DIP Episode 97 - The “Most Important” Podcast (USMLEs)

Okay, welcome. My name is Devine. I am a PGY-1 transitional year resident. That's ultimately going to reology. And this is episode 97 of the Divine Intervention Podcast. I've gotten a lot of requests recently. It's really from people taking like step two and step three. About making a podcast that relates to like the most important like prognostic factors for disease or like the most important complications of certain diseases or like the most important like predictors of like survival in certain diseases. And just going off of like people that have tutored, because I mean as you guys know, I don't have a crap to not tutoring. And they're just certain like key, high, like prognostic or let's call them like most important things that I implicated in certain diseases that are very high for you to know an NVME exam. So I will try to highlight them as we go along as we go along in this podcast. So just think of this podcast as the most important podcast. But I will talk about like prognostic factors and all that stuff. And I think that should really help with preparing you for these exams. I would really say that this podcast should be super helpful to people taking step two, CK, step three, the internal medicine, training exam and also the medicine boards. And again, some prognostic factors are most important things that we mentioned here.

Me not necessarily be like the super most important in the real world, but I would posit that they have the probably the most important things that you need to know for NVME exams. Okay. Because again, the NVME obviously does not test every single detail in the world. Okay. So I'll try to make this as short as sweet as possible. Right. So first question is what's the most important prognostic factor in a patient that is diagnosed with a right now detachment? What's the most important prognostic factor? The most important product is actually the time to surgical intervention. So how long does it take for you to basically getting with your pharmacologist to get surgery? Now, what is the most important prognostic factor in a patient that has breast cancer? Has a diagnosis of breast cancer? It's actually the involvement of axillary lymph nodes, right. So like the presence of axillary lymphadenopathy. In fact, if you want to be a little more specific, it's like the number of involved axillary lymph nodes that determines prognosis in breast cancer. But if you don't see that as an answer choice, the second most important prognostic factor in a breast cancer is actually the size of the tumor. Okay. Very high you to know that for tests. Now, what is the most important predator of survival in patients that have early quartetion? What is the most important predator of survival? It's actually the age when you basically repair the defect. Not the age of diagnosis, the age of repair.

Okay. So how you to keep that in mind for for your exam? Now, what is the most important factor that predisposes to the rupture of a triple leg? It's actually the diameter of the aneurysm, right. So obviously, the wider the aneurysm is, the more prone the aneurysm is to rupture. So that's a high-youthening again. When you keep at the back of your mind for a moment, what is the most important risk factor for the development of a like a squamous cell carcinoma of the skin? It's actually like cumulative exposure to the sun. Okay. Now, what is the most important prognostic factor in a patient that has a diagnostic melanoma? It's actually the depth of envision of the vision, right. So like sometimes on exams, you may see this referred to as the breast load depth. Okay. Now, what is the most important prognostic factor for outcome in a patient that has like acute mesenteric ischemia? This one is kind of like logical. It's actually the presence of bowel in function, like either detected on imaging or whatever. Okay. And what is the most, I guess, this is like a nifty mbmi question. What is the most, how do I put this? What is the most important measure in the prevention of a hepatocellular carcinoma? So prevention of hepatocellular carcinoma. It's actually the presence of a heavy vaccination, right. Heavy vaccination is the most important preventive strategy in the prevent, basically like preventing the development of a hepatocellular carcinoma. Okay.

Now, what is the most important risk factor in the development of a variant cancer? It's actually family history. Okay. And what is the most important prognostic factor in cervical cancer? It's actually the stage at which you diagnose the cancer. Okay. So it's the stage that you make the diagnosis. If you're asking, if you're looking for like the second most important prognostic factor there, it's actually like the involvement of like I guess like the pelvic lymph nodes or like the pariotic nodes. Those are common nodes that cervical cancer loves to spread to. Now, what is the most important risk factor for the development of prostate cancer? This one shows up all the time on the exams. That's age, right. And I guess if since we're talking about the prostate, what is the most important risk factor for the development of bladder cancer? That's actually smoking, right. And then for a patient I guess that has been diagnosed with a colon cancer. What is the most important prognostic factor in determining an outcome of treatment? That's actually the stage at diagnosis. Okay. And this is kind of an inocuous question, I'm in short for an exam. But what is the most important test that is needed in the diagnosis of like infectious endocraditis? It's actually a blood culture. Okay. And what is the, come on, divine think. What is the most, let's see, what is the most important complication of peritoneal dialysis, especially on MDM's? It's actually the development of a peritonitis.

