High Yield Family Medicine Review for Step 2 CK & Shelf Exam
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- Опубликовано: 30 сен 2024
- Get the official study notes on Amazon: www.amazon.com...
ERRATA:
1:06:44 Measles tx = Vitamin A
1:15:05 mark; the Dix-Hallpike Test is used for the diagnosis of BPPV, whilst the Epley Maneuver can be used for its treatment once BPPV is diagnosed.
This is a high yield review for 3rd and 4th year medical students preparing for Step 2 CK or their Family Medicine shelf exams. If you know most of the things in this video, you should be ready. Hope this helps! Feel free to speed up to 2x lol.
Straight to the point, no bs, high yield. You're a lifesaver. Listened to this video in its entirety about 4 times now driving to and from rotations because I'm a slow learner.
UPDATE to lung screening guidelines 2021: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative.
The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. 10 year or 40 whatever comes first.
mammogram- 40 every 2 year
Quick note (Unsure if this was mentioned elsewhere) for the pap smear screening, it is every 3 years with just isolated pap but every 5 years with pap + hpv which can be started at age 30. Also for the ASCUS workup, if the patient is between the ages of 21-24 with ASCUS, we don't work that up and just repeat the pap next year with the assumption that it will probably resolve on its own at that age.
i'm writing fam med tomorrow i'm glad i found this
Update: We don’t give MAC prophylaxis (Azithromycin) for CD4 count < 50 in HIV anymore. Simply treat if patient develops MAC with Azithro.
colonoscopy screening starts at 45yo as of 2021
would you consider this a good review for Family Medicine for CK because Uworld doesn't have FM in detail?
(for IMGs who don't have family medicine shelf)
Yeah I think it could be a good use of your time of the big topics in FM. It's only 1:16 hours and on 2x that's ~38 minutes. FM includes pediatrics, obgyn, and outpatient internal medicine. So by studying the other specialties you will be studying FM too.
@@DoctorHighYieldMD quick maths
Whos watching in 2021 right before their FM final? yes me
Yes meee
@@Afro_Sensei good luck tupac senpai, you’ll ace it
LEEESSS GO
Mee in 2022.. ❤️
Carrying on the tradition in 2024
Lung Cancer screening with low dose CT is now 50-80 with a 20 pk year who quit withing 15 yrs.
56:15 IBS
1:04:50 chronic PPI
1:05:00 meningitis
1:05:35 small pox vs chickenpox, rashes
1:07:00 breast screening, cysts
1:08:25 diabetes, back pain
1:11:00 essential tremor, tourettes, huntingtons
1:11:40 Asthma
1:12:20 asthma vs copd
1:13:30 sleep apnea, osteoporosis, pain management, chronic venous insufficiency
1:14:43 ear diseases
1:15:32 umbilical hernia, colon cancer screening (villous is worst)
49:00
50:50 hip
12:45 kid
15:00 allergies, diarrhea
19:23 msk, hematuria
22:22 thyroid ctd, ob
26:09 hyperca, hypona, k
29:10 bronchitis, ear
30:55 MI
34:40 ckd, GI
36:45 lung, depression
39:00 ob
40:18 CHF
41:53 OCPs
42:30 HTN
43:44 intussusception. Colicky 46:35
44:20 mid gut volvulus. Constant. Double bubble or corkscrew.
45:20 jejunal atresia. Maternal cocaine. Triple bubble.
Duodenal atresia. Double bubble, Down’s syndrome.
45:40 pneumomediastinum. Borhaave. No endoscopy.
46:53 dementia, weight loss, PCOS, migraine
48:40 statins
You're the GOAT for this, thank you
1:06:44 I thought you treat Measles --> SPPE with Vitamin A, not B6?
Wow Great catch. To all listeners/watchers: it should be vitamin A ***
Errata-Vit A
was looking to see if this was addressed! thank you!
updated Lung CA screen (as of March 2021) - 20 pack year (remember 2ppd for 10y is considered 20 pack-year) for 50-80 yo and that 15 year bit
Thanks.
Minor error at 1:15:05 mark; the Dix-Hallpike Test is used for the diagnosis of BPPV, whilst the Epley Manoeuvre can be used for its treatment once BPPV is diagnosed. Awesome videos, thank you for posting!
Dxy=dx ,while Eppl is tx
CORRECT. THANKS FOR ADDING THAT
1:40 per 2021 - Colorectal screening at age 45 is a grade B recommendation:
The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years.
See the "Practice Considerations" section and Table 1 for details about screening strategies.
You are correct but the "A" recommendation is 50.
UPDATE to lung screening guidelines 2021: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.
