Welcome. My name is Divine. This is episode 527 of the Divine Intervention Podcasts.

Into these podcasts, we're going to be continuing the rapid review series for the USMLE Step 2C and Step 3 exams.

It's going to be series 113. Let's jump right into it. So what if they give you a question about an African-American female, And they tell you that this lady has, over the last three months, stopped going to the beach,

because whenever she goes, she has this rush that breaks out on the skin, especially on her face.

And then you're giving some labs, and you notice that a ESR and CRP are markedly elevated.

And you notice that a hematocrit is decreased and Hawaii blood cell count is decreased.

What should you be thinking about?

I would hope you're saying, oh, divine, this is lupus.

I know someone may be like, wait, what?

Lupus?

Yeah, that's precisely what this person has.

And again, I think as I've said so many times on this podcast, the USMLs, the stock in trade

these days is same concepts, different descriptions.

That's the way to see if you're a memorizer or you're a person that really understands what's going on.

So let's ask ourselves, so why is this lupus?

Well, first it's a female, African-American female, and then you see this element of the sun bothering this person.

That's photosensitivity.

Again, our friends at the NBM is they're not going to always come out and say Miller Rush, Miller Rush, Miller Rush. Again, if they see Miller Rush, everyone will get a 270. Well, obviously, that does not happen. Right. So again, they are very big on descriptions, right. So, you know, they can just see photosensitivity or they can see the person has a rash that worsens with sun exposure.

You see all those things think about lupus.

And you may also wonder, divine, where did the low hematocrate and low white blood cell count come from?

Again, it's from an autoimmune cytopinia.

So the thing is, people that have lupus, they have this nasty habit of making auto-antibodies against their

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