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EN_B00000_S05462_W000006 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000007 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000008 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000010 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000011 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000013 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Let's just start out and say that preventing tumor lysis syndrome is a very important step.",
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EN_B00000_S05462_W000024 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000025 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000026 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000027 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " So, uh, as I mentioned, important to identify high risk patients and administer prophylactic therapy to reduce the risk of tumor lysis syndrome. The prophylactic therapy",
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EN_B00000_S05462_W000028 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Is going to be allopurinol and hydration. More recently, there is a medication that's come out called Rasbiricase, also marketed as Elatec. This is a recombinant urate oxidase,... | EN_B00000_S05462_W000028.mp3 | [
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EN_B00000_S05462_W000029 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000030 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And the hydration just helps your kidneys uh, move stuff around.",
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EN_B00000_S05462_W000031 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000032 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Uh, congestive heart failure again associated with increased fluid load. Dysrhythmia can be associated with hyperkalemia and syncope and sudden death.",
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EN_B00000_S05462_W000033 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000034 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000035 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000036 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000039 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000040 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000041 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000043 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000044 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000045 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " It does not. So Colchicine has no role in the treatment of tumor lysis syndrome. N-acetylcysteine. Where do you hear about this one?",
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EN_B00000_S05462_W000047 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " In other words, giving them sodium bicarbonate, uh, can be useful for solubilizing uric acid, but it is not going to be done prophylactically. And then prophylactic dialysis i... | EN_B00000_S05462_W000047.mp3 | [
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EN_B00000_S05462_W000049 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000050 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000051 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000054 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " physical is significant for pallor and multiple bruises on her arms and calves she denies abuse or injury remainder of the exam is unremarkable",
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EN_B00000_S05462_W000055 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Serum iron is low. Pt is 12 seconds, which is normal. Ptt is 45 seconds, which is prolonged.",
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EN_B00000_S05462_W000056 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Hey, von Willebrand's disease. Alright, so what is our initial impression of this patient just based on her history?",
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EN_B00000_S05462_W000057 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " One of the things that you have to think of, any woman who menstruates and says that she feels tired, you need to ask her about her periods. Because one of the more common rea... | EN_B00000_S05462_W000057.mp3 | [
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EN_B00000_S05462_W000058 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Uh, one of the more common reasons that we need to ask about because it's something that we can diagnose is iron deficiency anemia because of her periods. And this is going to... | EN_B00000_S05462_W000058.mp3 | [
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EN_B00000_S05462_W000059 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " They're a little heavy. Now, when you, when a woman tells you that her periods are heavy, that's kind of subjective. So you want to ask her how many pads do you go through.",
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EN_B00000_S05462_W000060 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And you should know, have this in your back pocket, that a pad holds about 10 milliliters of blood.",
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EN_B00000_S05462_W000061 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And you should not lose more than 80 milliliters of blood per cycle. So if she says that she's going through more than eight pads in her cycle, that's too much. And so you can... | EN_B00000_S05462_W000061.mp3 | [
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EN_B00000_S05462_W000062 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " So, the fact that she's got menorrhagia, and that she's got, uh, she's feeling tired, and then, when you do the physical exam, she's got pallor,",
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EN_B00000_S05462_W000063 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And when you look at her vitals, she's got an elevated heart rate. All of this looks like iron deficiency anemia, and so you'll want to get a CBC and iron studies.",
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"text": " Now, add to this, on her physical exam, she's got multiple bruises on her arms and calves. We are concerned about a bleeding disorder. HOWEVER, I want you to write this down an... | EN_B00000_S05462_W000064.mp3 | [
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EN_B00000_S05462_W000065 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " In an adolescent, so a teenage woman or girl.",
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EN_B00000_S05462_W000066 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Should always be attributed to a coagulopathy, a bleeding disorder, until proven otherwise. And Von Willebrand's disease is the most common of those.",
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EN_B00000_S05462_W000067 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000068 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000069 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000070 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000071 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000072 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " So hemophilia A and B are both out. Because hemophilia A is a factor 8 deficiency. Hemophilia B is a factor 9 deficiency.",
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EN_B00000_S05462_W000073 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000074 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And also, I'll just add, hemophilia A and B are X-linked recessive disorders, and so you would not expect to see these in a female.",
