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USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


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  #1  
Old 12-23-2012
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Group talk February 2013 Step 1 Takers

Hi,
i am planning to take step 1 in mid of feb2013,have finished 50% uworld (20 blocks), have planned to complete uworld in mid of jan,after that i will go thru first aid 2times,i will try to cover mine weak areas from kaplan notes,and will do NBME.

well this is mine study plan, lets motivate and encourage each thru this journey who are also taking exame on feb2013..



Get ready for feb 2013 and lets kick some doors open and help each other to reach our destinies....

Last edited by neha_subh; 12-23-2012 at 04:58 AM.
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  #2  
Old 12-24-2012
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Thumbs Up Me too at the end of February

I m also planing in the last week of February. Did 20% usmle world finish it end of January. I also have to work on my weak areas like anatomy. Keep it up we have to rock.
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  #3  
Old 12-24-2012
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at satr of jan.......abt to finish uw......
making myself ready fr nbme.......'
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  #4  
Old 12-24-2012
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i am planning for feb first week
have done uworld 50%
but m doing tutor untimed mode
my avg score is 60% , its so bad ,m scared
is it possible to improve my scores in just a month?
how u guys doing?
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  #5  
Old 12-24-2012
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Quote:
Originally Posted by drdj View Post
i am planning for feb first week
have done uworld 50%
but m doing tutor untimed mode
my avg score is 60% , its so bad ,m scared
is it possible to improve my scores in just a month?
how u guys doing?

hey do it in timed and random mode,i have no idea at end score improve or not but mine colegues who take exame in nov who was also sufered from same problem as we are with low score in uworld and NBME,but at end in real exame his score is about 233 now i can say we can do it
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  #6  
Old 12-25-2012
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Thumbs Up We can do it.

Don't worry guys about usmle world scores I have seen many people's less than 50% in usmle world but got 230+ in real exam so keep it up we have to do it and we can do it. Give ur best leave other things on GOD.
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  #7  
Old 12-25-2012
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Default count me in!

Hey everybody! I had originally planned to give my exam at da end of February but due to unavailability of seats in da center, i May have to give it mid February. I'm currently on my second read and I've done offline kaplan qbank. I plan to start uworld in January IA. Do you think I'll be able to give da exam in mid Feb with this prep? Also, what books are you all using for anatomy?
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  #8  
Old 12-25-2012
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Quote:
Originally Posted by fat1iscool View Post
Hey everybody! I had originally planned to give my exam at da end of February but due to unavailability of seats in da center, i May have to give it mid February. I'm currently on my second read and I've done offline kaplan qbank. I plan to start uworld in January IA. Do you think I'll be able to give da exam in mid Feb with this prep? Also, what books are you all using for anatomy?


start the uworld try to finish it within one month and then must give go thru fa and nbme for assesment,if you are satisfied with that then go ahead otherwise extend your's triplet
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  #9  
Old 12-28-2012
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Hello, we should keep this thread active. It will help us stay more focused... Kindly keep posting

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  #10  
Old 12-28-2012
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Originally Posted by mymleprep View Post
Hello, we should keep this thread active. It will help us stay more focused... Kindly keep posting

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yes had done with fa 2 times but subjectwise,after uworld again i will go thru it
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  #11  
Old 12-28-2012
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That's nice, planning to go thorough even Kaplan?

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  #12  
Old 12-28-2012
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Through*

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  #13  
Old 12-28-2012
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Default plz suggest and MOTIVATE

hello every body.... feel very relaxed to see a good subpost... plz guide me... me too a candidate for FEB( first week)

started prep in july.
first read done in 2 months
material used are
anatomy-fa
physio-kaplan notes and videos
pahrma-fa
biocem-fa
genetics-kln notes and lectures
behavioral sciences -kln notes and lec
patho- JUST AND JUST FA
micro and immuno- fa

second read done again in 2 months but this time i did SUBJECT WISE offline UWORLD( liking finishing the above mentioned subj from the above mentioned book and did UW-didnt do the UW of bs, immuno becuz i didnt have that)

UW offline scores
path-80% i swear i did only fa and i am scared as every body talks about pathoma and goljan but back at my medical school days i grabed gold medal in it... thanks to ALLAH
physio and pathphysio- 66%
anatomy-82%
pharma-78%
biochem- 68%
micro-80%
bs and immuno- didnt do that

now subscribed ONLINE UW 1 mon( started on 21 dec and uptill now finished 75 % of that.... hav flu for the last 3 days so didnt touched it even for the past 3 days)

my average score ONLINE is 85% RANDOM TIMED mode
scoring very low in biochem, biostatistics and IMMUNO( doing them first time)


plz help and guide... need motivation and a TRUE guidence how to improve now...

