Diary of a forever lazy girl @albedo456 - Tumblr Blog

🤎 Stuck-on waxy brown lesion + elderly + stable for years + rubbery texture = seborrheic keratosis. Benign. No treatment. Sudden multiple new SKs = Leser-Trélat = find occult cancer 🫠 (Most common: GI adenocarcinoma)

#medicine #dermatology #usmle step 2

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2 months bloody diarrhea + weight loss = undiagnosed IBD

+

fever + tachycardia + leukocytosis + distension

+

massively dilated colon on X-ray

=

TOXIC MEGACOLON — medical emergency

Lock-In Rule

Toxic megacolon = IBD + systemic toxicity + dilated colon on X-ray. Treatment = IV steroids + bowel rest + decompress. NEVER scope. NEVER give opioids — they dilate the colon further and cause perforation.

#usmle step 2 #surgery #GIT

retroperitoneal hematoma is the sneaky little rat of obstetrics

post c-section. hypotensive. tachycardic. pale. cold. dying.

visible bleeding: none. uterus: firm. incision: dry.

so where is the blood????

IN THE RETROPERITONEUM. just chilling. filling up silently like a villain origin story. the retroperitoneum said "I can hold so much blood actually" and went to work.

**the vibe check:**

- boggy uterus = atony. oxytocin. massage. easy.

- heavy bleeding + firm uterus = retained placenta. ultrasound.

- NO bleeding + firm uterus + patient is DYING = rat behavior. retroperitoneal hematoma.

unstable → OR. now. don't you dare order a CT.

stable → CT → embolization. fine.

#usmle step 2 #obgyn #pregnancy

Big baby + macroglossia + one side larger → Beckwith-Wiedemann syndrome 👶

Step 2 move: screen with abdominal ultrasound for Wilms tumor or hepatoblastoma 🫘

#peds #usmle step 2 #renal #tumor

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Diary of a forever lazy girl