All right, welcome to episode 614 of the Divine Intervention Podcasts.

In today's podcast, I'm going to be addressing the USMLA Step 2CK and Step 3 rapid review.

This is going to be series 126, series 126.

And this podcast, I'm really going to try to focus on some of the basic sciences that we're seeing a lot these days on step 2, Ski, and step 3. Let's begin. So what if they give you a question about a patient? They tell you that she's a 61-year-old female and that she has a history of, you know, Graves disease. And she was brought to the emergency room because she was found

unresponsive by her husband. And on presentation, her blood pressure was like 200 over 120. Our heart rate

was 300 beats per minute. And we're told that the patient was given an intravenous infusion of a

drug, and whichusion of a drug,

and which led to a rapid, you know, decrease in her blood pressure and in her heart rate.

And then they ask you, which of the following is the most likely mechanism behind resolution or control of the patient's symptoms?

I would really hope that you're picking the answer that talks about a peripheral inhibition of a 5 prime diiodynes, a 5 prime diodinase.

So what's going on with this question?

Well, this person came in with a thyroid storm, right?

This person came in with a thyroid storm.

And you may wonder, divine, how do you know this person came in with thyroid

storm well typically the way it's going to present on the exams is you're going to see a person with

some kind of thyroid history although sometimes they will not supply it but you'll be a person with

some kind of hyperthyroidism history and you notice that they have this really bad acute worsening of their symptoms,

where their heart rate just goes sky high. They may even have a fib, right? Because remember,

the most common arrhythmia in people that are hyperthyroid is atrial fibrillation. But their

heart rate will be extremely high. Their blood pressure will be extremely high. They'll be very unstable, right? And many times their TSAH will be like completely undetectable, right?

That's going to be thyroid storm. Or they may not give you that thyroid history, but it will

give you like these very crazy hemodynamics and the person will have an undetectable TSA.

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