High Yield Family Medicine Review for Step 2 CK & Shelf Exam

[@MedManiac1]

UPDATE to lung screening guidelines 2021: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative. The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. 10 year or 40 whatever comes first. mammogram- 40 every 2 year Quick note (Unsure if this was mentioned elsewhere) for the pap smear screening, it is every 3 years with just isolated pap but every 5 years with pap + hpv which can be started at age 30. Also for the ASCUS workup, if the patient is between the ages of 21-24 with ASCUS, we don't work that up and just repeat the pap next year with the assumption that it will probably resolve on its own at that age.

[@bishoyibrahim331]

♥

[@oceanfish2929]

56:15 IBS 1:04:50 chronic PPI 1:05:00 meningitis 1:05:35 small pox vs chickenpox, rashes 1:07:00 breast screening, cysts 1:08:25 diabetes, back pain 1:11:00 essential tremor, tourettes, huntingtons 1:11:40 Asthma 1:12:20 asthma vs copd 1:13:30 sleep apnea, osteoporosis, pain management, chronic venous insufficiency 1:14:43 ear diseases 1:15:32 umbilical hernia, colon cancer screening (villous is worst) 49:00 50:50 hip 12:45 kid 15:00 allergies, diarrhea 19:23 msk, hematuria 22:22 thyroid ctd, ob 26:09 hyperca, hypona, k 29:10 bronchitis, ear 30:55 MI 34:40 ckd, GI 36:45 lung, depression 39:00 ob 40:18 CHF 41:53 OCPs 42:30 HTN 43:44 intussusception. Colicky 46:35 44:20 mid gut volvulus. Constant. Double bubble or corkscrew. 45:20 jejunal atresia. Maternal cocaine. Triple bubble. Duodenal atresia. Double bubble, Down’s syndrome. 45:40 pneumomediastinum. Borhaave. No endoscopy. 46:53 dementia, weight loss, PCOS, migraine 48:40 statins

[@smellypatel5272]

You're the GOAT for this, thank you

[@smellypatel5272]

Straight to the point, no bs, high yield. You're a lifesaver. Listened to this video in its entirety about 4 times now driving to and from rotations because I'm a slow learner.

[@omeedpaknejad6133]

Minor error at 1:15:05 mark; the Dix-Hallpike Test is used for the diagnosis of BPPV, whilst the Epley Manoeuvre can be used for its treatment once BPPV is diagnosed. Awesome videos, thank you for posting!

[@teddyabrha7326]

Dxy=dx ,while Eppl is tx

[@ernstangervil05]

CORRECT. THANKS FOR ADDING THAT

[@DrDeusExMachina]

1:40 per 2021 - Colorectal screening at age 45 is a grade B recommendation: The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. See the "Practice Considerations" section and Table 1 for details about screening strategies.

[@jacobking2864]

You are correct but the "A" recommendation is 50.

[@pryiasimmons3281]

Lung Cancer screening with low dose CT is now 50-80 with a 20 pk year who quit withing 15 yrs.

[@pinoy7tfc]

updated Lung CA screen (as of March 2021) - 20 pack year (remember 2ppd for 10y is considered 20 pack-year) for 50-80 yo and that 15 year bit

[@myhome103]

Thanks.

[@7um3id]

Whos watching in 2021 right before their FM final? yes me

[@Afro_Sensei]

Yes meee

[@7um3id]

@@Afro_Sensei good luck tupac senpai, you’ll ace it

[@dactermd9067]

LEEESSS GO

[@Honey-nv9dp]

Mee in 2022.. ❤️

[@smellypatel5272]

Carrying on the tradition in 2024

[@ahmedbughrara6760]

Binge watching all your videos the day before my step2 exam, you are a life saver 👏🏼👍🏼👍🏼

[@shelby6630]

Thank you! Another thing to add if it hasnt been mentioned already: The new annual LDCT guidelines from the USPSTF now reccomend screening for ages 50-75 in pts with a 20 pack year history (or who have quit in the past 15 years). Ugh so many changes

[@encon92]

02:34 The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. Not at 40 years old

[@Shelbsssss]

40-49 years is a grade B recommendation and 50-74 is grade A :)

[@michaelchristensen5108]

@@Shelbsssss Actually 50-74 is grade B and 40-49 years is grade C

[@Kyle-vp2dk]

