StudyXing Medicine

@USMLEStepStudy

Study 8100+ #MedEd "flash-XCreations"- Reminders of topics to do a deeper study-dive. Zebra hoof-beats? Think Tyrannosaurus Rex 🦖Thanks 56,000!

Earth, WHO jurisdiction

Joined November 2009

8KPosts 57KFollowers 0Following

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StudyXing Medicine

@USMLEStepStudy

Nov 20

Long QT Syndrome - gene variant (KCNQ1, KCNH2) affecting cardiac K+ and Na+ chanels --> repolarization disruption --> long QT int; Triggers: LQT1: Sympathetic emotional/physical exertion, LQT2: Sudden noises, hypokalemia, QT-prolonging drugs, postpartum sleep disruption

USMLEStepStudy's tweet image. Long QT Syndrome - gene variant (KCNQ1, KCNH2) affecting cardiac K+ and Na+ chanels --&gt; repolarization disruption --&gt; long QT int; Triggers: LQT1: Sympathetic emotional/physical exertion, LQT2: Sudden noises, hypokalemia, QT-prolonging drugs, postpartum sleep disruption

USMLEStepStudy's tweet image. Long QT Syndrome - gene variant (KCNQ1, KCNH2) affecting cardiac K+ and Na+ chanels --&gt; repolarization disruption --&gt; long QT int; Triggers: LQT1: Sympathetic emotional/physical exertion, LQT2: Sudden noises, hypokalemia, QT-prolonging drugs, postpartum sleep disruption

USMLEStepStudy's tweet image. Long QT Syndrome - gene variant (KCNQ1, KCNH2) affecting cardiac K+ and Na+ chanels --&gt; repolarization disruption --&gt; long QT int; Triggers: LQT1: Sympathetic emotional/physical exertion, LQT2: Sudden noises, hypokalemia, QT-prolonging drugs, postpartum sleep disruption

StudyXing Medicine

@USMLEStepStudy

Nov 19

Tricuspid stenosis - rare diastolic, harsh, rumbling lower frequency murmur, LLSB (not apex) 4th ICS; MCC: rheumatic heart dz, carcinoid tumors, endocarditis, radiation, fibrosis; Rx: valve repair or replacement, percutaneous balloon valvuloplasty

USMLEStepStudy's tweet image. Tricuspid stenosis - rare diastolic, harsh, rumbling lower frequency murmur, LLSB (not apex) 4th ICS; MCC: rheumatic heart dz, carcinoid tumors, endocarditis, radiation, fibrosis; Rx: valve repair or replacement, percutaneous balloon valvuloplasty

USMLEStepStudy's tweet image. Tricuspid stenosis - rare diastolic, harsh, rumbling lower frequency murmur, LLSB (not apex) 4th ICS; MCC: rheumatic heart dz, carcinoid tumors, endocarditis, radiation, fibrosis; Rx: valve repair or replacement, percutaneous balloon valvuloplasty

USMLEStepStudy's tweet image. Tricuspid stenosis - rare diastolic, harsh, rumbling lower frequency murmur, LLSB (not apex) 4th ICS; MCC: rheumatic heart dz, carcinoid tumors, endocarditis, radiation, fibrosis; Rx: valve repair or replacement, percutaneous balloon valvuloplasty

USMLEStepStudy's tweet image. Tricuspid stenosis - rare diastolic, harsh, rumbling lower frequency murmur, LLSB (not apex) 4th ICS; MCC: rheumatic heart dz, carcinoid tumors, endocarditis, radiation, fibrosis; Rx: valve repair or replacement, percutaneous balloon valvuloplasty

StudyXing Medicine

@USMLEStepStudy

Nov 17

Uveitis = inflammation of uveal tract (iris, ciliary body, choroid); Sight-threatening requiring prompt diagnosis and management; Mnemonic for Common Causes: "A HORSE SITs"

USMLEStepStudy's tweet image. Uveitis = inflammation of uveal tract (iris, ciliary body, choroid); Sight-threatening requiring prompt diagnosis and management; Mnemonic for Common Causes: "A HORSE SITs"

USMLEStepStudy's tweet image. Uveitis = inflammation of uveal tract (iris, ciliary body, choroid); Sight-threatening requiring prompt diagnosis and management; Mnemonic for Common Causes: "A HORSE SITs"

