Welcome. This is Divine. This is episode 513 of the Divine Intervention Podcast. In today's podcast,

we're going to be continuing the rapid review series for step two and step three. So let's get right to it.

So what if they give you a question about a 16-year-old male?

And you're told that a specimen from this 16-year-old male was being analyzed at autopsy

and that he had a history of recurring respiratory infections.

And we're told that he had low levels of some of his immunoglobulins.

But some of his immunoglobulins were also elevated.

And then we're told that a biopsy of the brain,

like thorough analysis of a brain specimen,

shows the absence of Percengi cells in the cerebellum.

If you see that combination, what should you be thinking about?

I really hope you're saying, oh, divine, this sounds a lot like ataxia telenjectasia.

It's just one of these weird things that they love to test on the USMLA exams.

And it's not just for step one.

It's also for step two and for step three.

But generally, you're going to see these are going to be kids,

that they're going to have a lot of infections.

And you're going to notice that as they grow in life,

they're going to start having ataxia.

Many times it's going to start in the middle of their bodies and then it's going to

proceed peripherally. That's something we want to keep at the back of your mind. And one thing to

also keep in mind with ataxia and telangiotasia is that many times in the Q stem, so they'll give

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