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  #501  
Old 12-03-2013
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Another evidence based behavior: while reviewing marked questions in the end of block i managed : to change 3 incorrect answers to correct ones and 3 correct answers to incorrect ones so just.. As Daugherty says take your 50/50 and run
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  #502  
Old 12-03-2013
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tamta , you are always in the right spirit.Wish u all the best.Pray for me , I going through a family crisis.
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  #503  
Old 12-04-2013
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Hey guys.. Two new blocks of Uworld are just killer hard.. Although did on good percent 85% and felt awesome. Tomorrow home licensing exam
Good luck guys so exhausted can't move away from ipad.
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  #504  
Old 12-04-2013
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Good luck with your exam tomorrow.
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  #505  
Old 12-04-2013
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goodluck tamta!!!
day is going by so fast n I'm so slow n sleepy even coffee is not working, even took a 2 hour nap and its only 2 pm. must study but I'm falling asleep, and i had more than enough sleep yday
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  #506  
Old 12-04-2013
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Quote:
Originally Posted by tamta View Post
Hey guys.. Two new blocks of Uworld are just killer hard.. Although did on good percent 85% and felt awesome. Tomorrow home licensing exam
Good luck guys so exhausted can't move away from ipad.
Good luck with the test tamta!!
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  #507  
Old 12-04-2013
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Quote:
Originally Posted by tamta View Post
Hey guys.. Two new blocks of Uworld are just killer hard.. Although did on good percent 85% and felt awesome. Tomorrow home licensing exam
Good luck guys so exhausted can't move away from ipad.
Good luck!!
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  #508  
Old 12-04-2013
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Good luck all!!! Keep working hard!!! Stay blessed!!!
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  #509  
Old 12-04-2013
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Thanks guys, good early morning everyone. Pathophys sleep hygiene, don't nap, but here and there we are all out of control. Uesterday i went to sleep at 9 in the evening can't lie feel great and refreshed. Yeah guys january isjust a month from now, lets do our best. From tomorrow ten day uworled marked revision plan. 130 questions a day lets see if i can handle. Should do some reading along side.. 50 pages must. Finishing uworld unused ones today 71% so far
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  #510  
Old 12-05-2013
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Where is everybody.. So passed my exam guys.
Doing one and half block of uworld, and i am already nauseated, questions make me nauseated if i do them lot. This explanations are real thing, time-consuming, nauseating but good thing of course. Okay from tomorrow need some schedule of reading and together test doing. Making only tests is not good.
100 unused questions left only. Should i keep them? For hard days like for next nbme. Need to do cardiology well... Lot of trouble with that in every aspect and everytime, also this pulmonary embolism will one day give me pulmonary embolism and i still will not get what test should i be done first
I am planning timed tutor, for marked questions to do more questions during day. Think that should be okay.
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  #511  
Old 12-05-2013
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started uworld again aswell and reading but its so hard. i wanted to do 2 blocks a day plus a topic for IM but its hard to finish. get soo tired. n then i thnk what the point of reading if your not concentrating.!!!!

congrats on passing
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  #512  
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Quote:
Originally Posted by pathophysio1 View Post
started uworld again aswell and reading but its so hard. i wanted to do 2 blocks a day plus a topic for IM but its hard to finish. get soo tired. n then i thnk what the point of reading if your not concentrating.!!!!

congrats on passing
Yes thats true i dont have ability to do any readin now its almost 22:00
So you want to say that it will be as difficult on second time or you have done it quite a while ago?
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  #513  
Old 12-05-2013
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Congratulations! Keep going guys!
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  #514  
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not that long ago i guess I'm just slow reader in general maybe thats y. will try harder to finish 2 blocks and reading bc time is running out
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  #515  
Old 12-05-2013
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Originally Posted by pathophysio1 View Post
not that long ago i guess I'm just slow reader in general maybe thats y. will try harder to finish 2 blocks and reading bc time is running out
Lets do our best, me as well need to do at least 100 questions. I hope they must be easier going for me i have hardly finished uworld yet. And of course reading at least a chapter. This is must do from tomorrow. Sure time is ticking.. The more time we allow ourselves to lose more we forget everything. So keep our spirits up. Will have some fun with biostats making my own biostatistics chapter in the end of mtb.
This guy has done good job
Confounding and Effect Modification‏
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  #516  
Old 12-05-2013
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constipated, sneezing, coughing, tearing, nose running like my bathroom faucet-happiest period i have ever had in my preparation
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  #517  
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constipated, sneezing, coughing, tearing, nose running like my bathroom faucet-happiest period i have ever had in my preparation
Heroin withdrawal? But no diarrhea have fun jimi. My world mission for today is over, feel so fat
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  #518  
Old 12-05-2013
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congrats on passing tamta.I know you are feeling good today.
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  #519  
Old 12-05-2013
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Congrats Tamta!! Im sure step 2 will be just as good...I have been busy with the whole black friday shopping..Now back on track..Finished 29 blocks so far with 68%..While im doing uworld, i find it very hard to read MTB, does anyone else have the same problem? Im more interested in the questions i guess..Hope i finish the q bank in another 2 weeks and then start MTB..Good luck guys!!
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  #520  
Old 12-05-2013
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find it really hard to complete both of them together in the same day its really tiring. i feel really fat to tamta, all i do is sit, even if i don't feel like studying I'm eating rather than exercising
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  #521  
Old 12-05-2013
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Quote:
Originally Posted by pathophysio1 View Post
find it really hard to complete both of them together in the same day its really tiring. i feel really fat to tamta, all i do is sit, even if i don't feel like studying I'm eating rather than exercising
I think its okay even if you gain a few pounds here and there, you can always lose it once you are done with the exams..I personally like to sit in front of the computer whether i study or not, bcz chances are, you will eventually run out of things to do on your computer and get bored and finally go back to step 2..Happens to me atleast!!
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  #522  
Old 12-05-2013
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Originally Posted by pathophysio1 View Post
find it really hard to complete both of them together in the same day its really tiring. i feel really fat to tamta, all i do is sit, even if i don't feel like studying I'm eating rather than exercising
Im glad that im not alone yes i find it very hard to do mtb together with questions but hope it will be easier when reviewing marked questions.

