USMLE Forums banner

1 - 7 of 7 Posts

741 Posts
Discussion Starter #1
In the exam you may face a question that asks about a specific piece of information that you don't know or haven't read about or cannot remember.

In such a situation do not just panic and pick an option randomly and jump to the next question. You can still answer it! here's how;

Study the options carefully. Try to find which one is different. Which option is the odd among the others. You may find yourself answering the question correctly without the pre-request of knowing what it is talking about.

Patient developed acute extra-pyramidal syndrome after taking antipsychotic medication. You gave him a drug to treat that. Which of the following is an expected side effect of your medication?
- Diarrhea
- Miosis
- Bronchoconstriction
- Xerostomia
- Bradycardia

Ok, I forgot what do they give to treat acute parkinsonism for patients on anti-psychotics, but when I examined the options it seems that they are all talking about muscarinic effects. So my job is to find which of the options does not fit into a parasympathomimmetic action. Diarrea, bronchoconstriction, bradycardia, and constricted pupils are caused by increased parasympathetic activity. Therefore the only odd option is the dry mouth (Xerostomia).

This way I answered the question correctly without ever knowing or remembering that they actually give anti-muscarinics (such as trihexiphenidyl or benztropin) to treat the acute EPS.

Also, sometimes you can find the answer by a process of exclusion. Whereby you know for sure that these four options are definitely wrong then the correct answer must be the fifth one even though am not specifically aware of it.

Patient developed necrotic skin infection after burns. Which of the following is the virulent factor of the microorganism that helped in developing these skin ulcers?
- Pyocyanin
- Pilli
- Exotoxin
- Elastase
- ADP ribosylation

In the above example I correctly identified the microorganism as Pseudomonas and I know very well that pyocyanin is a pigment, Exotoxin and ADP ribosylation aid in inhibiting protein synthesis and the capsule helps in avoiding phagocytosis. So all these options that I know do not fit into the answer (destroying tissues and making necrosis). So am left with elastase and it is the correct answer. Even though I was not aware of the fact that Pseudomona aeroginosa has an elastase that is the cause of skin lesions.


1 - 7 of 7 Posts