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  #601  
Old 12-13-2013
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Hello people!!! Hope you are studying well and working hard!!!!
Was buzy for quite a few days!!!! Couldnt study much!!!
But yupp back again!!! Now started wth the MTB's. And wow these books are written so well i must say!!!
Keep working hard!!! Do the best you can do with ur day!!!
Good luck all!!!!
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  #602  
Old 12-14-2013
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So final turnover on this weekend, to give final decision nbme 6 on monday. It overestimates as i see so need a good score
Really have not done good review these two weeks still left with peds, surgery, onco hema, gi, biostats. Although struggled with everything else with mtb+ marked questions but. Alot marked questions are left to do. 1000
Doing renal today. With marked questions. Questions still take most of time.
I don't know what else to do, mist reviewing and reviewing. Am kind of dissociated. One american doctor encouraged me yesterday with his story. I guess we got lot of chances if we are in right place. So people with low score, with failures come on believe me there are lot of guys like you who are very cool doctors.
Need to do this exam like a boss..
Although really am afraid like a rabbit
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  #603  
Old 12-15-2013
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Start Pap from 21, despite onset of sexual activity.
(exceptions: immunocompromised, HIV, transplant pts, on chronic immunosuppression--> start at sex onset even if before 21)
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---> negative--->again in 1 year--> two negative paps--> continue routine screening. This also is same for LSIL in age 21-24.
If second pap positive, or ASC-H or HSIL---> colposcopy
ASCUS >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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  #604  
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Default Final Update

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 : Juvenile polyposis, Peutz jeghers, Turcots, gardners.
No routine screening for lung, ovarian, pancreatic, also bladder cancer even if at risk.
PSA testing should be determined pn a case by case basis between physician and patient, if patient insists should perform it.
All men age 65 who ever smoked AAA screening with US, also 65-75 with family hx
everyone age >18 BP checked every visit
Hyperlipidemia: Men >35, women >45
Diabetes: when pt has hypertension, hyperlipidemia screening with fasting glucose > 125- DM, 100-125 IGT, 70-99-->normal. HBA1C >6.5%--> DM. 5.7%-->normal, between Impaired Glucose Tolerance. Fasting means >8hrs no caloric intake.
OGTT- >200-->DM, 140-199--> IGT
Random >200+ signs of hyperglycemia-->DM.
osteoporosis: Dexa scan at 65. >-2.5 osteoporosis
kids 0-5 screen for strabismus, amblyopia, refractive errors--> eye exam.

Vaccinations:
Influenza and Pneumococcal:
Influenza: yearly, pregnant, healthcare workers. live intranazal: healthy, nonpregnant <50
inactivated: >50 or with chronic illnesses
Pneumococcal: CSF leaks, alcoholics, cochlear implants. everyone above 65 1 dose only. revaccination in 5 years if pt immunocompromised or first was prior to age 65.
BOTHinfluenza and pneumococcal to these guys:
Chronic heart lung (asthma emphysema) liver kidney dx
immunocompromised: HIV/AIDS, steroid users, cancer of asplenia. Diabetics.

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)
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!!!!!!!! recommended 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.

HIV pt vaccines:
Never give live vaccine like: BGG, anthrax, oral typhoid, intranasal influenza, oral polio. exceptions: MMR, varicella, zoster if >200 CD4, without evidence of AIDs defining illness and no previous immunity:
Give: Td, pneumococcal, influenza, hep A, B, meningococcal, HPV, HiB if missed in childhood.

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-- Mefloquine, Atovaquone/roguanil, alternative- doxy

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
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  #605  
Old 12-16-2013
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where is everybody today? wake up and study people.
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  #606  
Old 12-16-2013
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Default Nbme 6

got 235. Although i thought i was very cool and test was very easy and would get 250 at least. So will book date tomorrow. Hope i will improve at least 4-7 points and not worsen this score.
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  #607  
Old 12-16-2013
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Quote:
Originally Posted by tamta View Post
got 235. Although i thought i was very cool and test was very easy and would get 250 at least. So will book date tomorrow. Hope i will improve at least 4-7 points and not worsen this score.
That's great tamta!! But how predictable is the NBME? Bcz i thought you would get more than that. May be you would better on the actual test.
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  #608  
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Originally Posted by rockstar88 View Post
That's great tamta!! But how predictable is the NBME? Bcz i thought you would get more than that. May be you would better on the actual test.
I don.t know uwsa will tell me. I think Nbme 6overestimates.test seemed really easy so hope will not be too pissed of on exam. But renaissance took exam with 227 on nbme6 and got 242 so.. U can never say anything before test. Statistics only after exam.
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  #609  
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Quote:
Originally Posted by tamta View Post
got 235. Although i thought i was very cool and test was very easy and would get 250 at least. So will book date tomorrow. Hope i will improve at least 4-7 points and not worsen this score.
You will definitely do good. This was indeed a good score.
Good luck for the final exam. I could not complete my review so taking it on 21st dec now.
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  #610  
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Quote:
Originally Posted by a_usmle View Post
You will definitely do good. This was indeed a good score.
Good luck for the final exam. I could not complete my review so taking it on 21st dec now.

Nbme Page is under reconstruction on dec 20-21 check it. You may nOt be able to take test on those days
I also hope to do well on exam. It will depend on my final month which i will start tomorrow. I am not disappointed anyway. My step1 is 230 so.. I mist not make it worse. Whatever am very tired, had same episode of hypoglycemia and hypoxia on 4-th block as on my step1 exam
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  #611  
Old 12-16-2013
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Quote:
Originally Posted by polok15 View Post
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
I saw the question you are talking about. The option is Normal saline alone. MTB 2 says that Normal saline alone will worsen the condition. I guess its the answer when there is moderate hyponatremia and the option is normal saline+diuretics.
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  #612  
Old 12-16-2013
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Good job tamta!
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  #613  
Old 12-16-2013
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Quote:
Originally Posted by tamta View Post
got 235. Although i thought i was very cool and test was very easy and would get 250 at least. So will book date tomorrow. Hope i will improve at least 4-7 points and not worsen this score.
So u improved ur score. Thats a good news. Good job!! Keep it up!!!
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  #614  
Old 12-16-2013
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Not a very good job. But if i improve 5-10 points and not worsen 235 thats totally fine for me.
These incontinences drive me crazy....... Why am i so dumb..


Stress incontinence : multi parity, and sh!t, pelvic floor weakness, cystometry an volumes normal. Painless leakage with cough sneeze exercise.