LOVE u all and best of luck
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  #14  
Old 12-28-2012
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How did you get percentage in uw offline mode ???

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  #15  
Old 12-28-2012
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Thumbs Up Keep it up

Quote:
Originally Posted by Wajahat View Post
hello every body.... feel very relaxed to see a good subpost... plz guide me... me too a candidate for FEB( first week)

started prep in july.
first read done in 2 months
material used are
anatomy-fa
physio-kaplan notes and videos
pahrma-fa
biocem-fa
genetics-kln notes and lectures
behavioral sciences -kln notes and lec
patho- JUST AND JUST FA
micro and immuno- fa

second read done again in 2 months but this time i did SUBJECT WISE offline UWORLD( liking finishing the above mentioned subj from the above mentioned book and did UW-didnt do the UW of bs, immuno becuz i didnt have that)

UW offline scores
path-80% i swear i did only fa and i am scared as every body talks about pathoma and goljan but back at my medical school days i grabed gold medal in it... thanks to ALLAH
physio and pathphysio- 66%
anatomy-82%
pharma-78%
biochem- 68%
micro-80%
bs and immuno- didnt do that

now subscribed ONLINE UW 1 mon( started on 21 dec and uptill now finished 75 % of that.... hav flu for the last 3 days so didnt touched it even for the past 3 days)

my average score ONLINE is 85% RANDOM TIMED mode
scoring very low in biochem, biostatistics and IMMUNO( doing them first time)


plz help and guide... need motivation and a TRUE guidence how to improve now...

LOVE u all and best of luck
Don't be scared every one is facing same situation ur preparation seems good finish ur remaining usmle world and do one nbme than it will show ur week area than work on it that's it. Just relax and give ur best.
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  #16  
Old 12-29-2012
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Default thanks

sorry there was a typing mistake in my previous post... my UW in 75 % remaining.. done with 25 % of that uptill now...
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  #17  
Old 12-29-2012
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Quote:
Originally Posted by mymleprep View Post
How did you get percentage in uw offline mode ???

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its simple but a crude method... e.g in offline mode there r 15 blocks of patho... do 48 mcqs and calculate the percentage like 40/48 it comes out to be 90%... similarly calculate 15 blocks and add them together...
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  #18  
Old 12-29-2012
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Help bioavailability:

bioavailbility of isosrbide mononitrate is 100% then what will be the bioavailbility of the sublingual nitroglycerin?
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  #19  
Old 12-30-2012
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What's the explanation?

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  #20  
Old 12-30-2012
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Originally Posted by mymleprep View Post
What's the explanation?

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http://www.usmle-forums.com/usmle-st...-nitrates.html
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  #21  
Old 12-30-2012
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Default Target Feb 13

Oh its so good to hear about uworld scores, i was really getting depressed with my uworld scores. I am done with 30% of uw, doing first aid side by side. I want to take exam in feb 13 too !! Nice thread guys, keep it up. Any skype partner interested in any discussion or just to keep each other motivated and focused. Lemme know.
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  #22  
Old 12-30-2012
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Thank you so much each and every one of you. Really beautiful thread.
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  #23  
Old 12-31-2012
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Post first aid

