High Yield OB/GYN Review for Step 2 CK & Shelf Exam (Part 2 of 2)

[@ciararobb8049]

4 years later, and these are still helping countless students. Thank you for all you do!

[@DiamondPlayButton-nm3eg]

Breast cancer screening starts at 40 years old, every year. - HPV vaccine is given between ages 9 and 26. - Herpes zoster vaccine is given at age 60. - Pneumococcal vaccine is given at age 65. - Meningococcal vaccine is given at college age. - Pap smear for HIV patients is done every year; for normal population, start at age 21, every three years, and stop at age 65. - Hypothyroidism, prolactinoma, and pregnancy can cause galactorrhea. - Hypothyroidism increases TSH, which stimulates prolactin, leading to increased breast milk and osteoporosis. - Pregnancy increases beta-HCG, which stimulates prolactin, leading to increased breast milk. - Prolactinoma suppresses GnRH, causing low estrogen and osteoporosis. - Hypothyroidism suppresses LH and FSH, leading to low estrogen and osteoporosis. - Female athlete triad includes low BMI, excessive exercise, and eating disorders, leading to osteoporosis. - Hypogonadotropic hypogonadism due to low BMI or excessive exercise can cause osteoporosis. - Stress fractures are associated with low BMI. - Prevent osteoporosis with weight-bearing exercises, calcium, and vitamin D. - Secondary amenorrhea should first be evaluated for pregnancy with urine beta-HCG, then check prolactin and TSH. - Most effective emergency contraception is a copper IUD. - Copper IUD risks include increased pelvic inflammatory disease and menorrhagia. - Post-op fever causes include wind (pneumonia), water (UTI), walking (DVT), wound (infection), and wonder drugs and (abscess). - Stress incontinence is caused by pelvic floor issues; diagnose with Q-tip test- URETHRAL HYPERMOBILITY. In SUI, INT URETHRAL SPHINCTER BELOW PELVIC FLOOR - Kegel exercises are the first-line treatment for stress incontinence; pessary is second-line.THIRD- MID URETHRAL SLING - Urge incontinence is caused by an overactive bladder; treat with bladder training exercises or oxybutynin - Overflow incontinence is often due to diabetic neuropathy or post-anesthesia; treat with intermittent catheterization. OR BETHANECHOL. OVER 100 ML POST VOID - Pelvic organ prolapse types include cystocele (bladder herniation), rectocele (rectum herniation), and enterocele (uterine prolapse). BULGING SMOOTH MASS - Rectocele causes constipation relieved by digital rectal exam; differentiate from uterine fibroids and endometriosis(NO CONSTIPATION BUT DYSCHEZIA). - Post-c-section complications include evisceration, wound dehiscence, and wound infection. - Evisceration treatment: cover with sterile sponge, go to OR. - Wound dehiscence treatment: abdominal binder, go to OR. - Wound infection treatment: open wound, clean, and administer antibiotics. - Pelvic inflammatory disease- RED TENDER CERVIX, UTERINE, ADNEXAL TENDERNESS,FEVER, WBC, DYSPAREUNIA- is commonly caused by chlamydia and gonorrhea; can lead to tubo-ovarian abscess(MASS) and Fitz-Hugh-Curtis syndrome. - Vaginal infections include trichomoniasis (green frothy discharge, strawberry cervix), GARDNERELLA- bacterial vaginosis (thin white discharge, clue cells), and candidiasis (thick cheesy discharge). - Trichomoniasis is sexually transmitted; treat both partners. ADENOMYOSIS- PAINFUL, TX- OCP, NSAID ENDOMETRIOSIS- DYSMENORRHEA, DYSCHEZIA, DYSPAREUNIA. ON DRE- ODD TISSUE. A/W INFERTILITY BCZ DISRUPTS CYCLE IF PAIN RELIEVED WITH URINATION AND UTI RULED OUT- INTERSTITIAL CYSTITIS GROSS PAINFUL- KIDNEY STONE GROSS PAINLESS