Thank you! Another thing to add if it hasnt been mentioned already: The new annual LDCT guidelines from the USPSTF now reccomend screening for ages 50-75 in pts with a 20 pack year history (or who have quit in the past 15 years). Ugh so many changes
Zoster recombinant (Shingrix) starts at age 50, not 60 I believe :)
Thanks for the correction! If someone had natural infection, I would check titers first... I had natural infection at 3 years old and I'm 45 now- >165 means immune and I'm at 2,795. Natural immunity is always best.
@@divinecommerce3912 no, its reactivation of a latent virus. That means you are at risk if you ever had chickenpox.
@@divinecommerce3912 natural immunity is always best said no one with SSPE. Yikes. Are you a medical professional?
02:34 The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. Not at 40 years old
40-49 years is a grade B recommendation and 50-74 is grade A :)
@@Shelbsssss Actually 50-74 is grade B and 40-49 years is grade C
It’s 40 again y’all 😮💨
You give shingles vaccine after 50 not 60 yo *
Age 50 years or older: 2-dose series RZV (Shingrix) 2-6 months apart (minimum interval: 4 weeks; repeat dose if administered too soon), regardless of previous herpes zoster or history of zoster vaccine live (ZVL, Zostavax) vaccination (administer RZV at least 2 months after ZVL)
Now SGLT-2 inhibitors also decrease mortality in HF!
And GLP agonists?
who is watching 2020 ... gra8 video yaar
Binge watching all your videos the day before my step2 exam, you are a life saver 👏🏼👍🏼👍🏼
Letrozole: First line for ovulation induction for PCOS with clomiphene as alternative.
(Source: Amboss)
New guidelines for HFrEF are to add on an SLGT-2 inhibitor in addition to the ACEi, MRA, and beta blocker
You can also add a GLP Agonist
Yea just found out it in Uworld. Thanks for pointing out.
I learned from UWorld actually that only symptomatic vaginosis (malodorous discharge or pelvic pain) is treated with metronidazole and asymptomatic is not treated.
True but when they are pregnant they are always treated regardless of symptoms.
@@michigan1085 haha, aww thanks! I pray you do well on your shelf 🤗
Love this guy’s vids. Very helpful. And he’s nice to look at so that helps haha 😉
😊❤️
May I ask ,do u have any written notes for your lectures? I listen to it every nights when i am making my babies sleep,but at times I miss something. Hope to get a note to read together.
Minor note on the first fact regarding AAA, the screening is only for men 65-75 (not women) who have ever smoked
Thank you for doing these!! They're very helpful
I'm always amazed how some guy with a webcam does more in 1 hour than my school has done in 2 years. US education system is busted top to bottom, y'all
Owning my potential bias as a former public elementary school teacher who also has a Ph.D., the abomination I've experienced in the last two years only exists in the realm of medical education.
@@laneconner1078 I'm in the same boat, actually! Used to teach fifth grade math and now I'm a med student.
It's getting worse since COVID, too
I was doing pretty badly on my uworld fam med practice questions in anticipation of my shelf (rotation was 6 mos ago) but after watching this vid and reading USPSTF’s A & B guidelines I’m getting 80%s. Thank you so much!!
🙌
omg im praying this happens for me lol
I don't know how his voice doesn't sound in 2x
Good differentiation between IV bisphosphonates (Zoledronate) and oral (Alendronate) is Barrett's esophagus and CKD....give IV in those cases
=)) still a gold-standard reviews for Step 2ck 😊
Thank you so much ! You're amazing :)
Bro, this is gold for shelf!
The pap section of this video is really outdated, would recommend a more updated reference for anyone watching in 2022
you are a beast bro, thanks for compiling all this for us
haha sick bro
No more prophylaxis for MAC when CD4+ is below 50. We now only treat with azithro if they get it.
Quick note (Unsure if this was mentioned elsewhere) for the pap smear screening, it is every 3 years with just isolated pap but every 5 years with pap + hpv which can be started at age 30. Also for the ASCUS workup, if the patient is between the ages of 21-24 with ASCUS, we don't work that up and just repeat the pap next year with the assumption that it will probably resolve on its own at that age.
It's 2019, Emma Holliday is so out, Doctor High Yield, MD is in
Jordan Torres They’re both great! I happened to not find an FM review by Emma Holiday.
Yea unfortunately no Emma Holliday for FM, OB or EM :/
God bless you man. I think I learn more hear than Uworld lol
here*
Here *
Recent update: HPV vaccine you can now give up to 45 years old.
Thank you for sharing this! I thought that the Dix Hallpike Test was used to *diagnose* BPPV, while the Epley Maneuver is used to *treat* BPPV.