how many days to complete first aid?
i have read some topics from FA but never full FA ,so
this would be my first read of first aid. how many days do u guys think it will take ? n any suggestions on how to retain the info better
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Old 12-31-2012
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Quote:
Originally Posted by drdj View Post
how many days to complete first aid?
i have read some topics from FA but never full FA ,so
this would be my first read of first aid. how many days do u guys think it will take ? n any suggestions on how to retain the info better
everyone says complete it within 15days,do it more than 3 times,dont try to retain it but try to clear your's basic concepts then material automaticaly wil be retained,but because of lot of breaks in between prep thats why even mine concepts faded,but am trying to do mine best pls encourage each other to reach our destiny thanks
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Old 12-31-2012
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Originally Posted by Thrax_usmle View Post
Oh its so good to hear about uworld scores, i was really getting depressed with my uworld scores. I am done with 30% of uw, doing first aid side by side. I want to take exam in feb 13 too !! Nice thread guys, keep it up. Any skype partner interested in any discussion or just to keep each other motivated and focused. Lemme know.
i wana to inform you that no one get high scores in uworld in few blocks then day by day it improves
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  #26  
Old 01-01-2013
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I will do my exam in Feb too.
Will finish FA within 5 days and start UW.
Do I have enough time to revise FA again.
Which NBME's Should I do?
How can I correlate them with my scores?
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  #27  
Old 01-01-2013
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guys i finished fa once, finished uw score- 50%
yesterday gave nbme n scored 165
my target is >230
need some motivation and advise
i can postpone till feb end..
thanx
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  #28  
Old 01-02-2013
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Idea!

now here we wil discus first aid,we wil give clues then we have to give answr acording to that,lets first i am puting some key features make a diagnose:
1)hydrocephalous
2)chorioretinitis
3)intracranial calcification
diagnosis
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Old 01-02-2013
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Quote:
Originally Posted by neha_subh View Post
now here we wil discus first aid,we wil give clues then we have to give answr acording to that,lets first i am puting some key features make a diagnose:
1)hydrocephalous
2)chorioretinitis
3)intracranial calcification
diagnosis
i think its toxoplasmosis.. is it?
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  #30  
Old 01-02-2013
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Default toxo

Quote:
Originally Posted by neha_subh View Post
now here we wil discus first aid,we wil give clues then we have to give answr acording to that,lets first i am puting some key features make a diagnose:
1)hydrocephalous
2)chorioretinitis
3)intracranial calcification
diagnosis

Congential Toxoplasmosis... causative organism is Toxoplasma gondii... feco oral route of transmission.... also transplacental passage...
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  #31  
Old 01-02-2013
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Quote:
Originally Posted by nandish_m View Post
guys i finished fa once, finished uw score- 50%
yesterday gave nbme n scored 165
my target is >230
need some motivation and advise
i can postpone till feb end..
thanx

i think you must go thru goljan audio lectures, first aid and cover weak areas
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  #32  
Old 01-02-2013
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Quote:
Originally Posted by neha_subh View Post
now here we wil discus first aid,we wil give clues then we have to give answr acording to that,lets first i am puting some key features make a diagnose:
1)hydrocephalous
2)chorioretinitis
3)intracranial calcification
diagnosis
yes toxoplasmosis Gondi..
neonates get it in utero if mother inefcted till 2nd trimester
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  #33  
Old 01-02-2013
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Default Associations

what are the Lesions/diseases associated with palms and soles involvement
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  #34  
Old 01-02-2013
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what are the Lesions/diseases associated with palms and soles involvement
hand foot n mouth disease
syphilis
rocky mountain spotted fever
measles

Last edited by drdj; 01-02-2013 at 05:14 PM.
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  #35  
Old 01-02-2013
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Idea! vaginal discharge

differential for vaginal discharge?
fishy: ?
foul greenish: ?
curdy white: ?
any more suggestions?

Last edited by drdj; 01-02-2013 at 08:07 PM.
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  #36  
Old 01-02-2013
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differential for vaginal discharge?
fishy: ?
foul greenish: ?
curdy white: ?
any more suggestions?
fishy - gardnella vaginosis ( also clue cells found)
foul green- trichomoniasis
curdy white- candidiasis
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  #37  
Old 01-02-2013
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Originally Posted by drdj View Post
hand foot n mouth disease
syphilis
rocky mountain spotted fever
measles
wana to add 1 more,
coxsachie virus A (with oral ulcer)
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  #38  
Old 01-02-2013
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Quote:
Originally Posted by drdj View Post
differential for vaginal discharge?
fishy: ?
foul greenish: ?
curdy white: ?
any more suggestions?
(histopatho findings: inflamation+strawbery colored mucosa+corkscrew motility on wet prep mucosa-trichomoniasis,
clue cels without inflamation+positive whif test in bacterial vaginosis)

