dearlife
Forum Newbie
Topics: 5
Posts: 25
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Hi everyone
Today was day 1 of the exam. I got 4 Office blocks and 3 inpatient/ER blocks.
None of the questions(except 1) were long enough so that I had to scroll down.
I got 4 EKGs(I'm tooo bad at them, Im sure they were wrong)
5-6 derma pictures.
lots of ethics questions
4 biostats questions
DM/HT/Hypercholestrolemia was almost in every patient(except pediatrics)
Lots of CVS and Respi
8-10 Xrays
5 questions were exactly from UW, word to word.
Exam is very vague, In Inpatient block it is like a reading Marathon... run..run..read..run..read...run....run.read....run
I hate the fact that all the time I was in pressure to click on answer and got only 5-10 sec(after reading the question) to answer.
as said before in many other posts UW , crush, kaplan and FA arent enough to prepare you well. but will land you in a safe zone. your discretion, your intution, presence of mind and above all a GOOOD GUESS is what helps. I dont have any clinical experience as such so cant say how much it helps.
tommorow is part 2. I am dozing off now, lets see how does it go.. will post more..
good night everyone and goood luck
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| kochs
Forum Senior
Topics: 13
Posts: 141
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Thanks , Dearlife, so the second day is it is 45 mins x 4 blocks , so 3 hrs testing ....so 144 MCQs
PLUS 25 mins x 9 CCS ..so 3 hrs 45 mins plus 45 mins break for the entire day ....so a total of 3hrs + 3.45 + 45 mins so 7hrs 30 mins in total .
Please say my understanding is rite ? I have my exams starting tomorrow ...u have been a real help when nobody else responded in this forum...thanks again...may god bless you.
I realize u have day2 today so all the best ..do well.
my day 2 is on the 26th so please do respond before that.
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| step32007
Forum Newbie
Topics: 5
Posts: 42
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second day total duration of exam=8 hrs
1)4 blocks mcqs, 45 min each block = 3 hours
2)ccs for a duration of 4 hrs total
3)break time of 45 min + 15 min for ccs tutorial(skip tutorial , u will get extra break time)=1 hour
good luck
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| kochs
Forum Senior
Topics: 13
Posts: 141
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thanks..step32007...all the best for ur exam/scores....u took off a great doubt..
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| kalinka
Forum Newbie
Topics: 3
Posts: 11
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Guys, who recently took the exam , can you post your CCS cases?
thank you
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| dearlife
Forum Newbie
Topics: 5
Posts: 25
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i am not sure its allowed to post the CCS cases.. i guess its not allowed. but they were all from UW.. so dont worry.
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| dearlife
Forum Newbie
Topics: 5
Posts: 25
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hello people
I wanted to put in my input about CCs cases.
To me CCs cases were much easier than MCQs.
they were common medical conditions very well described in UW Ccs cases. common scenarios whcih we encounter in real life like a DM case, gi bleeding, poisning..etc
My advice: Do UW MCQs + Crush/ kaplan/FA + UW CCS cases.
i did 2 weeks intensive preparation and hardly studied month before cos I was travelling for ivs.
I am praying to pass now. I cant take this exam again.....
wish me luck!
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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crush/kaplan/fa u mean
crush or kaplan or fa
or crush and kaplan and fa !
how did u manage all that and ccs in 2 weeks !!?
did u use swanson/cmdt ?
good luck 
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| dearlife
Forum Newbie
Topics: 5
Posts: 25
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i meant crush or kaplan or fa.
i finished crush in 2 weeks. i used swansons for sports med and geriatrics and preventive med
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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thanks dearlife. one last question. was swanson helpful? in other words would u have fared any worse had u not read swansons ? m asking because i dont have the book and m planning not to buy it.
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| priyagrove
Forum Elite
Topics: 34
Posts: 428
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i will say not really helpful. You can manage very well without it and the stuff given in it is given in UW in form of questions. dont forget to see those 60 points of USPS taks force recommendation. I can post them here
here they are
The U.S. Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against the use of supplements of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease.
The USPSTF recommends against the use of beta-carotene supplements, either alone or in combination, for the prevention of cancer or cardiovascular disease.
CERVICAL CANCER
The USPSTF strongly recommends screening for cervical cancer in women who have been sexually active and have a cervix.
Rationale: The USPSTF found good evidence from multiple observational studies that screening with cervical cytology (Pap smears) reduces incidence of and mortality from cervical cancer. Direct evidence to determine the optimal starting and stopping age and interval for screening is limited. Indirect evidence suggests most of the benefit can be obtained by beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years. The USPSTF concludes that the benefits of screening substantially outweigh potential harms.
The USPSTF recommends against routinely screening women older than age 65 for cervical cancer if they have had adequate recent screening with normal Pap smears and are not otherwise at high risk for cervical cancer
Rationale: The USPSTF found limited evidence to determine the benefits of continued screening in women older than 65. The yield of screening is low in previously screened women older than 65 due to the declining incidence of high-grade cervical lesions after middle age. There is fair evidence that screening women older than 65 is associated with an increased risk for potential harms, including false-positive results and invasive procedures. The USPSTF concludes that the potential harms of screening are likely to exceed benefits among older women who have had normal results previously and who are not otherwise at high risk for cervical cancer.
