Divine Intervention Episode 434: USMLE Step 2/3 Rapid Review Series 90

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Divine-Favour Anene

Medicine, Education, Science & Medicine, Higher Education

4.9 • 929 Ratings

🗓️ 10 January 2023

⏱️ 24 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this HY episode, I discuss some classic vignettes while integrating the relevant physiology, pharmacology, and pathology. I also discuss ways to differentiate some closely related pathologies. Easy points on your test. Audio Download

Transcript

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0:00.0	Okay, welcome my name is Devine. This is episode 434 of the Devine Intervention
0:06.8	podcasts and in today's podcast I'm going to be continuing the rapid review
0:10.8	series for the USM E two second step three exams.
0:15.3	This is going to be series 90. This is going to be series 90 and first off I want to
0:21.1	welcome you to the new year. Thank you for supporting me last year and I really hope that you find this podcast to be even more helpful to your studies for all the USME exams and also for some of your residency board exams this year.
0:34.7	I have great plans for this year and I'm trusting God to help me make some really high quality
0:39.5	material this year.
0:41.0	So what if they give you a question about a 35 year old
0:44.4	so what if they give you a question about a 35 year old male? They tell you that he's
0:46.6	undergoing surgery and he's persistently
0:50.6	hypotensive during the surgery and they try to give this person
0:55.4	fluids they give the person phenyl effron and the person is not it remains
1:01.2	hypotensive and then they tell you that this patient has a history of some
1:07.8	autoimmune disease or they have a history of asthma. And then they ask for the mechanism behind the findings you observe. I really hope you're saying
1:17.1	oh divine this sounds a lot like adrenaline sufficiency. So I know you may be like Devine how do you mean adrenaline sufficiency? Well let me explain.
1:28.1	The thing is this person has a history of some other immune disease or asthma or whatever.
1:35.0	So this person is probably on corticosteroid therapy.
1:39.0	When you're on corticosteroids, that's going to cause atrophy of your HPA axis, your
1:47.8	hypothetical, adrenal axis. That cortisol will suppress all those things. When it does, the
1:57.2	unfortunate thing that's going to happen is that you will shut down CRH production, so corticotropin releasing hormone so that's going to be low.
2:06.2	You will also shut down a CTH production so that's going to be low as well.
2:18.0	And then, so these people should not have skin hyperpigmentation because the ECTH is low. And then you will also shut down the production of endogenous cortisol.
	...

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