Urge incontinence : sudden pain urgency frequency and stuff. Detrusor instability i.e OVERACTIVITY is here. Interstitial cystitis, bladder irritation from neoplasm.
most common cause of urge incontinence is involuntary and inappropriate detrusor muscle contractions. Idiopathic Detrusor Overactivity – Local or surrounding infection, inflammation or irritation of the bladder. Neurogenic Detrusor Overactivity – Defective CNS inhibitory response

Overflow incontinence [/COLOR:involuntary release of urine from an overly full urinary bladder, often in the absence of any urge to urinate. This condition occurs in people who have a blockage of the bladder outlet
Weak bladder muscles i.e detrusor weakness right?
Blockage of the urethra, such as by prostate enlargement
Medical conditions, such as tumors, that cause obstruction of urine flow
Nerve damage from diseases such as diabetes, alcoholism, Parkinson's disease, multiple sclerosis, or spina bifida

Last edited by tamta; 12-16-2013 at 09:43 AM.
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  #615  
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congrats tamta ! be happy u did well and there is always room for improvement and I'm sure u will do it
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  #616  
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Quote:
Originally Posted by tamta View Post
Nbme Page is under reconstruction on dec 20-21 check it. You may nOt be able to take test on those days
I also hope to do well on exam. It will depend on my final month which i will start tomorrow. I am not disappointed anyway. My step1 is 230 so.. I mist not make it worse. Whatever am very tired, had same episode of hypoglycemia and hypoxia on 4-th block as on my step1 exam
Thanks again for the info Tamta

Do you still have a month for final prep ? Then you will definitely have 10-15 points increment. You are already done with 2 readings and 2 nbme. So I think now u need to take only last USWA. Is that your plan ?
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  #617  
Old 12-16-2013
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Thanks friends, this thread really helps me a lot. My eligibility started in december i am planning in a month. I don't think postponing is a good idea. If i get score like this around 235 on UWSA in last week, which is my plan, then maybe i will consider postponing because UWSA around 235 is not reliable.
Also after this nbme MUST do neurology blood supply of stuff, opthalmic lesions, and PHARMA from step1 first aid. And definitely one good system wise review will not hurt anyone. Immunology !!!! I also have conrad's pharmacology flesh cards will do them as before step1. I will not add anything to psych and biostats cause i am good at it. Will work on biostats questions from uworld in last days.
Thats the plan. Around 1000 marked questions from uworld. And isolation. Have spent whole night listening to my kids cough last night. One month must be enough to get around 240 on real exam, if not it means i will never be able to get that score how further i did not postponed taking exam.
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  #618  
Old 12-16-2013
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like the blood suply from step one those syndromes lat medullary and wat not? and opthalmic lesions as in optic never pathway stuff
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  #619  
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Quote:
Originally Posted by pathophysio1 View Post
like the blood suply from step one those syndromes lat medullary and wat not? and opthalmic lesions as in optic never pathway stuff
I cant say about syndromes, but mostly i have problems about blood supply, MCA, PCA, i think we should be able to recognize PICA, brown sequard,also whats supplied by basilar and so on. Opthalmic like lesions straightforwardly, also pupillary reflex pathway.
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  #620  
Old 12-16-2013
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congrats tamta , I Think you will be just fine if u take the test by december


How many mistakes you did?
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  #621  
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Congrats tamta, you increased 14 points in 2 weeks, good job.Can u quickly tell us what you studied & how many times thus far and what you did between nbme 4 and 6( too lazy to go back through previous posts).Your jourrney is inspiring. I am done with kaplan obgyn,psych,surgery & peds, doing IM now. Planning to do mtb after finishing kaplan and then UW.When should I take my first nbme- after finishing mtb or after doing one round of UW too?Thanks.
You are almost there, get a even higher score on uwsa and you will be good to go.Good luck.
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  #622  
Old 12-16-2013
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good job girl !!!
10 more points and u gonna be over it
__________________
Everything is possible for him who believes (MARK 9:23)
245/247/passed on 1st attempt/223/2mos Obsie /3 US LORS/visa not needed/2008 grad
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  #623  
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@merci, step2ck does not have alot of assessment exams so u have to be frugal with what is available. My tip is 1st nbme after your 1st run in UW. Good luck!
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  #624  
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Confused with the statement :-
For Cushing's syndrome from MTB-2
Atleast 10% of the population has an abnormality of pituitary on MRI,
" If you start with a scan, you may remove the pituitary when the source is the adrenals " ?? Any help here??
Why would we remove pituitary for the source being in Adrenal
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Quote:
Originally Posted by Krazy View Post
Confused with the statement :-
For Cushing's syndrome from MTB-2
Atleast 10% of the population has an abnormality of pituitary on MRI,
" If you start with a scan, you may remove the pituitary when the source is the adrenals " ?? Any help here??
Why would we remove pituitary for the source being in Adrenal

Ya because if you start with a scan and find an abnormal tumor in the pituitary you may remove it even though it's not the source of the high ACTH (and was the adrenals).

What you should rather do is prove that it's a "hormonally active disease" and then you should proceed with a scan, to see if there is a tumor or not and if it was the cause for the hormone imbalance.
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  #626  
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Quote:
Originally Posted by egyptdoc66 View Post
Ya because if you start with a scan and find an abnormal tumor in the pituitary you may remove it even though it's not the source of the high ACTH (and was the adrenals).

What you should rather do is prove that it's a "hormonally active disease" and then you should proceed with a scan, to see if there is a tumor or not and if it was the cause for the hormone imbalance.
This makes sense!! Thanks!!
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  #627  
Old 12-17-2013
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Quote:
Originally Posted by merci12 View Post
Congrats tamta, you increased 14 points in 2 weeks, good job.Can u quickly tell us what you studied & how many times thus far and what you did between nbme 4 and 6( too lazy to go back through previous posts).Your jourrney is inspiring. I am done with kaplan obgyn,psych,surgery & peds, doing IM now. Planning to do mtb after finishing kaplan and then UW.When should I take my first nbme- after finishing mtb or after doing one round of UW too?Thanks.
You are almost there, get a even higher score on uwsa and you will be good to go.Good luck.
Yeah this thread came out a bit long.

i did one wuick read of MTB with Kaplan Q bank subjectwise without explanations, then I started kaplan notes for OBgyn and other subjects. have not done surgery vignettes so far. i gave quick read to kaplan notes. such quick that not even 2 weeks i guess, maybe 20 days. wanted to start uworld asap, so started it and finished in around 1,5 months. i took nbme4 when i was left with 10 unused blocks. i took 6 days and reviewed mtb2. i was not reading it while doing UWORLD. my BAD. got 221 (made 37 mistakes). then i finished those 10 blocks of uworld and started subject wise MTB2 with subject wise marked UWORLD questions which i still have around 1000. i have not revised peds. surgery, GI hematology, OBstetrics, biostats during these NBMES. even marked questions take lot of time. took NBME 6 yesterday 235. I made 27 mistakes.
my very serious advise: subscribe to uworld for three months--> you will save money. I renewed and renewed it for second time yesterday. just 3 month subscription is 199$, for me it came out 260$
starting DIT + same schedule of at least one block marked question explanations subjectwise + at least pharma subject wise during day. + for example today: started Neurology and did syndromes from STEP1 first Aid, eye lesions, puppilary reflex pathways also mTb2 is very deficient and i am also very deficient cause i did not recognize MCA lesion. need to clear NEURo basics.
i am scheduling appointment on 16-th january. if anybody is against it please i will not postpone it cause i will never be in better shape then i am now. i hope not to worsen my performance and get at least 235 on exam, if not 5-7 points more
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i went through incorrect NBME questions with my friend today who also wrote it yesterday and i got 3 more mistake then him so it was funny how stupid mistake we made because of time pressure and because we can not pay attention to that peace of info that makes us answer correctly. these were just couple of phrases that made me answer correctly, and he had found same 2-3 phrase clues for other questions that i answered incorrectly. so we clarified each others wrong answers. so just keep calm and festina lente during blocks on exam. you don't wanna miss that single two phrase that will make you choose right answer.
also while choosing answers: they usually give you correct answer with some bizarre word inserted in it so you think its wrong, so i would recommend to choose those questions that seem right but have some bizarre phrase inserted then those that seem wrong but have one word that seems correct.
i hope you got what i mean.
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Yeah this thread came out a bit long.

