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© Dr. Amin Afrasiabi
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MasterUSMLE is your go-to high-yield podcast for USMLE Step 2 CK! Hosted by Dr. Amin Afrasiabi, this podcast delivers concise, exam-focused reviews on medicine, surgery, pediatrics, OB/GYN, dermatology, and more.
71 Episodes
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36-year-old woman at 33 weeks gestation presents with a breech fetus and a past cesarean. But one key detail in her history shifts the entire delivery plan. In this Master Series episode, we dive into the high-stakes reasoning behind why some uterine scars mean no labor — ever.You’ll learn how to:• Identify contraindications to vaginal delivery• Understand the risks of classical cesarean scars• Apply gestational timing to cesarean scheduling• Avoid common errors with breech pregnanciesThis case is about more than position — it’s about pressure, timing, and lives on the line.
A 10-year-old boy is hit in the head with a baseball. He’s alert and neurologically intact at first. But while waiting for surgery, he becomes drowsy and develops left leg weakness. Pupils are still reactive. What’s the subtle danger here?In this Master Series episode, we break down a case of evolving intracranial pressure that teaches you how to recognize early brain herniation — before the pupils give it away.You’ll learn how to:Recognize subfalcine herniation and anterior cerebral artery compressionDifferentiate herniation syndromes based on symptomsCatch early warning signs of brain shift before they become fatalApply high-yield trauma neurology for Step 2 CK and real-life care
A 19-day-old infant presents in the middle of winter with nasal congestion, cough, and rapid breathing. His oxygen is stable, but his age makes you pause. What’s the silent threat here?In this Master Series episode, we dive into a deceptively common case that carries a high-stakes risk for the very young. Perfect for Step 2 CK prep and real-world pediatric reasoning.You’ll learn how to:Recognize subtle signs of bronchiolitis in neonatesUnderstand why infants under 2 months are especially vulnerableAvoid unnecessary imaging and focus on clinical judgmentIdentify when to monitor, when to admit, and what to watch for next
A 14-year-old girl presents with fatigue and microcytic anemia, but her periods are normal. On physical exam, you find subtle pigmentation around her lips and inside her cheeks. What’s the connection?In this Master Series episode, we guide you through the clinical reasoning behind a case that could easily be overlooked — until you connect the dots.You’ll learn how to:Recognize atypical presentations of iron deficiency anemiaIdentify mucocutaneous findings that signal genetic syndromesDecide when to escalate from iron therapy to full GI workupApply next-step logic for high-yield Step 2 CK casesThink beyond the common causes and catch what others miss
A 33-year-old man collapses without warning while seated at a café. Normal vitals. Normal ECG. But this isn’t the first time. In this Master Series episode, we unpack a subtle case of syncope that pushes you to think beyond the usual suspects.By the end of this episode, you’ll be able to:Understand the difference between reflex, orthostatic, and cardiac syncopeRecognize when a normal ECG isn’t enoughIdentify red flags that point to arrhythmic causesChoose the best next step — and avoid unnecessary testsBuilt for Step 2 CK prep and real-world decision-making.
In this episode of the Master Series, we explore the case of a 22-month-old girl with a sudden, harsh cough and noisy breathing during crying. She has no fever, is drinking fluids, and remains playful — but something isn’t quite right.Through this clinical scenario, you'll learn how to:Understand the differential for pediatric stridorRecognize upper airway obstruction patternsChoose when to observe and when to treatIdentify the best next step based on severityAvoid unnecessary testing in a stable childPerfect for Step 2 CK review and pediatric clinical reasoning.
In this high-yield Master Series episode, we explore a clinical case of a 69-year-old woman with progressive dysphagia to solids. Should you start a PPI, order manometry, or jump straight to endoscopy?You’ll learn how to:• Differentiate oropharyngeal vs esophageal dysphagia• Recognize mechanical obstruction patterns• Apply the dysphagia evaluation algorithm• Avoid common delays in diagnosis• Choose the right diagnostic test — and when to scope firstThis episode is perfect for Step 2 CK review, GI rotation prep, and mastering clinical reasoning when it matters most.
In this high-yield Master Series episode, we break down a clinical case of a 58-year-old woman with an incidental finding of anterior pelvic organ prolapse during a routine exam. Should you treat? Should you refer for surgery? Or is observation enough?You’ll learn how to:• Recognize key features of pelvic organ prolapse• Identify risk factors like age, parity, obesity, and menopause• Understand when to reassure and observe• Choose between pessary, pelvic floor therapy, and surgery• Avoid unnecessary testing or overtreatmentPerfect for Step 2 CK prep and clinical reasoning in primary care or gynecology settings.
