We discuss the general differential diagnosis & framework of workup for large-vessel, medium-vessel & small-vessel vasculitides, general treatment guidelines and prognostication for vasculitides; Then we focus (in this episode) on large-vessel vasculitides (Giant-cell & Takayasu arthritis)
Differential diagnosis and workup of primary versus 2ndary amyloidosis ( including indication for abdominal fat pad versus single-organ biopsy, required workup for plasma-cell dyscrasia in Biopsy-confirmed amyloidosis, Required organ-function tests in Amyloidosis ) as well as management for primary (AL) versus 2ndary (AA) amyloidosis.
In this episode we first finish the discussion of the remaining subtypes of SNSAPs (namely Reactive ARthritis & Entropathic arthropathies / IBD-related Arthropathies) while discussing the important differential diagnosis for each category. We finish with a high-yield subject of approach framework and step-up management options by comparing and contrasting proper treatment recommendations for each stage of management based on the most recent guidelines.
High-yield question-based review of clinical points regarding subjective, objective, assessment and plan (SOAP) approach to seronegatives; We first discuss the general points relevant to this category of inflammatory arthritides then we initiate an in-depth discussion of each individual disorder while remaining as brief as possible but not missing the high-yield points. This episode covers Ankylosing spondylitis and Psoriatic Arthritis.
General approach to preoperative functional assessment using American Society of Anesthesiology Functional & Preoperative Status guidelines , Metabolic Equivalent, Cardiac Risk Assessment of MACE based on risk of patient versus the risks of surgical procedures, Utilizing Revised Cardiac Risk Index in the approach.
We discuss surgical site infection (SSI), Wound disruption and dehiscence, Superficial & deep Fascial Disruption, as well as wound evisceration and ventral hernia.
Differential Diagnosis & Management Approach of common childhood seizures including some genetic & hereditary subtypes , like benign rollandic, juvenile myoclonic and childhood absence seizure; we finish with a DDxing of childhood hemiplegia. Please make sure you have reviewed our episode on febrile seizure before this one.
While the initial step in managing sleep disorders involves ruling out 2ndary causes, in most cases (including the primary sleep disorders) the first intervention includes sleep hygiene and behavioral modifications; it is crucial to know when CBT-Insomnia is the recommended initial intervention and when pharmacotherapy is indicated and what type of medications are used for each subtype of primary sleep disorders. We finish with discussing choice of pharmacotherapy in different sleep disorders wh...
Differential Diagnosis of 7 major DSM-V categories of sleep disorders including Insomnia, Parasomnias (REM-related & Non-REM type), Sleep related breathing disorders, Sleep related movement disorders, Central Hypersomnia (including Narcolepsy), and Circadian-Rhythm Disorders / Sleep-Wake Phase disorders. High-Yield hints are provided for differentiating these conditions after a framework of initial medical & organic categories are ruled out.
We discuss definition of febrile seizure with required criteria, followed by discussing simple versus complex types as well as their workup and management with an in-depth discussion of how to address family concerns; we then finish with the important differential diagnosis approach between febrile seizure and meningitis.
An overview of prenatal screening during pregnancy; we discuss first prenatal visit, overall algorithm of prenatal assessment, types of infectious and non-infectious labs as well as general versus risk-specific panels of prenatal screening as a high-yield framework of prenatal care and follow up.
Question-Based Review of Reproductive Embryology (only clinically relevant points)
High-yield differential diagnosis of heart sounds abnormalities including changes in the intensity and splitting of S1, S2 as well as etiologies of S3 & S4 gallops with strategies to identify them.
In-depth discussion of pathophysiologic mechanisms and examples of four major classes of hypersensitivity reactions; relevant for USMLE step 1 and USMLE step 2,3
Review of different classes of immunologic agents such as monoclonal antibodies, Interleukin receptor agonists & antagonists and other agents with their clinical indications and side effect profile; prerequisite to this episode is the review of foundational basic science of immunosuppressive agents
Following the format of conceptual / clinical understanding, Pathogenesis , Epidemiology & Risk Factors, followed by Clinical Findings, Diagnostic Workup and an important discussion of pharmacotherapy in gout and preventive measures.