i did one wuick read of MTB with Kaplan Q bank subjectwise without explanations, then I started kaplan notes for OBgyn and other subjects. have not done surgery vignettes so far. i gave quick read to kaplan notes. such quick that not even 2 weeks i guess, maybe 20 days. wanted to start uworld asap, so started it and finished in around 1,5 months. i took nbme4 when i was left with 10 unused blocks. i took 6 days and reviewed mtb2. i was not reading it while doing UWORLD. my BAD. got 221 (made 37 mistakes). then i finished those 10 blocks of uworld and started subject wise MTB2 with subject wise marked UWORLD questions which i still have around 1000. i have not revised peds. surgery, GI hematology, OBstetrics, biostats during these NBMES. even marked questions take lot of time. took NBME 6 yesterday 235. I made 27 mistakes.
my very serious advise: subscribe to uworld for three months--> you will save money. I renewed and renewed it for second time yesterday. just 3 month subscription is 199$, for me it came out 260$
starting DIT + same schedule of at least one block marked question explanations subjectwise + at least pharma subject wise during day. + for example today: started Neurology and did syndromes from STEP1 first Aid, eye lesions, puppilary reflex pathways also mTb2 is very deficient and i am also very deficient cause i did not recognize MCA lesion. need to clear NEURo basics.
i am scheduling appointment on 16-th january. if anybody is against it please i will not postpone it cause i will never be in better shape then i am now. i hope not to worsen my performance and get at least 235 on exam, if not 5-7 points more
In one of the posts above, you suggested to stick to mtbs rather than reading Kaplan. So do u think this goes for obs Gyn too ? Askig you again because I have read it once but I don't remember anything and was a bit skeptical about dividing time between Kaplan n mtbs or exclusively mtbs.

Thanks a lot Tamta. We should really meet after our exam. Your thread had been of immense help to me good girl. I am sure we all will ace this exam
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In one of the posts above, you suggested to stick to mtbs rather than reading Kaplan. So do u think this goes for obs Gyn too ? Askig you again because I have read it once but I don't remember anything and was a bit skeptical about dividing time between Kaplan n mtbs or exclusively mtbs.

Thanks a lot Tamta. We should really meet after our exam. Your thread had been of immense help to me good girl. I am sure we all will ace this exam

thank you a lot. Let's do this and then party
if you read OBGYN kaplan once. leave it alone. just try to bring MTB3 in MTB2. this is very hard especially for Gynecology but you will study everything and it will stick in your mind while suffering with this. in the end you will have to stick with one thing for revisions. i can give you pages that are must do from MTB3. even after incorporating them in MTB2. i have not had any troubles with Gynecology so far. you may read breast from kaplan INCONTINENCE which had made me miss 3 qs and not only yesterday . but i cleared it up in wikipedia in the end. so i still think kaplan maybe done in the beginning once, then you should stick with MTBs. my scores so far are purely MTB and UWORLD, i can tell you that for sure.

so I wanted to say: FIRST AID STEP1 Neurology MUST DO!!!!!! parietal non parietal lesions, blablablas, movement disorders, tremors, i forgot how well i knew them for STEP1. EYE LESIONS!!!! so improving my neuro today. we may still remember and bring out info but we should have things ready in our mind we will not have time on exam to think a lot. and evidence based a lot thinking will probbably help us invent something then answer correctly.

another thing about how exclusions should help us:
ex: there is q about what cushing causes with electrolytes.
and choices: hyperK, hypoK, HypoNa
i do remember that it changes them in different directions, but not exactly which in which direction.
so logically if the answer is HYPONATREMIA then as i remember K should change in opposite direction so HYPERKALEMIA is also correct, which eliminates both answers and we are left with HYPOkalemia.
and also when there are two opposite things around same concept that both make sense leave both options alone, third one is answer.

Last edited by tamta; 12-17-2013 at 08:24 AM.
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  #631  
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[QUOTE=tamta;231336]Thank you a lot. Let's do this and then party
if you read OBGYN kaplan once. leave it alone. just try to bring MTB3 in MTB2. this is very hard especially for Gynecology but you will study everything and it will stick in your mind while suffering with this. in the end you will have to stick with one thing for revisions. i can give you pages that are must do from MTB3. even after incorporating them in MTB2. i have not had any troubles with Gynecology so far. you may read breast from kaplan INCONTINENCE which had made me miss 3 qs and not only yesterday . but i cleared it up in wikipedia in the end. so i still think kaplan maybe done in the beginning once, then you should stick with MTBs. my scores so far are purely MTB and UWORLD, i can tell you that for sure.

so I wanted to say: FIRST AID STEP1 Neurology MUST DO!!!!!! parietal non parietal lesions, blablablas, movement disorders, tremors, i forgot how well i knew them for STEP1. EYE LESIONS!!!! so improving my neuro today. we may still remember and bring out info but we should have things ready in our mind we will not have time on exam to think a lot. and evidence based a lot thinking will probbably help us invent something then answer correctly.

another thing about how exclusions should help us:
ex: there is q about what cushing causes with electrolytes.
and choices: hyperK, hypoK, HypoNa
i do remember that it changes them in different directions, but not exactly which in which direction.
so logically if the answer is HYPONATREMIA then as i remember K should change in opposite direction so HYPERKALEMIA is also correct, which eliminates both answers and we are left with HYPOkalemia.
and also when there are two opposite things around same concept that both make sense leave both options alone, third one is answer



.[/QUOTE

Now I think I am not gonna thank you any more. Take it granted for each post from you thanks a lot Tamta!!

About doing mtb 3 , for all subjects I have done MtB 3 completely so not including in Mtb3 in mtb2. And thanks again for the help in providing me with the important pages from MtB 3 but as I have revised it again, I think I will prefer to revise it completely.

I always missed incontinence even in my step 1 exam so your post will really helped me a lot. Also your dermat pictures thread is worth visiting. Are you participating in any more such treads, which might be useful for ck prep, then please do let us know.

Guys Go ahead and check the dermat pictures thread. It's really helpful everything concised at one place.

See you very soon Tamta!!

Last edited by a_usmle; 12-17-2013 at 09:50 AM.
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Thank you my friend. You really have ended my evening with such nice words, that again I start to believe that I am a good girl thank you alone. I also love that derma thread although don't pay too much attention on it. Takes lot of time.
Sleeping on videos. Have had two very bad nights with my coughing kid. I made warm place for my study. I could have thought about it earlier. I was freezing all the time.
So good night. From tomorrow early early morning awakenings, school at 9 and study since then until january 15. @ a_usmle thank y again. We will find each other somehow thanks for lot of positive energy. I do need that so much
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  #633  
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although I have not watched conrad's videos for step2, I know he uses Walt Whitman every here and there.
here's my favourite from leaves of grass: named "To You."
http://classiclit.about.com/library/...w-toyouwho.htm

That's for you a_usmle
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  #634  
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Wil see you tomorrow. This wireless support from you is really helping me

Have a sound sleeeeep
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I have taken screenshots of summaries you provided here about screening and development and all. Now I have a folder in my phone, named "Tamta"

So sweet of you Tamta you are a good girl in real sense
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I have taken screenshots of summaries you provided here about screening and development and all. Now I have a folder in my phone, named "Tamta"

So sweet of you Tamta you are a good girl in real sense
I thought TAMATA WAS A BOY.
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Looks like I forgot ophthalmology and preventive a lot.So, pathetic ,I read Pap smear so well, now forgot what to do in Asus
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exploring depths of Gyn
overall this annotation is a very tiring process, more boring than doing questions with explanations
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Default losing motivation