It’s 40 again y’all 😮‍💨

[@jacobking2864]

Age 50 years or older: 2-dose series RZV (Shingrix) 2-6 months apart (minimum interval: 4 weeks; repeat dose if administered too soon), regardless of previous herpes zoster or history of zoster vaccine live (ZVL, Zostavax) vaccination (administer RZV at least 2 months after ZVL)

[@amarjotsingh3929]

Quick note (Unsure if this was mentioned elsewhere) for the pap smear screening, it is every 3 years with just isolated pap but every 5 years with pap + hpv which can be started at age 30. Also for the ASCUS workup, if the patient is between the ages of 21-24 with ASCUS, we don't work that up and just repeat the pap next year with the assumption that it will probably resolve on its own at that age.

[@TheDawnFinal]

UPDATE to lung screening guidelines 2021: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

[@slicendice8029]

Errata at 41:10, CHF is not diagnosed on echocardiogram, it is a clinical diagnosis based on Framingham criteria. HF with reduced vs preserved ejection fraction is diagnosed on echo.

[@justaveganexcitedaboutbeans]

I was doing pretty badly on my uworld fam med practice questions in anticipation of my shelf (rotation was 6 mos ago) but after watching this vid and reading USPSTF’s A & B guidelines I’m getting 80%s. Thank you so much!!

[@DoctorHighYieldMD]

🙌

[@stephanielee2497]

omg im praying this happens for me lol

[@Galgal999]

This has been the best video…straight to the point no extra “talking” between straight educational facts! Thank you!

[@omariqbal8889]

1:06:44 I thought you treat Measles --> SPPE with Vitamin A, not B6?

[@DoctorHighYieldMD]

Wow Great catch. To all listeners/watchers: it should be vitamin A ***

[@teddyabrha7326]

Errata-Vit A

[@kayveeh]

was looking to see if this was addressed! thank you!

[@erikb6576]

Minor note on the first fact regarding AAA, the screening is only for men 65-75 (not women) who have ever smoked Thank you for doing these!! They're very helpful

[@santoshaveera7084]

This definitely got me a few points on my FM shelf!! Such a great review even 4 yrs later

[@kaitlynestes9942]

Always watch the morning of my shelf! So helpful!

[@RadDad01]

watching this the night before my shelf and this is GOLD, thanks bro!

[@Thizzyify]

New guidelines for HFrEF are to add on an SLGT-2 inhibitor in addition to the ACEi, MRA, and beta blocker

[@mahmoudhadhoudahmed7156]

You can also add a GLP Agonist

[@kalpanagosai1709]

Yea just found out it in Uworld. Thanks for pointing out.

[@stevenyang9429]

you are a beast bro, thanks for compiling all this for us

[@theshortcut101]

haha sick bro

[@lawyerdoctor]

Good differentiation between IV bisphosphonates (Zoledronate) and oral (Alendronate) is Barrett's esophagus and CKD....give IV in those cases

[@sammir822]

Love this guy’s vids. Very helpful. And he’s nice to look at so that helps haha 😉

[@DoctorHighYieldMD]

😊❤️

[@vpmandin]

I learned from UWorld actually that only symptomatic vaginosis (malodorous discharge or pelvic pain) is treated with metronidazole and asymptomatic is not treated.

[@PepsiT98]

True but when they are pregnant they are always treated regardless of symptoms.

[@PepsiT98]

@@michigan1085 haha, aww thanks! I pray you do well on your shelf 🤗

[@TMHTNN]

Bro, this is gold for shelf!

[@alarica1041]

Zoster recombinant (Shingrix) starts at age 50, not 60 I believe :)

[@divinecommerce3912]

Thanks for the correction! If someone had natural infection, I would check titers first... I had natural infection at 3 years old and I'm 45 now- >165 means immune and I'm at 2,795. Natural immunity is always best.

[@rebeccab7213]

@@divinecommerce3912 no, its reactivation of a latent virus. That means you are at risk if you ever had chickenpox.

[@rebeccab7213]

​@@divinecommerce3912 natural immunity is always best said no one with SSPE. Yikes. Are you a medical professional?

[@jacobking2864]

No more prophylaxis for MAC when CD4+ is below 50. We now only treat with azithro if they get it.

[@kinzaahmed8182]

Now SGLT-2 inhibitors also decrease mortality in HF!