Okay. Now, what's the most important goal in the management of COPD? Smoking cessation. Very good. Okay. Now, what is the most important risk factor for the development of obstructive sleep apnea? That is actually obesity. Okay. Now, what is the most important like disease associated with central sleep apnea? That is actually heart failure. That's a classic USM listed three exam question. Now, what is the most important, I guess, let me call it non-pharmacologic intervention in the management of osteoarthritis? That's actually exercise. Okay. Let's see. What is the most, I guess, important modifiable risk factor in the development of osteoarthritis? That's actually obesity. Okay. What are the two most important risk factors? Come on, divine think. Two most important risk factors for the development of like c-difcolitis. That's actually the use of antibiotics, and then another high-level that shows up on tests is hospitalization. Now, what is the most important, I guess, opportunistic pathogen that causes infection after obtaining a transplant? That's actually CMV, especially like after the first month of the transplant. That's CMV, cytomegalovirus. That's why many transplant patients get like prophylactica, like a gypsy clover, like vulgantyclover. Okay. Now, what is the most important risk factor for the development of a colandio carcinoma? That's actually the presence of a primary sclerosinacolangitis. Believe it or not. Okay.

Now, what are the two most important risk factors in the development of hepatocellular carcinoma? One will be cirrhosis. Another one is also the presence of like a bee infection. Okay. Now, what is the most important risk factor for the development of, I guess, like long disease relief to asbestos? Wasbestos, or am Nigerian, I can pronounce things however I want, doesn't matter. That's actually like the cumulative exposure to asbestos fibers. Okay. Now, what is the most important, how do I put this? What is the most important, I guess, therapeutic step in the management of acute pancreatitis? It's actually fluid resuscitation, so basically like hydrating the patient adequately. Okay. Now, what is the most important physical exam finding in the diagnosis of eurics stenosis? It's actually the presence of like the pulse of a parvose tartus, right? So, basically it's like the delayed upstroke in the carotid pulse. Okay. Now, what is the most important prognostic predictor in patients with coronary artery disease? It's actually like left ventricular function. Okay. That's a very classic USMLE and medicine board's question. Okay. Now, what is the most important factor, I guess, in preventing like long injury from the use of ventilators? And I guess you can also say like I guess in proven survival in patients with ERGS. It's actually like mechanical ventilation with like a long protective strategy. So basically like mechanical ventilation with like low tidal volumes.

Now, what is the most important or ecological association in patients with like long term aceliac disease? It's actually the development of like a small bowel lymphoma. Okay. Small bowel lymphoma, I believe that's called like enteric associated like T cell lymphoma or EATL. Now, what is the most important disease of the retina in an old person, right? So in the elderly, it's actually macular degeneration. Okay. Now, what is the most important risk factor for the development of pressure ulcers? That's immobility. Okay. Now, what is the most important physical exam finding in the diagnosis of renal artery stenosis? It's actually the presence of an abdominal brewing, although remember, right? You only find this in like 50% of people. Okay. Now, what is the most important prognostic factor that sort of like, I guess if you are considering the preservation of neurologic function in patients that have like spinal cord compression? It's actually like early diagnosis, making the diagnosis early is actually very important in determining like the patient's prognosis with regards to like preserving a neurologic function. Now, what is the most important factor affecting like TB treatment, like the success of TB treatment worldwide? It's actually like adhering to your treatment regimen, right? It's a very like daunting regimen, so many people do not adhere to it.