Killer plan for next 10 days:

Day1- infectious + 135 marked qs every day
Day2- Cardiology
Day3- Endo+rheuma
Day4- Pulmo +Cardio review!!!
Day5- Hema+GI
Day6- Neuro+ Onco + preventive+Derma
Day7- Renal+ Cardio review!!!
Day8- Surgery+Peds
Day9- Ob-Gyn+ Eye
Day10- Psych+ER+ Cardio review!!!!!!
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  #523  
Old 12-05-2013
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after extensive work on kaplan qb in pediatrics and disappointment i feel so relieved when doing UW blocks - higher percentages and plenty of time at the end of the blocks
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  #524  
Old 12-06-2013
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wheres everybodyy. hate this weather depressing
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  #525  
Old 12-06-2013
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Quote:
Originally Posted by pathophysio1 View Post
wheres everybodyy. hate this weather depressing
Yeaahh but no time for depression. So i have lost whole study day today, because of laparoscopic operations but im happy cause review is going just greatly i managed infectious chapter from mtb and in 2 hours subjectwise block of infectious although still mistakes and on 80%. I generally have marked lot of questions more than half of bank.
So i can manage at least 150q a day and one chapter if not more. So .. I am fresh. funniest is i needed only 27 minutes for whole block. So timed tutor mode is great for review. And i recommend subject wise review on second run of uworld.
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  #526  
Old 12-06-2013
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TamTa tell me something.I know you encounter lot of low yield stuff in Kaplan q bank. Can u remember all those. I am doing subjectwise review and along with USMLEWORLD QS.

There are lots of things I read in USMLERX and made notes which I think I don't have time to review.

I am totally torn apart what to read and what to skip and there are lots of forgetting.


In short , what are the main resources you are following now
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  #527  
Old 12-06-2013
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Quote:
Originally Posted by pathophysio1 View Post
wheres everybodyy. hate this weather depressing
i love this weather
it increases my concentration
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  #528  
Old 12-06-2013
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Quote:
Originally Posted by tamta View Post
Yeaahh but no time for depression. So i have lost whole study day today, because of laparoscopic operations but im happy cause review is going just greatly i managed infectious chapter from mtb and in 2 hours subjectwise block of infectious although still mistakes and on 80%. I generally have marked lot of questions more than half of bank.
So i can manage at least 150q a day and one chapter if not more. So .. I am fresh. funniest is i needed only 27 minutes for whole block. So timed tutor mode is great for review. And i recommend subject wise review on second run of uworld.
Hey tamta, if you dont mind me asking, how much was your cumulative percentage on uworld the first time? Thank you
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  #529  
Old 12-06-2013
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Thats what i am telling it is better to follow one thing than be torn apart among two banks. I didnt do explanations of kaplan, just looked the correct answer so dont remember them. One question that i annotated from kaplan helped me answer incorrectly question from uworld. So stick with uworld and mtb. That is what i am doing.
My cumulative 71%. 2 unused blocks.
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  #530  
Old 12-06-2013
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I make mistakes on the questions that i answered correctly before. The incorrect questions i mostly remember well because spent lot of time on dofferentiating answers and annotating.
So mtb says most common valvular from rheumatic is mitral stenosis,
Uworld says most common is mitral r egurgitaion from MvP. How should i know the truth. of course i made mistake because i answered stenosis.
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  #531  
Old 12-07-2013
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Quote:
Originally Posted by MedicalExaminer View Post
i love this weather
it increases my concentration
I can't have privacy because it is very cold in my study room.. Also frind said it was so hot in prometric..he said i was nearly asleep and only sobering up when i came out on breaks.. So summer was definitely easier
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  #532  
Old 12-07-2013
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Did i say it was easy to review?? I could hardly manage cardiology marked qs block in 3.5 hours with 68%
Keeping calm and moving on
I want to pass exam in december and have a happy new year with my kids.
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  #533  
Old 12-07-2013
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Quote:
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I make mistakes on the questions that i answered correctly before. The incorrect questions i mostly remember well because spent lot of time on dofferentiating answers and annotating.
So mtb says most common valvular from rheumatic is mitral stenosis,
Uworld says most common is mitral r egurgitaion from MvP. How should i know the truth. of course i made mistake because i answered stenosis.


this is from goljan's RR pathology
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Last edited by MedicalExaminer; 12-07-2013 at 03:59 AM.
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  #534  
Old 12-07-2013
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Who will believe me that one block of marked cardiology questions totally sucked blood out of me
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  #535  
Old 12-07-2013
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Has anyone heard of surgery recall audio lectures?? How good is it??
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  #536  
Old 12-07-2013
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I hope this is the last time when my life sucks so much
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  #537  
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mine does too. its ok were all in this together and hopefully we come out strong with good marks! and hopefully it'll b worth it. how long did it take u to read all of cardio i have to read it as well not looking fwd
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  #538  
Old 12-07-2013
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hi;

i have been a silent follower of this tread all this while.. im planning to take ck by jan last. i just want to say good work people , u know motivating each other ( esp u tamta) sometimes this is the only thing that makes me feel like reading..
so far iam done with mtb 2 &3 and kaplan( could not complete it).
kaplan q bank with 67%
uw timed random (27% done)- 68%

god its a hard and long journey !!
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  #539  
Old 12-07-2013
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Quote:
Originally Posted by inspired View Post
hi;

i have been a silent follower of this tread all this while.. im planning to take ck by jan last. i just want to say good work people , u know motivating each other ( esp u tamta) sometimes this is the only thing that makes me feel like reading..
so far iam done with mtb 2 &3 and kaplan( could not complete it).
kaplan q bank with 67%
uw timed random (27% done)- 68%

god its a hard and long journey !!

