The Rx Bricks Podcast

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Pain Mechanisms Jul 16, 2024

Show notes

Pain is a sensation that warns of potential injury and alerts the person to avoid or treat it. For example, if you touch a hot object, you will feel pain and immediately remove your hand from that object, protecting your hand from further damage. As much as pain can burden and torment, ultimately it is an essential part of our bodies’ mechanisms of self-preservation.

Pain can be mild or severe, constant or intermittent, sharp or dull. Sometimes it can even be hard to describe the uncomfortable sensation in words. Nevertheless, clinicians always ask their patients to describe their pain. Why? Because its characteristics can help us better determine the mechanism behind a patient’s pain.

In the clinic, the patient’s subjective experience of pain can be crucial to arriving at the correct diagnosis and treatment. For this reason, understanding the different kinds of pain and their underlying biology is an essential building block of foundational clinical knowledge.

There is no standard system of classifying pain. In this discussion, we will classify the five main types of pain as nociceptive, breakthrough, inflammatory, neuropathic, and functional.

After listening to this AudioBrick, you should be able to:

Define the different classifications of pain and why they occur.
Describe the mechanisms of neuropathic pain.
Define and describe transient and chronic paresthesia.
Define and describe allodynia and hyperalgesia.

You can also check out the original brick on Pain Mechanisms from our Neurology and Special Senses collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

You will get 5 days of full access to our Rx360+ program, including nearly 800 Rx Bricks. After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.

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Gastrointestinal Regulatory Substances Jul 09, 2024

Show notes

As we eat, our gastrointestinal (GI) system releases a host of both local and distant regulators to control the process of digestion. We will begin with the primary hormones, then cover some of the secondary hormones, and lastly discuss how our body senses its intraluminal contents and then subsequently integrates all of the various stimuli it receives.

After listening to this AudioBrick, you should be able to:

Identify the location, cell type, release stimulus to the endocrine cells, and function of the major gastrointestinal (GI) hormones secretin, cholecystokinin (CCK), gastrin, vasoactive intestinal polypeptide (VIP).
Describe in brief the release stimulus and function of the GI regulatory peptides bombesin, GLP-1, GLP-2, ghrelin, leptin, motilin, somatostatin, and gastric inhibitory polypeptide (GIP).
Understand how the physical and chemical compositions of luminal contents are sensed and the hormonal responses that then occur.
Outline how GI cells integrate multiple regulatory inputs from hormonal and neural inputs to control function.

You can also check out the original brick on Gastrointestinal Regulatory Substances from our Gastrointestinal collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Migraine, Cluster, and Tension Headaches Jul 02, 2024

Show notes

Headaches are an unavoidable fact of life and often are nothing more than the result of sitting through one too many lectures. However, they can become debilitating and get in the way of daily life, especially when they become recurrent. Although some headaches have symptoms other than head pain, we typically think of headache pain relative to its location, how intense it is, and how long it lasts.

After listening to this AudioBrick, you should be able to:

Compare and contrast the clinical features of primary headache syndromes (migraine, cluster, tension-type headaches).
Differentiate migraine aura from other transient neurological disorders (eg, transient ischemic attacks, seizure, presyncope).
Discuss the mechanisms of central nervous system sensitization and pain referral and the interaction of neural structures, particularly pain pathways and neurovascular control.
Outline which patients warrant radiologic or other lab evaluation for headache.
Describe the treatment of patients with headache disorders and potential complications of treatment.

You can also check out the original brick on Migraine, Cluster, and Tension Headaches from our Neurology and Special Senses collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/

Patent Ductus Arteriosis Jun 19, 2024

Show notes

he ductus arteriosus (DA) is a structure that allows blood pumped from the right side of the heart to bypass the lungs while the fetus is developing in utero. Normally, the DA closes shortly after birth and becomes the ligamentum arteriosum. When the DA fails to close (remains open, or patent) after birth, it is known as patent ductus arteriosus (PDA). This acyanotic congenital heart defect causes abnormal blood flow from the left to the right side of the heart and can lead to heart failure and failure to thrive in neonates.

After listening to this AudioBrick, you should be able to:

Define patent ductus arteriosus (PDA).
Describe the anatomy and intrauterine function of the ductus arteriosus, the normal sequence of changes in the ductus during the transition from fetal to postnatal circulation, and the consequences of failure to close the ductus.
Describe the findings on physical exam of an infant with a PDA, the clinical presentation of a child with a significant PDA, and the diagnostic tests used to confirm the diagnosis of PDA.
Explain the treatment options for a child with a PDA, along with the risks and complications associated with an untreated PDA.

You can also check out the original brick on Patent Ductus Arteriosis from our Cardiology collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Congenital Disorders of the Reproductive Systems Jun 11, 2024

Show notes

In typical reproductive system development, recall that the intermediate mesoderm forms the mesonephric (Wolffian) and paramesonephric (Müllerian) ducts and the indifferent gonads; primitive germ cells migrate into the indifferent gonads. These are the structures that become the internal organs of the reproductive systems.

After listening to this AudioBrick, you should be able to:

Describe the normal development of male and female reproductive systems.
Compare and contrast anomalies of the uterus and vagina arising in the female reproductive system.
Compare and contrast anomalies of the testes, scrotum, and penile urethra arising in the male reproductive system.
Compare and contrast disorders of sexual development (DSD): ovotesticular DSD, 46 XX DSD, and 46 XY DSD.

