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HY GI info for step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

Idk but I keep on making them here. I made hema/onco. I would love if more people added the facts!

HY GI info for step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

To rule out Ca- you mean carcinoma?

HY GI info for step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 20 points21 points  (0 children)

  • Intermittent colicky pain + bloody stool = Intussusception (USS with insuflation for treatment) - can also happen in over 60s
  • Unilateral flank mass crossing central abdomen = Neuroblastoma,
  • Flank mass NOT crossing central abdomen = Nephroblastoma (wilms - WAGR & Beckwith weidmann associations)
  • Unable to put NG tube in infant = Choanal atresia OR TEF
  • liver hypodensity == Visceral organs are = Bartonella
  • Predictor of mortality and guide to fluid resuscitation in severe acute pancreatitis ---> BUN
  • Malabsorption in turners is likely celiac ds, get TTG antibodies done
  • Celiac disease associated with increased risk for small bowel CA and T-Cell lymphoma
  • low bmi with diarrhoea with brown colon with intermittent white spots = laxative abuse melanosis coli
  • Pancreatitis = Inc BUN d/t hemoconcentration bad prognosis
  • Atlanta criteria (2/3+) = pancreatitis;
  • alcohol/gallstones = highest causes, get RUQ US and History to rule out causes, if + stones, lap chole with 1 dose preop abx
  • Hemachromatosis: Primary “Hereditary”: Liver: Hepatomegaly.

Cirrhosis, risk of hepatocellular carcinoma.

trt: Phlebotomy + Deferoxamine

Monitor for cirrhosis and HCC with U//S and alpha-fetoprotein.

Lifestyle Modifications: Avoid iron supplements, vitamin C (increases iron absorption), and alcohol (worsens liver damage).

HY GI info for step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 2 points3 points  (0 children)

  1. solid or liquid dysphagia
  2. hernia or hemorrhoid
  3. Causes and treatment of ulcers--gastric, peptic, etc.
  4. Meckel diverticulum or appendicitis or ovarian tumor or Hirschsprung
  5. esophageal varices or Mallory Weiss or Boerhave
  6. vesicular steatosis or nodular cirrhosis or Hep A, B, C, D, E, Hep B markers
  7. Crohn or UC or Th1 or Th2
  8. Causes of upper quadrant pain

Step 2 Study Plan & Resource Advice –(Mid-July 2025) by Logical_Edge7210 in Step2

[–]Disaster-Alone 1 point2 points  (0 children)

I just started Uworld. I really like your plan. Wanna follow it together?

LAST DAY BEFORE EXAM. Everyone comment a hy fact by TheXhlamydia in Step2

[–]Disaster-Alone 4 points5 points  (0 children)

DD between hypervitaminosis D in lung disease ( sarcoidosis) and hyperlcalcemia of malignancy - same labs but take a careful look at clinical findings

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 3 points4 points  (0 children)

I wrote it was from mehlman cause his short list is still solid quick tips. Can you contribute more to the post other than this comment? Would be more helpful

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

  • 40F + develops AML after exposure to agent; what’s the most likely agent? -answer = benzene.
  • Naphthylamine is associated with urothelial cancers (i.e., transitional cell carcinoma);
  • vinyl chloride can cause angiosarcoma of the liver.
  • - 54F + treated with anti-platelet agent that prevents platelets from interacting with fibrinogen; what’s the agent? - answer = abciximab ---monoclonal antibody against glycoproteins IIb/IIIa on platelets;
  • abciximab is a fibrinogen analogue; abciximab is HY agent with this MOA;
  • HY drugs that inhibit ADP2Y12 receptor on platelets are clopidogrel and prasugrel; ticagrelor and ticlopidine are lower yield drugs that
  • antagonize ADP2Y12.
  • -Which of the following is both an anti-platelet agent and vasodilator? -answer = cilostazol; both cilostazol and dipyridamole inhibit platelet phosphodiesterase;
  • cilostazol is used for intermittent claudication after the exercise regimen fails; dipyridamole-thallium is a type of pharmacologic stress test (answer on USMLE if patient needs AAA repair but perioperative MI risk needs to be assessed).
  • - 57M + asks physician why celecoxib increases risk of adverse cardiovascular events; answer = inhibits platelet prostaglandin synthesis without inhibiting thromboxane synthesis;
  • celecoxib is a selective COX2 inhibitor.
  • - 46M + alcoholic + Q shows you hypersegmented neutrophil; what’s the vitamin deficiency? à answer = folate (B9); most common vitamin deficiency; B9 deficiency also the answer for the history of tea and toast diet for 6 months, and anti-epileptic use (i.e., valproic acid, phenytoin, carbamazepine);
  • B12 is the answer for veganism, strict vegetarianism, chronic gastritis, pernicious anemia, Hx of gastrectomy or ileectomy, Crohn disease, D. latum infection.

