vadimk
Forum Newbie
Topics: 1
Posts: 12
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About myself: 230 on step 1, 210 on nbme step 2 5 months ago studied kaplan notes UW questions on and off during rotations. Took last 3 weeks off to study, did mostly UW questions. Started out 61% avg doing blocks of 46 randomized, ended with a cumulative avg of 64%, in the end my UW avg was 70% for last 6 blocks. Hoped to get at least 230 on CK, but underestimated it somewhat. Questions seemed harder than UW to me, although while UW hits you with uncommon dz's i think kaplan gets you more on management of less common effect of common dz's.
Questions were long!!!! Time was never an issue for me on UW but it was here. Often 50-75% of the stem was extraneous info. Thank god for highlighting. Test felt overly long, felt wiped out.
Here are some topics: this is as much as I can say without breaking nbme rules.
-Jaundice!!! - 2 to 4 Q each block on this, know every possible differential. They might give you a person with >1 possible cause and you have to statistically figure it out. Often all labs are elvated (Alkphos, ast, alt, bili...) etc. Know solidly prehepatic, posthepatic and hepatic causes and associated labs and history.
-Peripheral edema - huge topic at least 2-4 q each block
-hypercalcemia - another huge subject know the mechanism of pth really well and every possible cause of it.
-As usual pulmonory: know PFT's for asthma, copd, restricitve. Step by step management i recurrent pneumonia, etc.
-As usual trauma know PE vs pneumothorax, vs effusion vs tamponade vs pericarditis. Know which is more likely in someone who has symptoms of both perhaps.
-In both peds and adults immunodeficiencies are HUGE: know the typical presentation of every immunodef, its etiology, cells involved vs complement vs. Ig's
Thyroid nodules - know everything aboutthis especially the flow chart for management in male, female, age, etc.
Ob Gyn - third trimester bleeds are big know solidly the diff between accreta, increta, previa, abruption, endometritis, cancer, atony, etc..
Know the mechanism of early, late, varible, and absent decels in contractions (I had at least 4 q on that)
-Mechanism of Alzheimers, nt. involved and parkinsons, brain structures involved
-Bone path: 2-3 q per block both adult and peds. Typical PE findings, xray findings, management
-Lupus vs. SLE vs. sarcoid vs RA - joint, kideny, lung findings in each and best treatment (steroids vs. nsaids vs. chemo)
-Know how to diff transudate vs. exudate and what it means. They might give you a person who has CHF, CRF, and cirrhosis and ascitis and ask about how to manage based on finding of paracentesis
-1-2 Q each block of collage vascular dz. - ddx, most likely, treatment
-total of about 3 ekg's (acute MI, old MI, etc.)
-statistics: 90% straight forward: sensitivity, spec, npv, ppv
-ethics: sources of bias, ethical concerns in med. "which is more important")
-psych: 80-85% straightforwards, pers d/o's. adjustment d/o, timelines in diagnosis, delirium vs. dementia, nph vs. parkinsons, alzheimeres vs. depression, etc. pseudodepression vs. depression)
-surprisingly no Q's on neurocutaneous dz's
-also I had about 40% IM, 20% peds, 10% ob, 10% surgery, 10% psych/ethics/statistics
-Hope to get my score soon, although I dont feel so confident about it. But time to move on with life ;-)
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| brucella2007
Forum Junior
Topics: 9
Posts: 72
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thanks a lot for generously sharing ur experience. may God give u an amazing score 
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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Thanks for sharing,
Good luck for your score.
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The Key to Succeed is Patience.
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| nadiabarati
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Thanks a lot for the very kind sharing. I'm sure you'lll get a great score as you deserve it.
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| nadiabarati
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big congratulations for the great success. I just want to know how much neurology and emergency medicine were tested in the exam? I'm not a kaplan reader, so I'm thinking about reading blueprints neurology and emergency medicine. Because they are independent books and a little bulky, I doubt if it worth to study these books.
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| vadimk
Forum Newbie
Topics: 1
Posts: 12
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I think for neurology I would concentrate on learning the major causes of dementia like alzheimers, parkinsons, nph, cva, multi stroke, also depression and pseudepression and differenty psychosis. Ofcourse there going to be overlap with psychiatry. I would also review b12 deficiency, vs folate deficiency. HIV dementia, jc virus, prions. major depression vs grief. delirium vs psychosis and know what every single drug overdose looks like. I think thats most of it.
I think first aid + boards and wards + some basic stuff from cmdt or wherever should be enough.
FOr emergency I would say "know everything about trauma" especiually trauma to the 1) thorax, 2) abdomen 3) extremeties. Know the mechanism of nursemaids elbow vs brachial plexus injuries vs upper extremety fractures. Know how to treat PE's, PT's, tamponade, MI, etc...
See my post above.
I think first aid + boards and wards + a good source of questions (kaplan, uw, or a good review book) should take care of 80%+ of the possible questions.
