Please keep them coming! I promise once I pass Step1 (coming soon) and get my next loan $$ disbursement to upgrade my patreon tier. You are definitely one of the most helpful resources out there! I have been following you for the past couple of years and your videos have been super helpful. I can't thank you enough.
Thank you so much for these videos (and all of them) I don´t think I can pay you enough for your magnific and dedicated work, but definitely you have my support!. I have couple of weeks following you, and definetely you are a huge helpful resource.
First of all, I cannot thank you enough for these videos...wondering if you would consider making a video on how to identify and differentiate the different types of conditions caused chronic gastritis vs acute gastritis. Thanks again!
I think you need to be careful with part 3. The pathophys of pregnancy loss in APS is not fully understood. It was originally thought that it was due to clots, but now it is thought that the mechanism in early pregnancy loss is different than late pregnancy loss. It is thought that early pregnancy loss is mediated by trophoblast dysfunction and apoptosis leading to poor placentation, while in late pregnancy loss is also 2/2 trophoblast dysfunction, but alongside inflammation mediated by APS antibodies and complement activation. So it’s not really as simple as saying it’s antibodies to platelets, and saying it is due to clot formation in the placenta or fetus is actually incorrect.
Although you’re right, the *most simple explanation* is usually the right answer on Board/Step exams. The NBME loves to crack on those who overthink about things like this. I only know because the NBME has cracked me into little tiny crumbs.
Firstly thanks for the question! Let’s say the first part had anticardiolipin ab as an option- Would we still pick FTA (coz you first want to confirm the presence or absence syph)?
RPR is a cheap screening test to detect syphilis ; BUT is a highly non specific test as it turns +ve due to the presence of heterophile anti - REAGIN antibodies in the sera of patients with syphilis ! Reagin is actually a phospholipid mixture predominantly made up of cardiolipin . Once RPR turns +ve ; the appropriate next step is to run a confirmation test with FTA either to confirm the diagnosis of syphilis or rule it out for antiphospholipid syndrome (APS) & lupus anticoagulant .
If coags had been listed as an option for part 1, would the right answer be coags or FTA-ABS? because I was looking for coags and got stressed when i didnt see it lol
That was really hard question thank you for choosing it easy question are boring, that's funny because I chose the right answer only at part 3, I got part 1 and 2 wrong 😂😂😂
In RPR test, they also have cardiolipin antigen in the test reagent, which reacts with anti-cardiolipin antibody and hence gives a false positive RPR in APS That's the only reason for false positive test and no other antibody in lupus or APS gives a false positive test.
Because 4 months ago she just had a depression screen for an aborted pregnancy, plus the history of previous spontaneous abortions makes pregnancy test not the best answer in the context of the question
Antiphospholipid anticoagulant : • in vitro prolongs PTT but... • actually in the body it is increasing clotting process and throwing clots which can lead to thromboembolic issues, recurrent pregnancy loss.
@@mickeysingh7443 With Warfarin, ⬆️ PT and slight ⬆️ in PTT can be seen. Warfarin affects factor 7, 2,9,10 , Protein C & S. Protein C & S affected first (can --> l/t warfarin necrosis... Hence, use heparin bridge) Factor 7 affected can --> l/t PT prolongation Factor 2,9,10 affected can l/t PTT prolongation. (I know I put in some extra points but all these are high yield and must knows). :) Happy studying.
Please keep them coming! I promise once I pass Step1 (coming soon) and get my next loan $$ disbursement to upgrade my patreon tier. You are definitely one of the most helpful resources out there! I have been following you for the past couple of years and your videos have been super helpful. I can't thank you enough.
Well just came out of the prometric center! I feel I'm the most stupidest person on earth lol. This video is important guys!
Thank you so much for these videos (and all of them) I don´t think I can pay you enough for your magnific and dedicated work, but definitely you have my support!. I have couple of weeks following you, and definetely you are a huge helpful resource.
First of all, I cannot thank you enough for these videos...wondering if you would consider making a video on how to identify and differentiate the different types of conditions caused chronic gastritis vs acute gastritis. Thanks again!
May God bless you
Gonna donate you a thousand bucks as soon as I get selected. Thanks a lot for the help buddy!
These are so good., with great tips even for med students, who are pretty practiced test takers.
Please continue this series. It's really good..
Just loved ur explanation to such important Q
Thanks DirtyUSMLE
If I got selected in December I ll donate u 1000 bucks ..u have my words
dont tease me. those med school loans are insurmountable :D
Did you get selected?
This is gold.
Many thanks for the pains taken to put such a jigsaw puzzle. Please continue to do so. Thank you so much 🙏🏻🙏🏻
Excellent video. Thanks for all your work and time.
