Source / episode info
- **Episode:**132
- **Title:**Divine Intervention Episode 132 – The Floridly High Yield USMLE Social Sciences Review (For Step 2CK, Step 3, and maybe Step 1)
- **Published:**2019-08-04
- Source:Episode page
One-liner
This episode provides a comprehensive review of social sciences and ethical principles in medicine, covering palliative care pharmacology, advanced directives, diagnostic biases (anchoring, blind obedience), detailed screening guidelines for colon cancer/osteoporosis/HPV, substance use disorder assessment tools, and complex vaccine protocols.
High-yield summary
- Palliative Care: For dyspnea due to malignancy, opioids (e.g., morphine) are standard of care; always administer a bowel regimen (e.g., docucol, lactulose).
- Ethics & Law: Decision-making capacity is determined by the physician (must understand risks/benefits); Advanced Directives combine a Living Will (specific instructions) and Health Care Power of Attorney (designated decision-maker).
- Diagnostic Biases: Be wary of Anchoring Bias (relying too heavily on initial findings) and Premature Closure Bias (stopping the differential diagnosis after finding one likely cause).
- Vaccines: The pneumococcal vaccine series requires PCV13 first, followed by PPSV23 one year later for adults >65; remember that MMR, Yellow Fever, and Varicella are live vaccines.
- Colon Cancer Screening: For a first-degree relative diagnosed with colon cancer at age 53, screening should start at the earlier of age 40 or 10 years prior to diagnosis (i.e., age 43).
Learning objectives
- Differentiate between decision-making capacity and legal competence in clinical practice.
- Apply appropriate pharmacological management for dyspnea and neuropathic pain in palliative care settings.
- Select the correct screening guidelines for colon cancer, osteoporosis, and HPV based on age and family history.
- Identify and apply the principles of advanced directives (Living Will vs. HCPOA) and surrogate decision standards.
- Recognize common diagnostic biases (Anchoring, Premature Closure) that lead to medical errors.
Board exam buzzwords