yeah hard and long but if we are persistent doable.
managed to review infectious questions quite well. cardiology is killing me but i will kill it no other way.
67% in kaplan is just great @inspired. very tired today. it was too much but need to aggravate myself until next NBME to take exam soon.
Good luck everyone.. keep heads up and work hard. Ck exam will set us free soon. hardest period but need to get over it. as we did for step1..
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  #540  
Old 12-07-2013
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Originally Posted by pathophysio1 View Post
mine does too. its ok were all in this together and hopefully we come out strong with good marks! and hopefully it'll b worth it. how long did it take u to read all of cardio i have to read it as well not looking fwd
I could only manage around 25 pages today: CHF, cardiomyopathies, valvular diseases second part of mtb cardio. Did one block of marked questions. It was hard exhausted me. Then i continued some leftover from infectious and 55 marked questions, which really made me happy it was way easier for me than cardio. So as my above ten day plan, of course its impossible to do 135 cardio questions a day, but i should be able to do 135 other questions. Lets see tomorrow i am leaving first part of cardio and doing endo and rheuma. Marked Questions in them are around 135. Lets see. And cardio of course is on everyday schedule. I have 4 days from those 10 for cardio review. So in the end i hope i will defeat the beast

And right now just finishing explanations of last block of 20 questions.which i didn't do before.
So totally i did today 115 qs. Not bad.
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  #541  
Old 12-07-2013
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thats amazing keep up the great work n have good good sleep
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  #542  
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Originally Posted by pathophysio1 View Post
thats amazing keep up the great work n have good good sleep
Thanks..
So this good guy got 202 on NBME 4 ---> 20days after 227 on NBME 6 --->25 days after 242 on exam
Progress thread

So morale from here. I will write Nbme 6 in about 10 days if i get over 230 i will give exam end december.
Why hurry?? Because i want to have fun with my kids on New years night..
And if he could, i also can with my nbme4 221..
240 is exact score i would love..
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  #543  
Old 12-07-2013
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Good job today tamta! Why don't u want to try your hand on nbme 2? Is form 6 better?
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  #544  
Old 12-07-2013
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Hey everybody,

Just a random question here: do breath sounds come on the Step 2 CK exam? I believe Conrad Fischer tells us in MTB 2 to be able to identify them in the exam, but they are not there in UW, so I was a bit confused about that. Anybody please clarify?
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  #545  
Old 12-08-2013
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Quote:
Originally Posted by neuralcrest View Post
Good job today tamta! Why don't u want to try your hand on nbme 2? Is form 6 better?
Its the newest one as i know. S actually i am thinking about final decision for exam date after this nbme.. Lets see .. Not a bad idea to do form 2 and save form 6 for later.. But already spent too much and i guess i will need uw extension also..

Okay so today endocrinology day wonderfull.. In 4.5 hours whole endo from mtb with lot of annotations and one block of marked questions 86% . Its funny how on second run we make mistakes in questions previously answered correctly. So definitely reviewing at least marked questions from uworld is so important subject wise i would advise definitely. So left with another 30-40 marked questions will do them and later evening cardiology probablu or should start rheumatology two chapters not perfectly doable with marked questions. Lets see.
So one more thing if you want to do uworld perfectly with reviewing marked ones and then again reviewing marked ones from marked ones take a three month subscription.. If you aim to do uworld twice then take three months with more courage i will probably extend for another month or two weeks if i decide to pass in december..

About breath sound i would myself love to hear them somewhere..

Blaufuss.org is for heart sounds
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Its the newest one as i know. S actually i am thinking about final decision for exam date after this nbme.. Lets see .. Not a bad idea to do form 2 and save form 6 for later.. But already spent too much and i guess i will need uw extension also..

Okay so today endocrinology day wonderfull.. In 4.5 hours whole endo from mtb with lot of annotations and one block of marked questions 86% . Its funny how on second run we make mistakes in questions previously answered correctly. So definitely reviewing at least marked questions from uworld is so important subject wise i would advise definitely. So left with another 30-40 marked questions will do them and later evening cardiology probablu or should start rheumatology two chapters not perfectly doable with marked questions. Lets see.
So one more thing if you want to do uworld perfectly with reviewing marked ones and then again reviewing marked ones from marked ones take a three month subscription.. If you aim to do uworld twice then take three months with more courage i will probably extend for another month or two weeks if i decide to pass in december..

About breath sound i would myself love to hear them somewhere..

Blaufuss.org is for heart sounds
Guys I did NBME 2 earlier (a month ago) and i think the questions are kinda old..At this point, to decide whether or not to take the actual test, I think NBME 6 is better than 2..NBME 2 is more for people like me, who's prep is going slow and need a test to increase the speed..So dont waste your money at this point on NBME 2 tamta.
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  #547  
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Guys I did NBME 2 earlier (a month ago) and i think the questions are kinda old..At this point, to decide whether or not to take the actual test, I think NBME 6 is better than 2..NBME 2 is more for people like me, who's prep is going slow and need a test to increase the speed..So dont waste your money at this point on NBME 2 tamta.