HEMATURIA- BLADDER CANCER, RCC Leiomyomas (fibroids) present as non-tender, midline masses; treat with NSAIDs, progestins, or hysterectomy. - Threatened abortion involves closed cervix with bleeding; inevitable abortion involves an open cervix. - Incomplete abortion has retained products; complete abortion has expelled all products. - Missed abortion has no bleeding or cramping but a non-viable fetus. - Ectopic pregnancy diagnosis requires ultrasound if HCG > 1500; treat with methotrexate IF 3CM- SALPINGOSTOMY OR SALPINGECTOMY, surgery. IF HYPOTENSIVE- EMERGENCY- SALPINGECTOMY - Molar pregnancies may progress to choriocarcinoma;A/W HYPEREMSESIS, PREECLAMPS, track beta-HCG and use OCPs post-D&C. - Septic abortion may lead to retained products and infection; treat with antibiotics CLINDA AND GENTA, IV fluids, and possible repeat D&C Molar pregnancies (complete/incomplete mole) present with elevated beta-HCG; complete moles have 46 chromosomes, incomplete moles have 69. - After D&C for molar pregnancy, track beta-HCG and use OCPs to avoid masking cancer development. - Retained products from an incomplete abortion can lead to sepsis; treat with antibiotics and possibly repeat D&C. - Septic abortion can lead to necrotizing endometritis; treat with hysterectomy if necessary. - Listeria can cause chorioamnionitis with intact membranes; treat with ampicillin. - Chorioamnionitis from ruptured membranes requires immediate delivery. - Benign breast masses include fibroadenomas and fibrocystic changes; follow standard diagnostic algorithms. Fibroadenoma is a firm, mobile, non-tender nodule in young females. Fibrocystic changes involve fluctuating masses; usually painful. - In females under 30 with a breast mass, perform ultrasound; over 30, perform mammography; biopsy all masses. - Most common breast cancer is invasive ductal carcinoma. - Intraductal papillary carcinoma presents with bloody or copper-colored discharge. - Cysts with fluid are drained; bloody cysts are biopsied. - Inflammatory breast cancer shows erythema, skin dimpling (Peau d'orange).DUE TO LN OBSTRUCTION - Paget's disease of the breast presents as a scab or rash over the nipple.UNDERLYING CANCER - BRCA testing is for individuals with strong family history; start breast MRI at age 25. - Triple-negative breast cancer has a poor prognosis; lacks estrogen, progesterone, and HER2 receptors. - Asherman syndrome results from D&C; diagnosed with hysterosalpingogram.- AMENORRHEA - Necrotizing endometritis treatment includes hysterectomy. - Sheehan syndrome: hypotension, pituitary necrosis, hormone replacement - Sertoli-Leydig cell tumors(ABRUPT): virilism, sudden onset, androgens, VS PCOS(GRADUAL, NO VIRILISM ONLY HIRSUITISM) granulosa cell tumors, precocious puberty - Ovarian torsion: severe pain, nausea, ultrasound, Doppler, surgery OVARIAN MASS- TORSION- OR - Congenital adrenal hyperplasia: 21-hydroxylase, 11-hydroxylase, 17-hydroxylase deficiencies - Turner syndrome: 45,X, OR 46 XY(TAKE OUT STREAK OVARIES) webbed neck, streak ovaries- LOW estrogen, GIVE FSH, LH growth hormone - Müllerian agenesis(XX) vs. androgen insensitivity(XY- EXCESS TESTOSTERONE GETS CONVERTED TO ESTROGEN): Müllerian agenesis results in the absence of the uterus and upper vagina, while androgen insensitivity syndrome (46,X,Y) results in female external genitalia and internal testes. Both lack a uterus but differ in testosterone levels and secondary sexual characteristics. - Kallman syndrome: GnRH neurons, anosmia, hypogonadism, infertility - Endometrial cancer: PRECEDED BY hyperplasia, TVS, ultrasound,- biopsy IF