Hi friends, I am almost done with kaplan LNs but I am feeling mentally and emotionally exhausted and demotivated.I feel like I am losing the will to study. I don't want to feel like this, It is becoming hard for me to see light at the end of the tunnel.4 months ago,I used to get excited thinking about applications and residency, now let alone residency, even thinking about ecfmg certification, I feel dejected.I need to be done with just this exam to be ecfmg certified and I am not finding in me the drive to try hard. what should I do? Please help
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Originally Posted by merci12 View Post
Hi friends, I am almost done with kaplan LNs but I am feeling mentally and emotionally exhausted and demotivated.I feel like I am losing the will to study. I don't want to feel like this, It is becoming hard for me to see light at the end of the tunnel.4 months ago,I used to get excited thinking about applications and residency, now let alone residency, even thinking about ecfmg certification, I feel dejected.I need to be done with just this exam to be ecfmg certified and I am not finding in me the drive to try hard. what should I do? Please help

all this learning process is an emotional roller coaster
u might feel low today but feel high tomorrow so
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I have taken screenshots of summaries you provided here about screening and development and all. Now I have a folder in my phone, named "Tamta"

So sweet of you Tamta you are a good girl in real sense

i am doing the same. yesterday restored my ipad so will do shots again , those are the summaries i am going to read in the evening before exam.
i will make good one today on Neuro syndromes. i am a very bad crammer so i need to have these summaries review every here and there.
SO doing FIRST AID STEP 1 pharmacology, + conrads pharm fleshcards, although nothing special, but pharma needs to be fresh in our mind.

Polok yeah i am a girl mother of 10 and 5 year old girls. NOT that old though i understand you i may sometimes sound like a man.

Merci come one if i had CS passed I WOULD fly higher than i try now. come one. start review, kaplan annotations are boring and yeah depressing, do some interactive study, make some mistakes in questions it will sober y up.
DON'T DON'T DARE TO LOOK AT MATCH THREADS. i used to do that and got demotivated. guys. we can do it. we MUST TRY to do it. if nothing else we will just be ECFMG certified. if that can be called JUST.
be quick and efficient. KEEP CALM and continue worrying
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hello everyone im quite new to this thread but i hope i can join in, feeling in need of support here taking my exam on 16th of january
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hello everyone im quite new to this thread but i hope i can join in, feeling in need of support here taking my exam on 16th of january
Hi dude, i registered for January 16th
Panic mode worst month and new year of my life. and hopefully its gonna be over, just we have to kill ourselves during next month
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Hi dude, i registered for January 16th
Panic mode worst month and new year of my life. and hopefully its gonna be over, just we have to kill ourselves during next month

tell me about it, i have no idea what else to cover for this exam, never seems like you do enough you know? i decided to go back to kaplan and combine it with MTB2 and while doing questions im coloring in my FA ...have no idea how this will work out but it keeps me studying....going over cardio now...man those algorithms are confusing no matter how many times you read it over...
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Smile

hi all

i tried to post before but i couldn't find my reply .... am a silent viewer of this thread i find it very helpful and motivating and i wish you all luck

i attached pdfs done by dr. RAMAHI , i found very helpful may be you already know it but no harm in reposting it i found it in one of the threads in this form

also i wanted to ask about NBME 4 is it predictive ?? i want to take it and schedule my exam do you think it is a good one ?? and what score will be assuring ???

thanks in advance to your help
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tell me about it, i have no idea what else to cover for this exam, never seems like you do enough you know? i decided to go back to kaplan and combine it with MTB2 and while doing questions im coloring in my FA ...have no idea how this will work out but it keeps me studying....going over cardio now...man those algorithms are confusing no matter how many times you read it over...
did you take Nbme? i am doing marked UW questions. MTB2 STEP1 First AID some topics and pharmacology. yeah how many times you didn't go over it same.. i am doing marked questions from UW and still spending hell lot of time on each block. Doing DITit really helps. will write UWSA after finishing it. what else to do really. if i don't get ridiculously low score on UWSA i am gonna take exam 100 %
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thanks EMMY24!
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Hello Tamta,

Can you please post the list of topics you find worth doing from FA - Step1 ?

What is DIT ?
Personally I would like to refer to the things I have alrady studied rather than doing something new
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hi all

i tried to post before but i couldn't find my reply .... am a silent viewer of this thread i find it very helpful and motivating and i wish you all luck

i attached pdfs done by dr. RAMAHI , i found very helpful may be you already know it but no harm in reposting it i found it in one of the threads in this form

also i wanted to ask about NBME 4 is it predictive ?? i want to take it and schedule my exam do you think it is a good one ?? and what score will be assuring ???

thanks in advance to your help
aRE these notes from uworld ? I really liked it but was wondering how do I take out some time to read these notes. So nice and concise
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Guys! This is not the time to get demotivated and disappointed..There was a time when i was disappointed too, but I'm over it, cuz i dont have the time to get demotivated and give up...I think when someone is not in the mood to study, instead of looking at the match forums, you should look at people's experiences and rotations and whatever will make your resume look better..DO NOT GO ON THE MATCH FORUMS!! IT DOESNT REFELCT THE REALITY...bcz people who actually get a lot of interviews dont really have the time to go on the forums and post it..hope it helps...Good day guys and study well!!!
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Hi dude, i registered for January 16th
Panic mode worst month and new year of my life. and hopefully its gonna be over, just we have to kill ourselves during next month
You have nothing to worry tamta...you should go for it on the 16th!!Good luck!!
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can somebody please help me understand the normal percentiles for pediatrics ?? How do we interpret it ?

Thanks
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Good day guys!! Study well!! Keep working hard!!!
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did you take Nbme? i am doing marked UW questions. MTB2 STEP1 First AID some topics and pharmacology. yeah how many times you didn't go over it same.. i am doing marked questions from UW and still spending hell lot of time on each block. Doing DITit really helps. will write UWSA after finishing it. what else to do really. if i don't get ridiculously low score on UWSA i am gonna take exam 100 %

MTB2 is great for those little details and algorithms...especially in internal medicine! as for the assesments.... i took all the NBME's and the UWSA (twice), for me the 6th one was the toughest for some reason...maybe because the question stems and the answers themseleves were quite different...but as ive heard nbme 6 is a refined version of the offline nbme 1.
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can somebody please help me understand the normal percentiles for pediatrics ?? How do we interpret it ?

Thanks
think of it very simple: the lower the percentile for height/weight - the worse the child is doing.....the higher the percentiles - the better he is doing....unless they are ridicoulsly high like 95% and up...which means something is wrong...i.e. if a 7 year old child is 95% for his age height...then he is taller than 95% of kids...and if they mention anything in the question stem like early pubic hair development or things like that...you could think towards precocious puberty and etc.
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hi all

i tried to post before but i couldn't find my reply .... am a silent viewer of this thread i find it very helpful and motivating and i wish you all luck

i attached pdfs done by dr. RAMAHI , i found very helpful may be you already know it but no harm in reposting it i found it in one of the threads in this form

also i wanted to ask about NBME 4 is it predictive ?? i want to take it and schedule my exam do you think it is a good one ?? and what score will be assuring ???

thanks in advance to your help
in reply to your NBME 4 question....personally i say take as many nbmes as you can and make an average...i think that would be the best predictor of how you are doing. ive read many posts about peoples scores on nbmes and relations..to be honest they all differ..some score high while others score lower than predicted. cant tell you the exact score, but for us IMG's the higher the better...id say 240+ is a good indicator that youre prepared.
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aRE these notes from uworld ? I really liked it but was wondering how do I take out some time to read these notes. So nice and concise

i don't think it is form u world , i guess you can just use it the day b4 the exam
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Default Confusing Topic: Murmurs and Maneuvers

While doing kaplan qbank, i noticed alot of cardiology questions related to murmurs and maneuvers...and they can be confusing!!

