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Old 01-06-2016
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Warning! Advice please of how to improve in this?

have been correcting uw wrong answers and come to noticed that i getting wrong topics which i know and just misread the questions or didn't understand what they asked and spend to much time trying to find out what they asked and getting short of time.
Could someone give me some advice of how i can correct making those mistakes to stop missing those questions?

Thank you!
"Trust yourself and be perseverant"
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Old 01-06-2016
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i am in same situation but only one rule check you answer.
50% of questions will be readily answered without reading the question when you are fully prepared.
A lot of the questions will not need you reading the whole long passage.By reading the question first will not only save time with a lot of questions but it also tells you what is required and thus you read the question with something in mind.

so my own steps are
1]read the question,i.e last sentence.

2]scan the options

3]read the labs and note any abnormalities calculates the anionic gap for example.
when long lab test are given,most times the diagnosis can be made from the labs.

4]read the first sentence,remember most questions the demographics can never be a trick.
it always holds a clue to your answer.

5]make the answer you think its right

6]just cancel out the other options-this is always a source of mistakes because most times we dont get to the last option and just tick.By cancelling out the other options you avoid this mistake

Like if you see ast:alt 2:1 ratio you know its alcoholic hepatitis.
If you see alt 2000 its something different say ischaemic liver necrosis....

Most times you know the answer,Make it.

Then last step is recheck,cancel out every other option by substituting in the that by reading the question completely or just scan to get the narrative.

by testing all alternative options you will avoid mistakes to zero.

Lastly,most very obscure answers are just to fill the options.If you have 2 options left pick the common one.Remember this is not a residency exam,no tricks in step 2 ck.

But if all your options don't feet the story pick the one you don't know.

For example a drunken man came to ED with history of RTA with fracture of leg.He was taken to surgery and reduction done with 4 pints of blood transfused due to severe bleeding.3 days latter post op he develops hepatitis.what is the diagnosis.


a alcoholic
b halothane
c ischaemic liver necrosis
d acute viral hepatitis
e sepsis

the markedly elevated ast and alt tells you the answer.It completely fits the narrative.when you check,i.e massive bleeding,post op hepatitis and low alp.

just do a brief check of the other four options,you will notice each is not completely wrong but none completely fits the narrative and the laboratory.Remember no tricks in step 2ck.If they wanted to ask you of halothane induced hepatitis,they won't go to great length talking of massive bleeding.

I just want to lastly say don't fall in trap of every question must fit the narrative and laboratory.They will add some things to derail you.In such situations you just have a gut feeling because its too easy.stay with the narrative.
a man comes with swollen hands following flu 3 that started 3dys ago.RF and ANA are positive.No significant past medical history.Took acetominophen

Viral arthritis
rheumatoid arthritis
SLE arthritis
drug induced

answer is viral.The labs are just there to distract you.The RA and SLE fit the labs but donot fit the narrative.Even if you dont know RF and ANA can be present in normal people if you stick to the answer that fits the narrative its viral.If you try substitute each of the answers you will discover that RA,SLE cannot cause a flu and will not develop in 3 days.Acetominophen unlikely to cause that.

If it helps am glad.Just add me in your prayers.Its just my humble opinion.

Last edited by dr tee; 01-09-2016 at 12:37 AM.
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The above post was thanked by:
jules07 (01-07-2016), samren17 (01-07-2016), SRI101 (01-06-2016)
Old 01-07-2016
jules07's Avatar
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Thank you for your advices Dr.tee, i really appreciated it!

Most of the time I use elimination and only let 2 options; but as i said before many of others questions are because i'm misreading the information(which i know the topic) missing the key for the diagnosis/answer.

You are added in my praying list, lets beat this beast!
"Trust yourself and be perseverant"
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Last edited by jules07; 01-08-2016 at 01:57 PM.
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