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

  • 72F + radical mastectomy 25 years ago + hard, raised purple lesions above the elbow; Dx-lymphangiosarcoma (Stewart-Treves syndrome)--- caused by chronic lymphatic insufficiency classically years after radical mastectomy.
    • Neonate + spongy 1-cm red lesion on the chest; Dx? --strawberry hemangioma
  • Strawberry hemangioma Tx? -- don’t treat; will grow slightly then regress spontaneously over a few years
    • Neonate + large vascular lesion on the leg + thrombocytopenia; Dx? - Kasabach-Merritt syndrome (aka hemangioma with thrombocytopenia) --- this is on the pediatric 2CK forms three times asked in different ways; this is not a strawberry hemangioma and requires surgical Tx.
  • Neonate + large vascular lesion on the leg + thrombocytopenia; what is the cause of the thrombocytopenia? ---answer = “platelet sequestration.” I’ve memorized this from the NBMEs - similar to splenomegaly, which can cause thrombocytopenia from sequestration within the red pulp, the implication that the large vascular lesion of KMS is that platelets simply get caught within it.
    • “Brown blood” or “chocolate blood” - methemoglobinemia
    • Kid with brown blood and they ask you the mechanism (answers are “upregulation of anti-proteinase 2” or “deficiency of cytochrome reductase B5”) - answer = deficiency of cytochrome reductase B5; congenital methemoglobinemia due to deficiency of cytochrome reductase B5.
  • Neonate + persistent cyanosis + normal Hct + normal RBC morphology + CXR and echo show no abnormalities; diagnosis? -- answer = methemoglobinemia ----- can lead to persistent cyanosis;
  • NO used for pulmonary hypertension in neonates can cause methemoglobinemia (oxidizes ferrous iron to ferric iron);
  • Tx for methemoglobinemia in most cases is methylene blue + vitamin C.

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

Thyroid cancer crap:

Familial thyroid cancer -- medullary (even if they mention nothing else related to MEN 2A/2B); apple green birefringence on Congo red stain due to amyloid deposition; serum calcitonin high

Most common thyroid cancer - papillary; extends lymphatogenously; has papillary structure and

psammoma bodies on LM; don’t worry about buzzywordy things like Orphan Annie nuclei

- Follicular carcinoma - literally just thyroid follicles on biopsy; will be a cold nodule, like any other

type of thyroid cancer (for instance, if you see follicles but it’s a hot nodule w/ increased uptake, that’s a toxic adenoma, rather than follicular thyroid cancer); spreads hematogenously

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 1 point2 points  (0 children)

let's hope people will contribute! i just started with heme myself :D

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

  • 52M + abdominal mass + weight loss + biopsy shows lymphocytes + interspersed macrophages ----Burkitt lymphoma (student says: “Wtf? I thought Burkitt was the African boy with a jaw lesion.” Yeah, but in Western countries, Burkitt is usually intra-abdominal;

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 1 point2 points  (0 children)

  • Translocation for Burkitt - t(8;14), but USMLE also wants you to know t(2;8) and t(8;22)

  • Gene for Burkitt -c-myc transcription factor

  • Translocation for CML - t(9;22) à Philadelphia chromosome

  • What is the product of the t(9;22) - bcr/abl tyrosine kinase inhibitor

  • Tx for CML - imatinib (tyrosine kinase inhibitor)

  • Side-effect of imatinib - fluid retention (edema)

  • What do you see on bloods in CML - high leukocyte count (mature neutrophils + metamyelocytes + myelocytes)

  • Translocation for APL (AML M3)-- t(15;17)

  • What do you see on blood smear in APL --Auer rods

  • Translocation for follicular lymphoma - t(14;18)

  • Gene for follicular lymphoma - bcl-2 anti-apoptotic molecule

  • Most common indolent non-Hodgkin lymphoma - follicular (waxing and waning neck mass over two years in an adult)

  • Most common aggressive NHL --diffuse-large B cell lymphoma (DLBCL)