[@Maria-qm9cg]

Thank you. 🙏🏻

[@ashwinibhonsle3221]

Thank u soooo much

[@rababsalem8591]

Super

[@richardcadenas8610]

great vids! Helped a lot before CK. A quick trick for CAH: first digit (HTN) second digit (virile) in alphabetical order-- assign a 1. 21 hydroxylase def == 1 in the second place so only virilization 17 == HTN only 11 == both

[@Ateleryx]

I like yours a lot! The one I used broke it down by 'male ages': -11 year old is hormonal [puberty] and a little salty about it --> (increased testo, little mineralocorticoid action) -17 year old is not manly yet and is very salty about it --> (decreased testo, high MC) -21 year old is manly and not salty about it --> (increased testo, no MC)

[@zSchreckensszene]

7:16: Pelvic Organ Prolapse 9:52: PID 14:12: Genital Ulcers: inguinale bubose ulcerate, venerum bubos don't 15:11: UTI part 2 17:02: Abortion 18:04: Ectopic Pregnancy 19:33: Molar Pregnancy - 20:34: choriocarcinoma 21:10: Septic Abortion 22:07: Listeria - 22:23: Chorioamnionitis (Listeria & Otherwise)* 23:29: Breast-mass algorithm 27:47: Secondary Amenorrhea (and progestin challenge test)

[@Awniooz]

Thanks 😊

[@nathanwilliams9778]

great job! these are so helpful. Just something else at 40:08 . infertility:

[@Alice-th6re]

I literally love you. My Uworld averages went up by a ton after watching your review, and now I feel well prepared for my shelf today. Your videos have been a huge help! Thanks so much for taking the time to do this!

[@DoctorHighYieldMD]

Glad I could help!

[@orlando666100]

These videos low key have step 3 high yield materials! Just took it btw

[@deepabarua6890]

Thanks Doc. really nice video but some little little mistakes-- # Granuloma inguinale -- extensive ulcerative lesions without any lympadenopathy # Lymphogranuloma venereum-- shallow ulcers with painful lymph nodes/ buboes which may ulcerate # positive whiff test(amine odor with KOH) --- for Gardenerella (bacterial vaginosis) not for trichomoniasis # Gardenerella (bacterial vaginosis)--treat with metronidazole or clindamycin

[@OMW2FYBROK]

Dude I got my shelf tomorrow. God bless your soul for blessing us with this content 🙌🏽

[@DoctorHighYieldMD]

JOVY BAINS crush it! 👊

[@alannagrafius9096]

Thank you for your video! Here's a couple things I noticed in error or were missing: -PID also predisposes to ectopic pregnancies. -Trichomonas is not a bacteria.. so it can't be "bacterial vaginitis." Also the KOH whiff test is for BV caused by Gardnerella not Trichomonas.

[@DoctorHighYieldMD]

PID does predispose to ectopic pregnancies correct. Trichomonas is a protozoa. Thank you for that correction. However, KOH whiff test can be positive for Trichomonas.

[@horschiday9449]

Agree!

[@jacobhernandez953]

Agree nice feedback

[@yunggalactus9945]

39:45 One important detail on fertility: you wait until one year of "trying for" a baby in patients who are under 35. Patients who are over 35 only need 6 months before follow-up testing is indicated (Sources: 1) my OBGyn residents 2) AMBOSS 3) "Trust me bro")

[@alphaspartan]

Uworld as well.

[@mimic1001]

Obgyn COMAT tomorrow and this has been fantastic for last minute review. Thanks so much

[@oceanfish2929]

47:56 Pregnant endometritis- clinda and gentamicin. Pregnant chorioamnionitis- clinda and amp. Tubal ovarian abscess- clinda and metro (anaerobes). Septic abortion- clinda and gent. Pulm edema- furosemide. Listeria- amp. PCOS- OCPs. Lichen sclerosis- topical steroids. Vaginal atrophy- topical estrogen. Mg overdose- calcium gluconate. UTI in preg- amox, ceph, nitro. UTI- bactrim, nitro, fluoroquinolones. Chlamydia- azithro. Gon- ceftriaxone

[@tiffanywood7080]

this was so helpful! starting my OBGYN rotation tomorrow and thankfully I won't walk in knowing nothing. I plan to watch these videos again closer to taking the shelf!!!

[@kalpanagosai1709]

These videos are pure gold in field of medicine.

[@thainewoodrow3960]

Thanks, Doc. Appreciate the time and effort you put into all of our medical education. Best of luck in your career.

[@HeyDoctorHelene]

Your videos are gold! I take CK tomorrow and your last minute reviews were amazing! Thanks so much💪🏾

[@orlando666100]

Mine is this Thursday any Last minute advice please?

[@DoctorHighYieldMD]

orlando urbano crush it

[@ferasaljohani4357]

I've listened to many of your reviews while i was on a long ride and it was the best thing to listen to! Plenty of useful high yield Information. Thank you.

