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Official nbme 15 discussion

Discussion in 'Step I' started by abelabbot, 03.07.13.

  1. abelabbot

    abelabbot

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    SDN Members don't see this ad. (About Ads)
    A new NBME 15 is out! Here is the official discussion page. How did you guys feel about this nbme?
  2. Leonidis I

    Leonidis I

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    what's up with the numbering system? there's nbme 1-7 but no 8, 9, 10. then there's nbme 11, 12, 13 and now 15 but no 14?
  3. abelabbot

    abelabbot

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    lol no idea
  4. CDI

    CDI Senior Member Gold Donor

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    Has anyone taken it?
  5. rafdelag

    rafdelag

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    Took it yesterday.

    Got 590 (Approximately 242)

    Felt tougher than NBME13. Felt more like UWorld (question stems tend to be long and multiple options given all look the same)

    Many questions were WTF-type of questions. Had to take many guesses. There are also some easy questions though.

    I think it is worth it if you still have 2 - 4 weeks before Step 1. My guess is that it reflects the type of questions on the current Step 1 exam.

    Best
  6. CDI

    CDI Senior Member Gold Donor

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    Man, I'm exactly 2 weeks out. Debating if I should or not. Don't want it to kill my confidence, I'm only around the 220s...

    How were your previous NBMEs in comparison?
  7. rafdelag

    rafdelag

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    NBME 13 and 12 were around 250...

    Check out this forum http://www.usmleforum.com/files/forum/2013/1/723796-2.php to see several questions and how you feel...

    If you decide to take it, take it in expanded-feedback mode so you can at least look up the wrong questions.

    PROS on taking it: could reflect current Step 1 questions (but not sure of this though)
    CONS: harder than NBME 13, might get you a lower score than expected, answers not yet available on forums

    Best
  8. Chirurg

    Chirurg

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    yet another one of the many NBME mysteries...in a long line of mysteries.
    What was the highest ever Score?
    What is the highest possible Score?
    How do they work out the Score?
    Is there a life after death?
  9. Good Mans Armor

    Good Mans Armor Gold Donor

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    :laugh: Good one!
  10. CDI

    CDI Senior Member Gold Donor

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    Doesn't look too terrible. I personally seem to manage the UWorld length/style a little better than the straight FA recalls. Too many stupid mistakes/second guesses. I'll have to consider taking this before my exam. Thanks for the input!
  11. 2cool4medschool

    2cool4medschool

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    overall i thought it was pretty fair - had a 238 on 11/12 and 242 on 15 a few weeks later despite misclicking on at least 2 answers and making an math* mistake...

    during repair of esophageal atresia, fibrotic esophagus with no lumen, what germ layers originally filled the lumen?
    endo/intermediate meso/NC/paraxial meso/surface ecto.
  12. Jismak

    Jismak

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    Endoderm
  13. Phloston

    Phloston SDN Lifetime Donor Lifetime Donor

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    Are you kidding!!

    I sat the Step1 in December and could only take up through 13. I'm so jealous. I'm thinking of sitting this one just for fun :love:
  14. dragon529

    dragon529 MS-III

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    "just for fun" sounds like something Phloston would say...
  15. CDI

    CDI Senior Member Gold Donor

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    Thanks for sharing. I'm taking the exam in a week, but decided against any more NBMEs at this time, so I'm glad to at least get input on the new form. (My confidence will probably be a real factor at the range I'm at, which is why I held off.)

    13. OP poisoning. Yeah, atropine, atropine and more atropine. Pralidoxime is for the fasciculations and regeneration of AChE. (Treated a ton of these cases myself, and lost a lot of these pts - common method of suicide for farmers overseas.)

    15. Annoying answers choices. I'd say A. Wouldn't E be deferring to someone else? Which is apparently never the right choice.
  16. CDI

    CDI Senior Member Gold Donor

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    Isn't it just hypothyroid because T4 is low? Then you look at TSH next to determine whats going on.

    And the Type 2 w/ Insulin Q. My guess would be the lowest - A. In Type 2, they still produce insulin - its the resistance thats the issue, until later stages. So we use other meds to inc. sensitivity, inc. secretion, or inc. gluc. uptake. If we're administering insulin it means the pancreas isn't putting enough out. That would be my reasoning. (No idea if its correct.)
  17. juromt987

    juromt987

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  18. CDI

    CDI Senior Member Gold Donor

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    I think you mean 2 D. (?)
  19. juromt987

    juromt987

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    Oh yeah. Typed it on my phone
  20. mmmcdowe

    mmmcdowe Duke of minimal vowels Moderator

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    This is a reminder, please refrain from posting complete scenario details, images, and exact, complete lists of the answer choices. These are grounds for copyright violation and the NBME has frequently pursued copyright violations in the past.
  21. ijn

    ijn

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    If you look at any of the other past NBME threads the exact same thing was done. I don't know how frequently the NBME actually pursues second year medical students posting questions on this forum for the purposes of learning.
  22. jackson2