Actually, i would like to correct myself..I think i should not say the questions seem old, bcz i didnt do the other NBMEs; may be they are not...But i still think NBME 6 is better than NBME 2 if you want to decide whether or not to take the test.
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  #548  
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@ rockstar,how did you fare in nbme 2?
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i also heard nbme 6 is a modified version of nbme 1
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@ rockstar,how did you fare in nbme 2?
I got 202..That was before uworld though..I had probably done 10 blocks on uworld back then.
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i also heard nbme 6 is a modified version of nbme 1
Yes modified but its newest and as good as form 4. Its a good one for making final decisions.
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Will consider doing form 6.
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Thanks rockstar and tamta for weighing in.
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Thanks rockstar and tamta for weighing in.
http://www.usmle-forums.com/usmle-st...-ck-score.html

4 and 6 are definitely best ones. Same as for step1 : 13 and 15 are latest and best. I had exact same score as on nbme15.

For ck uwsa is most accurate, but nbmes of course have their most important meaning in decision to take exam.

I was searching drug abstracts and ads.. i guess its futile.. Better to chew uworld biostats in and out than worry and mourn
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Gave a look at prometric available dates and latest in december is 26. I think my december plan is ruined, and i am quite happy about that. Plan was january 15 from the beginning and it should happen like that. Anyways will write nbme6 on 16-th and decide exactly.
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U are on track. Good luck with form 6.
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Have chosen very bad time to worry about externships, observships, specialties, matching blablabla..
Sticking with 50 pages+ 100 marked qs/per day regime. Pulmo today.
My blocks are low 80s.
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Have chosen very bad time to worry about externships, observships, specialties, matching blablabla..
Sticking with 50 pages+ 100 marked qs/per day regime. Pulmo today.
My blocks are low 80s.
Aha : )))))
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  #559  
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Thank for the reply Tamta

How many days dies it generally take it complete second round of uworld ?

Has anyone tried step3 Kaplan. I heard from a friend that questions are mostly like those of Kaplan step 3 qbank ??
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Hello guys. Want to say that I am a silent reader of this thread. All of you are doing great job and help me a lot with motivation. I have one question, my exam is very near, currently I am reviewing Uw notes and MTBs, I am done with nbme 4 and 6, so the only assessment tests left undone are uwsa and free USMLE questions(don't know the quantity, for step 1 it was 150q). Which one should I do just before exam? Please need your advice.
Thanks in advance.
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I would suggest free questions as in step 1 I had 3 questions exactly the same way as they were in those free questions.

You can always take one more nbme.

Good luck with exam!!
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Hello guys. Want to say that I am a silent reader of this thread. All of you are doing great job and help me a lot with motivation. I have one question, my exam is very near, currently I am reviewing Uw notes and MTBs, I am done with nbme 4 and 6, so the only assessment tests left undone are uwsa and free USMLE questions(don't know the quantity, for step 1 it was 150q). Which one should I do just before exam? Please need your advice.
Thanks in advance.
Why dont you do both of them..Bcz the free questions are free anyway, and i think its always better to do more questions..Besides, the free questions will just give you a percentage of the correct questions, while UWSA gives a 3 digit score..So, if you were to do only 1 of them, i would suggest UWSA.
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Why dont you do both of them..Bcz the free questions are free anyway, and i think its always better to do more questions..Besides, the free questions will just give you a percentage of the correct questions, while UWSA gives a 3 digit score..So, if you were to do only 1 of them, i would suggest UWSA.
No Rockstar I want to do both of them, just want to understand the order. Which one should be done now and which one just before exam? My exam is on Dec. 27. Thank you.
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Most people take uwsa first and Fred qs later.
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I agree with neural crest...when you do uwsa, you will know where you stand and if you are ready for the test or not..and then you could do the free questions probably couple days before the test and even if the questions do repeat from them, you will remember them better.
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UWSA definitely. I am saving it for last week. It is our precious self assessment tool that tells us exam result if done in last week. Very accurate with higher scores like >240. Very unpredictable below 235---> u can get anything from 210-220. Good luck. Free questions are just like doing tutorial days before. I would not use it for making any decisions.
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  #567  
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where is everyone todayyyyyyy. its so cold burrrr
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I thought uworld blocks get easier as you keep doing...But my percents are going down...My cumulative percentage is still at 68, but individual percents are dropping..Im losing interest and motivation now guys
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Today , I need to 100 questions. The explanation of World changed so much.

I got a question on hyponatrimia , did u guys notice that there is no role of normal saline according to uworld

Moderate symtoms
-hypertonic saline upto 120 mmol then fluid restriction
severe symptons like seizure- hypertonic saline

this doesnot match with books

post ur opinion guys
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There are so many things that usually are opposite to each other that i started not to pay attention on them and lose time. For example today did rheumatology. Mtb+ around 60 marked questions, i love this subject. So explanation said that RA causes joint narrowing, when indeed osteoarthritis does that. In rheumatoid there is even enlarged synovial fluid. So whatever.
Refreshed myself today with a nice fight until perspiration. Feeling great have planned evacuation of kids and final month of attack on exam. So feeling motivated and planning from level to leven in preparation is a really good and most important thing. What ablut losing motivation are you talking girl did unused block today 57% Have left one more unused and thats it. Uworld is study tool so study it, dont make percent demotivate you.
Moment of tenderness: im so happy that i have couple of wonderful friends, who are by my side. And without whom i would hardly do anything. This is really a great hope.
Good nigh.. God bless my friends..
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TAMTA , you will just do great in the real exam.Cause, you are sincere.

By the way, I did not get ur answer
so, is it hypertonic saline or nomal saline.