[@harvey2733]

I couldn’t thank you enough. Your videos were super helpful in Ck and now for Step-3 too. Thanks a ton. Just to add, Nitrofurantoin shouldn’t be used for UTI in preg lady in 1st trimester (recent UWorld)

[@ahmedelshafey4065]

Hypothyroidism stimulate release of TRH not the TSH and then TRH act on the ant pituitary releasing TSH as well as Prolactin . By the way your videos are great ... keep going .

[@Slimshady3minem]

Yea Im pretty sure he assumed we knew that.

[@ArjunKelaiya]

Factually incorrect. Hypothyroidism stimulate release of TSH and TRH both

[@alexborges2996]

Your videos are always my first line Go-to for the day before the shelf. You’re the GOAT!

[@rohnegi]

You guys are real doctors... doing charity for fellow docs !! thanks .

[@roosifdraculamcdoosif3092]

Thank you so much for putting so much time and effort into these videos. You can really see your dedication, even just in the editing of the video. You are WONDERFUL!

[@abnoosmoslehshirazi8948]

youre saving me for last minute review before my step 2, thank you so much for making this!

[@Jess-xw7ky]

i see u

[@ShanilR]

@45:15 = differential for rash on palms & soles -> CARS = coxsackie A, ricktessia, syphilis, staphylococcus

[@boredcow]

SO helpful. have my OB/GYN shelf in like 6 hours lol. thank you for your videos!!

[@ImAfterglow]

Correction @14:48: He says granuloma inguinale causes painful lymphadenopathy, when it does not cause lymphadenopathy. I believe he’s confusing it with chancroid (ducreyi), which presents with a single painful lesion and painful lymphadenopathy with potential for abscess formation. Hsv, chlamnydia, and chancroid are the only infections that present with painful lymphadenopathy

[@hanleylinify]

Bought your Step2CK notes and it's amazing! Very good for consolidating info and a quick review of high yield points before the exam.

[@wildturtlestudios1770]

Great job! I'm taking step 2 in 4 days and really appreciated how everything was straight to the point. Thank you and keep up the good work!!

[@DoctorHighYieldMD]

good luck!! you got this!

[@HadeerSinawe]

Good luck!

[@Dwijesh91]

Did you find the video helpful for your exam?

[@honeyferoza9652]

Super Super Thank you , Doctor

[@jacklyngarcia8887]

Essential part of my shelf studying. Thank you so much for your hard work , much appreciated

[@625cst]

Good day! Thank you for these high yield videos!!!! I just wanted to point out a minor correction, I think you mentioned that the positive KOH whiff test is for /Trichomonas vaginalis/ (Trichomoniasis), but I'm pretty sure that the KOH whiff test is for the /Gardnerella vaginalis/ (Bacterial vaginosis) and not trichomoniasis @11:29 :)

[@alan4019]

regarding lymphogranuloma inguinale and granuloma inguinale (aka Donovonosis): the latter --> beefy red ulcers without lymph node involvement. (Per Amboss). I think Dr HY says both involve lymph nodes in a few videos

[@leanzabuela3034]

i love you!!!!! testing for ck in 2 days and im binge watching all your videos. thank you for all your efforts!!!

[@MaxWalker-wj6zb]

You da best - just a heads up Letrozole is indicated over Clomiphene now for PCOS pregnancy induction

[@arasonyth3243]

@14:55 "LGV buboes are painful but don't ulcerate" This is wrong, I know because I just got the question wrong on uworld. LGV ulcerates, Granuloma Inguinale does not. I expand on this in a comment. That being said, this is a great resource that has helped me a tremendous amount, so thank you very much!

[@arasonyth3243]

"Granuloma inguinale is a sexually transmitted infection caused by Klebsiella granulomatis that typically presents with painless red ulcers with no associated inguinal lymphadenopathy" - Uworld. So it's closer to syphilis than LGV. Ducreyi chancroids are painful ulcers with tender lymphadenopathy that can suppurate.

[@DarikZoster]

Something I use to remember organisms that cause vaginitis Two protozas playing ping pong - trich Protozoal , treatment for partner , and the only one left so green A white fish - bv Fishy odor , whitish discharge Candida I believe is easier to remember and people het confused between the other two only

[@yizhou178]

These videos are gold! Good luck with your residency by the way!

[@DoctorHighYieldMD]

Thank you so much!!