StudyXing Medicine

@USMLEStepStudy

Nov 14

VITAMIN CDE disease categories

USMLEStepStudy's tweet image. VITAMIN CDE disease categories

StudyXing Medicine

@USMLEStepStudy

Nov 14

Diagnostics… 3 Steps:

USMLEStepStudy's tweet image. Diagnostics… 3 Steps:

StudyXing Medicine

@USMLEStepStudy

Nov 13

BROCA'S AREA - Inferior frontal gyrus (L. hemisphere) Brodmann 44, 45, Near motor cortex controlling face/mouth/tongue; Speech production, Articulation motor planning, Grammar/syntax processing, Coordinates muscles for speaking; Damaged Broca's --> Non-fluent, expressive aphasia

USMLEStepStudy's tweet image. BROCA'S AREA - Inferior frontal gyrus (L. hemisphere)
Brodmann 44, 45, Near motor cortex controlling face/mouth/tongue; Speech production, Articulation motor planning, Grammar/syntax processing, Coordinates muscles for speaking; Damaged Broca's --&gt; Non-fluent, expressive aphasia

USMLEStepStudy's tweet image. BROCA'S AREA - Inferior frontal gyrus (L. hemisphere)
Brodmann 44, 45, Near motor cortex controlling face/mouth/tongue; Speech production, Articulation motor planning, Grammar/syntax processing, Coordinates muscles for speaking; Damaged Broca's --&gt; Non-fluent, expressive aphasia

USMLEStepStudy's tweet image. BROCA'S AREA - Inferior frontal gyrus (L. hemisphere)
Brodmann 44, 45, Near motor cortex controlling face/mouth/tongue; Speech production, Articulation motor planning, Grammar/syntax processing, Coordinates muscles for speaking; Damaged Broca's --&gt; Non-fluent, expressive aphasia

StudyXing Medicine

@USMLEStepStudy

Nov 13

Kidney GFR = 125 mL/min (180 L/day filtered) ~20% renal plasma flow is filtered Filtration barrier: Fenestrated endothelium → basement membrane → podocyte foot processes Charge selective: Neg charges repel albumin Size: <7 kDa freely filtered; albumin (69 kDa) normally retained

USMLEStepStudy's tweet image. Kidney GFR = 125 mL/min (180 L/day filtered)
~20% renal plasma flow is filtered
Filtration barrier: Fenestrated endothelium → basement membrane → podocyte foot processes
Charge selective: Neg charges repel albumin
Size: &lt;7 kDa freely filtered; albumin (69 kDa) normally retained

USMLEStepStudy's tweet image. Kidney GFR = 125 mL/min (180 L/day filtered)
~20% renal plasma flow is filtered
Filtration barrier: Fenestrated endothelium → basement membrane → podocyte foot processes
Charge selective: Neg charges repel albumin
Size: &lt;7 kDa freely filtered; albumin (69 kDa) normally retained

USMLEStepStudy's tweet image. Kidney GFR = 125 mL/min (180 L/day filtered)
~20% renal plasma flow is filtered
Filtration barrier: Fenestrated endothelium → basement membrane → podocyte foot processes
Charge selective: Neg charges repel albumin
Size: &lt;7 kDa freely filtered; albumin (69 kDa) normally retained

StudyXing Medicine

@USMLEStepStudy

Nov 9

Leishmaniasis: parasitic dz spread by sand fly bites 🦟 ▶️ Cutaneous: Skin ulcers at bite site (MC) ▶️ Mucocutaneous: mouth/nose mucous membranes ▶️ Visceral: Fever, wt loss, splenomegaly, hepatomegaly Rx: 💊 Antiparasitic liposomal amphotericin B

USMLEStepStudy's tweet image. Leishmaniasis: parasitic dz spread by sand fly bites 🦟
▶️ Cutaneous: Skin ulcers at bite site (MC)
▶️ Mucocutaneous: mouth/nose mucous membranes
▶️ Visceral: Fever, wt loss, splenomegaly, hepatomegaly
Rx: 💊 Antiparasitic liposomal amphotericin B

USMLEStepStudy's tweet image. Leishmaniasis: parasitic dz spread by sand fly bites 🦟
▶️ Cutaneous: Skin ulcers at bite site (MC)
▶️ Mucocutaneous: mouth/nose mucous membranes
▶️ Visceral: Fever, wt loss, splenomegaly, hepatomegaly
Rx: 💊 Antiparasitic liposomal amphotericin B