U know what, I have decided to make usmleworld the ultimate reference , cause I see that all of the qs are updated recently within the last 2 to 3 months.
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Hello everyone....I think there is one question like that but it talks about SIADH and not hyponatremia in general and explains well why normal saline won't work esp if urine osmolarity is higher than normal saline I think......still remember putting it as normal saline lol...I hate these electrolytes.
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lets use some motivation
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TAMTA , you will just do great in the real exam.Cause, you are sincere.

By the way, I did not get ur answer
so, is it hypertonic saline or nomal saline.

U know what, I have decided to make usmleworld the ultimate reference , cause I see that all of the qs are updated recently within the last 2 to 3 months.
Thanks friend, really starting having trouble with sleep. I imagined myself in prometric between blocks and started having cramps really scared but ill do my best
I intentionally avoided to answer yesterday i looked at question now yes its about specifically SIADH, and yes mtb says normal saline +diuretic for moderate hypoNa. Also marginal note says in SIADH saline without diuretic makes it worse. So i guess that's it. I have marked this question, i answered it correctly on first run, but got it wrong on the second time.
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Why am i such a dummy to remember to ADMINISTER ASPIRIN first!!!!! In ACS.
Anyways cardiology looks easier today. So doing and doing again helps woth weak areas. I will suck blood out of Cardiology
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Why am i such a dummy to remember to ADMINISTER ASPIRIN first!!!!! In ACS.
Anyways cardiology looks easier today. So doing and doing again helps woth weak areas. I will suck blood out of Cardiology
friend!! ur not alone on that..i made the exact same mistake yesterday !!!
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Why am i such a dummy to remember to ADMINISTER ASPIRIN first!!!!! In ACS.
Anyways cardiology looks easier today. So doing and doing again helps woth weak areas. I will suck blood out of Cardiology
made the exact same mistake as well!!
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Thats great now it is important not to answer aspirin everywhere because we remember it so well!!
I wanted to add about usmle world they are oh so updated, even during my subscription.
Also interviews are still granted in december, so its true that when AMGs start to cancell their interviews IMGs still have hope even this late.
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in this cold weather studying "HOT" topics from obgyn
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Quote:
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in this cold weather studying "HOT" topics from obgyn
I would really love to know which topics dod you find hottest in OBgYn
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I would really love to know which topics dod you find hottest in OBgYn
PCOS
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Did psyhyatry tonight. For those interested on dsm5 changes: vaginismus is called: Genito pelvic pain/ penetration disorder.
Also Hoarding disorder. Maybe it was in dsm4 also just met for the first time. Also dsm5 does not require bypolars to have had a depressive episode.
Good night guys. 11 pm and i am totally out of this world. Had BP 90/50.
Purely usmle- hypotonic syndrome. Will show my tension on exam.
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Where is everybody.. So passed my exam guys.
Doing one and half block of uworld, and i am already nauseated, questions make me nauseated if i do them lot. This explanations are real thing, time-consuming, nauseating but good thing of course. Okay from tomorrow need some schedule of reading and together test doing. Making only tests is not good.
100 unused questions left only. Should i keep them? For hard days like for next nbme. Need to do cardiology well... Lot of trouble with that in every aspect and everytime, also this pulmonary embolism will one day give me pulmonary embolism and i still will not get what test should i be done first
I am planning timed tutor, for marked questions to do more questions during day. Think that should be okay.
congrats tamta, so done with one monster , soon it vl be ck,wish u best luck gal
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Hey can someone please tell me from where do we prepare immunization and development milestones ??

This is giving a hard time
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Stick with uworld for immunization. Check pg 5 on this thread for devt posted by tamta.
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[QUOTE=tamta;229010]we can only dream about this for next month

Mammography: every 2 years 50-74
Pap: every 3 years 21-65
Colon Cancer:colonoscopy every ten years starting from 50. OBT starting from 50 then yearly.
Single family member: at 40 or 10 years earlier when member got cancer, whichever comes first.
HNPCC, 3 family members, two generations, one premature (<50) colonoscopy at age 25, then every 1-2 years
FAP: screening sigmoidoscopy? at 12, then 1-2 years. proctocolectomy when detected.
No additional screening for : JHuvenile polyposis, Peutz jeghers, Turcots, gardners.

No routine screening for lung, ovarian, also bladder , pancreatic cancer even if at risk.

All men age 65 who ever smoked AAA screening with US, also 65-75 with famili hx
everyone age >18 BP checked every visit
Hyperlipidemia: Men >35, women >45
Diabetes: when pt has hypertension, hyperlipidemiascreening with fasting glucose (2 measurments over 125 or HBA1C >6.5%)
osteoporosis: Dexa scan at 65. >-2.5 osteoporosis
kids 0-5 strabismus, amblyhopia, refractive errors. eye exam.

Vaccinations:

Influenza:
live intranazal: healthy, nonpregnant <50
inactivated: >50 or with chronic ilnesses

influenza: yearly, pregnant, healthcare workers
pneumococcal: cfs leaks, alcoholics, cochlear implants. everyone above 65 1 dose only.
revaccination in 5 years if pt immunocompromised or first was prior to age 65.

give both influenza and pneumococcal to these guys:
Chronic heart lung (asthma emphysema) liver kidney dx
immunocompromised: HIV/AIDS, steroid users, cancer of asplenia. Diabetics.

my advice don't mass influenza vaccine with Haemophilus influenza type b
i did couple of times in a hurry.