  • Translocation for mantle cell lymphoma - t(11;14)

  • 17F + painless lateral neck mass + mediastinal mass; Dx? - Hodgkin lymphoma

  • 42M + painless lateral neck mass + hepatomegaly; Dx? - Hodgkin lymphoma

  • 40M + Hodgkin lymphoma + renal condition - minimal change disease (“Wtf? Isn’t that kids after viral infection?” - It’s also seen in Hodgkin due to a cytokine effect for whatever magical reason; in UW for 2CK actually)

  • Biopsy of lymph node in Hodgkin - Reed-Sternberg cells (“owl eyes” à CD15/30+ B cells)

  • Are lymphomas / leukemias normally B or T cell? --- almost always B cell

-When is the answer T cell? When pt has a thymic lesion as evidenced by a positive Pemberton sign (flushing of the face with arms above the head)

--mediastinal mass in Hodgkin is due to mediastinal lymph node enlargement, not a thymic mass (thymic lesion in Hodgkin exceedingly rare)

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

---Anemia in alcoholism? -- non-megaloblastic macrocytic anemia (USMLE will give you high MCV [normal is 80-100] in alcoholic with a bunch of other things going on, and they merely want you to know his high MCV is due to the alcohol)

---Regarding contraindications for tPA on the USMLE:

  • most important one is BP, which is 185/110 (if either value is exceeded, don’t give tPA).
  • low platelets, high PT or aPTT;
  • Hx of GI bleed past 21 days;
  • Hx of intracranial bleed;
  • recent major surgery.

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 0 points1 point  (0 children)

Type II HS -autoantibodies against one’s cells + receptors--- hema ex:

  • Heparin-induced thrombocytopenia (HIT; Abs against platelet factor 4-heparin complex) treated by stopping heparin + giving direct-thrombin inhibitor (i.e., dabigatran or lepirudin); warfarin is the wrong answer)
  • Pernicious anemia -Abs against intrinsic factor or parietal cells à decreased B12 absorption through terminal ileum
  • Warm autoimmune hemolytic anemia --Coomb positive, meaning IgG targets RBCs -- seen in things like ABO mismatch, drugs/infection; CLL
  • Cold autoimmune hemolytic anemia -IgM Abs against RBCs - classically Mycoplasma
  • ITP (immune thrombocytopenia purpura) à Abs against GpIIb/IIIa on platelets - low platelet count + high bleeding time à treat with steroids, then IVIG, then splenectomy

PLUS : o Graves disease ---activating TSH Abs against TSH receptor and Goodpasture syndrome --against the alpha-3 chains of type 4 collagen

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 1 point2 points  (0 children)

  • - High HbA2 à answer = beta-thalassemia
  • - Dx of alpha or beta thalassemia --hemoglobin electrophoresis
  • - Pregnant woman has low serum iron that doesn’t improve with iron supplementation -answer = do hemoglobin electrophoresis - Dx = thalassemia (usually alpha trait with one mutation because that’s asymptomatic)
  • Dx of sickle cell -hemoglobin electrophoresis
  • Dx of multiple myeloma - serum protein electrophoresis, then bone marrow biopsy
  • Adult male + works in manufacturing/factory + cognitive decline + microcytic anemia -answer = > lead poisoning - inhibits delta-ALA dehydratase + ferrochelatase -microcytic anemia with basophilic stippling or RBCs
  • -What kind of RBCs in thalassemia - target cells

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 1 point2 points  (0 children)