USMLEStepStudy's tweet image. Leishmaniasis: parasitic dz spread by sand fly bites 🦟
▶️ Cutaneous: Skin ulcers at bite site (MC)
▶️ Mucocutaneous: mouth/nose mucous membranes
▶️ Visceral: Fever, wt loss, splenomegaly, hepatomegaly
Rx: 💊 Antiparasitic liposomal amphotericin B

USMLEStepStudy's tweet image. Leishmaniasis: parasitic dz spread by sand fly bites 🦟
▶️ Cutaneous: Skin ulcers at bite site (MC)
▶️ Mucocutaneous: mouth/nose mucous membranes
▶️ Visceral: Fever, wt loss, splenomegaly, hepatomegaly
Rx: 💊 Antiparasitic liposomal amphotericin B

StudyXing Medicine

@USMLEStepStudy

Nov 9

Genu Varum (Bowlegs): Standing gap between knees. Common in toddlers, usually resolves by age 2. Genu Valgum (Knock-Knees): Knees touch, ankles apart. Peaks age 4-5, often corrects by age 7-8. Rx: RARELY needed. Bracing/surgery only for severe, persistent or underlying disease.

USMLEStepStudy's tweet image. Genu Varum (Bowlegs): Standing gap between knees. Common in toddlers, usually resolves by age 2.
Genu Valgum (Knock-Knees): Knees touch, ankles apart. Peaks age 4-5, often corrects by age 7-8.
Rx: RARELY needed. Bracing/surgery only for severe, persistent or underlying disease.

USMLEStepStudy's tweet image. Genu Varum (Bowlegs): Standing gap between knees. Common in toddlers, usually resolves by age 2.
Genu Valgum (Knock-Knees): Knees touch, ankles apart. Peaks age 4-5, often corrects by age 7-8.
Rx: RARELY needed. Bracing/surgery only for severe, persistent or underlying disease.

USMLEStepStudy's tweet image. Genu Varum (Bowlegs): Standing gap between knees. Common in toddlers, usually resolves by age 2.
Genu Valgum (Knock-Knees): Knees touch, ankles apart. Peaks age 4-5, often corrects by age 7-8.
Rx: RARELY needed. Bracing/surgery only for severe, persistent or underlying disease.

StudyXing Medicine

@USMLEStepStudy

Nov 8

Left (ventricular)-sided heart failure is when main pump fails 🫀 Pump: Left Ventricle ❌ Failure: Can't push blood forward to your body 🌊 Backup: Fluid floods back into the lungs 🤧 s/s: Drowning feeling (SOB, crackles, fatigue) #CardioX #HeartHealth #MedEd #MedEdTutor

USMLEStepStudy's tweet image. Left (ventricular)-sided heart failure is when main pump fails
🫀 Pump: Left Ventricle
❌ Failure: Can't push blood forward to your body
🌊 Backup: Fluid floods back into the lungs
🤧 s/s: Drowning feeling (SOB, crackles, fatigue)
#CardioX #HeartHealth #MedEd #MedEdTutor

USMLEStepStudy's tweet image. Left (ventricular)-sided heart failure is when main pump fails
🫀 Pump: Left Ventricle
❌ Failure: Can't push blood forward to your body
🌊 Backup: Fluid floods back into the lungs
🤧 s/s: Drowning feeling (SOB, crackles, fatigue)
#CardioX #HeartHealth #MedEd #MedEdTutor

USMLEStepStudy's tweet image. Left (ventricular)-sided heart failure is when main pump fails
🫀 Pump: Left Ventricle
❌ Failure: Can't push blood forward to your body
🌊 Backup: Fluid floods back into the lungs
🤧 s/s: Drowning feeling (SOB, crackles, fatigue)
#CardioX #HeartHealth #MedEd #MedEdTutor

USMLEStepStudy's tweet image. Left (ventricular)-sided heart failure is when main pump fails
🫀 Pump: Left Ventricle
❌ Failure: Can't push blood forward to your body
🌊 Backup: Fluid floods back into the lungs
🤧 s/s: Drowning feeling (SOB, crackles, fatigue)
#CardioX #HeartHealth #MedEd #MedEdTutor