Zoster vaccine: >60, prevents shingles.
post exposure prophy: immunocompetent, asymptomatic, no imune- varicella vaccine
immunocompromised- Varicella IG

Pertussis prevention: all close contacts- erythromycin for 14 days, regardless of age immunization and symptoms

HEP A, B: routinely in kids,
Adults if:chronic liver dz even if Pregnant, homosex men or multiple fckrs, household contacts with hep a.b. intravenous drug abusers.
additionaly: hep 1 to travelers to endemic countries (most asia, africa, egypt so we need to vaccinate before vacation
HepB: end stage renal dx, diabetes, health care workers.

Meningococcal: routinely age 11
adults with: asplenia, complement def, military recruits, dormitories, travelers to Mecca, saudi arabia pilgrimage. some asia, subsaharan africa.

Tetanus Vaccine:
all adults Td booster every 10 years, with Tdap once in place of Td regardless of age!!!!!!!!
Tdap are recomended during each pregnancy regardless of womans prior Td Tdap years.

Tdt with severe dirty wound who received booster >5 years ago and those with minor clean wounds who received booster >10 years ago.
TIG to any individual with severe dirty wound and unclear or incomplete immunization history. of course this is given above with toxoid.

Rabies
if dog not captured or wild assumed rabid---> both active and passive PEP
if captured, neighbors, own, triggered attack---> keep for observation for 10 days. if develops features ---> PEP
Start immediate PEP for head and neck bites

Malaria proph: chloroquine---> carribbean, Mexico, Costa rica, el salvador, paraguay, argentina, dominican republic. these are sensitive to chloroquine.
in all other malaria endemic areas-- Atovaquone/roguanil, alternatives are doxy and mefloquine.

Obesity:
normal BMI 18-25
BMI <30 simple exercise+ low calory diet
BMI >30 sibutramine to assist weight loss
BMI >40 gastric banding or bypass. if severe complications a/w obesity.

For vaccination of kids mtb3 has got chart although not really helping. I may work on it also later.
Good morning starting to work
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  #587  
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I'm really weak in surgery although I've watched the Kaplan lectures and read the notes and did MTB on it but I find myself not good in knowing the sequence of things that should be done.. any help on how I could get to be better in surgery please?
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I'm really weak in surgery although I've watched the Kaplan lectures and read the notes and did MTB on it but I find myself not good in knowing the sequence of things that should be done.. any help on how I could get to be better in surgery please?
i am also weak in surgery 60% in uworld. although i am twice sartified surgeon in adult and pediatric surgery. have not done kaplan notes first part well i did not like it. will do vignettes. still have to work on chart about abdominal trauma will post it.
when i look at my mistakes its ABC-s and shock types. i think we should just reinforce them.
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  #589  
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Start Pap from 21, despite onset of sexual activity.
21-29---> every 3 years
30-65---> every 3 years cytology, or every 5 years cytology +HPV testing.
>65---> no screening if recent prior tests negative.
No screening---> if hysterectomy for benign causes (i.s. no previous history of precancerous lesions, cervical cancer, or DES exposure)

Classification of Pap Smear:
ASCUS----> intermediate smear
HPV, Mild dysplasia, CIN1---> low grade squamous intraepithelial lesion LSIL
Moderate, Severe dysplasia, CIN2,3, CIS---> High grade HSIL
Cancer: Invasive cancer management: cervical biopsy (mc SCC), metastatic workup (pelvic exam, CT, cysto proctoscopy)----> hysterectomy.
if mets to lymph nodes, tumor>4cm, local reccurence,poor differentiation, positive margins---> Hysterectomy+ adjuvant therapy radiation or chemo)

Workup of abnormal Pap:
ASCUS----> 21-24----> repeat cytology in 1 year
>25 -----> HPV testing---> if positive do colposcopy, if negative- repeat Pap and HPV testing in 3 years.

MTB sais: after first ASCUS repeat Pap in 3-6 months and order HPV testing.

What is CLEAR for ASCUS:
2 consecutive Paps show ASCUS, or HPV16 and 18 are found or ABNORMAL Pap ------> colposcopy and biopsies.

Endocervical curettage---> all NONpregnant undergoing colposcopy for an abnormal Pap. ECC is done to rule out endocervical lesion.
Cone biopsy---> Performed after Colposcopy or ECC if Pap smear and biopsy findings are not consistent (i.e. abnormal cells were not biopsied); abnormal ECC histology; Endocervical lesion; Biopsy showing microinvasive carcinoma of cervix.

Observation ----> CIN1, and CIN2,3 after ablation or excision (follow up for 2 years with repeat PAps, colposcopy+paps, or HPV testing every 4-6 mo)
Ablative (cryo, laser vaporization, electrofolguration) or excisional procedures (LEEP, Cold-knife conization) ----> CIN2,3
Hysterectomy----> Biopsy confirmed (what? probably Cancer), Reccurent CIN2,3

Pap in pregnants managed same way except ENDOCERVICAL CURETTAGE. (because of increased cervical vacularity)
CIN/Dysplasia- pap and colposcopy every 3 months during pregnancy, repeat Pap and colpo 6-8 weeks postpartum. If persistent lesion definite treatment.
Microinvasive cervical cancer---> cone biopsy to rule out frank invasion, deliver vaginally reevaluate and treat 2 months postpartum.
Invasive cancer <24weeks---> radical hysterectomy + radiation
>24weeks---> conservative management up to 32-33 weeks, cesarean and definite treatment.