[@mahmoudhadhoudahmed7156]

And GLP agonists?

[@Gajargon]

Colon Cancer screening now starts at 45yo. Thanks for the great vid!

[@thisisfine19]

NB for developmental milestones 2 mths - prone, raises head; social smile 4 mths - uses forearms to prop self up; attempts to gain attention, interested in hands 6 mths - rolls from front to back; laughs, reaches for desired object, recognizes familiar faces 9 mths - independently sits, transfers objects between hands; stranger anxiety d/t development of object permanence 12 mths - pulls self to stand, cruises, pincer grasp; looks for objects after hidden 15 mths - few independent steps; imitates others, shares interest with others, stacks 2 objects 18 mths - walks unassisted, climbs on furniture independently 2 yrs - runs, kicks ball, feeds self w/ spoon 30 mths/2.5 yrs - jumps w/ 2 feet off ground; parallel play 3 yrs - independently puts on some clothes, uses fork; cooperative play with others 4 yrs - catches ball, undo buttons; imaginative pretend play 5 yrs - hops on a single foot; count to 10, writes some letters from name

[@SlapShotRegatta22]

I've seen a lot of questions regarding acute otitis media (AOM) vs. otitis media with effusion. Note, AOM has a (+) fever and effusion DOES NOT have a fever.

[@DoctorHighYieldMD]

Yes another key difference is the physical exam. With AOM you will see a bright red bulging angry looking tympanic membrane. In OME, the membrane looks pretty much normal, but there will be serous fluid behind the tympanic membrane with some fluid bubbles. No angry TM though.

[@SlapShotRegatta22]

@@DoctorHighYieldMD Excellent video my friend. Thank you so much.

[@sandrasamuel1547]

I just wanted to say this video was extremely helpful for my FM shelf and I definitely got multiple questions right just off of watching this. Thank you!

[@AliDemyati]

What are the USPSTF's new recommendations? In short, the task force now recommends women: Start breast cancer screening at age 40 instead of the previously recommended starting age of 50. Get screening mammograms every other year from ages 40 to 74.

[@BullDocDO]

who is watching 2020 ... gra8 video yaar

[@kandarpshah2350]

Letrozole: First line for ovulation induction for PCOS with clomiphene as alternative. (Source: Amboss)

[@camerondodge8939]

The reason herniated disc is more symptomatic in flexion is because the herniated disc herniates anteriorly into the spinal canal to cause compressive symptoms. The reason spinal stenosis is more symptomatic in extension is because the facets will close down more on spinal roots

[@GMDasLied]

Just a little correction, I think you mean the disc herniates posteriorly rather than anteriorly

[@jasmine9866]

So helpful morning of my FM exam, thank you!

[@jacobking2864]

Most cold thyroid nodules are not malignant but when compared to hot nodules cold are more likely to be malignant.

[@yousefbaghdadi]

Great lec! Small comment... you can't admit a child to inpt service to remove them from the abusers against their parents will. Only CPS or a judge can do it; therefore, contacting CPS immediately would be the right answer on the test 50:25

[@DoctorHighYieldMD]

They will not have you choose between removing from abusers vs contacting CPS. There are a few tricky questions, where the answer will be admit to inpatient instead of sending home as an indirect way to remove patient from abuser until proven otherwise.

[@camerondodge8939]

Little side note on the non-stress test, if it is reactive then it falls within the "15 in 15, 2 in 20" guidelines

[@momatik]

USPTF recommends mammogram screening for all women beginning at age 50.

[@DoctorHighYieldMD]

This is a very controversial topic. USPSTF and ACOG disagree on mammogram guidelines. ACOG says to do a mammogram every year starting at age 40. Whereas USPSTF says to start at age 50. However, USPSTF also says, "Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years". So use this with discretion. I usually went with ACOG guidelines for this one and I got the correct answer a lot of the time enough to stick with memorizing age 40. Maybe try the AAFP Q Bank questions and see if you get any mammography questions and insight to the correct way to approach it. I also think that you will most likely encounter questions that test on the USPSTF A rated guidelines only, but it is also safe to know the B ones just in case. Hope this helps.

[@morganmackey3405]

@@DoctorHighYieldMD AAFP Q bank references USPSTF for mammogram screening and uses it for their correct answer choices.