The questions will either:

1) describe how this murmur changes according to different maneuvers and then will ask you to identify it
2) ask which of the maneuvers will increase/decrease its intensity

So ive made this simple and easy summary that describes the maneuver and which murmurs will increase and which will decrease.

INCREASE IN PRELOAD (leg raising, squatting)

- AS, MS, AR, MR = will INCREASE IN INTENSITY
- HOCM, MVP = will DECREASE IN INTENSITY


DECREASE IN PRELOAD (standing, valsalva)

AS, MS, AR, MR - will DECREASE IN INTENSITY
HOCM, MVP = will INCREASE IN INTENSITY


INCREASE IN AFTERLOAD (hangrip)

AS, MS, HOCM, MVP = will DECREASE IN INTENSITY
AR, MR, VSD = will INCREASE IN INTENSITY

DECREASE IN AFTERLOAD (anything that will cause vasodilation or make the aorta "softer")

AS, MS, HOCM, MVP = will INCREASE IN INTENSITY
AR, MR, VSD = will DECREASE IN INTENSITY (less backward flow)


Hope it helps!
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  #659  
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I loved these notes. I was solving uworld but as soon as I saw it could nt refrain myself from reading it and once i started i felt like completing it. its a good revision tool.

highly recommended

thanks for posting it
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Oh guys i am so glad of your activity
i have less and less time so if you do summaries notes everything bring it on here. i will try to do good NEURO LESIONS summary.
i started neuro pharm from first aid and looked for lesions, tremors, head aches some stuff.. i will tell you as i go along. so far PHARMACOLOGY IS MUST DO.!!!!
lets make this thread as a thing you will sit the night of your exam and go through all those summaries. everyone find some time and take some bad topics.
anyone willing to say something about growth delay?? chronologic bone age blablabla have no nerves for it so far. also respiratory parametes for mechanical ventilation
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Quote:
Originally Posted by tamta View Post
Oh guys i am so glad of your activity
i have less and less time so if you do summaries notes everything bring it on here. i will try to do good NEURO LESIONS summary.
i started neuro pharm from first aid and looked for lesions, tremors, head aches some stuff.. i will tell you as i go along. so far PHARMACOLOGY IS MUST DO.!!!!
lets make this thread as a thing you will sit the night of your exam and go through all those summaries. everyone find some time and take some bad topics.
anyone willing to say something about growth delay?? chronologic bone age blablabla have no nerves for it so far. also respiratory parametes for mechanical ventilation
I wish I could be of help. But i am too bad at summarizing things so not posting any from my end. But its a good idea to post all summaries here so its useful to all of us.

About parameteres for mechanical ventilation, dr Ramahi s notes (posted today by Emmy) have some good points. so worth looking it there.
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Thanks everyone for the motivation and you all are right, going to the MATCH forums is deflating our motivation, I wont go there until I defeat this beast step 2 ck. I'm feeling better today, finishing up kaplan, I know reading Mtb will be fun( atleast not boring like KLN). You all are doing great, keep the motivation level up.
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Quote:
Originally Posted by tamta View Post
i am doing the same. yesterday restored my ipad so will do shots again , those are the summaries i am going to read in the evening before exam.
i will make good one today on Neuro syndromes. i am a very bad crammer so i need to have these summaries review every here and there.
SO doing FIRST AID STEP 1 pharmacology, + conrads pharm fleshcards, although nothing special, but pharma needs to be fresh in our mind.

Polok yeah i am a girl mother of 10 and 5 year old girls. NOT that old though i understand you i may sometimes sound like a man.

Merci come one if i had CS passed I WOULD fly higher than i try now. come one. start review, kaplan annotations are boring and yeah depressing, do some interactive study, make some mistakes in questions it will sober y up.
DON'T DON'T DARE TO LOOK AT MATCH THREADS. i used to do that and got demotivated. guys. we can do it. we MUST TRY to do it. if nothing else we will just be ECFMG certified. if that can be called JUST.
be quick and efficient. KEEP CALM and continue worrying
Thanks Tamta; no, Ecfmg certification is NOT JUST, it is a step to be crossed to reach our goal of residency which looks bigger than the certification. But we will get there after this exam.You are right, we should not look at the Match, I won't now.You energy is very inspiring and infectious,hopefully I'll get nbme scores like yours, lets all get this done.
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easier to snapshot format

INCREASE IN PRELOAD
(leg raising, squatting)
- AS, MS, AR, MR = will INCREASE IN INTENSITY
- HOCM, MVP = will DECREASE IN INTENSITY

DECREASE IN PRELOAD (standing, valsalva= diuretics)
AS, MS, AR, MR - will DECREASE IN INTENSITY
HOCM, MVP = willINCREASE IN INTENSITY

INCREASE IN AFTERLOAD (hangrip= fuller ventricle)
AS, MS, HOCM, MVP = will DECREASE IN INTENSITY
AR, MR, VSD = will INCREASE IN INTENSITY

DECREASE IN AFTERLOAD (anything that will cause vasodilation
or make the aorta "softer") Amyl nitrate= ACEi= emptier Left Ventricle
AS, MS, HOCM, MVP = will INCREASE IN INTENSITY no effect on MS i think?! verify
AR, MR, VSD = will DECREASE IN INTENSITY (less backward flow)

Inspiration increases Right sided murmurs i.e. tricuspid
Expiration increases Left sided i.e. mitral.

Diastolic murmurs: MS and AR only!!!
Systolic murmurs: AS,MR,TR,VSD,MVP
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Wonderful compilation, only thing I would add/change is HANDGRIP and AMYL NITRATE (& ACEi ) have NO EFFECT on MS.
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Quote:
Originally Posted by merci12 View Post
Wonderful compilation, only thing I would add/change is HANDGRIP and AMYL NITRATE (& ACEi ) have NO EFFECT on MS.
i have added amyl nitrate. so i remembered correctly

guys i think you should periodically check this thread. this gives most statisticly significant answers about nbmes correlations etc.

NBME, UWSA, Qbanks Averages, Correlation with Real Step 2 CK Exam Score
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@EMMY24, thank you so much for the PDFs, after a whole day of studying, these pdfs are perfect for quizzing ourselves; do you have anything like that for OBGYN too, if so please post.Thanks.
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Hey everybody,

Quick question:
Does panic disorder have an obvious precipitant? MTB 3 says that it does on page 464, and that it doesn't on page 465
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Quote:
Originally Posted by merci12 View Post
@EMMY24, thank you so much for the PDFs, after a whole day of studying, these pdfs are perfect for quizzing ourselves; do you have anything like that for OBGYN too, if so please post.Thanks.
unfortunately i didn't found ob gyn notes any where but if i came a cross them i will sure post them ..... glad that some found it helpful
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I dont really like pulmonary system so much..Did pulmonary system, endocrinology and dermatology from MTB 2...and then, did a block of pulmonary questions and how much do i get? 70%..As opposed to 90s and late 80 for Hem-onc, genitourinary and neurology that i have done earlier this week...I need to work real hard on pulmonology..Goodnight and goodluck guys!!
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Quote:
Originally Posted by fat1iscool View Post
Hey everybody,

Quick question:
Does panic disorder have an obvious precipitant? MTB 3 says that it does on page 464, and that it doesn't on page 465
Exactly what i was looking for too...
Anyone got the answer to this?
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Quote:
Originally Posted by asam87 View Post
Exactly what i was looking for too...
Anyone got the answer to this?