Yes that's correct, Dix Hallpike = dx, Epley = Tx
I've seen a lot of questions regarding acute otitis media (AOM) vs. otitis media with effusion.
Note, AOM has a (+) fever and effusion DOES NOT have a fever.
Yes another key difference is the physical exam. With AOM you will see a bright red bulging angry looking tympanic membrane. In OME, the membrane looks pretty much normal, but there will be serous fluid behind the tympanic membrane with some fluid bubbles. No angry TM though.
@@DoctorHighYieldMD Excellent video my friend. Thank you so much.
Colon Cancer screening now starts at 45yo. Thanks for the great vid!
after 35, HPV + pap screening every 5 years
Dania Albaba that's an option too I just gave the simple most common screening option but yes
after 30
21-29 Pap q3yr
30-65 Pap q3yr OR Pap + HPV (cotesting) q5yr
Errata at 41:10, CHF is not diagnosed on echocardiogram, it is a clinical diagnosis based on Framingham criteria. HF with reduced vs preserved ejection fraction is diagnosed on echo.
Excellent video, MAC prophylaxis is no longer recommended.
Tip =
When driving at 1.45X
At rest 2X
i thought Dx of asthma was made through spirometry first, then if that's normal you move to methacholine challenge
This definitely got me a few points on my FM shelf!! Such a great review even 4 yrs later
What are the USPSTF's new recommendations? In short, the task force now recommends women: Start breast cancer screening at age 40 instead of the previously recommended starting age of 50. Get screening mammograms every other year from ages 40 to 74.
You never discussed transient synovitis lol
FOR AOM: STRAIGHT FROM UWORLD:
Acute otitis media (AOM) is common in children age 6-18 months because their eustachian tubes are straight and drain poorly. Risk factors include day care attendance, cigarette smoke exposure, and recent upper respiratory infection. Breastfed children have lower rates of AOM due to a relative decrease in bacterial colonization of the nasopharynx. Common pathogens include Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis.
Diagnosis is confirmed on otoscopy by visualization of a bulging tympanic membrane (TM) and/or the presence of middle ear effusion (indicated by poor TM mobility on insufflation) with TM inflammation (eg, erythema). Treatment with oral antibiotics is recommended in specific situations:
First-line therapy with amoxicillin is indicated for infants age 39 C [102.2 F]), severe pain, or bilateral disease.
Second-line therapy with amoxicillin-clavulanate is indicated for refractory symptoms after 2-3 days of antibiotic therapy or recurrent AOM (within 30 days) after antibiotic therapy.
Therefore, this patient with high fever and recurrent, bilateral AOM after recent antibiotics warrants a course of oral amoxicillin-clavulanate.
Ototopical antibiotic drops are used to treat otitis externa. Presentation includes ear pain and discharge with edema and inflammation of the external auditory canal.
Otitis media with effusion (middle ear fluid without TM inflammation) can be observed for resolution. Unilateral AOM accompanied by low-grade fever and mild pain can also be treated supportively and observed in patients age >6 months. This patient has bilateral AOM with a high fever, warranting treatment.
Thank you so much for the video
Most cold thyroid nodules are not malignant but when compared to hot nodules cold are more likely to be malignant.
USPTF recommends mammogram screening for all women beginning at age 50.
This is a very controversial topic. USPSTF and ACOG disagree on mammogram guidelines. ACOG says to do a mammogram every year starting at age 40. Whereas USPSTF says to start at age 50. However, USPSTF also says, "Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years". So use this with discretion. I usually went with ACOG guidelines for this one and I got the correct answer a lot of the time enough to stick with memorizing age 40. Maybe try the AAFP Q Bank questions and see if you get any mammography questions and insight to the correct way to approach it. I also think that you will most likely encounter questions that test on the USPSTF A rated guidelines only, but it is also safe to know the B ones just in case. Hope this helps.
@@DoctorHighYieldMD AAFP Q bank references USPSTF for mammogram screening and uses it for their correct answer choices.
@@DoctorHighYieldMD category B would be mammography at age 50 while mammography at age 40 is considered category C. New papers now are even questioning the worth of mammography, as populations who did mammography vs. those who did not have a statistically significant difference in mortality.
www.sciencedaily.com/releases/2018/09/180912133536.htm
2021: Mammograms are Biannual.
just read the USPSTF a & B guidelines because they're constantly changing
Great lec! Small comment... you can't admit a child to inpt service to remove them from the abusers against their parents will. Only CPS or a judge can do it; therefore, contacting CPS immediately would be the right answer on the test 50:25
They will not have you choose between removing from abusers vs contacting CPS. There are a few tricky questions, where the answer will be admit to inpatient instead of sending home as an indirect way to remove patient from abuser until proven otherwise.
