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Old 09-20-2015
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Default Second time takers - what did you do differently?


I failed CK with a 201 despite having read MTB thoroughly and completing uworld x 4, kaplan x 1. I felt confident in my basic knowledge when I took the exam. I feel the problem lies in my approach/interpretation of nbme questions. Can you please provide advice on how you changed your way of tackling the questions?

I can provide a sample question here and maybe you can help me work through it.

A 72 year old woman is brought to the emergency department because of a 12 hour history of chest tightness, SOB, and paroxysmal nocturnal dyspnea. She has type 2 DM, HTN, and CAD. Meds include glyburide, atenolol and aspirin. She is having difficulty speaking and is in moderate resp. distress. Pulse is 104/min reg, resp 28/min, BP 168/100. JVD noted, crackles heard at both lung bases, S3 gallop. ABG at FiO2 of 40% shows: pH: 7.48, pCO2 30, pO2 - 102 mmHg.
X-ray shows fluffy bilateral insterstital and alveolar infiltrates. Which is the following is the most likely mechanism of dyspnea?

A. A-a mismatch
B. Central hypoventilation
C. Decreased alveolar macrophage activity
D. Decreased inspired oxygen
E. Increased parenchymal elasticity
F. increased tissue oxygen demand
G. large airway obstruction
H. neuromuscular dysfunction
I. oxygen toxicity
J. smooth m. contraction

My current schedule consists of regaining the basic foundation I once had through MTB 3 and questions from books (pretest/lange). Taking UWSA at the end of this week to see where I stand. Depending on my performance, I will gauge whether to take it this year. The next two weeks will be dedicated to completing 4 blocks of uworld daily and reviewing the incorrect questions/concepts. I just fear that my uworld assessment will be skewed by recall.

Feedback is appreciated!
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Old 09-21-2015
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I'm going to take CK once again as well. My score was 197. But first I will take step 1, I first took step 2 CK.
Our preparation is similar but I read FA + Kaplan Lecture Notes Internal Medicine 3 times and did UW 3 times. I believe my problem was lack of step 1 knowledge.
It's been 10 years since I finished med school and even though clinical stuff was familiar something was always on the air, I felt I couldn't put all pieces to right places.
Now I'm taking step 1, I feel things are fitting together now. Eventhough I suck at Biochem.

If you've already taken step 1 and having problems with 2. I would recommend you to take 2 practice tests and see the common weak areas and focus on them.
My weakest was OB/GYN, and I think because it was significantly bad, it actually pulled my score down, even though rest of the test was enough to pass.

Study hard, like doc007 said in other posts WE CAN DO IT! )
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