Dawn Phenomenon and the Somogyi Effect-USMLE CK

For Dawn phenomenon HYPER -INCREASE INSULIN 
For Somogyi phenomenon HYPO -DECREASE INSULIN

In other way which we are giving insulin :---
Somogyi = so much insulin. 
Dawn = down insulin.

How to approach USMLE Questions ?

Lyme disease

Lyme disease.Erythema chronicum migrans. Expanding “bull’s eye” red rash.

Caused by Borrelia burgdorferi,which is transmitted by the tick Ixodes A (also vector for Babesia). Natural reservoir is the mouse.Mice are important to tick life cycle.

Common in northeastern United States.

Initial symptoms—erythema chronicum migrans, flu-like symptoms, +/- facial nerve palsy.
Later symptoms—monoarthritis (large joints) and migratory polyarthritis, cardiac (AV nodal block), neurologic (encephalopathy, facial nerve palsy, polyneuropathy).

Treatment: doxycycline, ceftriaxone.

Family Planning Methods of Contraception by Dr Jeetendra C

Carotid Echocardiogram (right carotid artery plaque)

Patient is having a plaque in his right carotid artery 

How to approach USMLE questions ? ( Lesch–Nyhan syndrome )

Thyrotoxicosis with low radioactive iodine

The most important cause of thyrotoxicosis with low radioactive iodine uptake include:

1.Subacute painless thyroiditis
2.subacute granulomatous thyroiditis
3.iodine induced thyroid toxicosis
4.levothyroxine overdose
5.Struma ovarii