jhmd
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Hi to all of you...finally I decided to open my own journal so I can help myself to track my my studies and receive some advices of the people who are doing much better than me and whom have done with steps.
A little bit of me..I am an IMG graduated 2007, mom of a 2 y old girl ( very active and who is sleeping now so I can do it:nod and pregnant 8 months ...I am hoping to take my step 1 in December or January 2009...yes I will doing my studies with a new born and a 2 very active girl
I am reading Kaplan lecture notes and FA besides them , usually I am studying around 5 hours /day starting around 8pm -1 am..some days I do not feel I am working so good so I need some advices maybe of some of the moms who did it or any advice .
I know the way is a little long for me and a little hard for many reasons but I will focus in all that God has given me and work as harder as I can to get my ECFMG certificate and do my residency in 2009-2010.
I will write my progress here so I am sure it will help me to know how much in fact I am learning...
Have a blessed day of all you and work hard for your dreams ...
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| jhmd
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Ok , what I have done today...2 chapters of Goljan Patho ( neoplasias and vascular)..I am going to start the night since my 2 y old is kind of fussy with her cold....no matter the pain I have I am going to relax for 30 minutes and read FA...later I will post what I have learned today.
If someone dropped by my journal, please correct my English and feel free to give me advices or add something to remember.
Have a blessed day/night.
Edited by jhmd on 08/20/08 - 10:45 PM
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| jhmd
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Here I am Journal,
What I have need to remember about what I read yesterday:
-Fibrosis cap (plaque) is the pathognomonic lesion of atherosclerosis.
-Rupture of the plaque ---vessel thrombosis---AMI.
-C reactive peptide is high in patients with disrupted (inflammatory) plaques.
-Rupture Triad Abdominal Aortic Aneurysm: left flank pain,hypotension,pulsatil mass.
-Aortic Arch Aneurysm---tertiary syphilis---vasculitis of vasa vasorum.
Today I need to read at least 2 more chapters of Goljan and 5-10 pages of FA.... It has been a hard day , since my girl is very fussy ,I have a constant pain  which I am learning to live with until my EDD...but God is good I have still energy to do things and feel like I am so blessed ...I can read maybe little by little ...but each reading is a step ahead to reach my goals...
Have a blessed day...please do not let me just write if someone can give me any advice and maybe correct me I will be thankful.
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| MDIN2009
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Keep it up!
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| pipi99
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Welcome to the USMLE world. Now you are member of our friendly hard-working crew 
Keep doing!!!! 
___________________
The greatest part of courage is endurance!
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| mjbapana
Forum Elite
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Wow!!really appreciate u. am a mom of 2, could'nt do what u r doing when i had my kids, so now my son is 2 1/2am able to get to my books.
u r doing the right things right now goljan and fa.
good going!!keep it up and welcome aboard!!
___________________
Philippians, chapter 4verse 13 : "I can do all things through Him who strengthens me."
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| jhmd
Forum Senior
Topics: 5
Posts: 270
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Thank you to all of you who read my journal and give me support....
Yes mjbapana it is kind of hard with 2 little ones ( well now 1 just around me and the other will be here in 3 more weeks) ...but I think that with God all is possible so I am trying to do it...
Please give me any advice that can help me to improve my readings, studies strategies and whatever, I am new in this world since I never though I will be working here in USA like a physician ..I always wanted to be in my country after doing a fellowship in Europe or the States....but got married with a wonderful guy who is from here so God lead me to this place
Well, since I am in bed resting and can not be around the house so much....here is my reading :
Goljan 2 chapters: Heart Disorders and Red Blood Disorders:
-LHF : systolic dysfunction : EF<40% ,Diastolic dysfunction EF normal to high
S3 heart sound : 1st cardiac sign
-Stable angina: subendocardial ischemia with ST depression.
-Myocardial infarction types: TRANSMURAL ( new Q waves) SUBENDOCARDIAL ( non Q waves)
-Rheumatic fever: acute attack: Mitral regurgitation / Chronic disease: Mitral stenosis
-Mitral Stenosis---dysphagia for solid due to dilatation of left atrium ( most posterior chamber of heart)
-Folate supply : 3-6 months i the liver
-B12 supply : 6-9 years in the liver.
Also read FA 5 pages from Biochemistry ...Well I have to go for now, since my 2 y old is quite for now I will be reading a little more.
Feel free for write any extra point to remember so you can help me in my way to my >95
Have a blessed day all of you.
Edited by jhmd on 08/23/08 - 09:21 AM
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| mjbapana
Forum Elite
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May be u can also try listening to goljan audios for when u have to be up and about. they r really good and will help u in remembering the text that u read and he is entertaining too. GL
___________________
Philippians, chapter 4verse 13 : "I can do all things through Him who strengthens me."
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| Melu
Forum Senior
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Hi jhmd welcome to moms USMLE club!
I admire your spirit planning for USMLE with a 2 yr old and soon to be born one.
And don't be surprised if your little newone to be born wants to be a doctor too!
Goodluck
___________________
"The best preparation for good work tomorrow is good work today."- Elbert Hubbard
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| MDIN2009
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You mean B12 or B2?
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| jhmd
Forum Senior
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B12 . sorry for the mistake I am typing wrong when I am in the mornings since I got Carpal tunnel syndrome the last weeks ...thanks for correcting me. I am starting my day so I will be back soon.
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| jhmd
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Posts: 270
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Hi to all who take a time to read my journal...