In this episode of the Master Series, we break down a high-yield clinical case of community-acquired pneumonia in a 70-year-old man presenting with confusion, fever, and a lobar infiltrate. Learn how to apply the CURB-65 score to determine the need for hospitalization and select the most appropriate empiric antibiotic regimen.This case-based teaching episode walks you through:• Recognizing atypical pneumonia presentations in elderly patients• Using CURB-65 to guide admission decisions• Choosing the best empiric antibiotics for inpatient management• Avoiding common fluoroquinolone pitfalls on the exam• Understanding key supportive care principlesMaster the fundamentals of inpatient CAP management and reinforce your clinical reasoning for Step 2 CK.
In this episode of the Master Series, we explore a common yet often misunderstood diagnosis — Alzheimer disease. Through the lens of a realistic clinical case, we uncover the subtle clues that distinguish Alzheimer from other forms of dementia like vascular dementia, Lewy body dementia, and frontotemporal dementia.This case features an elderly patient with slowly progressing short-term memory loss, increasing paranoia, and preserved neurologic function — a classic presentation of Alzheimer disease.🎙️ What you’ll learn:• How to recognize early cognitive changes in Alzheimer disease• Why psychosis can emerge in later stages• How to differentiate Alzheimer from other dementia subtypes• Next steps in diagnostic workup and initial treatment strategies• Why caregiver support is a key part of managementThis is a high-yield episode perfect for Step 2 CK and clinical rotations.
In this episode of the Master Series, we walk through a high-stakes case of a 68-year-old man with fever, cough, and recurrent pneumonia — but there's more than meets the eye. With anemia, thrombocytopenia, massive lymphocytosis, and unexplained weight loss, this case challenges you to look past the infection and recognize a chronic hematologic condition in disguise.You’ll learn how to approach cases with lymphadenopathy and elevated white blood cell counts, distinguish reactive versus clonal lymphocytosis, and avoid common diagnostic traps on the exam.Key Learning Points:• When to suspect chronic lymphoproliferative disorders• Why flow cytometry is the critical next step• How infections reveal deeper immune dysfunction• Step-by-step reasoning to build your diagnostic confidencePerfect for Step 2 CK prep and clinical decision-making mastery. Study smart and stay focused.
Learn how to recognize and manage one of the highest-yield vascular emergencies tested on Step Two CK — acute-on-chronic limb ischemia. In this Master Series episode, we walk through a realistic clinical case, decode the red flags, and guide you through the proper diagnostic reasoning and life-saving treatment steps. Understand how to distinguish this condition from similar presentations like DVT or compartment syndrome, and learn why timing is everything when motor deficits appear.Master the six classic signs of acute limb ischemia, break down key pathophysiology, and prepare yourself for both the exam and real-life clinical emergencies. This is not just a review — it’s the kind of deep, structured clinical reasoning that will elevate your score and sharpen your decision-making.Stay focused. Study smart. And keep mastering your craft.
Welcome back, Master Series followers.In this high-yield Step 2 CK episode, we walk through a common yet misunderstood scenario — a patient with a positive hepatitis C antibody test. What comes next? Should you treat? Order a biopsy? Start imaging?We break down how to confirm chronic hepatitis C, when to order HCV RNA, and why a positive antibody alone is never enough. This case highlights key risk factors like past IV drug use, alcohol intake, and obesity — and guides you through the exact sequence of testing and management.Master the difference between exposure vs. active infection, avoid common traps on the exam, and solidify your approach to liver disease evaluation.By the end of this episode, you’ll confidently know: – When to order HCV RNA– Why not to jump into treatment– How to interpret hepatitis B serologies– What makes liver biopsy outdated– Why lifestyle still matters even without active hepatitisStay sharp. Study smart. Keep mastering your craft.
Amenorrhea can be overwhelming — unless you have a step-by-step approach.In this Master Series episode, we simplify the entire workup for both primary and secondary amenorrhea, based on clinical reasoning and what actually shows up on the exam.You’ll learn:– When to evaluate vs when to reassure– How to interpret breast development and FSH/LH levels– The difference between Müllerian agenesis and androgen insensitivity– When to use pelvic ultrasound, karyotyping, or hormone panels– The logic behind the progesterone withdrawal test– How to recognize red flag findings and next stepsWhether you're preparing for Step 2 CK or seeing real patients, this framework gives you confidence and clarity. Learn it once, apply it for life.Study smart. Master the system. Welcome to the Master Series.
