4.11 Antibody Review Rheumatology review for the USMLE Step 1 Exam. ANA Principles ANA (Anti-Nuclear Antibody): Non-specific antibody. Reacts against nuclear antigens, including proteins, DNA, RNA, and nucleic acid-protein complexes. Includes a group of antibodies such as anti-dsDNA, anti-histone, SSA/Ro, SSB/La, Scl-70, anti-aminoacyl-tRNA synthetase (Jo-1). Found in 20-30% of the general public without connective tissue disorder symptoms. ANA+ individuals may or may not have a...

4.10 Gout and Pseudogout Rheumotology review for the USMLE Step 1 Exam. Gout Caused by uric acid crystal deposition due to purine metabolism. Triggers inflammation when crystals precipitate in cooler joint fluid. Presents with severe, red, and swollen monoarticular joints, often in the big toe. Diagnosis through synovial fluid analysis. Acute treatment: colchicine, NSAIDs, and glucocorticoids. Preventive treatment: allopurinol, febuxostat, probenecid, and lifestyle changes. Pseudogout ...

4.09 Rheumatologic Emergencies Rheumatology review for USMLE Step 1 Exam Giant Cell Arteritis (GCA) A large vessel vasculitis, mainly in older individuals. Symptoms: headache, jaw claudication, vision loss. Ischemia from granulomas in large vessels causes vision loss. Immediate high-dose corticosteroids are crucial. Scleroderma Renal Crisis A complication of scleroderma. Symptoms: finger edema, skin tightening, sudden hypertension, rising creatinine. Renal artery fibrosis leads to high...

1.06 Systolic Heart Murmurs Cardiovascular system review for the USMLE STEP 1 Exam Heart murmurs are caused by turbulent blood flow in the heart There are 4 different types of systolic murmurs: ventricular septal defect (VSD), patent ductus arteriosus (PDA), aortic stenosis, and mitral or tricuspid regurgitation PDA produces a constant, machine-like murmur VSD produces a harsh holosystolic murmur Aortic stenosis produces a crescendo-decrescendo systolic ejection murmur ...

5.13 OCD and Related Disorders Psych review for the USMLE Step 1 Exam Obsessive Compulsive Disorder (OCD): Unwanted thoughts (obsessions) and repetitive behaviors (compulsions). Treat with CBT + SSRIs/SNRIs. Tic Disorders: Tourette Syndrome involves multiple motor and at least one vocal tic. Treat with Habit Reversal Therapy. Body Dysmorphic Disorder: Preoccupation with minor flaws, treat with SSRIs and CBT. Trichotillomania: Hair pulling disorder, treat with Habit Reversal Training and...

5.12 Anxiety Related Disorders Psychiatry review for the USMLE Step 1 Exam Anxiety is a normal response to threats or stressors in the environment Anxiety disorders occur when anxiety causes significant distress or impairment in functioning Generalized Anxiety Disorder (GAD) involves persistent and excessive worry about various aspects of daily life for at least 6 months, accompanied by physical symptoms Treatment for GAD typically involves a combination of cognitive-behavioral therapy...

5.11 Eating and Feeding Disorders Psychiatry Review for the USMLE Step 1 Exam Eating Disorders: Main disorders: bulimia nervosa, anorexia nervosa, and binge eating disorder. Bulimia and anorexia share anxiety and compensatory behaviors. Anorexia: low body weight, fear of gaining weight, treatment involves slow refeeding. Bulimia: normal weight, signs of forced vomiting, treated with CBT and SSRIs. Binge Eating Disorder: uncontrollable eating, negative emotions, SSRIs and CBT for...

5.10 Mood Disorders (Depression and Bipolar) Psychiatry Review for the USMLE Step 1 exam Mood disorders are persistent disruptions in emotion, categorized into bipolar disorders and depressive disorders. Bipolar disorders are characterized by manic or hypomanic episodes, while depressive disorders feature periods of depression. Major Depressive Disorder (MDD) is characterized by feelings of sadness, guilt, worthlessness, and anhedonia lasting for at least two weeks. SIG E CAPS is an...

5.09 Schizophrenia Psychiatry review for the USMLE Step 1 Exam Epidemiology: Slight male predilection (1.4:1 male to female ratio). Men present between 18-25, women between 28-35. Affects about 0.5% of the population. Symptoms: Positive symptoms: hallucinations, delusions, disorganized behavior and speech. Negative symptoms: flat affect, anhedonia, apathy, alogia, lack of interest in socialization. Cognitive symptoms: impairments in attention, executive function, working memory. ...

5.08 Cluster C Personality Disorders Psychiatry review for the USMLE Step 1 Exam Introduction: Cluster C personality disorders = anxious/worried. Disorders: avoidant, obsessive-compulsive, dependent. Distinguish from normal traits. Avoidant Personality Disorder: Inhibited, introverted, anxious. Fear of rejection, low self-esteem. Characteristics: avoidance, preoccupation with criticism/rejection, social ineptness. Treatment: Anti-anxiety drugs may help temporarily. ...

5.07 Cluster B Personality Disorders Psychiatry review for USMLE Step 1 Exam Cluster B personality disorders are the highest yield among all personality disorders. The cluster B disorders include borderline personality disorder, histrionic personality disorder, narcissistic personality disorder, and antisocial personality disorder. Substance abuse and comorbid mood disorders, particularly major depressive disorder (MDD), are commonly associated with cluster B disorders. Personality...

5.06 Cluster A Personality Disorders Psychiatry review for the USMLE Step 1 Exam. The cluster A personality disorders include paranoid, schizoid, and schizotypal. These disorders are characterized by individuals who are perceived as weird, awkward, and quiet. Personality disorders differ from normal personality quirks based on their negative impact on daily life, lack of awareness of the problem, and deviation from cultural expectations. Paranoid Personality Disorder: Patients are...

