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Old 11-20-2009
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Arrow Camouflaging the USMLE Question Stem

The USMLE is no longer straight forward. There are no more buzzwords and classic clues that will alert you to the diagnosis. They will use every possible synonym instead of the original familiar terms.

They will not tell you psamomma bodies, they'll say a whorling dark blue pattern. They will not tell you increased Iron, they'll say the patient caught by a metal detector. They will not tell you ballerina skirt, they'll say abundant cytoplasm with peripheral condensation. They will not tell you Prostaglandin, they'll say oxytocic activity. They will not tell you Currant Jelly, they'll say thick bloody. They will not tell you a deaf baby, they'll say a negative startle response. They will not tell you Koplik's spots, they'll say hypopigmented spot in anterior buccal mucosa. They will not tell you acetone breath, they'll say a nail polish remover smell....

We have to be astute and we should read between the lines. We should be in our feet and we should try to enter the brain of the question maker and find out what he's up to.

I don't think this is just a test of medical knowledge, this is a test of language skills, a test of verbal inferences, a test of your IQ.

Many students came out telling us: questions were just about the thing we already know but in a different style.

They'll try everything to camouflage the question. They will put the left ventricular volume on the X axis and the pressure on the Y axis. They'll put the true positive in the right lower corner of the 2X2 box instead of it's classical upper left position.

They'll play with us hide and seek. The clue is there and you know it's there but you have to be smart to find it.

Let's be smarter, let's find them, let's eat them for lunch before they take us for dinner, let's fight for our future, let's not be fooled by their exceedingly failing attempts at camouflaging the question.

Good luck to all my USMLE friends.
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The above post was thanked by:
ahmad_jafar (11-20-2009), Firas (11-22-2009), pallath (11-21-2009), smile135 (11-21-2009), StepTaker (11-21-2009)

Old 11-21-2009
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Well written, great post.

I lost many questions in my exam because of this camouflaging

One example you mentioned, is that I incorrectly chose step pnumoniae for a patient with a bloody sputum thinking they were telling rusty sputurm while in fact (as I think) they were pointing to red currant jelly sputum of klebsiella.

We should be very careful
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Step-1-Experience, Step-2-CK-Experience

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