StudyXing Medicine

@USMLEStepStudy

Nov 6

Secondary syphilis - s/s: rash, lymphadenopathy, fever, malaise, hepatitis (cholestatic pattern), high alkaline phosphatase, membranous nephropathy (immune complex deposition); Dx: T. pallidum hemagglutination assay, fluorescent treponemal antibody absorption test, RPR, VDRL

USMLEStepStudy's tweet image. Secondary syphilis - s/s: rash, lymphadenopathy, fever, malaise, hepatitis (cholestatic pattern), high alkaline phosphatase, membranous nephropathy (immune complex deposition); Dx: T. pallidum hemagglutination assay, fluorescent treponemal antibody absorption test, RPR, VDRL

USMLEStepStudy's tweet image. Secondary syphilis - s/s: rash, lymphadenopathy, fever, malaise, hepatitis (cholestatic pattern), high alkaline phosphatase, membranous nephropathy (immune complex deposition); Dx: T. pallidum hemagglutination assay, fluorescent treponemal antibody absorption test, RPR, VDRL

USMLEStepStudy's tweet image. Secondary syphilis - s/s: rash, lymphadenopathy, fever, malaise, hepatitis (cholestatic pattern), high alkaline phosphatase, membranous nephropathy (immune complex deposition); Dx: T. pallidum hemagglutination assay, fluorescent treponemal antibody absorption test, RPR, VDRL

USMLEStepStudy's tweet image. Secondary syphilis - s/s: rash, lymphadenopathy, fever, malaise, hepatitis (cholestatic pattern), high alkaline phosphatase, membranous nephropathy (immune complex deposition); Dx: T. pallidum hemagglutination assay, fluorescent treponemal antibody absorption test, RPR, VDRL

StudyXing Medicine

@USMLEStepStudy

Nov 6

Stages of syphilis infection- -Primary stage (chancre at ~3 wks) -Secondary stage (systemic dissemination at ~ 6 - 12 wks, -Latent stage, with tertiary complications (e.g., gummatous dz, CV syphilis, paresis, tabes dorsalis)...yrs later if infection not treated -Tertiary (Neuro)

USMLEStepStudy's tweet image. Stages of syphilis infection-
-Primary stage (chancre at ~3 wks)
-Secondary stage (systemic dissemination at ~ 6 - 12 wks,
-Latent stage, with tertiary complications (e.g., gummatous dz, CV syphilis, paresis, tabes dorsalis)...yrs later if infection not treated
-Tertiary (Neuro)

USMLEStepStudy's tweet image. Stages of syphilis infection-
-Primary stage (chancre at ~3 wks)
-Secondary stage (systemic dissemination at ~ 6 - 12 wks,
-Latent stage, with tertiary complications (e.g., gummatous dz, CV syphilis, paresis, tabes dorsalis)...yrs later if infection not treated
-Tertiary (Neuro)

StudyXing Medicine

@USMLEStepStudy

Oct 19

Hyaline Membrane Dz (Neonatal RDS) - ↓Surfactant; MCC: prematurity, Maternal DM (fetal hyperinsulinemia ↓ surfactant), c-section w/out labor; s/s: postnatal resp distress, grunting, nasal flaring, retractions, tachypnea, cyanosis

USMLEStepStudy's tweet image. Hyaline Membrane Dz (Neonatal RDS) - ↓Surfactant; MCC: prematurity, Maternal DM (fetal hyperinsulinemia ↓ surfactant), c-section w/out labor; s/s: postnatal resp distress, grunting, nasal flaring, retractions, tachypnea, cyanosis

USMLEStepStudy's tweet image. Hyaline Membrane Dz (Neonatal RDS) - ↓Surfactant; MCC: prematurity, Maternal DM (fetal hyperinsulinemia ↓ surfactant), c-section w/out labor; s/s: postnatal resp distress, grunting, nasal flaring, retractions, tachypnea, cyanosis

USMLEStepStudy's tweet image. Hyaline Membrane Dz (Neonatal RDS) - ↓Surfactant; MCC: prematurity, Maternal DM (fetal hyperinsulinemia ↓ surfactant), c-section w/out labor; s/s: postnatal resp distress, grunting, nasal flaring, retractions, tachypnea, cyanosis