but i think 2 findings smell and color of discharge suficient for step1
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  #39  
Old 01-02-2013
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Default strawberry conditions

strawberry conditions
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  #40  
Old 01-02-2013
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Quote:
Originally Posted by neha_subh View Post
strawberry conditions
strawberry vagina- trichomoniasisx
strawberry tongue - kawasaki disease (coronary artey involved- vasculitis)
strawberry hemangioma - benign, infancy regress spontaneously
i only know three.. plz add
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  #41  
Old 01-02-2013
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Help

any cherry conditions?
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  #42  
Old 01-03-2013
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strawberry vagina- trichomoniasisx
strawberry tongue - kawasaki disease (coronary artey involved- vasculitis)
strawberry hemangioma - benign, infancy regress spontaneously
i only know three.. plz add
add also folowing conditions:
strawbery gall blader---cholestrolosis
strawbery on a stick---tubular adenoma(Goljan point)
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Wink opthalmia neonatorum...

opthalmia neonatorum causes???
ocurs during intrapartum or in utero or postpartum??
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opthalmia neonatorum causes???
ocurs during intrapartum or in utero or postpartum??
chlamydia trachomatis types D-K
its acquired during intrapartum, occurs in neonates
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wana to add 1 more,
coxsachie virus A (with oral ulcer)
hand foot n mouth disease is caused by coxsakie a
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Default Regd.Palms and soles

Diseases/Lesions with palms and soles involvement

Secondary Syphilis = maculopapular rash on palms and soles
Coxsackie Virus A (hand,foot and mouth disease)
Rocky mountain Spotted Fever (Rickettsial rash) (Imp.points typhus rash starts centrally and spreads outwards without involving palms and soles)
Painful red lesions on palms and soles = Osler's node (Infective endocarditis)
Painless erythematous lesions on palms and soles = Janeway lesions (infective endocarditis)

Mnemonic We drive CARS with Palms and Soles (Cox A,Rocky and Syphilis) rest we ca remember painful osler's painless janeway
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any cherry conditions?
haha good one nandish, no seriously are there any cherry conditions? I remember there are a couple but i can't recollect.....
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Originally Posted by vnagubandi View Post
Diseases/Lesions with palms and soles involvement

Secondary Syphilis = maculopapular rash on palms and soles
Coxsackie Virus A (hand,foot and mouth disease)
Rocky mountain Spotted Fever (Rickettsial rash) (Imp.points typhus rash starts centrally and spreads outwards without involving palms and soles)
Painful red lesions on palms and soles = Osler's node (Infective endocarditis)
Painless erythematous lesions on palms and soles = Janeway lesions (infective endocarditis)

Mnemonic We drive CARS with Palms and Soles (Cox A,Rocky and Syphilis) rest we ca remember painful osler's painless janeway

Also Kawasaki:Hand foot ertythema.
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Originally Posted by nandish_m View Post
strawberry vagina- trichomoniasisx
strawberry tongue - kawasaki disease (coronary artey involved- vasculitis)
strawberry hemangioma - benign, infancy regress spontaneously
i only know three.. plz add
Strep Pyo: strawberry tongue with gray white tonsilar exudates(dnt conf with dipth)..Need not be classical but described in few UW Q..
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haha good one nandish, no seriously are there any cherry conditions? I remember there are a couple but i can't recollect.....
cherry hemangioma- benign, adults, increases wid age but no regression
cherry red spot on macula- niemen pick, tay sachs
lol i know des two.. ny more will be appreciated..
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Default Cardio

GIANT *V* waves seen in JVP in which codition... answer with concept
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Default Giant V waves