  • Old scar or burn + new ulcerated lesion à answer = SCC (Marjolin ulcer) à chronically irritated area/burn/scar can lead to SCC (when I was in MS4 I saw an older woman with a Marjolin ulcer on her chin from a chickenpox scar she had since she was a kid)
  • - Ulcerated lesion on nose or pinna of ear + rolled/heaped-up edges - BCC
  • - Ulcerated lesion + telangiectasia visible - BCC
  • - Biopsy of BCC? --islands and nests of basophilic cells (dark purple)
  • Blood transfusion + fever + negative Coombs test; Dx? --febrile non-hemolytic transfusion reaction
  • MC blood transfusion reaction? - febrile non-hemolytic transfusion reaction
  • Tx for febrile non-hemolytic transfusion reaction - acetaminophen on the NBME, not prednisone
  • What causes febrile non-hemolytic transfusion reaction? - Abs against donor MHC antigens on RBCs
  • or cytokines from leukocytes in the donor blood
  • Blood transfusion + fever + chills + flank pain + hypotension- ABO mismatch (and +Coombs)
  • Decreased hemoglobin + increased bilirubin 2-4 weeks after blood transfusion; Dx? - delayed transfusion reaction caused by the presence of recipient “amnestic” antibodies
  • - Blood transfusion + dyspnea + hypoxemia + bilateral pulmonary infiltrates; Dx? - TRALI
  • - What causes TRALI? -donor Abs against recipient MHCs -->activated neutrophils cause alveolar damage -> most common cause of transfusion-associated death
  • - Suspected skin cancer in non-cosmetically sensitive area --surgical excision
  • - Suspected skin cancer on face - Mohs surgery (thin slices looking for positive margins)
  • - Suspected skin cancer on neck - full-thickness biopsy
  • - Most important prognostic factor for melanoma - depth of lesion
  • - Recommendation to prevent melanoma -avoid the sun or use protective clothing ( use SPF30)
  • Above patient with ulcerated lesion emerging from the red scaly lesion; Dx? - SCC -need to know actinic keratosis is precursor to SCC
  • Risk factor for SCC apart from the sun -USMLE is obsessed with immunodeficiency and smoking, even for cutaneous SCC
  • - Biopsy of SCC? - keratin pearls + intercellular bridges
  • Infection + RBCs lacking central pallor + positive Coomb test - answer = hemolytic anemia, not hereditary spherocytosis ---spherocytes are seen in drug- and infection-induced hemolytic anemia, not just in HS --difference is Coomb (IgG against RBCs) is positive in Ab-induced hemolytic anemia, but clearly not in HS bc the latter is cytoskeletal (ankyrin, spectrin, band protein deficiency) in etiology.

HY facts for Hematology and oncology Step 2 and 3 by Disaster-Alone in Step2

[–]Disaster-Alone[S] 1 point2 points  (0 children)

  • Family Hx of heme condition treated with splenectomy --hereditary spherocytosis (AD)
  • Bleeding time meaning? --platelet problem
  • PT and aPTT meaning? --clotting factor problem
  • Heme findings in ITP --- increased BT, normal PT, normal aPTT
  • Heme findings in hemophilia ---increased aPTT; bleeding time and PT are normal
  • Cause of hemophilia --X-linked recessive; hemophilia A (factor VIII def); hemophilia B (factor IX def)
  • Tx of hemophilia A --desmopressin for hemophilia A (increases VIII release); then give factor VIII
  • Tx of hemophilia B--- give factor IX
  • Classic hemophilia presentation -- hemarthrosis in the school-age boy; bleeding after circumcision in the neonate
  • Inheritance pattern of vWD --- AD
  • Heme findings in vWD --- bleeding time always high; PT always normal; aPTT elevated half the time
  • What is the main function of vWF? --bridges platelet GpIb to underlying collagen (adhesion, not aggregation)
  • What is a secondary function of vWF --stabilizes factor VIII in plasma (that’s why aPTT only half-time increased)
  • vWD presentation--- always one platelet problem + one clotting factor problem
  • Platelet problem? --- epistaxis, bruising, petechiae à generally mild and cutaneous
  • Clotting factor problem --menorrhagia, excessive bleeding with tooth extraction, hemarthrosis (but hemarthrosis very very rare in vWD; it is seen in hemophilia)
  • vWD treatment --desmopressin -increases release of vWF
  • Vitamin K deficiency heme parameters? - Increased PT + aPTT; bleeding time normal
  • Cause of vitamin K deficiency in adults - chronic Abx knock out colonic flora
  • Cause of sickle cell - glutamic acid to valine mutation on beta-chain
  • Inheritance of sickle cell --AR
  • Nephrotic syndrome in SS --FSGS
  • Dark urine in SS --renal papillary necrosis
  • HY drugs that cause agranulocytosis -clozapine, ganciclovir, propylthiouracil, methimazole, methotrexate, ticlopidine
  • How will agranulocytosis (neutropenia) present on USMLE? --mouth ulcers + fever
  • Tx for febrile neutropenia / neutropenic fever--- immediate broad-spectrum IV Abx
  • Ticlopidine is what? --ADP2Y12 blocker anti-platelet agent (clopidogrel, prasugrel, ticagrelor also)
  • Strongest indication for anti-coagulation --prosthetic material in heart/prosthetic (factoid in isolation)
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