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September-October 2013; Step 2 CK Takers

10K views 121 replies 25 participants last post by  daniella 
#1 ·
I thought with just a month to go september and beyond, this might be the perfect time to start a september-october step 2 CK thread to discuss where we stand in our preps, and what we plan to do in the remaining days till our exam!

Well, from my side, i'm an IMG from India. Step 1 in jan, scored 243. I have a very romantic date with Prometric on september 24th :))

I'm done with KLN LN reads with the videos x1, where i noted down any extra points into MTB 2 and 3. I've also done MTB 2 and 3 thrice. For Ob/Gyn i liked the KLN notes better for some reason so i've been following that instead of MTB 2+3. For biostats and BS i've been following step 1 KLN notes.

Right after my 2nd read of all subjects, i took the NBME 4 online and scored a 233 (got 31 wrong), i thought that was acceptable with 2 months to go and entire UW to cover. I started UW immediately after, my first 2 scores were late 60s and early 70s. But by now i'm 10 tests down (all timed, random, unused) and my average is at 77% and last 4 tests have been 80+. Still got 40 blocks of UW to go, i'm hoping to get my UW cumulative to 80 atleast by the end of it! From what i've seen on the forum, a cumulative of 80 should get you a 250+ (which is my aim).

So my UW method has been to do a block a day (try to do 2 blocks on days i'm extra productive), and when i look at explanations i note down any extra points i come across on any question into a notebook i have, or wherever i still have space in my MTBs (which is not a lot really). I also re-read topics from the resources i mentioned above for questions where i think i'm not very comfortable with yet. I'm hoping to finish UW by september 1st week, so that i have enough time to get another revision done, followed by the UWSA and the remaining NBMEs.


I'd like it if all the people taking their exam in september-october could get together here to brainstorm and exchange ideas, and generally help each other out through this time!
 
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#3 ·
Oh nice, when's your exam Mr Mapsy? (Nice name btw, took me a few seconds to recall where the mnemonic applies :) )

Also did you take step 1 before?
 
#5 ·
IMG
Step 1 243
Was going to take exam in august but changed plans.
I have a 11 month old baby so my plans never go as I predict
So far
UW 1st pass 72% accumulative
Right now doing UW 2nd time
NBME 2 1 month and half ago. (223)

Still have to finish UW. Read MTB 2 and 3. Read UW notes from 1st pass and review FA step 1 some topics like pharmacology.
 
#6 ·
Yeah, i remember reading someone somewhere on the forum suggesting to read up that table of side effects from FA step 1. I should do that too.

The UW questions aren't like what MTB led me to believe. I don't see much of "most accurate test" questions, there are a few "next step of management" questions, but its always just the first step. I've never come across questions where they ask anything further than the first step, and maybe the best therapy/treatment. Do such questions come solely under step 3 then?
 
#7 ·
Can you explain this to me??
In bowel ischemia best initial test is CT scan and most accurate is Angiography.
In MTB 2 there is a ? that says what is the most appropriate next step??? It says angiography. Why???

Most appropriate means what???? Next step or initial test???? or most accurate????
 
#12 ·
I thought with just a month to go september and beyond, this might be the perfect time to start a september-october step 2 CK thread to discuss where we stand in our preps, and what we plan to do in the remaining days till our exam!

Well, from my side, i'm an IMG from India. Step 1 in jan, scored 243. I have a very romantic date with Prometric on september 24th :))

I'm done with KLN LN reads with the videos x1, where i noted down any extra points into MTB 2 and 3. I've also done MTB 2 and 3 thrice. For Ob/Gyn i liked the KLN notes better for some reason so i've been following that instead of MTB 2+3. For biostats and BS i've been following step 1 KLN notes.

Right after my 2nd read of all subjects, i took the NBME 4 online and scored a 233 (got 31 wrong), i thought that was acceptable with 2 months to go and entire UW to cover. I started UW immediately after, my first 2 scores were late 60s and early 70s. But by now i'm 10 tests down (all timed, random, unused) and my average is at 77% and last 4 tests have been 80+. Still got 40 blocks of UW to go, i'm hoping to get my UW cumulative to 80 atleast by the end of it! From what i've seen on the forum, a cumulative of 80 should get you a 250+ (which is my aim).

So my UW method has been to do a block a day (try to do 2 blocks on days i'm extra productive), and when i look at explanations i note down any extra points i come across on any question into a notebook i have, or wherever i still have space in my MTBs (which is not a lot really). I also re-read topics from the resources i mentioned above for questions where i think i'm not very comfortable with yet. I'm hoping to finish UW by september 1st week, so that i have enough time to get another revision done, followed by the UWSA and the remaining NBMEs.