Giant V waves on jvp tracings are seen in atrial myxomas...due to obstruction similar to a case of tricuspid valve regurgitation? the increased pressure and back flow transmit giant v waves...
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Giant V waves on jvp tracings are seen in atrial myxomas...due to obstruction similar to a case of tricuspid valve regurgitation? the increased pressure and back flow transmit giant v waves...
Normal v waves- is positive wave, due to venous return, TV closed
giant v waves- occurs in severe TR in which blood regurgitates to Rt atrium during ventricular systole
now i am not sure of atrial myxoma, coz atrial myxoma/TS causes prominant A waves. and occurs in atrial systole.. hope this helps.. plz correct me if i am wrong.
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chlamydia trachomatis types D-K
its acquired during intrapartum, occurs in neonates
chlamydia and neisseria (which can cause blindness)...
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chlamydia and neisseria (which can cause blindness)...
i think its chlamydia.. is it??
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chlamydia and neisseria (which can cause blindness)...
both of them can cause blindness by causing OPHTHALMIA NEONATORUM resulting in corneal opacification and blindness....
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Default Giant V waves

guys this was the concept i was trying to make clear... when we talk about v waves everybody gives examples in context to TR and right atrium..... giant v waves can also be seen in case of LEFT atrium in can of MR which causes regurgitant blood flow back to LA and cases Giant V wav pressure tracing... this concept i came across in UW

hope this helps
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Default QT intervel

drug which prolongs the QT interval but doesnt causes Torsade de pointes?????
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drug which prolongs the QT interval but doesnt causes Torsade de pointes?????
Amiodarone
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drug which prolongs the QT interval but doesnt causes Torsade de pointes?????
i have a doubt..
in fa its written that - anything that prolongs qt interval can predispose to torsades de pointes.. pg 288. thanks
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Amiodarone
yea hockey u r ry..... its amiodarone
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Originally Posted by nandish_m View Post
i have a doubt..
in fa its written that - anything that prolongs qt interval can predispose to torsades de pointes.. pg 288. thanks
Yes but amaidarone is with LEAST risk.
You may recall taht kaplan says answers with ALWAYS and NEVER in it are usually wrong.
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Question Anatomy

Organ which is NOT derived from FOREGUT but is supplied with Artery of FOREGUT ???/
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Originally Posted by nandish_m View Post
i think its chlamydia.. is it??
ya both of them can cause blindnes-ophthalmia neonatrum
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Originally Posted by Wajahat View Post
Organ which is NOT derived from FOREGUT but is supplied with Artery of FOREGUT ???/
Its spleen from mesoderm
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Default Regd.Foregut supply

Quote:
Originally Posted by Wajahat View Post
Organ which is NOT derived from FOREGUT but is supplied with Artery of FOREGUT ???/
Spleen!
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Default question

1) "Thumb sign on X-ray"-Pathology and cause

2) "Thyroid like kidney"

3)What is the difference between PCP overdose and LSD overdose?

Last edited by vnagubandi; 01-04-2013 at 08:17 AM.
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1) "Thumb sign on X-ray"-Pathology and cause

2) "Thyroid like kidney"

3)What is the difference between PCP overdose and LSD overdose?
1-Ac Epiglotitis- H.influenzae

2-Ch-Pyelonephritis and CA Kidney( not sure)

3-PCP overdosage causes Horizontal nd vertical nystagmus not incase of LSD
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Spleen!
good....its spleen derived from dorsal mesentry
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"Thumb sign on X-ray"-Pathology and cause: chronic pyelonephritis--H.influenzae

2) "Thyroid like kidney" : chronic pyelonehpritis

3) difference between PCP overdose: psychosis,agitated,delirium,homocidal,nystagmus(eye)

and LSD overdose: depresion,anxiety,delusion,pupil dilated(eye) visual halucination
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Quote:
Originally Posted by neha_subh View Post
"Thumb sign on X-ray"-Pathology and cause: chronic pyelonephritis--H.influenzae

2) "Thyroid like kidney" : chronic pyelonehpritis

3) difference between PCP overdose: psychosis,agitated,delirium,homocidal,nystagmus(eye)

and LSD overdose: depresion,anxiety,delusion,pupil dilated(eye) visual halucination
Buzz word for PCP overdose is Billigerence
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Quote:
Originally Posted by neha_subh View Post
"Thumb sign on X-ray"-Pathology and cause: chronic pyelonephritis--H.influenzae

2) "Thyroid like kidney" : chronic pyelonehpritis

3) difference between PCP overdose: psychosis,agitated,delirium,homocidal,nystagmus(eye)

and LSD overdose: depresion,anxiety,delusion,pupil dilated(eye) visual halucination
Everything is correct except, Thumb sign seen in ac.epiglottitis,and the causative organism is H.Influenzae