Very well explained !!! 👍
I think you need to be careful with part 3. The pathophys of pregnancy loss in APS is not fully understood. It was originally thought that it was due to clots, but now it is thought that the mechanism in early pregnancy loss is different than late pregnancy loss. It is thought that early pregnancy loss is mediated by trophoblast dysfunction and apoptosis leading to poor placentation, while in late pregnancy loss is also 2/2 trophoblast dysfunction, but alongside inflammation mediated by APS antibodies and complement activation.
So it’s not really as simple as saying it’s antibodies to platelets, and saying it is due to clot formation in the placenta or fetus is actually incorrect.
Although you’re right, the *most simple explanation* is usually the right answer on Board/Step exams. The NBME loves to crack on those who overthink about things like this.
I only know because the NBME has cracked me into little tiny crumbs.
Will join your patreon this month
Thank you. I've upgraded my patreon subscription.
Wow...what an Awesome vignette
Firstly thanks for the question!
Let’s say the first part had anticardiolipin ab as an option- Would we still pick FTA (coz you first want to confirm the presence or absence syph)?
RPR is a cheap screening test to detect syphilis ; BUT is a highly non specific test as it turns +ve due to the presence of heterophile anti - REAGIN antibodies in the sera of patients with syphilis ! Reagin is actually a phospholipid mixture predominantly made up of cardiolipin .
Once RPR turns +ve ; the appropriate next step is to run a confirmation test with FTA either to confirm the diagnosis of syphilis or rule it out for antiphospholipid syndrome (APS) & lupus anticoagulant .
Thank you! Very informative.
Please make a video on heparin vs aspirin vs warfarin
this is top notch!
Awesome
Thank You!
Good work bb
Thank you so much!
How come you wouldnt do urine pregnancy test first? I thought you want to make sure patient is not pregnant before you do any further testing?
No history of amenorrhea given or pain abdomen or vomiting etc
Nice Discussion
If coags had been listed as an option for part 1, would the right answer be coags or FTA-ABS? because I was looking for coags and got stressed when i didnt see it lol
Love this one the most... Appreciate it!
Part 3 was the most crucial as it is not in FA.
Dirty Medicine > First Aid (in my opinion)
But answer is in the diagnosis. AntiPhosphilipids. Membranes made of phospholipids
Thanks! Very Helpful
That was really hard question thank you for choosing it easy question are boring, that's funny because I chose the right answer only at part 3, I got part 1 and 2 wrong 😂😂😂
Doesn't Lupus Anticoagulant cause false postive RPR?
❤❤❤
*3 questions for the price of 1?!?!* OH HOW YOU SPOIL US, DIRTY
In part 2 why not anti b2 glycoprotein? It is also associated with antiphospholipid syndrome
In RPR test, they also have cardiolipin antigen in the test reagent, which reacts with anti-cardiolipin antibody and hence gives a false positive RPR in APS
That's the only reason for false positive test and no other antibody in lupus or APS gives a false positive test.
because while it is associated with APS-Syndrome, it is NOT the cause of the false-positive. Anti-cardiolipin is
@@DirtyMedicine Nice thank you. Continue the good work!
Is it called Anti Phospoholipid syndrome or Anti Cardiolipin syndrome?
Based on part 1 I was kind of stuck on antiphospholipid
Thank u so much
Why would you not also do a pregnancy test? Pregnancy can cause a false positive RPR.
Because 4 months ago she just had a depression screen for an aborted pregnancy, plus the history of previous spontaneous abortions makes pregnancy test not the best answer in the context of the question
@@Mr_Anderson99 she can still be pregnant
Why PTT or PT is increasing problem is in platelets ?
Antiphospholipid anticoagulant :
• in vitro prolongs PTT but...
• actually in the body it is increasing clotting process and throwing clots which can lead to thromboembolic issues, recurrent pregnancy loss.
@@06Apeksha thanks
One more doubt ,why in warfarin only PT increases not PTT
@@06Apeksha thanks
One more doubt ,why in warfarin only PT increases not PTT
@@06Apeksha thanks
One more doubt ,why in warfarin only PT increases not PTT
@@mickeysingh7443 With Warfarin, ⬆️ PT and slight ⬆️ in PTT can be seen. Warfarin affects factor 7, 2,9,10 , Protein C & S.
Protein C & S affected first (can --> l/t warfarin necrosis... Hence, use heparin bridge)
Factor 7 affected can --> l/t PT prolongation
Factor 2,9,10 affected can l/t PTT prolongation.
(I know I put in some extra points but all these are high yield and must knows). :) Happy studying.
I love you
Thank you soo much