#step 2ck

Ventricular Septal Defect

Atrial Septal Defect

Patent Ductus Arteriosus

cluelessmedic:

Gallstone Ileus

• stone erodes through the gallbladder in to the duodenum
• formation of fistula leads to air in biliary tree (pneumobilia)
• stone obstructs bowel, usually in terminal ileum

1. Right iliac fossa calcification (gallstone) possibly lodged at the ileocaecal valve
2. Pneumobilia - see RUQ
3. Dilated loop of small bowel indicating small bowel obstruction

mynotes4usmle:

Coronary Arteries in a nutshell

CHEMO MAN 2.0

usmle1mikmonics:

diseasesinthreewords:

Poeta uruguayo, Mauricio Saravia. Photo from www.lukeford.net posted on Wikimedia Commons in 2008. Another notabe case in a teenager from Haiti.

The three words of McCune-Albright disease:

1. The most famous (mouthfull) words of the condition: Polyostotic Fibrous Dysplasia. What that means is that the bone will grow tumor-like fibrous (scar) tissue instead of the normal medullary (bone marrow) bone tissue. Irregular Bony trabeculae That will cause the deformities that make the disease famous. It’s caused by mutation in the gene GNAS1 and affects mostly the extremities.Not cancerous. Mosaic G protein signaling mutation 
2. Premature puberty in girls. It can affect boys as well, but the question stem in exams tend to report female cases, like a 2-year-old with menstrual bleeding. Early puberty is one of the many endocrine problems of these patients and a favorite to put in exams. Other problems include over-reactivity of the thyroid, pituitary and adrenal glands (hyperthyroidism, acromegally and hypercortisolism). 
3. And, of course, Café-au-lait spots. The interesting feature is the tendency for the lesions to not cross the body’s midline.

McCune AlBright
C = Cafe au lait spots
E = Early puberty
AB = Abnormal Bones (Fibrous Dysplasia)

mynotes4usmle:

Paget Disease or Osteitis Deformans

Disorder in bone remodeling, 3 stages

1. Osteolytic (osteoclasts)
2. Mixed (osteclasts & osteoblasts)
3. Osteosclerotic (osteoblasts, “burn-out”)

Mosaic pattern on lamellar bone, big skull (no hat fits), foraminal narrowing (cranial nerve impingement), bone fractures, bone pain, warmth (increase vascularization).

Complications: AVshunt within bone marrow, can cause high output, cardiac failure, osteosarcoma

Possible underlying mechanism: Paramyxovirus infection of osteoclasts

Lab: Normal Calcium and Phosphate, INCREASED ALKALINE PHOSPHATASE

• MCC of an isolated, asymptomatic elevation of ALKALINE PHOSPHATASE in an elderly patient.
  
• Laboratory markers for bone turnover are elevated: PINP (procollagen type I N-propeptide or just remeber that song from 50cent “pimp”), urine hydroxyproline

• Imaging:XR (osteolytic or mixed lytic/sclerotic lesions), radionuclide bone scan (focal increase in uptake, also for staging)
• Tx:bibphosphonates

Newborn Respiratory Distress

TORCH Mnemonics