pathway for pain and temperature that crosses at the spinal cord level. Polio: Affects lower motor neurons causing flaccid paralysis and fasciculations. MS: Causes upper motor neuron symptoms like hyperreflexia and spastic paralysis. GBS: Causes lower motor neuron symptoms like hyporeflexia and flaccid paralysis. ALS: Combines upper and lower motor neuron deficits. BPPV: Vertigo triggered by head movement, diagnosed with Dix-Hallpike test. TX- MECLIZINE Meniere's Disease: Characterized by tinnitus, vertigo, and hearing loss. Acute Labyrinthitis: Hearing loss and vertigo following a viral infection. Syncope: Temporary loss of consciousness due to various causes including vasovagal response(PRODROME, DIAPHORESIS, HEADACHE, EMOTIONAL STRESS, INC SNS TONE, F/B STRONG PSNS) and orthostatic hypotension(VOLUME DEPLETED, SUDDEN STAND→ FAINT), AS(SYNCOPE WITH EXERTION), SEIZURE, ARRHYTHMIA(OLD , JUST FAINTED) Seizures: Differentiate complex partial seizures (postictal confusion) from absence seizures (no postictal state) Lewy Body Dementia vs. Alzheimer's Disease: Lewy Body Dementia features hallucinations before memory loss, while Alzheimer's has memory loss before hallucinations. Trigeminal Neuralgia (Tic Douloureux): Severe facial pain triggered by light touch, treated with Carbamazepine. Tabes Dorsalis: Loss of proprioception and touch due to tertiary syphilis, treated with Penicillin. SACD: B12 deficiency causing macrocytic anemia and upper motor neuron signs, treated with B12 supplementation. DORSAL AND CORTICOSPIN PROBLEM