-Peace
I hope this helps
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| vadimk
Forum Newbie
Topics: 1
Posts: 12
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Just checked oasis - it has been updated on the 11th...Hopefully will get the score in the mail in the next 1-3 days...
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| vanshita
Forum Guru
Topics: 26
Posts: 883
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Thanks for sharing with us
GOOD LUCK with your score
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| JH
Forum Senior
Topics: 19
Posts: 76
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vadimk wrote:
Just checked oasis - it has been updated on the 11th...Hopefully will get the score in the mail in the next 1-3 days...
Good luck for your score. Definitely, it will be a good one!
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| vadimk
Forum Newbie
Topics: 1
Posts: 12
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Finally got the reply today 231/94. The mean for that test was 221, sd 24. So I am about 10/24ths S.D. above the mean or about 65th percentile. Again to correlate to USMLE world my cum. avg was 64% which correlates perfectly with the formula people use to get the 3-digit score from the UW percent which is 2.3*(UW%)+84.
-Peace
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| vadimk
Forum Newbie
Topics: 1
Posts: 12
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By the way here's another hint. My weakest section was immunology. So hit those immunology concepts hard guys - understand the mechanism on the genetic, cellular, pathological (histo) level and know the diff dx of the commonest genetic dz. Be able to tell them apart from the presentation even when they are similar. I had a whole bunch of questions on those...
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| doc68
Forum Junior
Topics: 2
Posts: 56
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congradulations !!!! I am preparing for step 2 , planning on traking in Dec studying kaplan and UW , please gude me , how to study and go for the test
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| vadimk
Forum Newbie
Topics: 1
Posts: 12
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Well, I think a lot of what you pick up in your clerckships/attachments/wards is tested, general medical concepts about treating "bread and butter" diagnosis, as well as the more complicated stuff that you might not see on the wards typically. As you can read in my first post there were a lot of questions on the following subjects
-Jaundice!!! - 2 to 4 Q each block on this, know every possible differential. They might give you a person with >1 possible cause and you have to statistically figure it out. Often all labs are elvated (Alkphos, ast, alt, bili...) etc. Know solidly prehepatic, posthepatic and hepatic causes and associated labs and history.
-Peripheral edema - huge topic at least 2-4 q each block
-hypercalcemia - another huge subject know the mechanism of pth really well and every possible cause of it.
-As usual pulmonory: know PFT's for asthma, copd, restricitve. Step by step management i recurrent pneumonia, etc.
-As usual trauma know PE vs pneumothorax, vs effusion vs tamponade vs pericarditis. Know which is more likely in someone who has symptoms of both perhaps.
-In both peds and adults immunodeficiencies are HUGE: know the typical presentation of every immunodef, its etiology, cells involved vs complement vs. Ig's
Thyroid nodules - know everything aboutthis especially the flow chart for management in male, female, age, etc.
Ob Gyn - third trimester bleeds are big know solidly the diff between accreta, increta, previa, abruption, endometritis, cancer, atony, etc..
Know the mechanism of early, late, varible, and absent decels in contractions (I had at least 4 q on that)
-Mechanism of Alzheimers, nt. involved and parkinsons, brain structures involved
-Bone path: 2-3 q per block both adult and peds. Typical PE findings, xray findings, management
-Lupus vs. SLE vs. sarcoid vs RA - joint, kideny, lung findings in each and best treatment (steroids vs. nsaids vs. chemo)
-Know how to diff transudate vs. exudate and what it means. They might give you a person who has CHF, CRF, and cirrhosis and ascitis and ask about how to manage based on finding of paracentesis
-1-2 Q each block of collage vascular dz. - ddx, most likely, treatment
-total of about 3 ekg's (acute MI, old MI, etc.)
-statistics: 90% straight forward: sensitivity, spec, npv, ppv
-ethics: sources of bias, ethical concerns in med. "which is more important")
-psych: 80-85% straightforwards, pers d/o's. adjustment d/o, timelines in diagnosis, delirium vs. dementia, nph vs. parkinsons, alzheimeres vs. depression, etc. pseudodepression vs. depression)
-surprisingly no Q's on neurocutaneous dz's
however they have a question bank of tens of thousands of questions and your test might be 98% different. So, the general advice I would give is to learn to answer questions quickly!
When I was doing UW questions I would typically finish a block in under 30-35 minutes (out of 60 minutes) but on the real test the questions were LONG! So practice doing the actual test with the software. This test is as much about endurance as knowledge and reasoning.
doc68, I am assuming somehow that you are an img from perhaps india/pakistan? :-) and that your fund of knowledge of medical subjects is very good. So I would therefore just concetrate on using the knowledge that you have and applying it to the exam...
ok I am getting tired of writing here. Good luck on your test. -peace out and hope to see you in the US someday ;-)
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| doc68
Forum Junior
Topics: 2
Posts: 56
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thnks a lot for ur advice
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| tolito
Forum Fanatic
Topics: 119
Posts: 2,174
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congratulations. 230 step 1, 231 step 2. hmm. i pray i get similar scores too
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