USMLEStepStudy's tweet image. Hyaline Membrane Dz (Neonatal RDS) - ↓Surfactant; MCC: prematurity, Maternal DM (fetal hyperinsulinemia ↓ surfactant), c-section w/out labor; s/s: postnatal resp distress, grunting, nasal flaring, retractions, tachypnea, cyanosis

StudyXing Medicine

@USMLEStepStudy

Oct 16

Miliary tuberculosis - subacute or chronic febrile respiratory illness; Labs: Anemia, hypoalbuminemia, hyponatremia, elevated alk phos level, NL bilirubin, NL AST, NL ALT, LDH mild elevation; Extrapulmonary = lymph nodes, liver, bone marrow, CNS/meninges

USMLEStepStudy's tweet image. Miliary tuberculosis - subacute or chronic febrile respiratory illness; Labs: Anemia, hypoalbuminemia, hyponatremia, elevated alk phos level, NL bilirubin, NL AST, NL ALT, LDH mild elevation; Extrapulmonary = lymph nodes, liver, bone marrow, CNS/meninges

USMLEStepStudy's tweet image. Miliary tuberculosis - subacute or chronic febrile respiratory illness; Labs: Anemia, hypoalbuminemia, hyponatremia, elevated alk phos level, NL bilirubin, NL AST, NL ALT, LDH mild elevation; Extrapulmonary = lymph nodes, liver, bone marrow, CNS/meninges

USMLEStepStudy's tweet image. Miliary tuberculosis - subacute or chronic febrile respiratory illness; Labs: Anemia, hypoalbuminemia, hyponatremia, elevated alk phos level, NL bilirubin, NL AST, NL ALT, LDH mild elevation; Extrapulmonary = lymph nodes, liver, bone marrow, CNS/meninges

USMLEStepStudy's tweet image. Miliary tuberculosis - subacute or chronic febrile respiratory illness; Labs: Anemia, hypoalbuminemia, hyponatremia, elevated alk phos level, NL bilirubin, NL AST, NL ALT, LDH mild elevation; Extrapulmonary = lymph nodes, liver, bone marrow, CNS/meninges

StudyXing Medicine

@USMLEStepStudy

Oct 14

Allen's test - Chks blood flow to hand evaluating patency of radial and ulnar arteries and the completeness of the palmar arch; Before procedures like arterial blood draws, wrist surgeries to ensure hand has adequate collateral blood flow thru ulnar a. if radial a. is compromised

USMLEStepStudy's tweet image. Allen's test - Chks blood flow to hand evaluating patency of radial and ulnar arteries and the completeness of the palmar arch; Before procedures like arterial blood draws, wrist surgeries to ensure hand has adequate collateral blood flow thru ulnar a. if radial a. is compromised

StudyXing Medicine

@USMLEStepStudy

Oct 13

Oxalate - gut absorbed, liver produced, renal excreted --> Hyperoxaluria = 24-hr urinary oxalate excretion exceeding 45 mg / day; Primary hyperoxaluria - genetic hepatic overproduction; Secondary hyperoxaluria MCC enteric hyperoxaluria from fat malabsorption

USMLEStepStudy's tweet image. Oxalate - gut absorbed, liver produced, renal excreted --&gt; Hyperoxaluria = 24-hr urinary oxalate excretion exceeding 45 mg / day; Primary hyperoxaluria - genetic hepatic overproduction; Secondary hyperoxaluria MCC enteric hyperoxaluria from fat malabsorption

StudyXing Medicine

@USMLEStepStudy

Oct 11

IIH: Obese women. HAs, vision loss, tinnitus. Papilledema key. Weight loss, acetazolamide. Surgery if vision threatened

USMLEStepStudy's tweet image. IIH: Obese women. HAs, vision loss, tinnitus. Papilledema key. Weight loss, acetazolamide. Surgery if vision threatened

USMLEStepStudy's tweet image. IIH: Obese women. HAs, vision loss, tinnitus. Papilledema key. Weight loss, acetazolamide. Surgery if vision threatened

USMLEStepStudy's tweet image. IIH: Obese women. HAs, vision loss, tinnitus. Papilledema key. Weight loss, acetazolamide. Surgery if vision threatened

USMLEStepStudy's tweet image. IIH: Obese women. HAs, vision loss, tinnitus. Papilledema key. Weight loss, acetazolamide. Surgery if vision threatened