Last edited by vnagubandi; 01-05-2013 at 06:28 AM.
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Buzz word for PCP overdose is Billigerence
Absolutely! that is the word to remember!
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Default Dystrophic calcification

In dystrophic calcification, dystrophic calcium deposits as fine,gritty white granules or clumps. In H&E they appear as dark purple sharp edged aggregates. If the deposit develops lamellated outer layers it is described as psammoma body. Remember psamomma bodies are seen also in thyroid cancer and germ cell tumours of the ovaries.
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Quote:
Originally Posted by Wajahat View Post
1-Ac Epiglotitis- H.influenzae

2-Ch-Pyelonephritis and CA Kidney( not sure)

3-PCP overdosage causes Horizontal nd vertical nystagmus not incase of LSD
you are right about everything and i will check about ca.kidney and let you know
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In dystrophic calcification, dystrophic calcium deposits as fine,gritty white granules or clumps. In H&E they appear as dark purple sharp edged aggregates. If the deposit develops lamellated outer layers it is described as psammoma body. Remember psamomma bodies are seen also in thyroid cancer and germ cell tumours of the ovaries.
I think you mean surface epithelial tumors of the ovary, actually papillary serous ca is the one. I don't think germ cell tumors cause psammoma bodies.
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Everything is correct except, Thumb sign seen in ac.epiglottitis,and the causative organism is H.Influenzae
but in first aid its writen that this sign seen in chronic pyelonephritis-H.influnezae
i think thumb sign may be seen in both conditions acute epiglotitis and ch.pyelonephritis
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Originally Posted by vnagubandi View Post
In dystrophic calcification, dystrophic calcium deposits as fine,gritty white granules or clumps. In H&E they appear as dark purple sharp edged aggregates. If the deposit develops lamellated outer layers it is described as psammoma body. Remember psamomma bodies are seen also in thyroid cancer and germ cell tumours of the ovaries.
psamoma bodies are also seen in meningioma
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I think you mean surface epithelial tumors of the ovary, actually papillary serous ca is the one. I don't think germ cell tumors cause psammoma bodies.
you are right papillary serous ca.my bad! that's why it is seen both in papillary ca.of thyroid and surface epithelial tumours of ovary and as neha said,meningioma.

Thanks neha for the addition and i will check on that too.
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you are right papillary serous ca.my bad! that's why it is seen both in papillary ca.of thyroid and surface epithelial tumours of ovary and as neha said,meningioma.

Thanks neha for the addition and i will check on that too.
confirm it from CNS--patho.kaplan lectures notes
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Question pulsus paradoxus

pulsus paradoxus: define it,etiology,& reason of this findings
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Originally Posted by vnagubandi View Post
Everything is correct except, Thumb sign seen in ac.epiglottitis,and the causative organism is H.Influenzae
hey sorry ya you are right thumb sign on x-ray seen in acute epiglotitis..
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now you can remember it and never foget it!
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Quote:
Originally Posted by neha_subh View Post
pulsus paradoxus: define it,etiology,& reason of this findings
During normal inspiration:

the pleural pressure and the pulmonary interstitial pressure decrease---> increase in pulmonary vascular capacitance.

what does this lead to? --->decrease in venous inflow to the LEFT heart and subsequently decrease in cardiac output.

BUT,its not over though,

as we know during inspiration there is increased venous venous return to the RIGHT heart, ---> increased pulm.blood flow--->increased.venous inflow to the LEFT heart ---->this kind of offsets the decrease in cardiac output as we've seen above.

So that is normal. Now, the conditions that impede the COMPENSATORY RIGHT ventricular filling and subsequently increased output kind of exaggerate this situation and decrease in output in inspiration.

This leads to Pulsus Paradoxus which is a 20mm Hg drop in systolic B.P. (due to decrease C.O.) during inspiration (rather than the opposite).

So what conditions cause this? Constricitive pericarditis definitely, in addition cardiac tamponade, pulmonary emobolism,asthma and of course cor pulmonale.

I hope that makes sense.
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This is a big one

African-American it is kind of like a buzzword. I mean what are all the things associated with African americans? (Diagnosis,Disorders,traits,associations,incidence ....anything). If we discuss it here i think we can group them all in one place and can get an idea of what to think about during the exam when we see "African American".

