Source / episode info

• **Episode:**256
• **Title:**Divine Intervention Episode 256 – USMLE Step 2CK Rapid Review Series 41 (and Step 2CK 10 hr Course 9/5/20).
• **Published:**2020-08-24
• Source:Episode page

One-liner

This episode is a high-yield review of basic science concepts for the USMLE Step 2CK exam, emphasizing associations between malignancies and paraneoplastic syndromes (e.g., SIADH, H.O.A.), tumor markers (AFP, CEA), characteristic calcified masses in neuroimaging, and specific histological patterns (Burkitt lymphoma).

High-yield summary

• EBV Associations: EBV is strongly associated with Burkitt Lymphoma (t(8;14)), Hodgkin's Lymphoma, Nasopharyngeal Carcinoma, and Primary CNS Lymphoma (especially in HIV+ patients).
• HCC Risk: Chronic exposure to grains/aflatoxins leads to Hepatocellular Carcinoma (HCC), which is a critical association for liver pathology.
• Perineoplastic Syndromes: Lung cancer can cause multiple syndromes: SIADH (hyponatremia, hypertonic urine >1.012 SG), Hypertrophic Osteoarthropathy (H.O.A.), and Lambert-Erythroasthenic Syndrome (LEMS).
• Calcified Masses: Calcification in the meninges/brain is highly specific: Hemangioblastoma (cerebellum, calcified mass) vs. Craniopharyngioma (pituitary stalk, calcified mass) vs. Oligodendroglioma (frontal lobe, calcified mass).
• Tumor Markers: Specific markers are associated with primary sites: AFP (Yolk Sac Tumor, HCC), CA-125 (Ovarian Cancer), CEA (Colorectal/Pancreatic), and PSA (Prostate Cancer).

Learning objectives

• Identify the key associations between common malignancies and their associated paraneoplastic syndromes (e.g., SIADH, H.O.A.).
• Differentiate the clinical presentation and imaging findings of various calcified intracranial masses (Hemangioblastoma vs. Craniopharyngioma).
• Interpret tumor markers (AFP, CEA, CA-125, PSA) to suggest a primary site of malignancy.
• Recognize the characteristic histology and genetics of lymphomas like Burkitt lymphoma.
• Understand the pathophysiology of paraneoplastic hypercalcemia from various sources (PTHrP, Sarcoidosis, Multiple Myeloma).

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