Watching it at 2x speed the morning of my shelf 😅
Little side note on the non-stress test, if it is reactive then it falls within the "15 in 15, 2 in 20" guidelines
Always watch the morning of my shelf! So helpful!
Ultrasound has higher sensitivity for intraductal non calcified lesions such as intraductal papilloma. Question stem will say unilateral nipple bleeding, mammogram was inconclusive what is next best step? Answer is US
WOW THIS IS BY FAR THE BEST VIDEO ON RUclips CHANNEL! KEEP UP THE GOOD WORK. I WOULD BY YOUR BOOK BUT IM AN AUDITORY LEARNER, CAN YOU MAKE VIDEOS FOR SALE LIKE MP3. ILL BE HAPPY TO SUPPORT YOU.
So helpful morning of my FM exam, thank you!
At the very end, colonoscopy is every 5 (not 3) years if a polyp is found. If normal then 10 year intervals
The reason herniated disc is more symptomatic in flexion is because the herniated disc herniates anteriorly into the spinal canal to cause compressive symptoms. The reason spinal stenosis is more symptomatic in extension is because the facets will close down more on spinal roots
Just a little correction, I think you mean the disc herniates posteriorly rather than anteriorly
Miller Joseph Moore Mary Garcia Timothy
taking my family medicine shelf this friday! has anyone taken their shelf and can attest to how helpful/High Yield this is?! love the video and the content, just want to make sure i don't skim through it super quickly! thank you so much!
Taking it this Friday! How helpful did you find it?
@@nnerdistan Hi@ Just wondering how helpful you guys found this video?
@@nnerdistan how helpful was it >? I am taking mine this friday lol
Just another monthly reminder of how helpful y’all found this video haha
38:20 SIGECAPS MDD needs *4* or more for 2 weeks
Awesome review. Thank you. BTW you have very kissable lips.
You are awesome...thank you brother
Such great videos...thankyou fellow human
Dr. HY dropping heat again.
also we use nimodipine not nifedipine in subarachnoid hemorrhage right
That's what sketchy says haha
This has been the best video…straight to the point no extra “talking” between straight educational facts! Thank you!
courvosiers sign can also be a cholangiocarcinoma along with pancreatic tumor. Great video!
This is so so helpful, thank you for making this! You are amazing!! :)
I wish there was a review like this based on the Canadian system! :p I might use this as a base though - to see what topics to cover.
nice video sir
Thank you for making this extremely helpful high-yield video!! FM ITE coming up soon. 2021
I'm also here door FM ITE😂
atypical pneumonias have Bilateral interstitial infiltrates whereas typical pneumonias have lobar consolidation on CXR
Also, thiazides are first line for HTN in general. Give thiazides to all, as well as to African Americans first line. Change to ACEi for AA if they have any renal disease. There is more benefit to AA patients if they are on Acei in this situation
@@MS-eg2we Where is the evidence based medicine? African Americans or as you referred “ AA”
These videos are incredibly helpful. Thank you so much for making these! You're awesome :)
Only men get AAA screenings if they’ve ever smoked (age 65-75), per USPSTF
Ovarian and endometrial cancer have same r/f because of proximity or? Opposite to breast cancer?
Regarding, OCP &ESTROGEN EXPOSURE INCREASES BREAST CANCER?
EARLY MENARCH AND LATE MENOPAUSE AND NULL PARITY BREAST CANCER TOO?
Dr Anxiety inducer before exam. just kidding. Amazing stuff!
The most informative and helpful video to watch before Family Med EOR, thank you!!! - from a PA student.
So Listeria , Groul b steep and H.flu vs E.coli ? In children meningitis? I thouugt similar ro pneum.
In adult : S.pneumo,h.flu,n.gonorhea
For lung cancer, its 20 pack history
Its the asthma has different flavors for me!😅. Thanks for this review! God bless you!!
Things move so quickly! Most of these screenings are already outdated
:(
Is it a hysterectomy after lsis and hlis are shown cancerous after colpo? Is it not a LEEP or conization?
newest guidelines recommend Colonoscopy screenings starting at 45 years old
hey guys. uworld says you dont need to treat asymptomatic BV in pregnancy! coudl someone confirm
Cu Iud? Why mennorrhagia..is it like anticoagulant?
Good one. Thank you for this!!
Amazing video, Doc! 🙏
Nifedipine or nimodipine? I was reading somewhere that nifedipine is contra. Can someone help?
Thank you so much for this awesome video!
Watching this the morning of my FM shelf let’s go!
Is a renal review coming soon?
Hey Doctor Helene yes !