I'd like it if all the people taking their exam in september-october could get together here to brainstorm and exchange ideas, and generally help each other out through this time!
Hey my plan is similar to yours. How long did you take to study (I have about 5 months and I'm on the same plan as you)Did you do kaplan qbank? What did you do for peds? Thanks in advance buddy
 
#13 ·
I started studying around april, but i goofed around a bit here and there, especially during may-june. Maybe lost a couple of weeks there. So i'd say 5 months should be enough!

For Paeds do NOT do KLN. Its really really bad. The videos are worse. I'm sticking to MTB 2+3 and annotating it with uworld notes.

I didn't do kaplan qbank and i dont intend to. There's not much learning potential in there for the time frame i have in mind.

What about you? Where exactly are you at your preps? What are you doing different from my plan?
 
#23 ·
Im freaking out....any advice would be appreciated! Im planning on taking step 2 CK the last week of august or first week of september. I just finished Uworld first pass, timed, random mode with 60%. I feel i always end up with 2 choices left and have to make a guess (at least in most of the questions). Should i repeat world, or should i do an NBME first, and if so, which one should i do?
I have been studying from MTB CK, MTB 3 and Uworld only!
Thanks
 
#24 ·
How about you do a quick revision of all your material for a few days, followed by either UWSA or an NBME (UWSA apparently might be more predictive for CK), and see where you stand? Based upon that score, and your target score, you can decide what you can do next. UW cumulative percentage according to me isn't the best indicator of performance because different people have different percentages depending on the stage of study they did their UW in, and also whether it was random, timed, unused mode, or a tutor mode etc. So my 2 cents, do a NBME/UWSA after a quick revision of your material, and get a better idea of where you currently stand.
 
#25 ·
Hey great thread!!
I'm also hoping to get this over with sometime in September! Wanted to get it done in august, but I too have been wasting a lot of time here and there and have not been serious yet about studying..
Have been studying on and off since may. Did kaplan IM videos and annotated MTB 2 along. Read the rest of the chapters from MTB 3. And started uworld immediately after, so havnt even really properly read IM. So far just done with 30% uworld :indifferent: (slacking off really bad)
Hoping to finish first round of uworld and take it from there! Want to do DIT and second round of uworld my last month of prep.
Let's keep each other motivated!! :)
 
#32 ·
I've been doing uworld, and i've come across 3 abstracts till now. The questions involving interpretation of the abstracts per se haven't been too hard, just slightly time consuming because it takes time to figure out where to look for what they're asking exactly, but these follow up questions sometimes contain biostat questions i havent come across ever in KLN or FA. I've been seeing a few links about on the forum directing you to some more examples of drug abstracts. But i'm not sure about another source for drug abstract questions!

Anyone else knows?
 
#34 ·
Yeah I saw some links in some other sites in the forum as well, don't know if that is helpful or if I will have time for it. Those of you at the end of your studying how would you compare studying for step 2 as opposed to step 1 in terms of hours and stuff. I'm finding it relatively easier to study for it (although the exam or so I've heard is tougher).. Or maybe its because I get distracted here and there unlike step 1 which literally use to do 12-14 hour days. Any thoughts?
 
#35 ·
I agree the studying aspect is easier for CK. Especially if you've had prior clinical experience. I'd rather be learning about treatment of asthma exacerbations over which enzyme defect is present for metachromatic leukodystrophy :D

But like you said, the questions are definitely longer for CK, and each block seems to take a lot out of me unlike the step 1 blocks.

I'd rather not over-analyse it, but just focus on getting the CK monkey off my back asap!
 
#36 ·
So i've been doing UW, a block a day, and last 5 blocks or so i've been getting 80+ , but now over the last 2 blocks i've suddenly come down to 73 in each block. The average scores haven't been much different, but compared to the blocks i was getting 80+ in, these last 2 blocks, i found the questions much more vague and harder. Am i crashing, or are fluctuating UW scores normal? (i still have 75% of UW left)
 
#37 ·
I'm pretty sure its normal as long as you learn from your mistakes! At least that's what I heard from friends who took the exam. So I'm doing it subjectwise and I started off with surgery and I'm starting off with like 60's and sometimes 50's is this normal or should I give kaplan one more read?
 
#45 ·
Hello guys!
My exam is in last week of Oct. Doing MTB 2, MTB 3 and Uworld.
I have done 74% of U world(mixed timed and unused) with an average score of 64%. Will do U world one more time.
Should I do Kaplan Q bank too, what do you think?


My step 1 score 228/83.
 
#46 ·
I have researched reviews of the kaplan qbank for step 2 and alot people say its a waste of time (even US grads don't use it) I would say use it if you have the time if not I would go through another run of UW prob more relevant to the exam. I did some of surg for kaplan qbank and found it poorly written so I'm sticking to UW. Its upto you tho if you have time by all means go for it!
 