Today has been an not easy day but better than others , I am still resting but doing little things and taking care of house, family ans studies as much as God permits me
I could read a little more since my baby girl is out with my dear husband so I could rest better and study with out a little one who is always asking why for every thing...sometime it helps
What I have read today:
Goljan 2 chapters (White blood cell disorders and Lymphoid Tissue disorders):
-Corticosteroids produce: neutrophilic leukocytosis,eosinopenia,lymphopenia.
-Bone Marrow Findings in Leukemia: Acute Leukemia:>20% blast cells----Chronic leukemia < 10 % blast cells.
-Polycythemia Vera: Only Polycythemia with high PV and low EPO.
-Painful lymphadenopathy:inflammation
-Painless lymphadenopathy :malignancy
-Hand -Schuller-Christian Histicytosis : Classic Triad is 1-Cystic skull defects 1- Diabetes insipidus 3-exophthalmos.
-Malignant histiocytosises: skin involvement is common.
-Mast cell disease: pruritus, swelling, hyper pigmentation.
Also read 5 pages from FA but I reported in FA 5 day club.
Since my dear people are not at home yet I will continue reading....I feel a little step ahead in my way to reach my goal...I am not sure who I could manage the next months...but with GOD I CAN DO IT .
Have a blessed and productive day and enjoy each blessing from the life...again feel free to add any other point to remember and thanks for reading this journal.
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| jhmd
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Forgot to say thanks mjbapana for the advice I will start listening Goljan
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| jhmd
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Posts: 270
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Hi Journal…
It is a good day, we went to church and we are going to celebrate my husband’s b day..so we are just getting ready for some place to enjoy with our dear girl…Other than that I feel a little heavy today , the contractions are less and I hope they are just Braxton Hicks since we have done the plan and got the help with my 2 ye old for 15th September…God is my helper is all I can say.
I just could read a chapter or Goljan this early morning ( 1am ) since baby boy did not let me sleep, still in some pain and with Carpal Tunnel Syndrome  …so I will report later….
I want to take this step in December/January and need the support that comes from God through some people and my family of course…it seems a long way and harder at this point of my life but I do hope everything will be good.
Have a blessed day and write something if you want to.
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| jhmd
Forum Senior
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Posts: 270
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Here I am again , it has been a nice day ...time to share at church , celebrating my husband's day and talking to my relatives who are in my country....what else could I ask?..yes time to study.But although I want to get my >95 I have to admit that my family comes first....
Anyways despite my "hurts" I thank God that I could read 2 more chapters of Goljan (Hemostatic Disorders and Blood-banking Transfusion Disorders)....Here my points to remember:
-Vit K dependents factors: II, VII,IX,X,,protein C/S---activated in liver by epoxido reductase (inhibited by warfarin....present in rat poison).
-PT test---extrinsic system ( use to follow patients taking warfarine,liver synthetic function)
-PTT test---intrinsic system ( use to follow heparin therapy)
-Heparin enhances AT III.
-Thrombotic Thrombocytopenic Purpura ( TTP) Pentad:1- fever 2- thrombocytopenia 3- renal failure 4- microangiopathyc hemolytic anemia 5- CNS deficits.
-Elderly people frequently lose their natural antibodies ( may not have hemolytic transfusion reaction)
-ABO incompatibility protects mother from Rh sensitization ( cause any fetal RBCs in her circulation will be destroyed ).
I am in my half way to finish the next chapter ...so since baby boy is still awake and very active I will read a little bit...
Have a good night ( it is 12:20 am here) and blessed day tomorrow...with God besides me I can tell myself I CAN DO IT!
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| jhmd
Forum Senior
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Posts: 270
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For today I need a lot of prayers...please help me with prayers through this day.Have a blessed day.
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| humble
Forum Newbie
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well i really appreciate your dedication and surely we cant do anything without god help.Always remember god gives us the task which we can face..so YOU CAN DO IT.[>95].just keep going and thanking god.
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| MDIN2009
Forum Newbie
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You are doing great...one day at a time.
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| jhmd
Forum Senior
Topics: 5
Posts: 270
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Thank you folks for your support ..it is god to know that somebody read it.
Yesterday was a very hard day I was so sick and also my girl...I could understand some of my mom's words...when you are a mom you are second ,your child comes firstand I was most concerning of her than me until baby boy remember me that He is still in my body...Thanks God I am well today and have the strength to read something. and take care of myself and my family ..yesterday I felt like a little girl who needed so desperately her mom ...mine is so so far away...but dear husband was very very supportive and took care of us very well...so I feel so blessed I hope that I can read more tonight when my beloved people are sleeping...THANK YOU GODcause I could feel better and it was not ended in the ER.
Well ,my reading until now: Goljan upper &lower respiratory Disorders:
Points to remember:
-Primary TB lesion: upper part of lower lobes or lower part of upper lobes.
-Secondary ( reactivation) TB: one or both apices in upper lobes/cavity lesion.
-Pulmonary Thromboembolism---Majority are located in lower lobes( perfusion is greater)
-Emphysema: pink puffers.Types: 1- centracinar (smoking association) :upper lobes.2- paracinar (AAT deficiency) :lower lobes.others types to remember: Paraseptal :risk of spontaneous pneumothorax (does not produce obstructive airway disease)
-Lung Cancer : Small & Squamous Cell cancer ---Smoking association.centrally located
It was one of my favorite chapters cause I could remember most of thing I learned when I was in med school
Well, that's all for now I still have to read 2 chapters more and 10 pages from FA( it is my target for today) but I will not force myself so much since my body is still weak...
have a blessed day all of you who take a time for reading it.
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| mjbapana
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http://www.youtube.com/watch?v=RGdO4_iwBHA&fe... its awesome.
___________________
Philippians, chapter 4verse 13 : "I can do all things through Him who strengthens me."
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