[@brainoverbrawn3404]

Also give metformin for PCOS. Awesome videos Doc!!

[@alexandramaningat8487]

A

[@alexandramaningat8487]

The first year I had the last two years I

[@zsadiq5]

Seriously saving me for my shelf tomorrow. Thank you!

[@DoctorHighYieldMD]

Zahoor Sadiq you got this!

[@speedyjl888]

(06:57) bethanechol - muscarinic agonist, be sure to r/o urinary obstruction prior use. :)

[@manuelarias8359]

Man that was unbelievable...thank you so much!

[@DoctorHighYieldMD]

Manuel Arias haha thanks, np. wishing you all the best

[@montycobra7340]

This is great. Thanks so much. Would be even better if you streamlined the order a bit. Regardless, some of the best comprehensive stuff out there

[@01ssingh]

These videos are amazing! Thank you for taking the time to do these :)

[@nicoleebose20]

God bless you real good for this....can't wait to crush myself tomorrow 💃🏾💃🏾💃🏾💃🏾💃🏾

[@johnkevin1104]

14:58 granuloma inguinale does not usually have lymphadenopathy or buboes, I think

[@ignitedmedical7415]

purchased your notes - can't wait to see them!! honestly this is so refreshing after watching lots of onlinemeded.

[@prajjwalkunwar9287]

I think for LSIS you go for HPV testing like Ascus. Great job with all the high-yield videos. I can't thank you enough it's super helpful.

[@digitiminimi5730]

Thank you so much Dr🙏🏽❤️ Here's the thing, the indications u said like 1 man or 2 family member with breast cancer etc, is for ovarian cancer screening not breast cancer

[@swativanaparthy6630]

Ur videos are the bomb!! thanks a bunch! But I think it’s TRH that stimulates prolactin not TSH?

[@DoctorHighYieldMD]

Yes both can

[@maeri6040]

I love this mans😭😭😭✨ just one edit: whiff test/koh is for bacterial vaginOsis/Gardnerella :)

[@syedsaeedalam6929]

simplly excellent. i have exam after one week. and i found this . it is very helpful in review. i feel more confident now hehehe

[@laithazzam5322]

This was extremely helpful. Thank you so much!

[@megane.7792]

If sounds like fibroadenoma, but bilateral and several masses => most likely fibrocystic changes

[@shriramjawahar22]

My guy you are something else thank you!!!🎉❤❤❤

[@duniacafe]

Fantastic job my friend!

[@MrGreed2000]

Very good review. Thank you. I hope you will have a Surgery Shelf Review video up before my shelf! What rotation are you in right now?

[@DoctorHighYieldMD]

The surgery review will be up soon. Stay posted! Finished all my rotations haha, starting residency this July

[@DoctorHighYieldMD]

I uploaded it: kzbin.info/www/bejne/nGjFmYyFg7-ahrs

[@iZain23]

Very appreciative of your work man!

[@user-cq4jq7lx9e]

You may have addressed this, but in part 1 you said Mg Tox 1st sign was clonus/hyperreflexia, but in this video you said it was loss of DTRs.

[@travelwithdrawal8067]

I heard hyporeflexia in the first one? It's loss of DTRs/hyporeflexia.

[@DoctorHighYieldMD]

Correct. Not sure where I said that. But the classical first sign of hypermagnesemia is LOSS OF DTRS/HYPOREFLEXIA.

[@morganpotter4248]

These are so great! Has anyone typed this stuff up? Wish I would have found them sooner so I could do it myself.

[@ThatBandGirlRocks]

I think he sells HY notes on amazon!

[@harsimratdhaliwal1790]

This is so amazing! Thank you so much!

[@DoctorHighYieldMD]

No problem 😊

[@nicarlosnicomateo9131]

Positive whiff test ~ 12 minutes ~ is for gardnerella (BV) not really trich.

[@DoctorDisney]

46:55 "six month year old" I do this all the time on rounds hahaha

[@ghizlanechemcham574]

@ Doctor High Yield. MD: Great review !!! love love it :) .... Just wondering if you have an ebook/kindle ebook version of your notes beside the paperback version on Amazon? Thank you !!!

[@tylerjohn15]

Very helpful for shelf studying.. Thank you!

[@choibento]

thanks bro my shelf is tomorrow!

[@jennarivers9499]

This is GOLD!! Thank you!