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EN_B00000_S05462_W000075 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000076 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Because Bernard-Zullier syndrome is a deficiency of GP1B, like a protein 1B, which is on the platelet. So the platelet is going to be disorder, your bleeding time will be prolo... | EN_B00000_S05462_W000076.mp3 | [
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EN_B00000_S05462_W000077 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " But with Von Willebrand's disease, you have a deficiency of factor 8 in addition to the deficiency of Von Willebrand's factor. For reasons I will go into on the next slide.",
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EN_B00000_S05462_W000078 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000079 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And then primary menorrhagia due to adolescence. I will say that adolescence because of disturbances, immaturity rather, of the hypothalamic-pituitary-ovarian axis can cause",... | EN_B00000_S05462_W000079.mp3 | [
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EN_B00000_S05462_W000080 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " That certainly is not the case in this instance because she's got the bruises on her arms and calves.",
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EN_B00000_S05462_W000081 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Bleeding disorder, uh, it's not restricted to just her uterus.",
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EN_B00000_S05462_W000082 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " So Von Muehlbrand's disease is the most likely diagnosis, but please, please, please remember, and I'm going to say it again, menorrhagia in an adolescent should be attributed... | EN_B00000_S05462_W000082.mp3 | [
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EN_B00000_S05462_W000083 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " And on some of these internal medicine hematology questions on the USMLE.",
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EN_B00000_S05462_W000084 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " So just to run over bleeding disorders, remember that platelet type bleeding, as we saw in this patient, will result in superficial cutaneous or mucus membrane bleeding. So no... | EN_B00000_S05462_W000084.mp3 | [
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EN_B00000_S05462_W000085 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " So von Wuhlbrand's disease, Bernard-Sully-A syndrome, thrombocytopenia.",
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EN_B00000_S05462_W000086 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000087 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000088 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000089 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000090 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000091 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Your PT, which primarily measures the activity of factor 7, will be normal. And your PTT, which measures 12, 11, 9, and 8, as well as your, uh, your combined pathway, common pa... | EN_B00000_S05462_W000091.mp3 | [
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EN_B00000_S05462_W000092 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Uh, will be prolonged, and that's because of the factor 8. To diagnose Von Willebrand's disease, the most accurate test is the ristocetin cofactor assay. There's also somethin... | EN_B00000_S05462_W000092.mp3 | [
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EN_B00000_S05462_W000093 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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EN_B00000_S05462_W000094 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " If the bleeding time is normal, then that suggests a factor issue. You look at your PTT. If your PTT is prolonged, then of course you're looking at 12, 11, 9, 8, and the commo... | EN_B00000_S05462_W000094.mp3 | [
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EN_B00000_S05462_W000095 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"speaker": "EN_B00000_S05462",
"text": " Uh, that can be, uh, you'll look at PT then. If the PT is prolonged, then you think of things like liver disease. Uh, if the PT is normal, then you look at things like hemophi... | EN_B00000_S05462_W000095.mp3 | [
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EN_B00000_S05462_W000096 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"speaker": "EN_B00000_S05462",
"text": " Why would liver disease with the PT be prolonged? Because 7 is made by the liver, and PT is 7, factor 7, and so you think of liver disease. If the PTT is normal, uh, you look ... | EN_B00000_S05462_W000096.mp3 | [
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EN_B00000_S05462_W000097 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
"dnsmos": 3.3852,
"duration": 8.608,
"id": "EN_B00000_S05462_W000097",
"language": "en",
"speaker": "EN_B00000_S05462",
"text": " If the PT is prolonged, then you look at factor 7 deficiency. If the PT is normal, then you look at factor 13 deficiency or drugs.",
"wav": "EN_B00000/EN_B00000_S05462/mp3/EN... | EN_B00000_S05462_W000097.mp3 | [
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EN_B00000_S05462_W000098 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"id": "EN_B00000_S05462_W000098",
"language": "en",
"speaker": "EN_B00000_S05462",
"text": " Both Prolonged PT and PTT. You can copy this down if you want. This really just, uh, goes over what we talked about. Some of these bleeding disorders are inherited. As you can ... | EN_B00000_S05462_W000098.mp3 | [
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EN_B00000_S05462_W000099 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"language": "en",
"speaker": "EN_B00000_S05462",
"text": " Recessive, uh, Von Willebrand's disease here with the little pound sign up here is autosomal dominant. And then this little carrot here are the X-linked recessive disorder. So... | EN_B00000_S05462_W000099.mp3 | [
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EN_B00000_S05462_W000100 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"duration": 13.413,
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"language": "en",
"speaker": "EN_B00000_S05462",
"text": " Haemophilia C is an autosomal recessive disorder, so you can see that in females, but it is quite rare. Uh, it's more common among the Ashkenazi Jewish population. It's one of ... | EN_B00000_S05462_W000100.mp3 | [
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EN_B00000_S05462_W000101 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"text": " Uh, some of these factor 5, factor 10 deficiency, prothrombin, fibrillation deficiency, they're very rare.",
"wav": "EN_B00000/EN_B00000_S05462/mp3/EN_B00000_S05462_W000101.m... | EN_B00000_S05462_W000101.mp3 | [
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EN_B00000_S05462_W000102 | hf://datasets/amphion/Emilia-Dataset@bcaad00d13e7c101485990a46e88f5884ffed3fc/EN/EN-B000002.tar | {
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"duration": 15.857,
"id": "EN_B00000_S05462_W000102",
"language": "en",
"speaker": "EN_B00000_S05462",
"text": " Uh, do keep in mind vitamin K deficiency is a common cause of prolonged PT. Remember you need vitamin K to clot. Uh, so that's a possibility particularly in patients who have ... | EN_B00000_S05462_W000102.mp3 | [
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