PPH: over 500 milliliters, vaginal delivery, over 1 liter, cesarean section, D/T uterine atony, hemorrhage, boggy uterus ABOVE umbilicus, TX- uterine massage, oxytocin. - Retained placenta: incomplete placenta, usg- uneven endometrial lining, tx- dilation and curettage (D&C). - Lacerations: forceps delivery, below the umbilicus, ultrasound, even endometrial lining, tx- pelvic exam, inspect, suturing. Latent- 0-6cm Active phase of labor: 6-10 centimeters, cervical dilation, arrest of active phase no cervical change over 4 hours with adequate contractions or 6h w/o adequate contractions, adequate contractions= >200 Montevideo units, sum of uterus pressure changes above baseline in 10 minutes If from 10 cm dilation till delivery- arrest of descent, cephalopelvic disproportion, tx=cesarean section. - Uterine rupture: sudden intense pain, baby's head higher station, diffi to palpate as baby might be in peritoneal cavity, immediate laparotomy. - Cord prolapse: umbilical cord thru cervix, tx= cesarean delivery. - Fetal tachycardia: heart rate over 160 beats per minute, d/t maternal fever- pyelonephritis, chorioamnionitis, endometritis. - Uterine tachysystole: more than five contractions, ten minutes, can lead to fetal bradycardia, tx- tocolytics, terbutaline. s/e- pulmo edema - Beta thalassemia: microcytic anemia, elevated hemoglobin A2 - Physiological changes in pregnancy: increased cardiac output, glomerular filtration rate (GFR), glucose excretion, glucosuria, respiratory alkalosis, tidal volume, decreased PCO2, physiological anemia - Shoulder dystocia: McRoberts maneuver, hyperflexion of hips, r/f- prior shoulder dystocia, macrosomia, gestational diabetes. delivery complications: Erb's palsy, clavicular fractures(reassure), fetal hypoxia, crepitus. - Fetal bradycardia: maternal hypotension, uterine tetany, cord compression→ reflex vc of spiral arteries, decreased fetal oxygenation. - Fetal heart rate accelerations(inc hr by 15 in 15 sec, 2 in 20 min): non-stress tests→ biophysical profile. If score<4- deliver - Endometritis: inflammation, cesarean sections, tender uterine fundus, fever, foul-smelling lochia, clindamycin, gentamicin. - Chorioamnionitis: asc infection, prolonged rupture of membranes, over 18 hours since water broke,tx- ampicillin, gentamicin. - Nuchal translucency: Down syndrome, trisomy 18, If > 2 or 2.5 sd- ntd alpha-fetoprotein (AFP)- neural tube defects, gastroschisis, omphalocele. Abnormal AFP levels: dating error, Down syndrome- nuchal fold translucency, echogenic bowel, duodenal atresia. Multiple gestations: preterm delivery, congenital malformations, preeclampsia, postpartum hemorrhage, clomiphene- estrogen receptor antagonist, stimulates hypothalamus, more GnRH, LH, FSH- ovulation. Kleihauer-Betke test: before giving Rhogam. Depending on % of fetal blood cells rhogam is given. If 50%-give certain dose of rhogam. if 10%- less rhogam Preeclampsia: hypertension, proteinuria(protein/crea> 0.3), preterm delivery, placental abruption, eclampsia, tx- pulmonary edema, diuretics, furosemide. Preeclampsia with severe features- 160/110 , end organ damage(high LFT, CREAT, AMS) - Herpes simplex virus (HSV): painful, acyclovir, cesarean section if active lesions, prodromal symptoms itch, new lesions. - Chancroid: *Haemophilus ducreyi*, painful genital ulcers, ragged edges, on necrtoic base, school of fish tx- ceftriaxone, azithromycin. - Chancre: syphilis, painless ulcer, smooth border, penicillin. - Placental abruption: third trim bleding, painful vaginal bleeding,inc contractions, r’f - trauma, previous abruption, hypertension, cocaine use, polyhydramnios, cigarette smoking. - Placenta previa: painless bleeding, placenta covering cervical os, r/f : previous cesarean sections. - Placenta accreta spectrum disorders: accreta, increta, percreta, abnormal placental attachment, Tx- cesarean delivery, look for hemorrhage prevention. - Pregnancy-related cutaneous conditions: itchy, intrahepatic cholestasis, pruritus, elevated liver enzymes, ursodeoxycholic acid, bile acids - Intrahepatic Cholestasis of Pregnancy (ICP): pruritus, elevated bile salts, elevated liver function tests (LFTs), tx- ursodeoxycholic acid (Urso), lowers serum bile acid. - PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy aka polymorphic eruption of preg): stretch marks, itchy, plaques, papules, eczema-like, tx- steroids. - Herpes Gestationis:like a bullous pemphigoid of pregnancy, IgG antibodies, hemidesmosomes, corticosteroids, vesicles. - Acute Fatty Liver of Pregnancy: emergency, nausea, vomiting, hypoglycemia, elevated liver enzymes,d/t mitochondrial dysfunction of breaking down fatty acid, deliver immediately. - Deep Vein Thrombosis (DVT): increased risk, IVC compression, hypercoagulable state, venous duplex, lead to pulmonary embolism (PE), dyspnea, tachycardia, tachypnea, low pulse ox, dx- VQ scan, tx- heparin, rivaroxaban - Amniotic Fluid Embolism: maternal bloodstream, confusion, rash, c-section, abruption, supportive treatment, can cause DIC - Preeclampsia/Eclampsia:deliver , magnesium to prevent seizures, sign of toxicity- hyporeflexia. Can cause dic(a.w abruption, afe, preeclapsia) - Premature Birth Interventions: magnesium (up to week 32), tocolytics (up to week 34), betamethasone (up to week 37 for lung maturity - Neonatal Infections: Group B Strep, E. coli, Listeria, a/w meningitis. - Preterm Premature Rupture of Membranes (PPROM): leakage, oligohydramnios, cord compression, recurrent variable decelerations , tx- reposition if cord compression, amnioinfusion. - Parvovirus: arthralgias, malaise, myalgias, fetal erythrocyte destruction, aplastic anemia- hf, pulmo edema, third spacing- hydrops fetalis, fetal anemia- sinusoidal heart rate pattern. - Lupus in Pregnancy: fetal complete heart block. - Cytomegalovirus (CMV): chorioretinitis, microcephaly, ventricular calcification, hand washing, avoid sharing utensils. - Toxoplasmosis: undercooked meat, cysts of cat feces, intracranial calcifications, chorioretinitis, hydrocephalus, tx- spiramycin, pyrimethamine, sulfadiazine. - Rubella: cataracts, deafness, cardiac anomalies- PDA, pulmonic stenosis. - Amniotic Fluid Volume: normal 5-25 cm, oligohydramnios, polyhydramnios. - Anemia in Fetus: middle cerebral artery Doppler, increased flow. -IUGR: size below 10 percentile: UA doppler- reverse flow- bad HIV VAGINAL IF VIRAL < 1000 COPIES IF MOM HAS HEP B- VACCINE AND IG IODINE UPTAKE HIGH- NEW THY PRODUCTION . IN POSTPARTUM- DEC I UPTAKE BCZ NO NEW PRODUTION, ONLY LEAKING OF PRE-FORMED - Asymptomatic Bacteriuria: UTI risk, pyelonephritis, urine culture,TX- amoxicillin, cephalosporins, nitrofurantoin. IN NON PREGGO- TMP SMX, FQ - GBS Prophylaxis: ampicillin 4H B4 DELIVERY, prior CHILD WITH GBS infection, positive culture, ASX OR SX UTI THIS PREGNANCY, GBS FOUND DURING SCREENING IN WEEKS 35-37, IF UNKNOWN STATUS WITH MATERNAL INFECTION OF PROM , PRETERM - Postpartum Thyroiditis: anti-thyroid peroxidase antibodies, hyperthyroidism, low iodine uptake, thyroid hormone leakage, hypothyroidism, recovery. - Postpartum Infections: endometritis, gentamicin, clindamycin. - Breastfeeding: LACK vitamins D & K, breast milk vs. formula- CASEIN HIGH IN FORMULA- HARD TO DIGEST antibodies, lysozymes, exclusive breastfeeding- six months. - Gestational Diabetes: 50-gram glucose load, 100g glucose tolerance test at 1,2 3 h, tx- diet→, insulin. - Fundal Height Discrepancy: ultrasound, fetal growth assessment.

