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We have many USMLE Step 1 and Step 2 CK Buzzwords mentioned in our website.

These "buzzwords" serve to remind us of specific diagnoses which then would certainly help us in answering USMLE questions.

So when you see a patient who's having "beaking" of the esophagus you immediately think of achalasia as the potential diagnosis in that case.

However, there is very important caveat here.

The guys who are putting the USMLE questions nowadays are fully aware that students are becoming more and more aware of these buzzwords as they are mentioned in all USMLE-oriented textbooks, qbanks, courses, medical school classes ....etc

Therefore, they improvised a new approach to counter attack us. They are now occasionally using (what I call it) the Reverse Buzzword approach!

So what is it?

These guys they don't want to lose the important clinical significance of buzzwords as they are still sound and proper scientific clues and they are still heavily relied on in clinical practice. So they still want us to know that "beaking" esophagus is a sign of achalasia.

However, to complicate the matter and to really test our overall knowledge and understanding they use the same buzzword in order to confuse us.

So they'll say a 75 year old alcoholic smoker presented with progressive dyspahgia for solids and liquids and profound weight loss and his Barium swallow showed "beaking". Looking at this case you may be tempted to choose achalasia as the diagnosis. But wait! this patient is an elderly and he has all the risk factors for esophageal cancer and his scenario (except for the reverse buzzword) is typical of esophageal cancer. It turned out that the real answer is esophageal cancer.

So the lesson is that we should not "blindly" accept buzzwords as hints to our favorite diagnoses. We should be cautious in interpreting them and we should weigh the chances carefully and take a holistic approach to any case they present to us.

This case also heightens the significance of demographic data. Never underestimate the importance of patient's age, race, sex, ethnicity, location, and other demography. They usually use them as hints towards the diagnosis.
 

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reverse buzzwords

I think there may be a revolution in the review industry of working out the work-arounds, where they use stock phrases specifically to avoid the buzz-words. New buzzwords so to speak.

Another distractor, as I call them, or reverse-buzz word, is a paeds question where they refer to a Jewish infant. This serves to make everyone think of Tay-Sacks disease, but that may not be in the list of answers, confusing the testee.
 
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