No it should NOT have precipicant: if it has then its something else like specific phobia, social phobia, agoraphobia.
May just have anticipation though about having panic attack and worry about that. leave alone MTB3 for psychyatry just look at Antipsychotics from there
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Default Stoke, Neuro lesions

Stroke:
Ischemic: Global--> HIE
Focal: <24hrs---> TIA. >24hrs Ischemic stroke
Ischemic Stroke: thrombotic, embolic, lacunar
Hemorrhagic:
Intracerebral from hypertension: in basal ganglia, Thalamus, internal capsule, cerebral lobe, pons, cerebellum.
SAH: Berry aneurysm, AV malformations.

Lacunar Syndromes: all this have NO CORTICAL signs like: aphasia, apraxia, hemianopia.
Pure motor stroke: posterior limb of internal capsule: unilateral motor deficit of face, arm, leg. NO SENSORY
Pure sensory: VPL nucleus of Thalamus: unilateral hemisensory deficit (numbness) of face, arm, trunk, legs. NO MOTOR
Ataxic-hemiparesis: anterior limb of Internal capsule: weakness, ipsilateral arm-leg discoordination, ataxia out of proportion to motor defect
Dysarthria-clumsy hand syndrome: at pons base: hand weakness, clumsiness, dysarthria, dysphagia, facial weakness. NO SENSORY.
There is one more SENSORY-MOTOR i don't have nerves for it.

ACA--> LOWER limb, medial and superior surface contra loss of sensory and/or motor in legs, feet, trunk
MCA-->UPPER limb and FACE, lateral surfaces and temporal lobes.
weakness in face, arm, hands, Broca, Wernicke, conduction or global aphasia
PCA--> Visual defects occipital lobes--> hemianopia with macular sparing.
Basilar-->Midbrain, Pons: Cranial Nerve abnormalities, contra full body weakness, coma/alterations in consciousness, decreased sensation, vertigo, loss of coordination, difficulty speaking, visual abnormalities

PICA--> supplies majority of inferior cerebellum: ipsi sensory face loss, contra sensory limb loss. CN 9,10 dysphagia, dysarthria. LImb ataxia, dysmetria- cerebellar symtpoms
AICA---> pons, parts of cerebellum: FACIAL nerve symtpoms- unilateral facial paralysis without loss of light touch on that side, vestibular cochlear nuclei- vertigo, nystagmus, unilateral deafness.

Lesions:
Dominant is Left, Non dominant --> Right
Dominant Parietal--> Gerstmann's: agraphia, acalculia, Right and left confusion, finger agnosia
Nondominant Parietal--> Hemispacial neglect
Frontal lobe--- Brocas. Dorsal prefrontal: Docile, Dirty, Dim. Orbitomedial: inappropriate social behavior. Frontal eye fields---> eyes look towards lesion!!
Dominant Temporal---> happy psychotic, euphoria, Wernicke, auditory hallucinations
Bilateral amygdala lesion--> Kluver bucy: tachysexuality, hyperorality disinhibition
Bilateral Mammillary bodies: Wernicke-Korsakoff's
Subthalamic nucleus--> contralateral hemiballismus
Cerebellar hemisphere--> Intention tremor, ataxia, loss of balance, ipsilateral deficits, tendency to fall toward side of lesion.
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Stroke:
Ischemia: Global--> HIE
Focal: <24hrs---> TIA.

Ischemic stroke: >24 hours

Thrombotic: Atherosclerosis risk factors: uncontrolled hypertension, Diabetes, Hyperlipidemia, fluctuating symptoms periodic improvements.
Embolic:
Afib, carotid bruit, Infective Endocarditis, Abrupt onset, symptoms maximal at the beginning.

Lacunar Syndromes: all this have NO CORTICAL signs like: aphasia, apraxia, hemianopia.
Pure motor stroke: posterior limb of internal capsule: unilateral motor deficit of face, arm, leg. NO SENSORY
Pure sensory: VPL nucleus of Thalamus: unilateral hemisensory deficit (numbness) of face, arm, trunk, legs. NO MOTOR
Ataxic-hemiparesis: anterior limb of Internal capsule: weakness, ipsilateral arm-leg discoordination, ataxia out of proportion to motor defect
Dysarthria-clumsy hand syndrome: at pons base: hand weakness, clumsiness, dysarthria, dysphagia, facial weakness. NO SENSORY.
There is one more SENSORY-MOTOR i don't have nerves for it.

Hemorrhagic:
Intraparenchymal: in basal ganglia, Thalamus, internal capsule, cerebral lobe, pons, cerebellum.
Cocaine, Amphetamine use, hx of hypertension, coagulopathy, 2nd common cause: Amyloid angiopathy and is typically lobar in location.
Progression within minutes to hours, Focal neuro symptoms more prominent, progression with increased ICP symptoms: remember Cushing's triad: Hypertension, bradycardia, respiratory depression.
SAH: Berry aneurysm, AV malformations. Severe headache more prominent, focal deficits uncommon, neck stiffness form meningeal irritation

Other lesions:
ACA--> LOWER limb, medial and superior surface contra loss of sensory and/or motor in legs, feet, trunk
MCA-->UPPER limb and FACE, lateral surfaces and temporal lobes.
weakness in face, arm, hands, Broca, Wernicke, conduction or global aphasia
PCA--> Visual defects occipital lobes--> hemianopia with macular sparing.
Basilar-->Midbrain, Pons: Cranial Nerve abnormalities, contra full body weakness, coma/alterations in consciousness, decreased sensation, vertigo, loss of coordination, difficulty speaking, visual abnormalities

PICA--> supplies majority of inferior cerebellum: ipsi sensory face loss, contra sensory limb loss. CN 9,10 dysphagia, dysarthria. LImb ataxia, dysmetria- cerebellar symtpoms
AICA---> pons, parts of cerebellum: FACIAL nerve symtpoms- unilateral facial paralysis without loss of light touch on that side, vestibular cochlear nuclei- vertigo, nystagmus, unilateral deafness.

Dominant is Left, Non dominant --> Right
Dominant Parietal--> Gerstmann's: agraphia, acalculia, Right and left confusion, finger agnosia
Nondominant Parietal--> Hemispacial neglect
Frontal lobe--- Brocas. Dorsal prefrontal: Docile, Dirty, Dim. Orbitomedial: inappropriate social behavior. Frontal eye fields---> eyes look towards lesion!!
Dominant Temporal---> happy psychotic, euphoria, Wernicke, auditory hallucinations
Bilateral amygdala lesion--> Kluver bucy: tachysexuality, hyperorality disinhibition
Bilateral Mammillary bodies: Wernicke-Korsakoff's
Subthalamic nucleus--> contralateral hemiballismus
Cerebellar hemisphere--> Intention tremor, ataxia, loss of balance, ipsilateral deficits, tendency to fall toward side of lesion.