#47 ·
I second Daniella here, Kaplan qbank is definitely not useful, i've heard it from many people. UW should do. Although if you're really intent on doing a 2nd qbank, kaplan qbank might be one of the options.
 
#48 ·
can anybody answer the q

a 42 year old woman comes for a follow up visit
Two weeks ago,
her blood pressure was 152/94 mm Hg during a routine
visit. Her blood
pressure today is 150/94 mm Hg, pulse is 76/min, and
respirations are
14/min. Examination shows no other abnormalities.
Serum studies show:


Na+ 142 mEq/L
Cl– 105 mEq/L
K+ 4 mEq/L
HCO3– 26 mEq/L
Urea nitrogen (BUN) 12 mg/dL
Glucose 101 mg/dL
Creatinine 0.8 mg/dL

An ECG shows no abnormalities. Which of the following
is the most
appropriate next step in management?

A
) Measurement of plasma renin activity

B
) Serum lipid studies

C
) 24-Hour urine collection for measurement of
metanephrine level

D
) Echocardiography

E
) Captopril renal scan
 
#49 ·
can anybody answer the q

a 42 year old woman comes for a follow up visit
Two weeks ago,
her blood pressure was 152/94 mm Hg during a routine
visit. Her blood
pressure today is 150/94 mm Hg, pulse is 76/min, and
respirations are
14/min. Examination shows no other abnormalities.
Serum studies show:

Na+ 142 mEq/L
Cl- 105 mEq/L
K+ 4 mEq/L
HCO3- 26 mEq/L
Urea nitrogen (BUN) 12 mg/dL
Glucose 101 mg/dL
Creatinine 0.8 mg/dL

An ECG shows no abnormalities. Which of the following
is the most
appropriate next step in management?

A
) Measurement of plasma renin activity

B
) Serum lipid studies

C
) 24-Hour urine collection for measurement of
metanephrine level

D
) Echocardiography

E
) Captopril renal scan
I have no idea, worth a shot!

I would go with B, only because I could rule out all the other reasons,
A)if renin was increased so will aldo and that would cause your abnormal NA/K
C)metanephenrine level, no signs and symptoms of pheochromocytoma
E) for Renal artery stenosis, should show change in BP in the diff limbs.
D) echo is generally for some structural problem, but she has no other sympt.
 
#51 ·
Random Surgery question.. If someone comes in with a penetrating Neck trauma do you secure airway first or go in for surgical exploration (ie for Zone 2, angiogram in zone 1 or 3) . And if he is coughing up blood\expanding hematoma in the neck then u can't intubate right you have to go for a cric or a tracheostomy? Correct me if I am wrong ?
 
#52 ·
In any trauma, securing the ABCs are most important, so i'd say secure the airway 1st before going for surgical exploration.

And yes, expanding hematoma/gurgling sounds because of blood (drowning in own blood) you'd like to do a cricothyroidotomy. An alternate would be a percutaneous (not open) tracheostomy.
 
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#59 ·
This is just my reasoning...there are subtle hints as to why one option is not the answer in case there is a narrowing down to 2 options which seem probable.
In renal artery stenosis, captopril scan isn't the preferred option of testing. MRA, CT and Duplex doppler are better options.This is because of high prevalence of asymmetric renal blood flow in general population which can confuse the results.
 
#54 ·
6. During a routine examination, a 32-year-old man
has a blood
pressure of 120/80 mm Hg. He is concerned because his
father, grandfather,
and two uncles have hypertension. He works as a
systems programmer for
a large computer company and frequently has to meet
tight deadlines.
He has smoked one pack of cigarettes daily for 10
years. He is 4.5 kg
(10 lb) overweight and drinks three cups of coffee
daily. Which of the
following measures is most likely to reduce this
patient's risk for
hypertension over the next 5 years?

A
) Increase intake of dietary fiber

B
) Restrict caffeine

C
) Stress management

D
) Weight loss

please answer the q
 
#57 ·
Thanks a lot for pointing that out! And you're right. If you want to discuss NBME questions please start a new thread on the step 2 forum or just search the forum because I'm sure most questions have been discussed in the forum previously. Or just use Google. There are plenty of answer keys and explanations available.
 
#58 ·
Hey people, how's your preparations going?

I was wondering, I'm 50% done with UW now, and most questions are diagnosis questions, with a few being treatment questions. Do you guys know if that's the trend in the actual exam too? Or should we be paying equal emphasis on treatment, especially 2nd and 3rd choice drugs. MTB seems to emphasise on knowing those drugs, but UW barely tests 2nd and 3rd line drugs.
 
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