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First Aid for the USMLE Step 1 2019 Medical (MD/DO) School Study Aid


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Polymyositis / Dermatomyositis Disease
Pathophysiology
Idiopathic Inflammatory Myopathy
More Common in Women
Endomysial Inflammation with CD8+ Cells (Polymyositis)
Perimysial Inflammation with CD4+ Cells (Dermatomyositis)
Signs and Symptoms (Both)
Symmetric Proximal Muscle Weakness
Dysphagia
Lung and Cardiac Involvement
Signs and Symptoms (Dermatomyositis)
Malar Rash
Shawl-like Shoulder Rash
Gottron Papules on Knuckles
Heliotrope Rash
2 mins
Acanthosis Nigricans
Associations
Endocrine Disorders
Diabetes Mellitus
Obesity
Malignancy
Presentation
Velvety Plaques
Dark, Thickened Flexural Areas
Diagnosis
Hyperkeratosis with Melanocytes
Treatment
Treat Underlying Disorder
1 min
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
2 mins
Hypercalcemia Causes
Two CHIMPANZEES Acronym
Thyroid Disorders
Calcium Supplements
Hyperparathyroidism
Iatrogenic (Drugs, immobility)
Milk-Alkali Syndrome
Paget's Disease of Bone
Acromegaly or Addison's Disease
Neoplasms
Zollinger-Ellison Syndrome
Excessive Vitamin A
Excessive Vitamin D
Sarcoidosis
1 min
Cushing's Syndrome Characteristics
More Common in Women
Exogenous Cause (Taken in from Outside)
Glucocorticoids
Endogenous Causes
Decreased ACTH
Primary Adrenal Disease
Increased ACTH
Pituitary Adenoma (Cushing's Disease)
Paraneoplastic: Small Cell Carcinoma
CRF-releasing Tumors
1 min
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
1 min
Polycythemia Vera Disease
Pathophysiology
JAK2 Mutation leading to increased red blood cells
Tyrosine Kinase
Symptoms
Erythromelalgia
Pruritus
Often After Hot Shower
Headache
Treatment
Phlebotomy
Aspirin
1 min
Lambert-Eaton Syndrome
Mechanism
Autoantibody to the Presynaptic Calcium Channel on Motor Neurons
Inhibits Acetylcholine (ACh) Release at Neuromuscular Junction
Paraneoplastic Syndrome
Small Cell Lung Cancer
Symptoms
Proximal Muscle Weakness
Improves with Muscle Use
Autonomic Symptoms
Extraocular Muscle Sparing
2 mins
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
1 min

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