Last edited by tamta; 12-19-2013 at 06:40 AM.
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Bartter VS Gitelman VS Liddle's syndrome VS Vomiting

Barrter syndrome is loop diuretic like
Gitelman syndrome is thiazide diuretic like
Liddle syndrome is hyper-aldo like

Hypokalemia and Metabolic alkalosis -------> Bartter, Gitelman & Liddle's syndrome ,VOMITING
Bartter & Gitelman -----> Normal/Dec BP
Liddle's ---------> Inc BP

Bartter ------> Normal Mg, Hypercalciuric
Gitelman ------> Dec Mg , Hypocalciuric
VOMITING dec mg and dec BP by hypotension

Bartter,Gitelman, Liddle's syndrome all have increased Urinary chloride levels.
Urinary chloride levels are low in Vomiting (Hypochloremic)


Treatment:
Bartter: NSAIDS, Potassium diuretic to preserve K+, Inc salt diet, Inc K+ ,
Gitelman: Same as bartter, NSAIDS not used
Liddle's : Amiloride
Vomiting: Fluids
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Had really struggled with these neuro syndromes...... Kept on showing up in uworld. About time to cover them solidly.
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Quote:
Originally Posted by rockstar88 View Post
I dont really like pulmonary system so much..Did pulmonary system, endocrinology and dermatology from MTB 2...and then, did a block of pulmonary questions and how much do i get? 70%..As opposed to 90s and late 80 for Hem-onc, genitourinary and neurology that i have done earlier this week...I need to work real hard on pulmonology..Goodnight and goodluck guys!!
Pulmonology kaplan vids (Dr.Faselis) are very good, he explains the concepts very clearly and systematically, listen to them in 1.5 or 2* speed and they will help you understand and remember well.
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Finished reviewing endocrinology, pulmonology, and cardiology (Kaplan and MTB2, filled in FA while doing questions) and did all the subject based questions from kaplan qbank. Does anybody else think that some kaplans cardiology questions are AWFULLY hard and specific? I mean Im in panic here...
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Quote:
Originally Posted by merci12 View Post
Pulmonology kaplan vids (Dr.Faselis) are very good, he explains the concepts very clearly and systematically, listen to them in 1.5 or 2* speed and they will help you understand and remember well.
Thanks a lot..I appreciate it.
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Hey guys im studying Infectious and Gastro this week. Ill try to make a neat table for the sexually transmitted infections while im at it and ill post it up as soon as its ready. Study hard everyone!
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wonderful thread! Count me in too!
would like to thank all of you for posting these summaries/pdf`s.. was a silent observer and gained a lot.
..
I am staring with my 500 incorrect UW questions. Could anyone tell me, if the number of incorrect questions get reduced once you start solving whole incorrect blocks? Like if I select a bock now, will it be 456 incorrect left after that? Thanks!
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Quote:
Originally Posted by beattheboards View Post
wonderful thread! Count me in too!
would like to thank all of you for posting these summaries/pdf`s.. was a silent observer and gained a lot.
..
I am staring with my 500 incorrect UW questions. Could anyone tell me, if the number of incorrect questions get reduced once you start solving whole incorrect blocks? Like if I select a bock now, will it be 456 incorrect left after that? Thanks!
hey i think that option exists only for the "unused" questions. i guess that when you will do only the incorrect, it will just randomly shuffle and pick 44 from those 500... and every time you do a new block some questions may repeat. but if it does end up being as you hypothesized, do let us know
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Quote:
Originally Posted by beattheboards View Post
wonderful thread! Count me in too!
would like to thank all of you for posting these summaries/pdf`s.. was a silent observer and gained a lot.
..
I am staring with my 500 incorrect UW questions. Could anyone tell me, if the number of incorrect questions get reduced once you start solving whole incorrect blocks? Like if I select a bock now, will it be 456 incorrect left after that? Thanks!
i am doing marked questions subjectwise and still leaving couple of qs marked in each subject. incorret questions will still be left as incorect everything same as you did on first run. just these new blocks will count as additional questions and percentages will go up usually

Yanichyts: i guess you are using first aid for CK. can y tell us more about it? have y done MTB? could y compare. I know its late for me asking that but other people might get benefit.

And i would recommend everyone EMMYs pdfs they look just great. like power point show easy to get with. i will efinitely try to find time for them. its on this page little upper. post form EMMY24
okay guys started full blown study yesterday, did A LOT. now getting kids out of town. and that's it. i will do my best.
I will not even have a new year tree but i never cared for it even in previous years without USMLE
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Default Rhinne and Weber

Abnormal Rhinne---> Conductive hearing loss
abnormal means: heard longer on mastoid!!!!
Normally should be heard twice longer at external auditory meatus.

Weber:
Normally should not lateralize.
Lateralizes to affected side ---> Conductive hearing loss
Lateralizes to unaffected side ---> Sensorineural hearing loss
I don't care why!

Conductive loss causes: cerummen impaction, middle ear fluid or infection, otosclerosis!!
Sensorneural: Meniere's, acoustic neuroma, Presbycusis, ototoxic antibiotics.
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Quote:
Originally Posted by tamta View Post
i am doing marked questions subjectwise and still leaving couple of qs marked in each subject. incorret questions will still be left as incorect everything same as you did on first run. just these new blocks will count as additional questions and percentages will go up usually

Yanichyts: i guess you are using first aid for CK. can y tell us more about it? have y done MTB? could y compare. I know its late for me asking that but other people might get benefit.

And i would recommend everyone EMMYs pdfs they look just great. like power point show easy to get with. i will efinitely try to find time for them. its on this page little upper. post form EMMY24
okay guys started full blown study yesterday, did A LOT. now getting kids out of town. and that's it. i will do my best.
I will not even have a new year tree but i never cared for it even in previous years without USMLE

I have done Kaplan, MTB2 and FA. Ive read alot of negative feedback about the FA and surprisingly I found it to be a great source of reference, review and even some new information to learn (nice concise tables on lipid lowering therapy and when to begin and etc.) I would recommend it. Although it does lack some details just like FA for step 1, I think that could be annotated in easily from doing questions and your personal notes. Overall its an excellent book. As for MTB2... its one of the best, definitely a great source with very nice explanations and step by step treatment algorithms (lets just say Conrad knows how to put it)..but there is one thing about MTB2, its amazing only for internal medicine...the other subjects (peds, obgyn, etc...) i found very short and summarized lacking very much if were to be compared to kaplan notes (MTB3 could be a solution to that).
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  #686  
Old 12-20-2013
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Can someone please tell me about all contraindications for anti coagulation ?
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  #687  
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I don't see any algorithms for any diesease management in my MtB 2. Can it be because I have an older version ??

Let me know soon so that I can atleast see those from
New MtB
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  #688  
Old 12-20-2013
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Quote:
Originally Posted by a_usmle View Post
I don't see any algorithms for any diesease management in my MtB 2. Can it be because I have an older version ??

Let me know soon so that I can atleast see those from
New MtB
there are no actual tables, if you read the diagnostic sections you will see that he will say which test is the most accurate and which is done first and etc. and also in his tip sections, he mentions sometimes specific criteria
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  #689  
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Quote:
Originally Posted by a_usmle View Post
Can someone please tell me about all contraindications for anti coagulation ?
This is FA/Kaplan Qbank combination

Absolute contraindications:
1. stroke/head trauma withing 3 months
2. INR > 1.7 or prolonged PTT
3. recent MI
4. Prior intracranial hemorrhage or a known neoplasm
5. platelets <100,000
6. Surgery within last 2 weeks
7. GI bleed withing the last 3 weeks
8. Aortic Dissection

Relative Contraindications:
1. prolonged CPR (>10 min.)
2. surgery withing last 3 weeks
3. active peptic ulcer
4. current use of anticoagulants
5. dementia
6. prior allergic reaction to streptokinase
7. pregnancy

Guys add/correct if you feel something is missing or wrong.
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  #690  
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Thanks a lot!!

So it's okay if I don't refer the new edition ? Because I was planning to go through it once.
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Thanks a lot!!