If sounds like fibroadenoma, but bilateral and several masses => most likely fibrocystic changes

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

nice video sir

Most of the times he says “young girl”, I’m pretty sure he means “middle aged woman” 😂😂 Good content review though

Also antihistamine effect of low potency 1st gen antipsychotics causes increased appeptite

"might as well just burn it" sent me over the top lol much needed laugh. We appreciate the humor!🤣

38:58 Aplastic crisis vs Aplastic anaemia Aplastic crisis destruction of reticulocytes in pregnant mother leading to reduced RBC; fetal hypoxia leading to tachycardia (occurs specially in sickle cell mother by Parvovirus B19 infection) Aplastic anaemia reduced all 3 blood cell lines

FYI we don't do thyroid uptake in pregnant women - its teratogenic to the baby!

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

Confusion + disoriented -> oxygen supplement Low urine output -> bladder scan - Lots of urine in bladder -> neurogenic bladder -> foley catheter Hernia - Direct: old age, medial to hesselbach - Indirect: congenital, lateral to epigastric artery - Femoral (female): below inguinal ligament Paralytic ileus - no bowel sound, flatus, distension, hypokalemia Wound healing - Wound dehiscence: fascial tearing (obesity) -> bind wound -> lap - Evisceration: lap - Wound infection: erythema -> open, irrigate, antibiotics Dysphagia - Dif: obstruction, Zenker diverticulum, achalasia... - first-> barium swallow - weight loss -> endoscopy - IDA -> colonoscopy Mallory weiss / Boerhavve - Tear of mucosa at the lower eso sphincter -> endoscopy - transmural perforation -> leakage -> widened mediastinum -> water-soluble contrast (most common cause: endoscopy) H. pylori: gastric cancer (PUD) and MALT lymphoma Small bowel obstruction: hernia + adhesion 2nd to surgery - Symp: nausea, vomit, distension, no flatus, constipation - Diag: abs xray - distension, air-fluid level - NPO, NG sunction -> sur Pseudomembranous colitis - C.diff, fever, leukocytosis, watery diarrhea - Stool toxin -> oral vancomycin Ulcerative colitis - toxic megacolon, PSC Anal fissure - 6 o clock position - topic nitric, Ca blocker, sitz bath Acute mesenteric ischemia - worst pain, RF like hypertension, smoking - CTA Pyogenic liver abscess - 2nd to acute ascending cholangitis (charcot triad) - CT Echinococcus: dogs, hydatid cyst on imaging Cholecystitis - cholesterol or biliary stone in the cystic duct - biliary colic (stone stuck and off) until stone stuck -> inflammation - fever, leukocytosis, murphy sign - Ultrasound -> wall thickening, fluid, gallstone; if unclear -> HIDA scan - cholecystectomy Acalculous Cholecystitis - ICU patient - treat: cholecystectomy tube Choledocholithiasis - stone stuck in the common bile duct - biliary colic without fever - ALP increase, dilated duct on US - ERCP treatment - COMPLICATION -> cholangitis Pancreatitis - If diagnosis fulfilled (pain, amylase lipase) -> US to find gallstone - COMP: pancreatic pseudocyst -> leave alone unless > 6cm -> drainage Breast cancer RF: age Abdominal aortic aneurysm - if > 5cm or >1cm per year -> treat - screening in smoking people age > 65 Aortic dissection - Widened mediastinum, tearing pain - CTA or eso echo - If renal disease -> no contrast

How did I just learn more renal physiology in 15 minutes than I did in weeks worth of renal uworld problems 🙃 you're a lifesaver Dr. High Yield 🥰

new guideline; if nodule >1cm + malign risk or >2cm do FNA biopsi

You guys are real doctors... doing charity for fellow docs !! thanks .

Updated treatment for gonococcal conjunctivitis is IV or IM third-generation cephalosporin. Ointment erythromycin is for prevention and oral erythromycin is used to treat chlamydia.