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USMLE Step 2 UWORLD NOTES with Over 2000 Correctly Elaborated Questions Latest Update 2023.
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USMLE Step 2 UWORLD NOTES with Over 2000 Correctly Elaborated Questions Latest Update 2023.
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USMLE Step 2 UWORLD NOTES with Over 2000 Correctly Elaborated Questions Latest Update 2023. Abrupta Placenta - 4 - Correct Answer Pt presents with vaginal bleeding, ABDOMINAL PAIN, and uterine tenderness.The absence of hemorrhage DOES NOT rule out this Dx. DDX: Placenta Previa,
absence of bleeding RULES OUT this dx
Risk factors are - Correct Answer 1-HT and preecclampsia, 2-Placental abruption
in previous pregnancy, 3-trauma, 4-short umbilical cord, 6-COCAINE abuse. AP is the mcc of DIC in pregnancy, which results from a release of activated thromboplastin from the decidual hematoma in to
maternal circulation
Risk factors - Correct Answer are smoking, Folate def. Once dx is made, large-bore IV , as well as Foley cathater is inserted. Pts with AP in LABOR rapid vaginal delivery, this will remove the inciting cause of DIC and hemorrhage.
Now if pt is stable tocolysis with MgSO4 is considered, Ritordin is CI in pt with HT
once we dx - Correct Answer next step is Vaginal delivery with augmentation of labor if necessary. Now if mother
and baby are not stable or if there is CI, then Emergency C-section is indicated. USMLE Step 2 UWORLD NOTES with Over 2000 Correctly Elaborated Questions Latest Update 2023. Now if there is Dystocia ( narrowing of the birth passage) then Forcepts can be used.
ABCD of Homeostasis - Correct Answer 1-Airway 2- breathing 3- circulation 1-AIRWAY: - Correct Answer An airway is needed for all unconscious pts, in the ER best method is Orotrachial intubation and in the field its needle cricothyroidectomy. For consciouns pt the best airway is chin lift with face mask. 2-BREATHING: - Correct Answer Cervical spine injury should be analyzed but the first step is to establish ABC. 3-CIRCULATION: - Correct Answer control of bleeding and restoring the BP . pressure on bleeding . pts with hypotension should receive rapid infusion of isotonic fluid like ringer lactate to prevent life threatening hypotension. adults do saphaneous vein cut down, children intraosseous membrane cannulation
Absence seizures - 3 - Correct Answer Ethosuximide is tx. USMLE Step 2 UWORLD NOTES with Over 2000 Correctly Elaborated Questions Latest Update 2023. Phenytoin and Carbamazapine are first line drug used for primary generalized tonic clonic sezure or partial seizures, both work by blocking Na channels voltage dependent, Phenytoin is a second line for myoclonic and tonic clonic seizure. Phenytoin SE - Correct Answer is gingivial hypertrophy, lymphadenopathy, hirsutism and rash, Both Phenytoina & Carbamazepine can cause Steven Johnson synd and Toxic Epidermal
Necrolysis
Absence siezures Tx - Correct Answer is Ethusuxamide or VALPROATE. Classic EEG is symetric
3mhtz spike and wave Acarbose SE - Correct Answer It blocks carbohydrate break down in the intestinal tract. The most significant SE is
GI disturbance due to increased undigested CHO in the stool
ACE inhibitor SE, Respira, 6/2 - Correct Answer CAPTOPRIL : Cough, Angioedema, Pregnancy, Taste change, hypOtention, Proteinuria,Rash, Increase renin, Lower AId and HyperKalemia. USMLE Step 2 UWORLD NOTES with Over 2000 Correctly Elaborated Questions Latest Update 2023. Cough is caused - Correct Answer by accumulation of Kinins possibly by activation of arachadonic acid pathway.
Kinins are degraded by ACE, when there is no ACE they increase. Angioedema - Correct Answer that is seen in ER. Pt presents with non-
inflamatory subcutaneous edema and
laryngeal edema due to bradykinin stimulation
Acetaminophen toxicity - 2 - Correct Answer Acute alcoholic intake can reduce the risk of hepatic injury by Acetaminophen
because it competes with CYP2E1, so there is less production of toxic metabolites
Chronic alcohol intake - Correct Answer increases risk of hepatic injury by stimulating P450 system
and decreasing the amount of Glutathione (used for metabolism of acetaminophen)
Management process - Correct Answer 1-4-hr post ingestion AA levels are determined to decide
whether the pt will benefit from NAC or not. 2-On the other hand if the pt has
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