High Yield discussion for vaccination guidelines among patients with primary immunodeficiencies;
We discuss the following disorders of adaptive immune system resulting in primary immunodeficiency: B-cell disorders: Agammaglobulinemia (including Bruton's), Selective IG deficiency (including selective IgA deficiency), Common Variable Immunodeficiency T-cell Disorders: DiGeroge, IL-12 receptor pathway disorders (Mendelian Susceptibility to Mycobacterial Infection), Chronic Mucocutaneous Candidiasis Combined B & T cell disorders: Severe combined immunodeficiency (SCID), Autosomal- Dominant ...
These (HLH & ALPS) are the major syndromes of innate and adaptive immune dysregulation respectively resulting in primary immunodeficiency. For the discussion of complement system dysregulation refer to episode on innate immune deficiencies of innate immune system. Also compare HLH with MAS (macrophage activation syndrome) discussed in pharmacotherapy of Juvenile Rheumatoid Arthritis
Very clinically-oriented episode on important clues on subjective & Objective assessment of a patient to help clinically identify different types of primary immunodeficinecies;
Basic science foundational knowledge required for understanding the pathogenesis of different primary immunodeficiency syndromes as well as closely-related mechanisms interrupted by immunosuppressive agents;
A question-based review of Paget's disease, Osteopetrosis and Avascular Necrosis relevant for USMLE step 1 & 2
Both subtypes (limited cutaneous including CREST syndrome and diffuse cutaneous) of systemic sclerosis are discussed with workup and management point followed by discussion of important complications (including scleroderma renal crisis)
Very High-Yield subject including differentials of SLE (A premium content podcast)
High-yield discussion of pharmacotherapy in rheumatoid arthritis; includes choice of the drug based on the stage of disease management (Non-DMARDs, conventional DMARDs, Biological DMARDs including TNF-inhibitors & non-TNF inhibitors); The understanding of the medication choice, their side effects and pretreatment or follow up assessment is essential for many other rheumatology chapters in internal medicine & pediatrics (including seronegative spondyloarhtropathies, vasculitis arthritis, ...
Comparing & Contrasting the Pathogenesis, Clinical features, Patterns of joint involvement, Diagnostic workup and Management options for rheumatoid arthritis versus osteoarthritis (AKA Degenerative Joint Disease); Next episode will provide a more in depth-discussion of rehumatoid arthritis management with focus on pharmacotherapy with DMARDs.
Lots of zebras that can be relevant for basic science and to some extend for clinical science assessment; the focus will be on molecular pathogenesis and diagnostic features of Achondroplasia, Osteogenesis Imperfecta, Dysostoses and Fibrous Dysplasia including the polyostotic variant McCune Albright; A high-yield discussion regarding differential diagnosis off Cafe-au-Lait macules is offered at the end. (Note: Some resources consider Klippel-Feil syndrome also as part of skeletal dysplasias, how...
A high-yield discussion of clinical assessment and management options for kyphosis, scoliosis, and causes of low back pain in children (including muscle strain, spondylolysis, Discitis and Herniated Disk)
We continue our rapid-fire question-based review of pediatric orthopedics with focusing on Brachial plexus injuries (Mainly Erb & Klumpke's palsy) with some high-yield review of over-all upper extremity innervation; We follow that with Nursemaid's elbow and Anterior shoulder dislocation; We then begin our discussion of spine disorders with cervical spine: Torticollis, Atlantoaxial instability, and Klippel-Feil syndrome; We follow the rest of spine disorders (including Kiphosis & scoliosi...
Bullet-point review questions on miscellaneous lower extremity disorders of childhood associated with pain
