by Sam Smith
USMLE Step 1 audio lessons designed to be listened to over and over again. Episodes cover material from many different areas including the cardiovascular system, pulmonary system, microbiology, and more! Listen when at the gym, commuting, cooking, or whenever you are on the go. Episodes are written, recorded, and mixed by Sam Smith.
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Publishing Since
11/18/2022
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November 15, 2023
<p>4.11 Antibody Review</p> <p>Rheumatology review for the USMLE Step 1 Exam.</p> <p><strong>ANA Principles</strong></p> <ul> <li>ANA (Anti-Nuclear Antibody): <ul> <li>Non-specific antibody.</li> <li>Reacts against nuclear antigens, including proteins, DNA, RNA, and nucleic acid-protein complexes.</li> <li>Includes a group of antibodies such as anti-dsDNA, anti-histone, SSA/Ro, SSB/La, Scl-70, anti-aminoacyl-tRNA synthetase (Jo-1).</li> <li>Found in 20-30% of the general public without connective tissue disorder symptoms.</li> </ul> </li> <li>ANA+ individuals may or may not have a rheumatologic disorder.</li> <li>Further workup is needed in ANA+ cases to determine the specific disorder.</li> </ul> <p><strong>Antibodies by Disease Process</strong></p> <ul> <li> <p><strong>Systemic Lupus Erythematosus (SLE)</strong></p> <ul> <li>Anti-dsDNA antibody.</li> <li>Anti-Smith antibody.</li> </ul> </li> <li> <p><strong>Drug-Induced Lupus</strong></p> <ul> <li>Anti-histone antibody.</li> </ul> </li> <li> <p><strong>Diffuse vs. Limited Scleroderma</strong></p> <ul> <li><strong>Diffuse</strong>: Anti-Scl-70 (anti-topoisomerase I).</li> <li><strong>Limited</strong>: Anti-centromere (often called CREST syndrome, with CREST standing for centromere).</li> </ul> </li> <li> <p><strong>Sjogren's Syndrome</strong></p> <ul> <li>Anti-SSA (Ro).</li> <li>Anti-SSB (La), which usually occurs in the presence of SSA.</li> <li>SSA is considered the Sjogren-specific antibody, leading to the presence of SSB.</li> </ul> </li> <li> <p><strong>Rheumatoid Arthritis (RA)</strong></p> <ul> <li>Anti-CCP (Cyclic Citrullinated Peptide).</li> <li>RF (Rheumatoid Factor) is non-specific.</li> </ul> </li> </ul> <p>Thanks for listening!</p>
November 8, 2023
<p>4.10 Gout and Pseudogout</p> <p>Rheumotology review for the USMLE Step 1 Exam.</p> <p><strong>Gout</strong></p> <ul> <li>Caused by uric acid crystal deposition due to purine metabolism.</li> <li>Triggers inflammation when crystals precipitate in cooler joint fluid.</li> <li>Presents with severe, red, and swollen monoarticular joints, often in the big toe.</li> <li>Diagnosis through synovial fluid analysis.</li> <li>Acute treatment: colchicine, NSAIDs, and glucocorticoids.</li> <li>Preventive treatment: allopurinol, febuxostat, probenecid, and lifestyle changes.</li> </ul> <p><strong>Pseudogout</strong></p> <ul> <li>Resulting from calcium pyrophosphate crystal deposition, often due to ATP breakdown.</li> <li>Manifests with painful, swollen joints, typically affecting multiple upper extremity joints, especially the knee.</li> <li>Diagnosis through synovial fluid analysis.</li> <li>Acute treatment resembles gout management.</li> <li>No direct preventive treatment to lower calcium pyrophosphate levels.</li> </ul> <p>Thanks for listening!</p>
November 1, 2023
<p>4.09 Rheumatologic Emergencies</p> <p>Rheumatology review for USMLE Step 1 Exam</p> <p><strong>Giant Cell Arteritis (GCA)</strong></p> <ul> <li>A large vessel vasculitis, mainly in older individuals.</li> <li>Symptoms: headache, jaw claudication, vision loss.</li> <li>Ischemia from granulomas in large vessels causes vision loss.</li> <li>Immediate high-dose corticosteroids are crucial.</li> </ul> <p><strong>Scleroderma Renal Crisis</strong></p> <ul> <li>A complication of scleroderma.</li> <li>Symptoms: finger edema, skin tightening, sudden hypertension, rising creatinine.</li> <li>Renal artery fibrosis leads to high blood pressure.</li> <li>Treat with IV ACE inhibitor, not steroids.</li> </ul> <p><strong>Acute Transverse Myelitis in SLE</strong></p> <ul> <li>Inflammation of the spinal cord in lupus.</li> <li>Symptoms: bilateral numbness, tingling, weakness.</li> <li>Treat with corticosteroids.</li> </ul> <p><strong>Catastrophic Antiphospholipid Syndrome (CAPS)</strong></p> <ul> <li>A rare, life-threatening form of APS.</li> <li>Symptoms: unexplained miscarriages, unexplained clots, multiorgan failure.</li> <li>Treat with anticoagulation followed by immune suppression</li> </ul>
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USMLE Step 1 audio lessons designed to be listened to over and over again. Episodes cover material from many different areas including the cardiovascular system, pulmonary system, microbiology, and more! Listen when at the gym, commuting, cooking, or whenever you are on the go.
Episodes are written, recorded, and mixed by Sam Smith.
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