[@jasonperlmutter7849]

@@DoctorHighYieldMD category B would be mammography at age 50 while mammography at age 40 is considered category C. New papers now are even questioning the worth of mammography, as populations who did mammography vs. those who did not have a statistically significant difference in mortality. www.sciencedaily.com/releases/2018/09/180912133536.htm

[@Sam-qv8dq]

Update: We don’t give MAC prophylaxis (Azithromycin) for CD4 count < 50 in HIV anymore. Simply treat if patient develops MAC with Azithro.

[@JavierMartinez-cl8qf]

taking my family medicine shelf this friday! has anyone taken their shelf and can attest to how helpful/High Yield this is?! love the video and the content, just want to make sure i don't skim through it super quickly! thank you so much!

[@nnerdistan]

Taking it this Friday! How helpful did you find it?

[@clairewilson3527]

@@nnerdistan Hi@ Just wondering how helpful you guys found this video?

[@khabibi1]

@@nnerdistan how helpful was it >? I am taking mine this friday lol

[@gamefreak2050]

Just another monthly reminder of how helpful y’all found this video haha

[@ruiminhuang6661]

May I ask ,do u have any written notes for your lectures? I listen to it every nights when i am making my babies sleep,but at times I miss something. Hope to get a note to read together.

[@EagleEye1104]

At the very end, colonoscopy is every 5 (not 3) years if a polyp is found. If normal then 10 year intervals

[@NhanNguyen-wb7fc]

=)) still a gold-standard reviews for Step 2ck 😊

[@shaynemcgowan4049]

Ultrasound has higher sensitivity for intraductal non calcified lesions such as intraductal papilloma. Question stem will say unilateral nipple bleeding, mammogram was inconclusive what is next best step? Answer is US

[@reharabbani1035]

This is so so helpful, thank you for making this! You are amazing!! :)

[@01ssingh]

These videos are incredibly helpful. Thank you so much for making these! You're awesome :)

[@harsharaju7237]

courvosiers sign can also be a cholangiocarcinoma along with pancreatic tumor. Great video!

[@katiemyers2119]

Thank you for sharing this! I thought that the Dix Hallpike Test was used to *diagnose* BPPV, while the Epley Maneuver is used to *treat* BPPV.

[@DoctorHighYieldMD]

Yes that's correct, Dix Hallpike = dx, Epley = Tx

[@yoyoyo0608]

38:20 SIGECAPS MDD needs *4* or more for 2 weeks

[@DoctorDeva]

I don't know how his voice doesn't sound in 2x

[@jomich]

Thank you so much ! You're amazing :)

[@ositagarcia]

Thank you for making this extremely helpful high-yield video!! FM ITE coming up soon. 2021

[@kristiez4966]

I'm also here door FM ITE😂

[@SJ-hd1br]

Recent update: HPV vaccine you can now give up to 45 years old.

[@1rcromwell]

i thought Dx of asthma was made through spirometry first, then if that's normal you move to methacholine challenge

[@AsiansFirst]

Watching this the morning of my FM shelf let’s go!

[@Dwijesh91]

God bless you man. I think I learn more hear than Uworld lol

[@nichogonzalez9883]

here*

[@Dwijesh91]

Here *

[@user-by5ug4qq6v]

also we use nimodipine not nifedipine in subarachnoid hemorrhage right

[@camerondodge8939]

That's what sketchy says haha

[@med_stube9121]

Such great videos...thankyou fellow human

[@MS-eg2we]

atypical pneumonias have Bilateral interstitial infiltrates whereas typical pneumonias have lobar consolidation on CXR

[@MS-eg2we]

Also, thiazides are first line for HTN in general. Give thiazides to all, as well as to African Americans first line. Change to ACEi for AA if they have any renal disease. There is more benefit to AA patients if they are on Acei in this situation

[@teddyabrha7326]

@@MS-eg2we Where is the evidence based medicine? African Americans or as you referred “ AA”

[@teddyabrha7326]

Ovarian and endometrial cancer have same r/f because of proximity or? Opposite to breast cancer? Regarding, OCP &ESTROGEN EXPOSURE INCREASES BREAST CANCER? EARLY MENARCH AND LATE MENOPAUSE AND NULL PARITY BREAST CANCER TOO?

[@samuelberg3335]

Excellent video, MAC prophylaxis is no longer recommended.