5.05 Hallucinogens (Types, Intoxication, and Withdrawal) Psychiatry review for the USME STEP 1 Exam. Hallucinogens are a diverse class of drugs that cause hallucinations and other symptoms. Common hallucinogens discussed in the podcast are LSD, marijuana, PCP, and ketamine. LSD activates serotonin receptors, causing visual and auditory hallucinations, time and reality distortions, mood elevation, and dilation of the pupils. No notable withdrawal symptoms. Marijuana acts as a depressant,...

5.04 Depressants (Types, Intoxication, and Withdrawal) Psychiatry review for the USMLE Step 1 exam. Depressants decrease neuronal activity in the brain. They can work by stimulating GABAergic neurons or binding to opiate receptors. Common GABA-promoting depressants: alcohol, benzodiazepines, barbiturates, and inhalants. Opioid depressants include heroin and morphine derivatives. Alcohol enhances GABA receptor effects, inhibits glutamate activity, and causes intoxication symptoms such as...

5.03 Stimulants (Types, Intoxication, and Withdrawal) Psychiatry review for the USMLE Step 1 Exam. Stimulants increase CNS activity and activate the sympathetic nervous system. They can block reuptake of neurotransmitters or stimulate their release. Intoxication symptoms include agitation, dilated pupils, sweating, euphoria, hallucinations, and increased norepinephrine, epinephrine, dopamine, and serotonin levels. Prescribed stimulants: amphetamine, dextroamphetamine, and methylphenidate...

5.02 Classical and Operant Conditioning Psychiatry review for the USMLE Step 1 Exam Classical Conditioning: Pavlovian conditioning discovered by Ivan Pavlov, a Russian physiologist known for his experiments with dogs. Learning through association. Example: Conditioning dogs to respond to a noise the way they would respond to meat. Involves associating an unconditioned stimulus with a new conditioned stimulus to elicit the same response. Process of Classical Conditioning: Start with...

5.01 Ego Defenses Psychiatry review for the USMLE Step 1 Exam Defense mechanisms protect the unconscious part of our personality from anxiety caused by unacceptable thoughts or feelings. Ego defenses are categorized into three groups: mature, neurotic, and immature. Immature defense mechanisms include projection, regression, denial, acting out, and splitting. Projection involves attributing objectionable thoughts or emotions to others. Regression is behaving in an age-inappropriate way to...

4.08 Myasthenia Gravis and Lambert Eaton Syndrome MSK/Rheumatology review for the USMLE Step 1 Exam Introduction: Review of neuromuscular junction and its components: presynaptic part, postsynaptic part, synaptic cleft. Cascade of events leading to the release of acetylcholine into the synaptic cleft. Myasthenia Gravis: Autoimmune neuromuscular junction disease. Fluctuating muscle weakness, especially ocular and eyelid weakness, distal limb weakness. Antibodies target nicotinic...

This high yeild podcast covers schizophrenia type disorders for the USMLE Step 1 exam. I cover the following topics: Defining psychotic symptoms: hallucinations, delusions, and disorganized thoughts/speech Example of a delusional belief about a small being inside the body Schizophrenia spectrum disorders: schizophrenia, schizophreniform, and brief psychotic disorder Differentiating the disorders based on the duration of symptoms: brief (6 months) Progression from brief psychotic disorder...

4.07 Polymyositis and Dermatomyositis MSK/Rheum review for the USMLE Step 1 Exam Polymyositis and dermatomyositis are autoimmune inflammatory myopathies. They are caused by abnormal activation of T cells that attack skeletal muscle and both cause proximal muscle weakness, especially of the shoulders and pelvic girdle muscles. Polymyositis develops when there is abnormal activation of CD8 T cells, while dermatomyositis is primarily attacked by CD4 T cells. Both are diagnosed through a...

4.06 Osteoarthritis vs Rheumatoid Arthritis Rheumatology review for the USMLE Step 1 exam Rheumatoid arthritis and osteoarthritis both cause joint inflammation, joint pain, and can limit joint range of motion Osteoarthritis is a degenerative joint disease that occurs when the articular cartilage that covers the ends of bones begins to degrade and erode The most common joints affected by osteoarthritis are the hips and knees, and the distal interphalangeals of the hands are also commonly...

4.05 Scleroderma Rheumatology review for the USMLE Step 1 exam Scleroderma is a chronic autoimmune connective tissue disease that causes thickening and hardening of the skin, as well as fibrosis (excess deposition of collagen and other ECM proteins) throughout the body. Autoreactive immune cells activate endothelial cells, which produce large amounts of endothelin 1, leading to overactivation of fibroblasts that overexpress collagen. It typically affects younger women (35-50 years old)...

HIGH YIELD 2: Marfan's vs Homocystinuria vs Ehlers-Danlos High yield review for the USMLE Step 1 exam. Marfan's syndrome, Ehlers-danlos, and homocystinuria are three distinct diseases that affect connective tissue. They share similarities like tall stature, long fingers, scoliosis, high arched palate, chest wall deformities, joint hypermobility, and lens dislocation. Marfan's syndrome is caused by FBN1 gene mutation on chromosome 15, and it results in defective fibrillin-1. It causes...

4.04 Systemic Lupus Erythematosus Rheumatology review for the USMLE Step 1 Exam Marfan's syndrome, Ehlers-danlos, and homocystinuria are three distinct diseases that affect connective tissue. They share some clinical features like tall stature, long fingers, scoliosis, high arched pallet, chest wall deformities, joint hypermobility, and lens dislocation. Marfans is caused by a mutation in the FBN1 gene, resulting in defective fibrillin-1, and the main complication is aortic root dilation....