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First Aid for the USMLE Step 2 CK (8th Ed.)/
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First Aid for the USMLE Step 2 CK (8th Ed.) | Medicine (MD/DO) School Study Aid
Amyloidosis
- Etiologies
- Primary
- Multiple Myeloma
- Secondary
- Tuberculosis (TB)
- Rheumatoid Arthritis
- Pathology
- Congo Red Stain
- Apple Green Birefringence
- Complications
- Nephrotic Syndrome
2 mins
Granulomatosis with Polyangiitis (GPA) Symptoms
- Upper Respiratory Tract
- Saddle Nose
- Perforation of Nasal Septum
- Chronic Sinusitis
- Otitis Media
- Mastoiditis
- Lower Respiratory Tract
- Cough
- Dyspnea
- Hemoptysis
- Kidney
- Rapidly Progressive Glomerulonephritis
- Hematuria
- RBC Casts
2 mins
Acetazolamide
- Indications
- Glaucoma
- Altitude Sickness
- Pseudotumor Cerebri
- CHF
- Metabolic Alkalosis
- Mechanism of Action
- Carbonic Anhydrase Inhibitor
- Sodium Bicarbonate (NaHCO3) Diuresis
- Side Effects
- Metabolic Acidosis
- Paresthesias
1 min
Loop Diuretics
- Mechanism of Action
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl- Symporter
- Sulfa Drug
- Drug Names
- Furosemide
- Lasix
- Side Effects
- Gout
- Ototoxicity
- Hypocalcemia
- Hypokalemia
4 mins
Mannitol (Osmitrol)
- Indications
- Increased Intracranial Pressure (ICP)
- Glaucoma
- Drug Overdose
- Mechanism of Action
- Osmotic diuretic
- Increased Urine Flow
- Side Effects
- Dehydration
- Contraindications
- Anuria
- CHF
2 mins
Thiazide Diuretics
- Early Distal Tubule
- Inhibits Na/Cl Reabsorption
- Sulfa Drug
- Hyperglycemia
- Hyperlipidemia
- Hypercalcemia
- Hyperuricemia
- Hyponatremia
- Hypokalemic Metabolic Alkalosis
2 mins
Hypokalemia
- Assessment
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- Interventions
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Nursing Considerations
- Monitor Respiratory Status
3 mins
Hyperkalemia
- Assessment
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- Interventions
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
2 mins
Blood Acid-Base Control
- Characteristics
- In a State of Acidemia
- Medullary Chemoreceptors Control Ventilation Rate
- Expulsion of CO2 through Lungs Increases pH
- Bicarbonate Reabsorption from the Kidney Increases pH
- Kidney Excretion of H+ Increases pH
2 mins
Hypomagnesemia
- Assessment
- Confusion
- Increased Deep Tendon Reflexes (DTRs)
- Neuromuscular Irritability
- Seizures
- Muscle Cramps
- Tremors
- Insomnia
- Tachycardia
- Interventions
- Magnesium Sulfate
- Foods High in Magnesium
1 min
Hypermagnesemia
- Assessment
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Interventions
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
2 mins
Anion Gap Metabolic Acidosis
- Pathophysiology
- Increased Anion Gap
- MUDPILES
- Methanol
- Uremia
- Diabetic Ketoacidosis (DKA)
- Propylene Glycol
- Isoniazid or Iron
- Lactic Acid
- Ethylene Glycol
- Salicylates
1 min
Metabolic Alkalosis
- Diuretic use
- Vomiting
- Antacid
- Hyperaldosteronism
26 secs
Metabolic Alkalosis Interventions
- Interventions
- Treat Underlying Cause
- Stop Potassium (K+) Wasting Diuretics
- Spironolactone
- Acetazolamide
- IV Fluids
- Sodium Chloride
- Replace Potassium (K+)
- Considerations
- Monitor Respiratory Rate
- Monitor Heart Rate
- Seizure Precautions
2 mins
Normal Gap Metabolic Acidosis
- HARD-ASS
- Hyperalimentation
- Addison's Disease
- Renal Tubular Acidosis
- Diarrhea
- Acetazolamide
- Spironolactone
- Saline Infusion
2 mins
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
Respiratory Acidosis
- Hypoventilation
- Increased PaCO2 > 45
- Barbiturates Depress Central Respiratory Center of Brain
- Opioids Depress Central Respiratory Center of the Brain
- Airway Obstruction
- Respiratory Muscle Weakness/Paralysis
3 mins
Respiratory Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
Respiratory Alkalosis
- Hyperventilation
- High Altitude
- Aspirin
- Restrictive Lung Disease
- Pulmonary Embolism
- Pregnancy
- Progesterone
- Rib Fracture
- Anxiety
2 mins
Respiratory Alkalosis Interventions
- Treat Underlying Cause
- Mechanically Ventilated Patients
- Decrease Tidal Volume and/or Respiratory Rate
- Give Adequate Pain Control and Sedation
- Hyperventilation Syndrome
- Rebreathing into Paper Bag
- Sedatives
- Antidepressants
- Considerations
- Compensatory Drop in Serum Bicarbonate
- Correct CO2 Slowly
2 mins
Nephritic Syndrome
- Inflammatory
- Hematuria
- RBC casts
- Increased Nitrogen in blood
- Oliguria
- Hypertension
- Proteinuria < 3.5 grams per day
2 mins
Spironolactone (Aldactone)
- Mechanisms
- Inhibition of Aldosterone