I mean NO OFFENSE to anyone. It is just to group under one heading the various things we see on the exam and for easier recall. I am just asking this because i've seen it on a lot of questions repeatedly.
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Old 01-06-2013
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Quote:
Originally Posted by vnagubandi View Post
During normal inspiration:

the pleural pressure and the pulmonary interstitial pressure decrease---> increase in pulmonary vascular capacitance.

what does this lead to? --->decrease in venous inflow to the LEFT heart and subsequently decrease in cardiac output.

BUT,its not over though,

as we know during inspiration there is increased venous venous return to the RIGHT heart, ---> increased pulm.blood flow--->increased.venous inflow to the LEFT heart ---->this kind of offsets the decrease in cardiac output as we've seen above.

So that is normal. Now, the conditions that impede the COMPENSATORY RIGHT ventricular filling and subsequently increased output kind of exaggerate this situation and decrease in output in inspiration.

This leads to Pulsus Paradoxus which is a 20mm Hg drop in systolic B.P. (due to decrease C.O.) during inspiration (rather than the opposite).

So what conditions cause this? Constricitive pericarditis definitely, in addition cardiac tamponade, pulmonary emobolism,asthma and of course cor pulmonale.

I hope that makes sense.



seen in 4 conditions: COPD,constrictive pericarditis,cardiac temponade,and restrictive pericarditis
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Originally Posted by vnagubandi View Post
This is a big one

African-American it is kind of like a buzzword. I mean what are all the things associated with African americans? (Diagnosis,Disorders,traits,associations,incidence ....anything). If we discuss it here i think we can group them all in one place and can get an idea of what to think about during the exam when we see "African American".

I mean NO OFFENSE to anyone. It is just to group under one heading the various things we see on the exam and for easier recall. I am just asking this because i've seen it on a lot of questions repeatedly.

sarcoidosis,sickle cell anemia,b:THALASEMIA,G6PD,cystic fibrosis...
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sarcoidosis,sickle cell anemia,b:THALASEMIA,G6PD,cystic fibrosis...
I agree! but i think caucasians relate more to CF than african americans do..
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btw anyone knows why the testosterone level in bilateral cryptorchidism decreases with a increased in LH? It's from the FA 2012 errata. The leydig cells should still be unaffected to to the raised body temperature right? Thus, the level of testosterone should be similar as the unilateral cryptorchidism i guess..
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Quote:
Originally Posted by vnagubandi View Post
During normal inspiration:

the pleural pressure and the pulmonary interstitial pressure decrease---> increase in pulmonary vascular capacitance.

what does this lead to? --->decrease in venous inflow to the LEFT heart and subsequently decrease in cardiac output.

BUT,its not over though,

as we know during inspiration there is increased venous venous return to the RIGHT heart, ---> increased pulm.blood flow--->increased.venous inflow to the LEFT heart ---->this kind of offsets the decrease in cardiac output as we've seen above.

So that is normal. Now, the conditions that impede the COMPENSATORY RIGHT ventricular filling and subsequently increased output kind of exaggerate this situation and decrease in output in inspiration.

This leads to Pulsus Paradoxus which is a 20mm Hg drop in systolic B.P. (due to decrease C.O.) during inspiration (rather than the opposite).

So what conditions cause this? Constricitive pericarditis definitely, in addition cardiac tamponade, pulmonary emobolism,asthma and of course cor pulmonale.

I hope that makes sense.
i think i am getting it..
does that mean that these conditions like tamponade, pericarditis will decrease the compensatory mechanism(compensatory Rt heart(Ventri) filling) and hence the decrease in B.P is solely due to increased pulm vessel capacitance---->decrease venous return to Lt heart-->decrese C.O ???
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yes you are right,that is basically it.
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  #92  
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Quote:
Originally Posted by blackychen View Post
btw anyone knows why the testosterone level in bilateral cryptorchidism decreases with a increased in LH? It's from the FA 2012 errata. The leydig cells should still be unaffected to to the raised body temperature right? Thus, the level of testosterone should be similar as the unilateral cryptorchidism i guess..
nice question
i am jst giving my view..
In B/L Cryporchidism sertoli cells r affected(TEMP SENSITIVE) --> decrease ABP.. (ABP maintains testosterone levels)
---->decreased testosterone --->feedback increase in LH
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  #93  
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have a look a t des buzz words


USMLE Step 1 Radiology buzzwords
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  #94  
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Quote:
Originally Posted by blackychen View Post
I agree! but i think caucasians relate more to CF than african americans do..
ya you are right thanks for correction..
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Default pulsus paradoxus:

Quote:
Originally Posted by vnagubandi View Post
During normal inspiration:

the pleural pressure and the pulmonary interstitial pressure decrease---> increase in pulmonary vascular capacitance.

what does this lead to? --->decrease in venous inflow to the LEFT heart and subsequently decrease in cardiac output.

