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USMLE Step 3 Forum USMLE Step 3 Discussion Forum: Let's talk about anything related to USMLE Step 3 exam


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  #1  
Old 03-07-2014
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Post HyperMedic's Step3 Journal



Honestly, Step 3 section of this forum is least active one. not sure if everyone gets busy and rush their step3 during the match or they don't care that much.
anyway, i remember during my step 1 and 2 preparation here in the forum, we used to have journals so we can add our progress and cool hints and tip-of the day.


Start date: 1/3/2014
goal for exam: 15/8/2014
average pace for first month: 6-8 h / day

i know ppl on average take three months for preparation, but since i am busy nowadays, i will expand to cover for the few hours i study daily.
My pace is kinda slow for the first month as it is hard to sit down again on the chair to study.

i won't subscribe to any online qbank before first of April, so i can read the whole material enshalla in March.

hopefully i will be updating every day or every other day.

for the first week that already passed, i finished
-half cardio
-ID
-half hematology

Cool Tips for Today

- invasive aspergillosis> ttt: voriconazole , if failed Amphotercin B or capsofungin

- for oral thrush, topical azoles (clotrimazole) is better than topical nystatin

- ceftaroline is the only cephalosporin to cover MRSA

- MCV-4 isn't indicated for HIV patients, however it is for Asplenics and those with complement deficiency

- Toxoplasmosis prophylaxis (CD4<100) is TMP-SMX, while ttt. is sulfadiazine and pyrimethamine

- In malaria, if mental status changes, check for hypoglycemia

- In EBV, NORMAL T cells responding to infected B cells

- in histoplasmosis it is mostly pulmonic manefestation, while in blastomycosis it is mostly skin infection. NOT a must but helps in MCQs


well, that's enough for today, back to my desk, oppss wait: i am already on it
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  #2  
Old 03-07-2014
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"My pace is kinda slow for the first month as it is hard to sit down again on the chair to study." ----> feel exactly the same!!! Could not to sit down for serious study about 2 weeks and feel so bad about it!!!

God bless you on Step 3 prep, and I will try to follow your journal for better motivation!!!
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Old 03-07-2014
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Really good start! i may join you as well here. but i want to take the exam in June or before. what material are you doing if not solving the qbanks?
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Old 03-07-2014
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Quote:
Originally Posted by aspirant5 View Post
Really good start! i may join you as well here. but i want to take the exam in June or before. what material are you doing if not solving the qbanks?
kinda need to re-fresh my base knowledge right now.
so i am revising my combined FA+MTB2/3 notes from CK old times along with my Kaplan and UW qbank notes.

enshalla when i start kaplan qbank by first week of April hopefully , i will do it subject wise or cluster wise ( 2-3 branches per time ), to prepare myself for full Random timed in UW after that

let's keep it rolling
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  #5  
Old 03-07-2014
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I myself have been pushing to study from the past 2 weeks or more.. Not being able to concentrate. I just finished CK less than 3 months ago. So, hoping knowledge from CK is atleast fresh.

Rest I will try to watch the Archer 88$ video..read MTB 3 and solve Uworld from April . Don't want to start it and get low scores.

Let's read more and put down our each day efforts to inspire each other.


Guys how long has it been for CK for you?
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Old 03-09-2014
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Default hematology

alright fellas
i am done with hematology today. currently, reviewing oncology, Preventive, Allergy and Radio altogether.

hopefully by tomorrow morning, i will be done with them.
by this i should be done with the first cluster.
enshalla when i start solving Qbanks, i will be solving kaplan in clusters, so my first cluster includes:
-heme
-ID
-Onc./rad./Prev./Allergy

Now i am done almost ~13% of my first Read the pace is still slow

for tip of the day, i will be listing quick review of all treatments of hematology since there are zillion conditions that require quick refreshing


Hematology Chapter Treatment Review

Iron deficiency anemia:
• Ferrous sulfate
• IM iron
• EPO
• Sideroblastic: B6 or pyridoxine
• Thalassemia major: transfusion lifelong, chelation: deferasirox PO, deferoxamine IV

Sickle cell anemia:
• O2 , hydration, analgesia
• Fever/↑ WBCs: ceftriaxone, Levo/Moxi-floxacin (LM)
• Folic acid
• Pneumococcal vaccination
• Hydroxyurea: ↑ Hb F
• Exchange transfusion: V.O crisis

Hereditary Spherocytosis:
• Folic acid
• Splenectomy

Autoimmune (Ig G) hemolysis:
• Prednisone ( U can reduce the dose by giving: cyclophosphamide, cyclosporine, MMF..etc)
• Splenectomy
• IVIG
• Rituximab

Cold agglutination disease:
• NO steroids or splenectomy
• Stay warm
• Rituximab
• Cyclophosphamide, cyclosporine….etc

G6PD deficiency:
• No treatment, just avoid oxidant stress

TTP/HUS:
• Plasmapharesis/plasma exchange
• If not available give FFP
• NO platelet transfusion (worsen)

PNH:
• Prednisone
• BM transplant
• Eculizumab ( C5 inhibitor)

Aplastic Anemia:
• Treat cause
• BM transplant
• If not available: Antithymocyte Globulin ATG, cyclosporine, tacrolimus

Polythycemia Vera:
• Phlebotomy
• Hydroxyurea
• Aspirin ( since it is prothrombotic)

Essential thrombocytosis: if > 60 or >1.5 million
• Hydroxyurea
• Anagrelide : if RBCs suppressed
• Aspirin for erythromelalgia

Myelofibrosis:
• Thalidomide
• Linalidomide
• BM transplant

AML/ALL:
• Good cytogenics: induction remission via chemotherapy
• Bad cytogenics: immediate BM transplant
• ATRA for M3
• Intrathecal MTX for ALL
• Rasburicase and Allopurinol to prevent Tumor lysis syndrome

CML:
• Tyrosine kinase inhibitors: imatinib(Gleevec), dasa & nilo – tinib
• BM transplant

Leukostasis:
• Leucopharesis

Myelodysplastic Syndrome:
• Transfusion
• EPO
• Lenalidomide
• Azacitidine: to ↓ transfusion dependence, but no ↑ in survival

CLL:
• Stages 0,1 : no treatment
• Stages 2,3: fludarabine, rituximab
• Stage 4: same + prednisone
• If resistant: cyclophosphamide, chlorambucil, IVIG

Hairy Cell Leukemia:
• Cladribine (nucleoside analogue)
• Splenectomy
• IFN-α

NHL HL
C Cyclophosphamide D Dacarbazine
H Adriamycin H Adriamycin
O Oncovorin O Oncovorin
P prednisone B Bleomycin

MM:
• Dexamethasone
• Lenalidomide
• Bortezomib
• Melphalan
• BM transplant

WM:
• Plasmapharesis
• Prednisone
• Chlorambucil
• Fludarabine

Acute porphyria:
• Avoid triggers
• High dose glucose

Neutropenia: ANC < 1500
• Cefepime, if no improvement in 72h, give Vancomycin
• G-CSF
• IVIG
• BM transplant

Eosinophilia:
• Corticosteroids
• Cytotoxic agent

Transplant medicine:
• Prednisone
• MMF
• FK506 (tacrolimus)
• TMP-SMX
• Ganciclovir
• Ketoconazole

that's enough for today
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