[@jordantorres2441]

It's 2019, Emma Holliday is so out, Doctor High Yield, MD is in

[@sbrandybuck]

Jordan Torres They’re both great! I happened to not find an FM review by Emma Holiday.

[@disturbia1378]

Yea unfortunately no Emma Holliday for FM, OB or EM :/

[@anniedevinney495]

Watching it at 2x speed the morning of my shelf 😅

[@rababsalem8591]

Doc, I have a question, does the book of CK include family medicine and obstetrics and psychiatry? I am gonna to buy the book ?

[@nerdnerd4891]

would you consider this a good review for Family Medicine for CK because Uworld doesn't have FM in detail? (for IMGs who don't have family medicine shelf)

[@DoctorHighYieldMD]

Yeah I think it could be a good use of your time of the big topics in FM. It's only 1:16 hours and on 2x that's ~38 minutes. FM includes pediatrics, obgyn, and outpatient internal medicine. So by studying the other specialties you will be studying FM too.

[@omega3pictures]

@@DoctorHighYieldMD quick maths

[@uni1316]

So Listeria , Groul b steep and H.flu vs E.coli ? In children meningitis? I thouugt similar ro pneum. In adult : S.pneumo,h.flu,n.gonorhea

[@SJ-hd1br]

GTT (glucose tolerance test) at 28 weeks of pregnancy is 75g not 50g.

[@inchyokk]

Think the 2h glucose test is 75 and thats post oartum to screen for DM from gdm. But 50 is Ossulivans and then official is 100 over 3hrs. Or so ive read unless its changed.

[@serellamadole]

Thank you so much for this awesome video!

[@okidokidoc]

Amazing video, Doc! 🙏

[@ApolyonTheSoulRender]

Thank you for making this!

[@yunggalactus9945]

I'm always amazed how some guy with a webcam does more in 1 hour than my school has done in 2 years. US education system is busted top to bottom, y'all

[@laneconner1078]

Owning my potential bias as a former public elementary school teacher who also has a Ph.D., the abomination I've experienced in the last two years only exists in the realm of medical education.

[@yunggalactus9945]

@@laneconner1078 I'm in the same boat, actually! Used to teach fifth grade math and now I'm a med student. It's getting worse since COVID, too

[@nickolasmundo3761]

This is awesome! Thank you for taking the time to make this!

[@Tompguyn]

Is it a hysterectomy after lsis and hlis are shown cancerous after colpo? Is it not a LEEP or conization?

[@breveennkukan3603]

Excellent review!! You are amazing.

[@EmilyJackson-z6s]

Thank you for saving me on my shelf

[@daze8326]

Absolutely awesome! Thank you

[@ciao_abhi]

just read the USPSTF a & B guidelines because they're constantly changing

[@ernstangervil05]

WOW THIS IS BY FAR THE BEST VIDEO ON KZbin CHANNEL! KEEP UP THE GOOD WORK. I WOULD BY YOUR BOOK BUT IM AN AUDITORY LEARNER, CAN YOU MAKE VIDEOS FOR SALE LIKE MP3. ILL BE HAPPY TO SUPPORT YOU.

[@davidleventer2727]

Very helpful. Thanks for the review!

[@dominiquehayduk9692]

Very helpful videos! Thank you!

[@teddyabrha7326]

Cu Iud? Why mennorrhagia..is it like anticoagulant?

[@user-by5ug4qq6v]

hey guys. uworld says you dont need to treat asymptomatic BV in pregnancy! coudl someone confirm

[@simplemeals1540]

You are awesome...thank you brother

[@cameronshea01]

Why is this so EPIC?

[@ZebralterMedical]

Good one. Thank you for this!!

[@poeticindulgence753]

i'm writing fam med tomorrow i'm glad i found this

[@tripthisugumar5555]

I wish there was a review like this based on the Canadian system! :p I might use this as a base though - to see what topics to cover.

[@erinhegarty8018]

I love this guy

[@Jenette818]

Dr. HY dropping heat again.

[@selmanmujevic2789]

Nifedipine or nimodipine? I was reading somewhere that nifedipine is contra. Can someone help?

[@maabhussein9910]

Do you have PDFs for your vedios???

[@terry-annlawrence3543]

This is super helpful!! Thank you so much!

[@teddyabrha7326]

Bradykinin = histamine Angioedema ?

[@duniacafe]

Fantastic job, thank-you so much!!