And then, I guess kind of to wrap up today, this is just one topic that shows up quite commonly on the USMLE, so go ahead and talk about it, right? But basically, it's like knowing like certain cancers that are associated with like infectious agents, right? So, this should not take too long, right? So like cervical cancer or like anal cancers, right? You want to think about like HPV, right? So like the human, papenoma virus. Remember that actually having HIV is something that shows up on OB-GYN shelves a lot. Having HIV actually increases your risk of cervical cancer. And basically, the most sexual partners you have, the higher your risk of a cervical cancer. And then don't forget like carpocystorchoma, right? Remember, HHV, so like KSHV, the carpocystorchoma, herpes virus, is associated with the development of carpocystorchoma. Remember, basically, right? Classically on MDM Es, it was shopping like a young guy that has sex with other men. Okay, and remember, right? But needle-hensely can cause a disease that's slightly similar to a carpocystorchoma, right? Bacillaria and Geomatosis. The presentation is very similar, right? And it's also classically found in HIV patients, but it will usually give you like, like high old things that can help you differentiate between both. Now, HHV lymphoma, right? Don't forget your EBV. Remember HHV lymphoma you already have strumbergal cells? And then, how about brachyxlymphoma? Also EBV, right?

Remember, your 8-14 translocation for brachyxlymphoma and the starry sky pattern on histology. And remember, I mean, EBV can cause many other things, right? You can cause like many cancers of like the oropharynx, you can cause like nizopharyngeocarsinoma. And in fact, in people that have like lymphomas after transplant, EBV is actually implicated in a potential like causative agent in many of those things. Now, how about a motlem-forma, right? So like a mucousel associated with lymphoid tissue lymphoma, right? Think about H Pylaury, right? This is why H Pylaury, you give antibiotics, you give the PPI's to sort of like reduce the risk of developing a motlem-forma. How about HCC, right? So like hepato-syllocarsinoma, don't forget your HB, don't forget your HFC, okay? Very high yield to know those for tests. And also don't forget, right? So I talked about cervical cancer at HBV. HBV also causes a lot of like ketonect cancers, especially if you have the kind of present that gives like oral sex, okay? So just one of those high yield things you want to keep in mind for exams. Okay, so I think I'm going to go ahead and stop here. This is probably one of my shortest podcasts, but this is probably one of my more high yield podcasts as well.

And as I round up, remember I do offer one on one tutoring if you ever interested for the USM at step one, two CK, two CS and step three, preclinical exams, 30-year shelf exams, the internal medicine, internal medicine, internal exam, internal medicine board exams. And then if you're a med student applying for residency, so like ER As applications or college student applying for med school, like AMCA's applications, I do offer like consulting for those, like application prep, like interview prep, personal statement help. And just basically putting together like an outstanding application. Pretty much all the people I worked with this past cycle, matched into like their top three or four choices. Most of them much than their first choices. And then if you really have an acquaintance that's a niche tutoring for like organic chemistry or physics or general chemistry or biochem of physiology or histology, even I do offer a tutoring for those. So I'll see you in the next podcast. Have a wonderful rest of your night and God bless. I'll see you next time.

Presence of bowel integrity/function (detectable on imaging).

Primary sclerosing cholangitis.

Abdominal bruit (though only found in 50% of people).

Smoking cessation.

Cytomegalovirus (CMV).

Adherence to the full treatment regimen.

The stage at which the cancer was diagnosed.

Smoking (tobacco use).

Delayed upstroke of the carotid pulse (parvus et tardus).

Exercise.

Human Papillomavirus (HPV) infection and HIV status.

Cirrhosis and chronic HBV infection.

The stage at which the cancer was diagnosed.

Smoking (tobacco use).

Delayed upstroke of the carotid pulse (parvus et tardus).

Exercise.

Human Papillomavirus (HPV) infection and HIV status.

Cirrhosis and chronic HBV infection.