Show Notes
4.03 Large Vessel Vasculitis Rheumatology review for the USMLE Step 1 Exam Vasculitis is inflammation of blood vessels Vasculitis is split into three groups based on the size of blood vessels affected: large, medium, and small vessel vasculitis Large vessel vasculitis involves inflammation of the aorta and its main branches Two distinct large vessel vasculitidies: temporal (or giant cell) arteritis and takayasu arteritis Temporal (giant cell) arteritis primarily affects older women (>60) and the branches of the common carotid arteries Symptoms of temporal arteritis: jaw pain (jaw claudication), headaches, tenderness along temporal artery Complication of temporal arteritis: blindness Takayasu arteritis mostly affects young Asian women (Symptoms of takayasu arteritis: weak upper extremity pulse, constitutional symptoms, myalgias, skin nodules, ocular disturbances Both temporal arteritis and takayasu arteritis are treated with a course of steroids
More from Step 1 Basics (USMLE)
4.11 Antibody Review Rheumatology review for the USMLE Step 1 Exam. ANA Principles ANA (Anti-Nuclear Antibody): Non-specific antibody. Reacts against nuclear antigens, including proteins, DNA, RNA, and nucleic acid-protein complexes. Includes a group of antibodies such as anti-dsDNA, anti-histone, SSA/Ro, SSB/La, Scl-70, anti-aminoacyl-tRNA synthetase (Jo-1). Found in 20-30% of the general public without connective tissue disorder symptoms.
4.10 Gout and Pseudogout Rheumotology review for the USMLE Step 1 Exam. Gout Caused by uric acid crystal deposition due to purine metabolism. Triggers inflammation when crystals precipitate in cooler joint fluid. Presents with severe, red, and swollen monoarticular joints, often in the big toe. Diagnosis through synovial fluid analysis. Acute treatment: colchicine, NSAIDs, and glucocorticoids. Preventive treatment: allopurinol, febuxostat, probenecid, and lifestyle changes. Pseudogout Resulting from calcium pyrophosphate crystal deposition, often due to ATP breakdown. Manifests with painful, swollen joints, typically affecting multiple upper extremity joints, especially the knee. Diagnosis through synovial fluid analysis. Acute treatment resembles gout management. No direct preventive treatment to lower calcium pyrophosphate levels. Thanks for listening!
4.09 Rheumatologic Emergencies Rheumatology review for USMLE Step 1 Exam Giant Cell Arteritis (GCA) A large vessel vasculitis, mainly in older individuals. Symptoms: headache, jaw claudication, vision loss. Ischemia from granulomas in large vessels causes vision loss. Immediate high-dose corticosteroids are crucial. Scleroderma Renal Crisis A complication of scleroderma. Symptoms: finger edema, skin tightening, sudden hypertension, rising creatinine. Renal artery fibrosis leads to high blood pressure. Treat with IV ACE inhibitor, not steroids. Acute Transverse Myelitis in SLE Inflammation of the spinal cord in lupus. Symptoms: bilateral numbness, tingling, weakness. Treat with corticosteroids. Catastrophic Antiphospholipid Syndrome (CAPS) A rare, life-threatening form of APS. Symptoms: unexplained miscarriages, unexplained clots, multiorgan failure. Treat with anticoagulation followed by immune suppression
1.06 Systolic Heart Murmurs Cardiovascular system review for the USMLE STEP 1 Exam Heart murmurs are caused by turbulent blood flow in the heart
5.13 OCD and Related Disorders Psych review for the USMLE Step 1 Exam Obsessive Compulsive Disorder (OCD): Unwanted thoughts (obsessions) and repetitive behaviors (compulsions). Treat with CBT + SSRIs/SNRIs. Tic Disorders: Tourette Syndrome involves multiple motor and at least one vocal tic. Treat with Habit Reversal Therapy. Body Dysmorphic Disorder: Preoccupation with minor flaws, treat with SSRIs and CBT. Trichotillomania: Hair pulling disorder, treat with Habit Reversal Training and sometimes SSRIs. PANDAS: Pediatric disorder after strep infection, sudden OCD-like symptoms. Treat with antibiotics, CBT, and SSRIs.