The USPSTF recommends against routine Pap smear screening in women who have had a total hysterectomy for benign disease.
Rationale: The USPSTF found fair evidence that the yield of cytological screening is very low in women after hysterectomy and poor evidence that screening to detect vaginal cancer improves health outcomes. The USPSTF concludes that potential harms of continued screening after hysterectomy are likely to exceed benefits.
The USPSTF concludes that the evidence is insufficient to recommend for or against the routine use of new technologies to screen for cervical cancer.
Rationale: The USPSTF found poor evidence to determine whether new technologies, such as liquid-based cytology, computerized rescreening, and algorithm based screening, are more effective than conventional Pap smear screening in reducing incidence of or mortality from invasive cervical cancer. Evidence to determine both sensitivity and specificity of new screening technologies is limited. As a result, the USPSTF concludes that it cannot determine whether the potential benefits of new screening devices relative to conventional Pap tests are sufficient to justify a possible increase in potential harms or costs.
The USPSTF concludes that the evidence is insufficient to recommend for or against the routine use of human papillomavirus (HPV) testing as a primary screening test for cervical cancer
Rationale: The USPSTF found poor evidence to determine the benefits and potential harms of HPV screening as an adjunct or alternative to regular Pap smear screening. Trials are underway that should soon clarify the role of HPV testing in cervical cancer screening.
OSTEOPOROSIS
The U.S. Preventive Services Task Force (USPSTF) recommends that women aged 65 and older be screened routinely for osteoporosis. The USPSTF recommends that routine screening begin at age 60 for women at increased risk for osteoporotic fractures .
Rationale: The USPSTF found good evidence that the risk for osteoporosis and fracture increases with age and other factors, that bone density measurements accurately predict the risk for fractures in the short-term, and that treating asymptomatic women with osteoporosis reduces their risk for fracture. The USPSTF concludes that the benefits of screening and treatment are of at least moderate magnitude for women at increased risk by virtue of age or presence of other risk factors.
The USPSTF makes no recommendation for or against routine osteoporosis screening in postmenopausal women who are younger than 60 or in women aged 60-64 who are not at increased risk for osteoporotic fractures.
Rationale: The USPSTF found fair evidence that screening women at lower risk for osteoporosis or fracture can identify additional women who may be eligible for treatment for osteoporosis, but it would prevent a small number of fractures. The USPSTF concludes that the balance of benefits and harms of screening and treatment is too close to make a general recommendation for this age group.
BREAST CANCER
The U.S. Preventive Services Task Force (USPSTF) recommends screening mammography, with or without clinical breast examination (CBE), every 1-2 years for women aged 40 and older.
Rationale: The USPSTF found fair evidence that mammography screening every 12-33 months significantly reduces mortality from breast cancer. Evidence is strongest for women aged 50-69, the age group generally included in screening trials. For women aged 40-49, the evidence that screening mammography reduces mortality from breast cancer is weaker, and the absolute benefit of mammography is smaller, than it is for older women. Most, but not all, studies indicate a mortality benefit for women undergoing mammography at ages 40-49, but the delay in observed benefit in women younger than 50 makes it difficult to determine the incremental benefit of beginning screening at age 40 rather than at age 50.The absolute benefit is smaller because the incidence of breast cancer is lower among women in their 40s than it is among older women. The USPSTF concluded that the evidence is also generalizable to women aged 70 and older (who face a higher absolute risk for breast cancer) if their life expectancy is not compromised by comorbid disease. The absolute probability of benefits of regular mammography increase along a continuum with age, whereas the likelihood of harms from screening (false-positive results and unnecessary anxiety, biopsies, and cost) diminish from ages 40-70. The balance of benefits and potential harms, therefore, grows more favorable as women age. The precise age at which the potential benefits of mammography justify the possible harms is a subjective choice. The USPSTF did not find sufficient evidence to specify the optimal screening interval for women aged 40-49
The USPSTF concludes that the evidence is insufficient to recommend for or against routine CBE alone to screen for breast cancer.
Rationale: No screening trial has examined the benefits of CBE alone (without accompanying mammography) compared to no screening, and design characteristics limit the generalizability of studies that have examined CBE. The USPSTF could not determine the benefits of CBE alone or the incremental benefit of adding CBE to mammography. The USPSTF therefore could not determine whether potential benefits of routine CBE outweigh the potential harms.
The USPSTF concludes that the evidence is insufficient to recommend for or against teaching or performing routine breast self-examination (BSE).
Rationale: The USPSTF found poor evidence to determine whether BSE reduces breast cancer mortality. The USPSTF found fair evidence that BSE is associated with an increased risk for false-positive results and biopsies. Due to design limitations of published and ongoing studies of BSE, the USPSTF could not determine the balance of benefits and potential harms of BSE.
The U.S. Preventive Services Task Force (USPSTF) recommends against the routine use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women.