So it's okay if I don't refer the new edition ? Because I was planning to go through it once.

youre welcome!
i dont know so much about the difference between the old and the new, but if you have the new, read that ..its better
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  #692  
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Default Great thread..I am in!

This is amazing way to help each other and your own self..
Count me in..Am finishing off UW and am doNe with 2 readings to MTB.
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  #693  
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Default Just out of the blue..

Is the use of transvaginal ultrasonography contraindicated
in Placenta Previa ?
-No. Although it may appear to be dangerous to introduce an ultrasound
probe into the vagina of a woman with a placenta previa, this technique
has routinely been shown to be safe. Given the substantially improved
quality of sonograms with the transvaginal approach, this technique is
often preferred to a transabdominal ultrasound.
It is important to note that a pelvic examination in which a
finger is passed through the cervix in an attempt to palpate the placenta
should not be performed, as direct manipulation of the placenta can
induce severe hemorrhage.
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  #694  
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Default hi.

thankyou guys .this is an amazing thread. esp. tamta :yours posts are very helpful.

i am a bit confused about ATP3 LDL goals:
when do you start : statin for a person with CAD or CAD equivalent. is it LDL= 100 or 130?

the books (mtb) says 100 so does the old atp 3 guidelines. but the new ones i am currently doing in uworld say that : start lifestyle modification at 100 and drug therapy at 130.

which is correct?

it will be really helpful if anyone can answer it. thnx.
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  #695  
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Default

Yeah, stick to UW.
In short, for:
CHD/Risk Equivalent do Lyf Mod at 100 and Drug at 130
>2 Risk Factors do Lyf Mod at 130 and Drug at 160
0-1 Risk Factor do Lyf Mod at 160 and Drug at 190
My mnemonic to remember CHD/Risk Equivalent:
PADS- Peripheral Art Dis, AAA,DM,Symptomatic CAD.
and for Risk Factor:
ABCDE- Age >45M,55F;BP>140/90;Cig Smoking;hDL<40;Early CHD in Family members <55M,<65 F

Don`t ever forget to reduce 1 risk factor if HDL>60. This simple thing can change the answer completely!
Hope u find it useful!
Quote:
Originally Posted by sandman268 View Post
thankyou guys .this is an amazing thread. esp. tamta :yours posts are very helpful.

i am a bit confused about ATP3 LDL goals:
when do you start : statin for a person with CAD or CAD equivalent. is it LDL= 100 or 130?

the books (mtb) says 100 so does the old atp 3 guidelines. but the new ones i am currently doing in uworld say that : start lifestyle modification at 100 and drug therapy at 130.

which is correct?

it will be really helpful if anyone can answer it. thnx.
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  #696  
Old 12-20-2013
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Great work guys!! Everyone's coming up with a lot of algorithms and reviews of different topics..Sadly, I neither do i understand them, nor make any like you guys...I need the whole explanation instead of quick reviews..But everyone's doing a great job!! Im going to finish internal medicine revision today..and will start surgery next..Im weakest in Surgery.. Good luck guys!!
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  #697  
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Quote:
Originally Posted by beattheboards View Post
Yeah, stick to UW.
In short, for:
CHD/Risk Equivalent do Lyf Mod at 100 and Drug at 130
>2 Risk Factors do Lyf Mod at 130 and Drug at 160
0-1 Risk Factor do Lyf Mod at 160 and Drug at 190
My mnemonic to remember CHD/Risk Equivalent:
PADS- Peripheral Art Dis, AAA,DM,Symptomatic CAD.
and for Risk Factor:
ABCDE- Age >45M,55F;BP>140/90;Cig Smoking;hDL<40;Early CHD in Family members <55M,<65 F

Don`t ever forget to reduce 1 risk factor if HDL>60. This simple thing can change the answer completely!
Hope u find it useful!
yeah i found it useful. because i was repressing those explanation from uworld. just keeping in mind goal lower than 100. u are doing good job. i like y from Confounding Effect modification.
SO if CAD equivalent has got LDL100 we dont cae about statins just life style modification?
and yeahhh that placenta previa realy out of blue thing. dont stick anything in 3rd trimester with bleeding.
Guys this thread is becoming so hot hard to follow.
I just signed in to say that i am getting nauseated after 60 UW explanations but this thread is real antiemetic. thanks everyone. keep up good job. lets have a nice new year for our futures!!!
I feel really cool that i can differentiate Schizoaffective disorder ( i remember myself in step1 FA written along it WTF?)
from Major depressive with psychotic features,
also Conduct disorder from Oppositional defiant. not to say anything about Autism and Asperger
come on we are so cool
i developed tourette's with coprolalia today when i went outside to finish some things not to get out anymore until exam day. i am developing psychosis anytime something interferes with my study hours.

Guys keep it up and Emmys pdf look just great thing to do on ipad before jumping into REM sleep.

Last edited by tamta; 12-20-2013 at 08:09 AM.
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  #698  
Old 12-20-2013
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Quote:
Originally Posted by tamta View Post
yeah i found it useful. because i was repressing those explanation from uworld. just keeping in mind goal lower than 100. u are doing good job. i like y from Confounding Effect modification.
SO if CAD equivalent has got LDL100 we dont cae about statins just life style modification?
and yeahhh that placenta previa realy out of blue thing. dont stick anything in 3rd trimester with bleeding.
Guys this thread is becoming so hot hard to follow.
I just signed in to say that i am getting nauseated after 60 UW explanations but this thread is real antiemetic. thanks everyone. keep up good job. lets have a nice new year for our futures!!!
I feel really cool that i can differentiate Schizoaffective disorder ( i remember myself in step1 FA written along it WTF?)
from Major depressive with psychotic features,
also Conduct disorder from Oppositional defiant. not to say anything about Autism and Asperger
come on we are so cool
i developed tourette's with coprolalia today when i went outside to finish some things not to get out anymore until exam day. i am developing psychosis anytime something interferes with my study hours.

Guys keep it up and Emmys pdf look just great thing to do on ipad before jumping into REM sleep.

I find psychiatry super easy..so far i didnt watch the videos or study anything..I'm not even going to do it from the MTBs.. Still my performance is pretty decent on uworld (78% so far)
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  #699  
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Quote:
Originally Posted by rockstar88 View Post
I find psychiatry super easy..so far i didnt watch the videos or study anything..I'm not even going to do it from the MTBs.. Still my performance is pretty decent on uworld (78% so far)

same here. but go over it in MTB for sure. and STEP1 pharmacology. pharmacology is really not good in MTB for psych. and generaly pharmacology needs to be revised separately for every subject. good night everyone. days are getting harder. Brain is getting super puffy
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  #700  
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Quote:
Originally Posted by sandman268 View Post
thankyou guys .this is an amazing thread. esp. tamta :yours posts are very helpful.

i am a bit confused about ATP3 LDL goals:
when do you start : statin for a person with CAD or CAD equivalent. is it LDL= 100 or 130?

the books (mtb) says 100 so does the old atp 3 guidelines. but the new ones i am currently doing in uworld say that : start lifestyle modification at 100 and drug therapy at 130.

which is correct?

it will be really helpful if anyone can answer it. thnx.

I think when things are not very clear or when different recommendations say different things, USMLE doesnt bother students too much with such details..Thats what Conrad fischer says at least...Controversial topics are not tested on the exam..Probably they will either give numbers like 150md/dl or 90mg/dl but not something in between...I may be wrong, but i just remembered what conrad fischer said in one of the videos.
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