StudyXing Medicine

@USMLEStepStudy

Oct 8

Cirrhosis --> liver architectural distortion --> increased intra-hepatic vascular resistance --> portal hypertension (elevated portal pressure) --> drives fluid from hepatic sinusoids thru surface capsule --> into peritoneal cavity --> overwhelming lymphatic drainage --> ascites

USMLEStepStudy's tweet image. Cirrhosis --&gt; liver architectural distortion --&gt; increased intra-hepatic vascular resistance --&gt; portal hypertension (elevated portal pressure) --&gt; drives fluid from hepatic sinusoids thru surface capsule --&gt; into peritoneal cavity --&gt; overwhelming lymphatic drainage --&gt; ascites

USMLEStepStudy's tweet image. Cirrhosis --&gt; liver architectural distortion --&gt; increased intra-hepatic vascular resistance --&gt; portal hypertension (elevated portal pressure) --&gt; drives fluid from hepatic sinusoids thru surface capsule --&gt; into peritoneal cavity --&gt; overwhelming lymphatic drainage --&gt; ascites

USMLEStepStudy's tweet image. Cirrhosis --&gt; liver architectural distortion --&gt; increased intra-hepatic vascular resistance --&gt; portal hypertension (elevated portal pressure) --&gt; drives fluid from hepatic sinusoids thru surface capsule --&gt; into peritoneal cavity --&gt; overwhelming lymphatic drainage --&gt; ascites

USMLEStepStudy's tweet image. Cirrhosis --&gt; liver architectural distortion --&gt; increased intra-hepatic vascular resistance --&gt; portal hypertension (elevated portal pressure) --&gt; drives fluid from hepatic sinusoids thru surface capsule --&gt; into peritoneal cavity --&gt; overwhelming lymphatic drainage --&gt; ascites

StudyXing Medicine

@USMLEStepStudy

Oct 7

• HCM murmur: Louder (standing/Valsalva,↓preload), softer (squatting/handgrip,↑preload/afterload) • MR: Louder (squatting/handgrip,↑preload/afterload), softer (standing/Valsalva,↓preload) • AS: Louder (squatting,↑preload/afterload), softer (standing/Valsalva, ↓preload)

USMLEStepStudy's tweet image. • HCM murmur: Louder (standing/Valsalva,↓preload), softer (squatting/handgrip,↑preload/afterload)
• MR: Louder (squatting/handgrip,↑preload/afterload), softer (standing/Valsalva,↓preload)
• AS: Louder (squatting,↑preload/afterload), softer (standing/Valsalva, ↓preload)

StudyXing Medicine

@USMLEStepStudy

Sep 30

Castleman's disease - rare nonclonal lymphoproliferative disorders (unicentric, multicentric); s/s: fever, wt loss, anemia, organomegaly; Class: HHV8-positive, idiopathic & POEMS-associated; Dx: lymph node bx; Rx: surgery (UCD), IL-6 targetted (MCD)

USMLEStepStudy's tweet image. Castleman's disease - rare nonclonal lymphoproliferative disorders (unicentric, multicentric); s/s: fever, wt loss, anemia, organomegaly; Class: HHV8-positive, idiopathic &amp; POEMS-associated; Dx: lymph node bx; Rx: surgery (UCD), IL-6 targetted (MCD)

USMLEStepStudy's tweet image. Castleman's disease - rare nonclonal lymphoproliferative disorders (unicentric, multicentric); s/s: fever, wt loss, anemia, organomegaly; Class: HHV8-positive, idiopathic &amp; POEMS-associated; Dx: lymph node bx; Rx: surgery (UCD), IL-6 targetted (MCD)

USMLEStepStudy's tweet image. Castleman's disease - rare nonclonal lymphoproliferative disorders (unicentric, multicentric); s/s: fever, wt loss, anemia, organomegaly; Class: HHV8-positive, idiopathic &amp; POEMS-associated; Dx: lymph node bx; Rx: surgery (UCD), IL-6 targetted (MCD)

USMLEStepStudy's tweet image. Castleman's disease - rare nonclonal lymphoproliferative disorders (unicentric, multicentric); s/s: fever, wt loss, anemia, organomegaly; Class: HHV8-positive, idiopathic &amp; POEMS-associated; Dx: lymph node bx; Rx: surgery (UCD), IL-6 targetted (MCD)

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