BUT,its not over though,

as we know during inspiration there is increased venous venous return to the RIGHT heart, ---> increased pulm.blood flow--->increased.venous inflow to the LEFT heart ---->this kind of offsets the decrease in cardiac output as we've seen above.

So that is normal. Now, the conditions that impede the COMPENSATORY RIGHT ventricular filling and subsequently increased output kind of exaggerate this situation and decrease in output in inspiration.

This leads to Pulsus Paradoxus which is a 20mm Hg drop in systolic B.P. (due to decrease C.O.) during inspiration (rather than the opposite).

So what conditions cause this? Constricitive pericarditis definitely, in addition cardiac tamponade, pulmonary emobolism,asthma and of course cor pulmonale.

I hope that makes sense.

normaly,
during inspiration increase venous return to right side of heart and right ventricle bulges forward and ocupies pericardial cavity---~ increase pulmonary venous return to left heart------increase cardiac output.
pathology,
during inspiration increase venous return to right side of heart but right ventricle unable to bulge forward into pericardial cavity due to pathology asociated with pericardium its restricts the forward bulging thats why right ventricle bulges to the oposide side(left side) and it decreases the capictance of left ventricle for incoming blood through pulmonary veins thats why decrease cardiac output this findings asociated with drop in BP with each inspiration
thats pathophysio which i know...
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Default mechanism of DNA exchange..

mechanism of DNA exchange:conjugation,transduction,transformation.. ...
please explain it for me in simple way,i studied this topic lot of times but then dont know why it gets easily wash out from mine mind,its might because i couldnt undrstand this topic properly so please discus with me this topic
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Old 01-09-2013
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Default nbme

have u guys done any nbme yet?
i was hoping on starting with nbme 5
what score should i expect at this time( 1 month before exam)?
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Quote:
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mechanism of DNA exchange:conjugation,transduction,transformation.. ...
please explain it for me in simple way,i studied this topic lot of times but then dont know why it gets easily wash out from mine mind,its might because i couldnt undrstand this topic properly so please discus with me this topic
TRANSFORMATION- uptake of free DNA from environment under favourable condition, incorporated by homologous recombination.Eg H.influenza, bacillus, nisseria

CONJUGATION- gene tramsfer from donor to recipient by cell to cell contact.

2 types Hfr * F- and F+ * F-
common features -have fertility plasmids or F factor which controls
conjugation( it contains tra gene)
-have oriT region from where transfer begins
-a single DNA strand is transferred from donor.

difference -sex change occurs in F+ *F- BUT not in Hfr * F- coz Hfr is often
interrupted
-homologous recombination occurs in Hfr * F- to stbilize
transferred gene.

TRANSDUCTION- transfer of DNA by phage vector.

2 types generalised and specialised
Generalised- requires virus wid lytic life cycle
lytic phage injects phage DNA.Replication of phage DNA and its structural proteins occurs. release of phage by cell lysis and here a packaging error occurs in which one phage incorporates bacterial DNA.
-ANY GENES CAN BE TRANSFERRED

Specialised- requires temperate phage wid repressor gene
-phage DNA is incorporated in bacterial cell and during excision a part of bacterial DNA is incorporated wid the phage and this phage then infects other cells
-is a form of excision error
-ONLY GENES NEAR THE VIRUS INSERTION SITE CAN BE TRANSFERRED
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  #99  
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Hey ur explanation of bacterial genetics is awesome! Now I wont open Kaplan again for this topic
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Quote:
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Hey ur explanation of bacterial genetics is awesome! Now I wont open Kaplan again for this topic
thank u.. i tried to integrate all the things, am glad u all like it..
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