- Potassium Retention
- Indications
- Hypertension
- Edema
- Heart Failure
- Side Effects
- Hyperkalemia
- Endocrine Effects
- Consideration
- Avoid Potassium Supplements
2 mins
Alport Syndrome
- Pathophysiology
- Nephritic
- X-linked
- Mutation in Type IV Collagen
- Diagnosis
- Split Basement Membrane
- Basket Weave Appearance
- Signs and Symptoms
- Ocular Disorders
- Deafness
2 mins
Berger's Disease (IgA Nephropathy)
- Nephritic
- IgA Nephropathy
- Immune Complex Deposit in Mesangium
- Increased Synthesis of IgA
- Most Common Cause of Nephritic Syndrome
- Overlapping Features with Henoch–Schönlein Purpura
- Presents with Pharyngitis, URI or Acute Gastroenteritis
1 min
Post Streptococcal Glomerulonephritis
- Pathophysiology
- Nephritic
- Children
- Signs and Symptoms
- Edema
- Cola Colored Urine
- Follows Group A Streptococcal pharyngitis or Skin Infection
- Diagnosis
- Neutrophils
- Immunofluorescence (IF) Granular
- Lumpy Bumpy Appearance on Immunofluorescence (IF)
- Subepithelial Immune Complex Humps
2 mins
Rapidly Progressive Glomerulonephritis
- Pathogenesis
- Nephritic Syndrome
- Crescent Shape
- Crescents Consist of Fibrin and C3b
- With Parietal Cells, Monocytes, and Macrophages
- IMMUNOFLUORESCENCE
- Linear Immunofluorescence
- Negative Immunofluorescence
- Granular Immunofluorescence
- Etiology
- Goodpasture Syndrome
- Granulomatosis with Polyangiitis (Formerly Wegener's)
- Microscopic Polyangiitis
- Prognosis
- Poor Prognosis
3 mins
Granulomatosis with Polyangiitis (GPA) Characteristics
- Pathophysiology
- Small Vessel Vasculitis
- Necrotizing
- Lungs and Upper Airway
- Crescentic Glomerulonephritis
- DIAGNOSTICS
- c-ANCA
- X-ray
- Multiple Nodules in Lungs
- Treatment
- Cyclophosphamide
- Corticosteroids
- Rituximab
3 mins
Diabetic Glomerulonephropathy
- Pathophysiology
- Nonenzymatic Glycosylation of Glomerular Basement Membrane
- Nonenzymatic Glycosylation of Arterioles
- Hyperfiltration
- Increased GFR
- Histological Findings
- Hyaline Arteriolosclerosis
- Mesangial Expansion
- Type IV Collagen Deposition
- Kimmelstiel Wilson Lesions
- Presentation
- Nephrotic
2 mins
Focal Segmental Glomerulosclerosis
- Most Common Cause of Nephrotic Syndrome in Hispanic People and African Americans
- Associated with Sickle Cell Disease and HIV
- Associated Interferon Therapy and Heroin Abuse
- Histopathology
- LM Segmental Sclerosis and Hyalinosis
- EM Focal Damage of Visceral Epithelial Cells
- IF Negative
- Signs & Symptoms
- Microscopic Hematuria
- Nonselective Proteinuria
- Considerations
- Poor Prognosis
2 mins
Membranous Glomerulonephritis
- Characteristics
- Nephrotic
- Diagnosis
- LM Thickening of Capillary and Glomerular Basement Membrane (GBM)
- EM Spike and Dome Appearance with Subepithelial Deposits
- IF Granular
- Primary
- Phospholipase A2 Receptor Autoantibodies
- Secondary
- NSAIDS
- Gold
- Solid Tumors
- Hepatitis B Virus (HBV)
- Lupus
3 mins
Minimal Change Disease
- Pathophysiology
- Nephrotic
- Most Common in Children
- May be Triggered by Recent Infection or Immune Stimulus
- Diagnosis
- On Electron Microscopy (EM) See Foot Process (Podocyte) Effacement
- On Light Microscopy (LM) See Normal Glomeruli
- Loss of Negative Charge
- Selective Loss of Albumin
- Treatment
- Responds to Corticosteroids
2 mins
Nephrotic Syndrome
- Signs and Symptoms
- Massive Proteinuria > 3.5g per Day
- Edema
- Increased risk of infection
- Thromboembolism
- Hyperlipidemia
- Fatty casts
1 min
Membranoproliferative Glomerulonephritis
- Nephritic-Nephrotic Syndrome
- Type I
- Subendothelial Immune Complexes
- Hepatitis C Virus
- Granular IF
- Tram Tracks Caused by Splitting of the GBM
- Ingrowth of Mesangium
- Type II
- Dense Deposit Disease
- C3 Nephritic Factor
2 mins
Hydrocele
- Mechanism
- Impaired Lymphatic Drainage
- Signs and Symptoms
- Large Scrotum
- Painless
- Considerations
- Needle Aspiration or Surgery
- Scrotal Support
- Monitor for Bleeding and Infection
1 min
Benign Prostatic Hyperplasia (BPH) Disease
- Mechanism and Characteristics
- DHT-induced Growth Factors
- Common in Men > 50 Years Old
- Smooth, Symmetric, Firm Enlargement
- Affects Lateral and Middle (Periurethral) Gland
- Urethra Compression
- Symptoms and Complications
- Increased Urinary Frequency
- Nocturia
- Dysuria
- Urinary Tract Infection
- Hydronephrosis
1 min
Benign Prostatic Hyperplasia (BPH) Diagnosis and Treatment
- Diagnosis
- Digital Rectal Exam
- Urinalysis to Detect Infection or Blood
- Treatment
- Alpha-1 Antagonists
- Tamsulosin
- 5 Alpha Reductase Inhibitors
- Finasteride
- TURP (Transurethral Resection of Prostate)
1 min