HPV vaccination:
Quadrivalent HPV recombinant vaccine (Gardasil)---->8-26years
Sexually active women can also receive vaccine but in above age range only
not recommended for pregnant, lactating, or immunosuppressed women, also recommended for men same age to prevent Genital warts. Vaccinated ones should still follow with Pap smears.
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  #590  
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Updating the chart so i could print it. so although i protested it is very important to make one book. because on my review before NBME i skipped all subjects from MTB3. i have scribbled some important things in MTB2 but scribbled is not as same as reading whole pages of MTB3. so i will read twice form my scribbled mtb2 notes + mtb3 wholw pages. so make it from the beginnin. so pages from MTB3 Gynecology:
I dont know what to do with breast yet.
others: p431 pap workup. P436-to-440 ammenorrheas, p447- infertility- to 449 gestational trophoblastic dx

@Medical Examinet please help me in same way with Pediatrics, you would greatly help me if you tell me which pages are must from MTB3. i will save time. ive united OBstetrics from both books on first run.

Last edited by tamta; 12-12-2013 at 12:20 AM.
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For surgery, do kaplan videos and the vignettes together same time and review the vignettes quickly when u are done.
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Tamta, so finally have you done Kaplan books or not ? Some how I am not able to get te conversation here.
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  #593  
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[QUOTE=tamta;230559]Start Pap from 21, despite onset of sexual activity.
21-29---> every 3 years
30-65---> every 3 years cytology, or every 5 years cytology +HPV testing.
>65---> no screening if recent prior tests negative.
No screening---> if hysterectomy for benign causes (i.s. no previous history of precancerous lesions, cervical cancer, or DES exposure)

Classification of Pap Smear:
ASCUS----> intermediate smear
HPV, Mild dysplasia, CIN1---> low grade squamous intraepithelial lesion LSIL
Moderate, Severe dysplasia, CIN2,3, CIS---> High grade HSIL
Cancer: Invasive cancer management: cervical biopsy (mc SCC), metastatic workup (pelvic exam, CT, cysto proctoscopy)----> hysterectomy.
if mets to lymph nodes, tumor>4cm, local reccurence,poor differentiation, positive margins---> Hysterectomy+ adjuvant therapy radiation or chemo)

Workup of abnormal Pap:
ASCUS----> 21-24----> repeat cytology in 1 year
>25 -----> HPV testing---> if positive do colposcopy, if negative- repeat Pap and HPV testing in 3 years.

MTB sais: after first ASCUS repeat Pap in 3-6 months and order HPV testing.

What is CLEAR for ASCUS:
2 consecutive Paps show ASCUS, or HPV16 and 18 are found or ABNORMAL Pap ------> colposcopy and biopsies.

Endocervical curettage---> all NONpregnant undergoing colposcopy for an abnormal Pap. ECC is done to rule out endocervical lesion.
Cone biopsy---> Performed after Colposcopy or ECC if Pap smear and biopsy findings are not consistent (i.e. abnormal cells were not biopsied); abnormal ECC histology; Endocervical lesion; Biopsy showing microinvasive carcinoma of cervix.

Observation ----> CIN1, and CIN2,3 after ablation or excision (follow up for 2 years with repeat PAps, colposcopy+paps, or HPV testing every 4-6 mo)
Ablative (cryo, laser vaporization, electrofolguration) or excisional procedures (LEEP, Cold-knife conization) ----> CIN2,3
Hysterectomy----> Biopsy confirmed (what? probably Cancer), Reccurent CIN2,3

Pap in pregnants managed same way except ENDOCERVICAL CURETTAGE. (because of increased cervical vacularity)
CIN/Dysplasia- pap and colposcopy every 3 months during pregnancy, repeat Pap and colpo 6-8 weeks postpartum. If persistent lesion definite treatment.
Microinvasive cervical cancer---> cone biopsy to rule out frank invasion, deliver vaginally reevaluate and treat 2 months postpartum.
Invasive cancer <24weeks---> radical hysterectomy + radiation
>24weeks---> conservative management up to 32-33 weeks, cesarean and definite treatment.

HPV vaccination:
Quadrivalent HPV recombinant vaccine (Gardasil)---->8-26years
Sexually active women can also receive vaccine but in above age range only
not recommended for pregnant, lactating, or immunosuppressed women, also recommended for men same age to prevent Genital warts. Vaccinated ones should still follow with Pap smears.[/QUOTe
ur summaries are great!!!!
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  #594  
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Tamta, so finally have you done Kaplan books or not ? Some how I am not able to get te conversation here.
I answered you on page 5. Yes i have done them. After first read of MTB and kaplan bank. Started with other subjects then did internal. But very quickly. And honestly do not remember anything from them.
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  #595  
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Quote:
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I answered you on page 5. Yes i have done them. After first read of MTB and kaplan bank. Started with other subjects then did internal. But very quickly. And honestly do not remember anything from them.
I might have missed that discussion. I apologize for the inconvenience.

I was just worried as for medicine, I haven't read Kaplan.
I m taking my first nbme on 17th dec so will post it.

Now, I feel incomplete if I don't talk to you and others on this page once a day
Special thanks to you!!
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  #596  
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Quote:
Originally Posted by a_usmle View Post
I might have missed that discussion. I apologize for the inconvenience.

I was just worried as for medicine, I haven't read Kaplan.
I m taking my first nbme on 17th dec so will post it.