You can also check out the original brick on Congenital Disorders of the Reproductive Systems from our Reproductive collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Substance Use Disorders: Foundations and Frameworks Jun 04, 2024

Show notes

Substance use disorder (SUD) refers to a pattern of substance use—be it nicotine, cannabis, cocaine, or something else—that causes significant impairment or distress to the user. SUD is prevalent and growing in the United States and around the world. People of any age may be at risk for developing a substance use disorder. But exposure to and experimentation with alcohol and drugs usually begins in early adolescence. Many adolescents experiment with substances and then taper down or stop using them. Others continue to advance their drug use, leading to a diagnosable substance use disorder with negative health and social consequences.

TheDiagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5) is the widely accepted and respected guide to diagnosing psychiatric disorders in the United States. Substance abuse has been recognized in the DSM-5 as a mental health disorder for many years. The manual no longer describes substance abuse and dependence separately but instead globally uses substance use disorder with specifiers to determine the severity of the use.

After listening to this AudioBrick, you should be able to:

Define and explain the essential features of substance use disorders.
Describe the epidemiology of substance use disorders.
Explain how the reward pathway in the brain is involved in the development of substance use disorders, and describe how the brain changes during active use and recovery.
Describe the evidence-based assessments and treatment approaches for substance use disorders.

You can also check out the original brick on Substance Use Disorders from our Psychiatry collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/

Stimulants and Cognitive-Enhancing Drugs May 21, 2024

Show notes

Stimulant medications are drugs that increase alertness and attention. They also elevate heart rate, blood pressure, and respiratory rate. Stimulants are used to treat many conditions, including attention-deficit/hyperactivity disorder (ADHD), chronic lethargy, narcolepsy, and obesity. Examples of stimulants include caffeine, amphetamines (such as dextroamphetamine), methylphenidate, and modafinil.

Cognitive-enhancing drugs serve a similar purpose, increasing memory, alertness, and attention. These drugs are used to treat Alzheimer disease, Lewy body dementia, and other neurocognitive disorders.

After listening to this AudioBrick, you should be able to:

Name conditions for which stimulants and cognitive-enhancing drugs are used as treatment.
Describe the mechanism of action of stimulants and cognitive-enhancing drugs.
List the main examples of stimulants and cognitive-enhancing drugs.
Describe the significant adverse effects of stimulants and cognitive-enhancing drugs.

You can also check out the original brick on Stimulants and Cognitive-Enhancing Drugs from our Psychiatry collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/

Hematopoietic Malignancies: Putting It All Together May 14, 2024

Show notes

If you’ve studied the hematopoietic system malignancies—all the leukemias, lymphomas, and plasma cell disorders—you probably feel like you’ve been hit with the good old medical school fire hose. Now’s a good time to take a step back from all the details, make sure that you remember the underlying framework, and pull together some information that connects several different diseases.

In this brick, we’ll revisit some of the hematopoietic diseases that we often talk about in pairs: acute vs chronic leukemias, benign lymph node diseases vs lymphoma, and low-grade vs high-grade lymphomas. Also, in case you haven’t already done this on your own, we’ll pull together all the important translocations, their respective diseases, and the reasons why we should remember them.

After listening to this AudioBrick, you should be able to:

Compare and contrast acute and chronic leukemias.
Compare and contrast the morphologic features of benign follicular hyperplasia and follicular lymphoma.
Compare and contrast the morphologic and clinical features of low-grade and high-grade lymphomas and give examples of each.
Know the following translocations and name the disease (and prognostic significance, if any) associated with each: t(8;21), t(15;17), inv(16), 11q23, FLT3 mutation, t(9;22), t(11;14), t(14;18), and t(8;14).

You can also check out the original brick on Hematopoietic Malignancies: Putting It All Together from our Hematology collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/

Substance Use Disorders: Foundations and Frameworks May 07, 2024

Show notes

After listening to this AudioBrick, you should be able to:

Define and explain the essential features of substance use disorders.
Describe the epidemiology of substance use disorders.
Explain how the reward pathway in the brain is involved in the development of substance use disorders, and describe how the brain changes during active use and recovery.
Describe the evidence-based assessments and treatment approaches for substance use disorders.

You can also check out the original brick on Substance Use Disorders from our Psychiatry collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/

Megaloblastic Anemia Apr 30, 2024

Show notes

Megaloblast. Now there’s a word you don’t hear every day. The root -blast (from the Greek blastos, meaning germ or bud) may be somewhat familiar since we talk about blast cells (very young hematopoietic precursor cells) in hematology. And megalo- (from the Greek megas, meaning large or great) is also used fairly frequently, as in splenomegaly (enlargement of the spleen). So does “megaloblast” just mean a large, immature cell? We’ll answer this question, and many more, in this discussion of megaloblastic anemia.

After listening to this AudioBrick, you should be able to:

Describe the pathogenesis of megaloblastic anemia.
List common causes of B12 and folate deficiency and associated nonhematologic symptoms of each.
List and understand the characteristic complete blood count values in megaloblastic anemia.
Describe and identify the morphologic changes present in the blood and bone marrow in a patient with megaloblastic anemia.
Describe the treatment of megaloblastic anemia.

You can also check out the original brick on Megaloblastic Anemia from our Hematology collection, which is available for free.

Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com

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Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/

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