In this episode of Master the exam, we explore a subtle but powerful finding on cardiac auscultation — the fourth heart sound, or S4.Follow the story of a 62-year-old man with exertional dyspnea and a soft extra heart sound that changes everything. You’ll learn how to recognize S4, what it means physiologically, and why it’s one of the most testable clues in heart failure with preserved ejection fraction.We’ll break down how to:Differentiate S4 from other soundsUnderstand its link to chronic hypertensionEliminate wrong answer choices on the examIf you’re prepping for Step 2 CK, this episode will give you an edge on cardiac auscultation questions.Study smart. Master your craft. And stay tuned for more.
In this Master Series episode, we unpack a high-yield case of antipsychotic-induced hyperprolactinemia. A twenty-nine-year-old man presents with low libido, erectile dysfunction, and gynecomastia after starting risperidone. What seems like a straightforward side effect opens the door to mastering the four dopamine pathways—mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular.This episode breaks down:How dopamine blockade leads to hyperprolactinemiaThe distinct clinical roles of each dopamine pathwayHow to approach antipsychotic side effects on Step 2 CKThe management of risperidone-induced endocrine symptomsBy the end of this episode, you’ll be confident in navigating dopamine physiology, choosing the right antipsychotic alternatives, and avoiding classic exam pitfalls.Stay focused. Study smart. And keep mastering medicine.
In this Master Series episode, we explore the puzzling case of a seventeen-month-old boy who suddenly stops talking, avoids eye contact, and becomes increasingly irritable. His grandmother is concerned. His growth chart shows something unexpected, and his vital signs are subtly off.What’s hiding behind the behavioral changes?What does a sudden shift in head growth really mean?We’ll walk you through the clinical reasoning from the first clue to the final insight—step by step. This episode is designed to sharpen your diagnostic thinking, especially when it comes to developmental regression and neurologic red flags in toddlers.You’ll learn how to:Approach regression with a structured differentialInterpret pediatric growth charts like a proIdentify the early signs of dangerous neurologic pressureDistinguish key features of conditions that mimic each other on the examThink you’ve got it figured out?Let’s find out together—no spoilers here.Keep mastering your craft, and let’s dive in.
In this Master USMLE episode, we explore the high-yield clinical consequences of thiazide diuretics like chlorthalidone. Learn how these commonly prescribed medications can cause serious metabolic shifts—often missed on Step 2 CK questions.We break down:– Why thiazides cause hyperglycemia and worsen insulin resistance– How they elevate uric acid levels and trigger gout– The key electrolyte changes: low potassium, low magnesium, high calcium– Which patients are at greatest risk for complications– What exam traps to avoid and how to reason through themBuilt around real-life clinical reasoning, this episode strengthens your test-day strategy and your clinical instincts.Follow the Master USMLE podcast for more high-yield, case-based reviews to help you study smarter and score higher.
In this high-yield episode of the Master Series, we break down a classic Step 2 CK endocrine case that tests more than just basic knowledge. A patient with weight loss, tremor, and bulging eyes walks into your clinic — but what treatment do you avoid?We dive deep into Graves disease, thyroid eye disease (TED), and why radioactive iodine can backfire in the wrong clinical setting. Learn how to choose between methimazole, RAI, and thyroidectomy based on one crucial detail.This episode covers:Graves disease key featuresTED pathophysiology and red flagsWhy RAI worsens eye symptomsWhen to use steroids with RAIPretibial myxedema and other exam cluesHow to tell Graves apart from other causes of hyperthyroidismTreatment strategies by patient profileQuick recall quiz to reinforce learningPerfect for anyone prepping for Step 2 CK, this case-based discussion helps you master clinical reasoning and avoid common traps.Keep mastering your craft.
In this high-yield episode of Master USMLE, we tackle a classic Step 2 CK challenge: hypocalcemia.A malnourished patient presents with cramps, twitching, and perioral numbness. His calcium is low—but is that the real issue?We walk you step-by-step through how to approach low calcium on the exam:How to confirm true hypocalcemiaThe three key questions you must ask firstWhy magnesium is often the missing pieceWhen to check PTH, and how to interpret itThe difference between gland failure and PTH resistanceThis episode trains your clinical reasoning, not just your memory. Learn how to break down these questions just like you would on test day.Study smart.Stay sharp.Keep mastering your craft.
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