USMLE Do I need to know general physio to understand cardiovascular (or other organ) pathology

[doctorwho9999]

Hi,

Do I need to know general physio to understand cardiovascular (or other organ system's) pathology?
I'm trying to figure out how to structure my board's studying.
Should I review all of general physio first before diving into the organ systems, or should I review physio, patho, and pharm vertically focusing on one system at a time?

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[WaibelPalade]

Physiology is not necessary for understanding every pathology involved with a disease, but it is crucial for understanding the pathophysiology. For example, why is there a decrease/increase intensity of murmur with squatting in one heart murmur as opposed to another? Physiology exposes you to concepts that you can not absolutely miss such as baroceptor/osmoreceptor reflexes, renin angiotensin cascade etc. In fact, I actually reviewed physiology as I studied systemic pathology and this, in turn, strengthened my physiology to begin with. Goljan RR is the king of pathology for a reason. He incorporates. a ton of physio in his path. If you dont skim though his physio portions, you will make a lot of connections. After reading Goljan, brs physio is a breeze (although I would not go as far as to say that reading goljan exempts you from reading brs physio). In the long run, you will save yourself from a lot of memorization if you can rely on your physiology to make connections!

 

[cbrons]

If you dont understand normal physiology you wont understand the abnormal - at least not completely. Step I has 2-step reasoning questions, meaning basically that you have to have some depth to your knowledge of a topic. Sadly lots of M1 and M2 professors write garbage exams that encourage memorization of factoids and superficial level understanding in order to do well on the class exams... But i digress

A good usmle question will be like: "patient 26 y/o female comes to your office with disorder of conjugate lateral gaze etc etc (describing INO),

Then the stem will NOT be "what is the most likely diagnosis?" (1 step reasoning - all you have to know is INO in young people is most often MS - you couldve memorized that from 1 powerpoint slide and knew jack about MS. The Step I stem will instead be like, "what is the most likely cause of this patients motor deficits?" Then the answer would be something like "impaired saltatory conduction" or something of that nature with a few red herring answers. Basically you would have to know first that MS causes demyelination and second what the significance of that is (what myelination provides normal axons) and third what specifically of all the changes caused by the disease result in the specific problem exhibited in the question.

So anyway the reason i use this example is because to answer these types of questions you really have to know about normal -> process of becoming abnormal -> reason why things stay abnormal.


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[DermViser]

If you dont understand normal physiology you wont understand the abnormal - at least not completely. Step I has 2-step reasoning questions, meaning basically that you have to have some depth to your knowledge of a topic. Sadly lots of M1 and M2 professors write garbage exams that encourage memorization of factoids and superficial level understanding in order to do well on the class exams... But i digress

A good usmle question will be like: "patient 26 y/o female comes to your office with disorder of conjugate lateral gaze etc etc (describing INO),

Then the stem will NOT be "what is the most likely diagnosis?" (1 step reasoning - all you have to know is INO in young people is most often MS - you couldve memorized that from 1 powerpoint slide and knew jack about MS. The Step I stem will instead be like, "what is the most likely cause of this patients motor deficits?" Then the answer would be something like "impaired saltatory conduction" or something of that nature with a few red herring answers. Basically you would have to know first that MS causes demyelination and second what the significance of that is (what myelination provides normal axons) and third what specifically of all the changes caused by the disease result in the specific problem exhibited in the question.

So anyway the reason i use this example is because to answer these types of questions you really have to know about normal -> process of becoming abnormal -> reason why things stay abnormal.

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BINGO. The test writers have gotten away (or tried to for the most part) from rote memorization (at least to get a great score).

 

[Brain Bucket]

There is a lot of repetition in Med school. The pathology/pathophysiology will invariably refer to the relevant physiology in any decent text.

 

[NeedToStudy]

There is a lot of repetition in Med school. The pathology/pathophysiology will invariably refer to the relevant physiology in any decent text.

Does this include the pathoma text?

 

[Brain Bucket]

Does this include the pathoma text?

Nope. That's more of a note packet than an actual text.

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[NeedToStudy]

Nope. That's more of a note packet than an actual text.

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If you don't mind me asking if you could choose one text or review book to give a solid foundation of physiology/pathology/pathophysiology which text would you choose?

 

[Fatalis]

to gain foundation? You gotta start from the ground up my friend...a review book is well a review book and you cant review something you have not learned.
If you learned it before but just need a refreasher to say "oh ya, I remember that now" BRS phys and first aid are great!

 

[Brain Bucket]

If you don't mind me asking if you could choose one text or review book to give a solid foundation of physiology/pathology/pathophysiology which text would you choose?

You don't need more than costanzo+ questions for physio.

There aren't many great books for pathophys other than lilly for cardio and vander and/or rennke for nephro.

You'll get most of the pathophysiology you need between questions + costanzo + rapid review path.

For path, do the pathoma videos with his book before you start every block and follow along with rapid review + questions. If you have the time / energy you can do Robbins. I think I got more out of reading Robbins now than I did before pathoma + RR.

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[NeedToStudy]

You don't need more than costanzo+ questions for physio.

There aren't many great books for pathophys other than lilly for cardio and vander and/or rennke for nephro.

You'll get most of the pathophysiology you need between questions + costanzo + rapid review path.

For path, do the pathoma videos with his book before you start every block and follow along with rapid review + questions. If you have the time / energy you can do Robbins. I think I got more out of reading Robbins now than I did before pathoma + RR.

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If you don't mind me asking what med school you go to? You sound like a hardcore harvard med student.

 

[Brain Bucket]

If you don't mind me asking what med school you go to? You sound like a hardcore harvard med student.

Lowly IMG.

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[swoopyswoop]

you will never really understand CV pathophysio until you understand the physio. it's all pressures and volumes.

 

[Brain Bucket]

you will never really understand CV pathophysio until you understand the physio. it's all pressures and volumes.

And lilly will cover both admirably. Heck, even the kaplan videos do a half-decent job. What's your point?

 

[swoopyswoop]

And lilly will cover both admirably. Heck, even the kaplan videos do a half-decent job. What's your point?

I was answering the original question...

 

[Brain Bucket]

I was answering the original question...

Ah, my bad.

 

[NeedToStudy]

Is there anything like lilly for neuro?