Now, I feel incomplete if I don't talk to you and others on this page once a day
Special thanks to you!!
Forget about kaplan. Review mtb and ace nbme. I was planning on monday 16, but still need to review things so maybe i will also write on 17 and then hopefully choose exam date
We are here only social support to each other. How much everyone family, friends ( other then usmle buddies) didn't care about our exam, they still dont understand why are we acting like schizoids, with no interest to environment and social occasions. We will show them our interests soon..
I dont know how about you guys, but i feel and am disheveled, poorly groomed, fat.. But this is just feeling. We are all same cool boys and girls as we were before, when we were social We are passing hardest exam in the world.. So we have to meet all the DSM 5 criteria, and those should positively interfere with our daily activities
We are honored just to be able to achieve what we are doing.. Remember yourselves when you considered someone passing steps as geniuses?
So must keep on hard work.. We will be appreciated either way, wherever we did not go.
I have proposition to get more social everyone on this thread after exam. Pm each other and find each other on social networks.
So good night everyone.. Done gynecology with one marked block and one block of psychiatry. Also shouted a lot on kids in the evening.. I should stop doing that.
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  #597  
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Quote:
Originally Posted by tamta View Post
Forget about kaplan. Review mtb and ace nbme. I was planning on monday 16, but still need to review things so maybe i will also write on 17 and then hopefully choose exam date
We are here only social support to each other. How much everyone family, friends ( other then usmle buddies) didn't care about our exam, they still dont understand why are we acting like schizoids, with no interest to environment and social occasions. We will show them our interests soon..
I dont know how about you guys, but i feel and am disheveled, poorly groomed, fat.. But this is just feeling. We are all same cool boys and girls as we were before, when we were social We are passing hardest exam in the world.. So we have to meet all the DSM 5 criteria, and those should positively interfere with our daily activities
We are honored just to be able to achieve what we are doing.. Remember yourselves when you considered someone passing steps as geniuses?
So must keep on hard work.. We will be appreciated either way, wherever we did not go.
I have proposition to get more social everyone on this thread after exam. Pm each other and find each other on social networks.
So good night everyone.. Done gynecology with one marked block and one block of psychiatry. Also shouted a lot on kids in the evening.. I should stop doing that.

Poorly groomed, agree with that, but i dont gain weight when i study..USMLE is a good workout for me at least!! ..But seriously, im not as serious of a student as you tamta, i think i can do about 6-7hrs a day, that's it..Anyways, I finished 40 blocks so far, with the same percentage, 68...I will stop doing the q bank as of now and revise MTB 2 and 3 bcz i could'nt do both questions and MTBs at the same time...Once im done with MTBs, i will finish the rest of the questions..Does anyone have any suggestions? Thanks guys!!

Last edited by rockstar88; 12-12-2013 at 11:53 AM.
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Poorly groomed, agree with that, but i dont gain weight when i study..USMLE is a good workout for me at least!! ..But seriously, im not as serious of a student as you tamta, i think i can do about 6-7hrs a day, that's it..Anyways, I finished 40 blocks so far, with the same percentage, 68...I will stop doing the q bank as of now and revise MTB 2 and 3 bcz i could'nt do both questions and MTBs at the same time...Once im done with MTBs, i will finish the rest of the questions..Does anyone have any suggestions? Thanks guys!!
Yah thats a good idea i did the same when i was left with 10 unused blocks. It is hard to read and do unused blocks together. So you are forgetting when you stop reading. U will feel confident with review. MTB really is loveable on third read doing chapters in around 2 hours.
Btw rockstar what kind of music do you listen to with regards to your name
My kid had some itching these days, now couple of lesions appeared, i would misdiagnose her if teacher at daycare did not say about chickenpox incident there. So i guess we got chickenpox in the house.. If this will make you happy rockstar i cleaned the house yesterday at 3-4 am. Could not sleep anyways
If anyone knows evidence based sleep aids, which will not make you sleep and miss exam appointment in the morning.. Please share.
Although i am still for sleep hygiene.. How can i sleep normally when finish doing biostats or some shitty qs at 00:00, then fantasize about exam and prometric. I am really scared when i start imagining myself between breaks.
Okay lets work guys done with neurology now starting marked 100 questions. My friend gave me good clue how to combine MTB3 pediatrics: you can spread them in internal medicine relevant topics.
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Quote:
Originally Posted by tamta View Post
Yah thats a good idea i did the same when i was left with 10 unused blocks. It is hard to read and do unused blocks together. So you are forgetting when you stop reading. U will feel confident with review. MTB really is loveable on third read doing chapters in around 2 hours.
Btw rockstar what kind of music do you listen to with regards to your name
My kid had some itching these days, now couple of lesions appeared, i would misdiagnose her if teacher at daycare did not say about chickenpox incident there. So i guess we got chickenpox in the house.. If this will make you happy rockstar i cleaned the house yesterday at 3-4 am. Could not sleep anyways
If anyone knows evidence based sleep aids, which will not make you sleep and miss exam appointment in the morning.. Please share.
Although i am still for sleep hygiene.. How can i sleep normally when finish doing biostats or some shitty qs at 00:00, then fantasize about exam and prometric. I am really scared when i start imagining myself between breaks.
Okay lets work guys done with neurology now starting marked 100 questions. My friend gave me good clue how to combine MTB3 pediatrics: you can spread them in internal medicine relevant topics.
Yeah, i hope i get better with MTB revision...Rock music is the only form of music that i dont like..I dont really follow it..Im more into pop music..But i secretly think im a rockstar , hence the name...You are dreaming about the exam now!! I think you should not be so hard on yourself..bcz i think you are definitely going to do well on the test, so there's no need to stress out...But i guess it gets to you at some point..Now im in a rush to finish a lot of things..I need to do MTBs and finish the q bank and review the q bank once again; all this by mid january..I have to take the test in january to start rotations in February, which im sooo looking forward to..My husband will let me start the rotations only if i take step 2 by then..Anyways, thanks for the advice tamta, i know i can always count on you!!
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I really apprecitae your efforts towards this exam. And it motivates me a lot.

As I think I cannot handle my studies alongwith my other course and you all are managing so many things at the same time.

Thanks for the motivation Tamta and rockstar!

Together we will ace this exam for sure
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