[@maleehab3964]

Thank you for these fantastic videos 😀

[@katerynastrubchevska1813]

Thanks! You did this great!

[@mandya8084]

Great review, just to add something, breast cancer screening starts at age 50 for average risk women every 2 years. Thank you

[@kaym6939]

It depends on which guidlines you are following. ACOG, ACR, and NCCN say age 40 for average risk. The practice I was at for my OBGYN rotation started at age 45.

[@travelwithdrawal8067]

@@kaym6939 ACOG is 40, ACR is 45, and USPSTF is 50.

[@disturbia1378]

Why does ACOG have so many differences in recommendations compared to the standard....no other specialty organization has as many differences from the standard as ACOG

[@prowala]

Amazing job dude this is great

[@metoceedeelee]

Any chance you have the notes for your videos? (BTW they are amazing, thank you)

[@DoctorHighYieldMD]

Hello yes, I am planning on having notes sometime in the future for you guys to have. I still have to review them, edit them, and make them presentable.

[@dr.sanjaybalasubramaniam7344]

Doctor High Yield, MD it’s very appreciable. We are waiting. Thanks to you.

[@ajayajitpalsingh1344]

Whiff test is also positive for BV.

[@kemiyoshida]

13:07 I cracked up :) thanks for the review, you're awesome!

[@dirtymikeandtheboys5940]

the cancerous HPV are 16 AND 18 not 16-18 and also 31 and 33 among others. not exclusive

[@farahchohan7831]

Great video. Thanks so much for all of these wonderful videos, my exam is in 4 days and I m listening to all of your videos rn :) Also isnt breast cancer screening from 50? and every 2 years instead of 40 and annually?

[@candicesaylors8275]

it depends on the source, ACOG says annually 40 and up so for OBGYN shelf that is what I would go by. USPFS says 50 which is what family medicine goes by, I think.

[@daniellelutchman485]

if you find Ascus and HPV is negative, how long do we wait to follow up? 1 year or 3?

[@manders4777]

3 years! If its LSIL and the HPV is negative, this is when you redo cotesting in 1 year

[@cucumbermelon6166]

1:13 i ask that same question to myself lol

[@DoctorHighYieldMD]

Cucumber Melon 😂

[@Ss-pj8vn]

Question: if Quad screen is positive and done in 2nd trimester then how can chorionic villous sampling happen at weeks 10-12 (first trimester) ?

[@lansoncolaco9033]

You can do the CVB at 12 weeks following abnormal downs syndrome screening post your first trimester scans - papp-a, nuchal translucency, bHCG

[@nnannaojembe3713]

Great stuff man. Thanks

[@Hearty_Heart]

Doc can i ask something if the fibroids trigger at thesame time also pregnant what she supposed to do ?is there any medicine for it?

[@justinlee2838]

another solid video

[@ampanchal95]

Excellent, excellent, excellent!!!!!

[@19mterry]

Amazing video 😘🥰👏🏽👏🏽👏🏽👏🏽👏🏽

[@sameral1651]

Thanks alot , you did a great job 🌹🌹🌹🌹

[@johnkevin1104]

HPV vaccine can be given upto age 45 now, right?

[@alhadiibrahim1195]

This is so helpful bro I mean soo helpful

[@eg3535]

changed age for VZV vaccine = 50 yo !!

[@Hearty_Heart]

Thankyou Doc.

[@nicolemountz3868]

note to self: secondary amenorrhea workup at 27:30

[@johnjones1543]

Great topic

[@psuvansanya375]

just wondering in uworld one of the question about postmens bleedings, the answer was biopsy, I also ask one of the OB gyne professor and they said biopsy too. can you please share what's on your mind :) thank

[@DoctorHighYieldMD]

I agree. Post menstrual bleeding is endometrial cancer until proven otherwise. Therefore endometrial biopsy is usually the correct answer.

[@step_zero]

I subbed so fast

[@laiela5939]

Stress fracture not seen on xray

[@rehabaljassmi506]

very helpful. thank you

[@antonybasta1591]

We love you.

[@quranrecitationsandmemoriz1474]

thank you

[@MrBiloo1995]

thank you!

[@scapelplease8273]

thank you bro

[@laiela5939]

Prolactin,tsp dec gnrh

[@taha20raha]

Thanks❤

[@jayswish857]

Legand, thanks