Rationale: The USPSTF found good evidence that the use of combined estrogen and progestin results in both benefits and harms. Benefits include reduced risk for fracture (good evidence) and colorectal cancer (fair evidence). Combined estrogen and progestin has no beneficial effect on coronary heart disease and may even pose an increased risk (good evidence). Other harms include increased risk for breast cancer (good evidence), venous thromboembolism (good evidence), stroke (fair evidence), cholecystitis (fair evidence), dementia (fair evidence), and lower global cognitive function (fair evidence).Because of insufficient evidence, the USPSTF could not assess the effects of combined estrogen and progestin on the incidence of ovarian cancer, mortality from breast cancer or coronary heart disease, or all-cause mortality. The USPSTF concluded that the harmful effects of combined estrogen and progestin are likely to exceed the chronic disease prevention benefits in most women.
The USPSTF recommends against the routine use of unopposed estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy.
Rationale: The USPSTF found good evidence that the use of unopposed estrogen results in both benefits and harms. The benefits include reduced risk for fracture (good evidence). Harms include increased risk for venous thromboembolism (fair evidence), stroke (fair evidence), dementia (fair evidence), and lower global cognitive functioning (fair evidence). There is fair evidence that unopposed estrogen has no beneficial effect on coronary heart disease. Because of insufficient evidence, the USPSTF could not assess the effects of unopposed estrogen on the incidence of breast cancer, ovarian cancer, or colorectal cancer as well as breast cancer mortality or all-cause mortality. The USPSTF concluded that the harmful effects of unopposed estrogen are likely to exceed the chronic disease prevention benefits in most women.
COLORECTAL CANCER
The USPSTF strongly recommends that clinicians screen men and women 50 years of age or older for colorectal cancer.
Rationale: The USPSTF found fair to good evidence that several screening methods are effective in reducing mortality from colorectal cancer. The USPSTF concluded that the benefits from screening substantially outweigh potential harms, but the quality of evidence, magnitude of benefit, and potential harms vary with each method.The USPSTF found good evidence that periodic fecal occult blood testing (FOBT) reduces mortality from colorectal cancer and fair evidence that sigmoidoscopy alone or in combination with FOBT reduces mortality. The USPSTF did not find direct evidence that screening colonoscopy is effective in reducing colorectal cancer mortality; efficacy of colonoscopy is supported by its integral role in trials of FOBT, extrapolation from sigmoidoscopy studies, limited case-control evidence, and the ability of colonoscopy to inspect the proximal colon. Double-contrast barium enema offers an alternative means of whole-bowel examination, but it is less sensitive than colonoscopy, and there is no direct evidence that it is effective in reducing mortality rates. The USPSTF found insufficient evidence that newer screening technologies (for example, computed tomographic colography) are effective in improving health outcomes.There are insufficient data to determine which strategy is best in terms of the balance of benefits and potential harms or cost-effectiveness. Studies reviewed by the USPSTF indicate that colorectal cancer screening is likely to be cost-effective (less than $30,000 per additional year of life gained) regardless of the strategy chosen.It is unclear whether the increased accuracy of colonoscopy compared with alternative screening methods (for example, the identification of lesions that FOBT and flexible sigmoidoscopy would not detect) offsets the procedure's additional complications, inconvenience, and costs.
The U.S. Preventive Services Task Force (USPSTF) recommends against routine use of tamoxifen or raloxifene for the primary prevention of breast cancer in women at low or average risk for breast cancer
Rationale: The USPSTF found fair evidence that tamoxifen and raloxifene may prevent some breast cancers in women at low or average risk for breast cancer, based on extrapolation from studies of women at higher risk. The USPSTF concluded, however, that the potential harms of chemoprevention may outweigh the potential benefits in women who are not at high risk for breast cancer.
The USPSTF recommends that clinicians discuss chemoprevention with women at high risk for breast cancer and at low risk for adverse effects of chemoprevention. Clinicians should inform patients of the potential benefits and harms of chemoprevention.
Rationale: The USPSTF found fair evidence that treatment with tamoxifen can significantly reduce the risk for invasive estrogen-receptor-positive breast cancer in women at high risk for breast cancer and that the likelihood of benefit increases as the risk for breast cancer increases. The USPSTF found consistent but less abundant evidence for the benefit of raloxifene. The USPSTF found good evidence that tamoxifen and raloxifene increase the risk for thromboembolic events (for example, stroke, pulmonary embolism, and deep venous thrombosis) and symptomatic side effects (for example, hot flashes) and that tamoxifen, but not raloxifene, increases the risk for endometrial cancer. The USPSTF concluded that the balance of benefits and harms may be favorable for some high-risk women but will depend on breast cancer risk, risk for potential harms, and individual patient preferences.
The U.S. Preventive Services Task Force (USPSTF) strongly recommends that clinicians discuss aspirin chemoprevention with adults who are at increased risk for coronary heart disease (CHD) .Discussions with patients should address both the potential benefits and harms of aspirin therapy.
___________________
"Experience is the name every one gives to their mistakes." Oscar Wilde
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| dr_gladiator
Forum Junior
Topics: 1
Posts: 53
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thanks for the informatio and wish you good luck..
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| medocuk
IM-RES
Topics: 26
Posts: 1,499
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Good luck and thanks for the information.
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