    jackson2

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    ...
    Last edited: 03.16.13
  23. lira126

    lira126

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    670/261. felt pretty good about this one. a couple of WTF tricky ones but doable after thinking them through for more than a minute. this was my first NBME with the real thing coming up in less than a month. I felt that the questions were for the most part on par with UWorld. Currently hitting around 81% with a little over 100 questions left on my first pass.
  24. shazy2

    shazy2

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    I have a few NBME 15 questions i need help with... would anyone help me answering them?
  25. lira126

    lira126

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    Yep! took it pretty recently. Toss them on this thread and I'll try to remember which answer choices I picked.
  26. shazy2

    shazy2

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    I also wanted to ask if anyone has nbme 15 offline. My exam is in a week and i wanted to review it inside out because all my friends who took the step said it was really really similar
  27. jpudge12

    jpudge12

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    ....
    Last edited: 04.05.13
  28. lira126

    lira126

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    ah good catch
  29. shazy2

    shazy2

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    Thank you for your help.....The one with the kid crying i read other places they said its normal grief still not sure about that one
  30. lpmarcus010

    lpmarcus010

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    I put normal emotional response and it didn't come up for me.
  31. shazy2

    shazy2

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    yea i think its normal because the kids doing good in school and he is not crying all the time, jst when he remembered his sister he cried so i thinks thts normal...

    I searched everywhere nobody has this damn nbme offline....lol
  32. lira126

    lira126

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    that sounds about right. I think this might have been one that I was split on and guessed correctly. I felt that this test definitely had a handful of questions that came down to eliminating to two choices and flipping a coin.
  33. jpudge12

    jpudge12

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    I felt like this for half of the questions on this nbme...very tough form!
  34. mastmastdonan

    mastmastdonan

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    My score went down from NBME 13 to 15 (took 2 weeks apart). Found 15 tougher overall, more experiment type questions, more "murky" answers. Probably more representative of the actual Step 1. Score fell 4 points. Not a major dropoff but a good reality check.

    Did you guys also have a question that straight just asked for the average of ten different ages? I re-read it so many times thinking they were trying to trick us somehow but in the end I guess that's all they wanted lol.

    And then there was ridiculous experiment thing with botulism and end plate potentials and Ach, I had no idea what was going on.
  35. lira126

    lira126

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    Yea it was definitely a form that required more thought than usual. As for the botulism question, mEPP and the mV change per vesicle of ACh would be constant as they're intrinsic qualities of the neuromuscular junction. It's the total EPP that decreases because less ACh is released per depolarizing event.
  36. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    ^ exactly, mastmastdonan, I was like epp mepp wtfbbqpwned

    Overall I agree with the person who said it had a lot of easy questions with a few crazy wtf ones interspersed.
  37. NickNaylor

    NickNaylor Daisy the Dog

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    Took it this past weekend. Got a 240 - agree with everyone else. Lots of questions were ridiculously easy (calculate the mean of 10 numbers - LOL). Some were more theoretical (like that botulism ACh one), and some I genuinely wish I could see an explanation to because I had what I (clearly incorrectly) thought were good reasons for going with two answers.

    Thought it was a little harder than 13 (which I took before), but still easier than UWorld.
  38. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING Bronze Donor

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    Just finished taking NBME 15...I'll agree with everyone else as well and say that there were way more UWorld style questions. A lot more vague symptoms too (way less "buzzwords") and more questions (I thought) where I was wavering between a couple answers. A lot more questions than the other NBME that I just straight up guessed on.

    Yeah somehow I got that botulism one right but have no idea how. About to go read the wikipedia article on mEPPs haha. I also got some ridiculously dumb ones straight from FA wrong though like the coronary circulation one and the acute intermittent porphyria enzyme one.

    The only other NBME I've taken so far was NBME 12. Crazily enough I scored higher on this one than 12 even though I felt like 12 was easier.

    12 (4/9/13): 610/247
    15 (4/16/13): 630/252
  39. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING Bronze Donor

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    Oh I also didn't understand the one where H. pylori was the answer for the esophageal mass. Can anyone shed some light on this?
  40. lira126

    lira126

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    I can't remember the question exactly but did it give you a picture of the biopsy? I think this one was just adenocarcinoma (following GERD-induced intestinal type metaplasia).
  41. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING Bronze Donor

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    Yeah I figured that's what it was too.

    The thing is there isn't a consensus the H. Pylori actually is a risk factor for GERD so I thought the question was pretty stupid (even though it was the one that made the most sense I guess). Like if you go the the Uptodate article on H. Pylori and GERD it says there's no consensus on the association and there have been reports that say H. Pylori actually is protective against GERD. Bad question I think.
  42. lira126

    lira126

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    I really don't like these types of questions either. I guess sometimes we just have to suck it up and pretend that dogma is truth and go with it.
  43. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING Bronze Donor

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    I'm gonna throw another one out there if anyone has the answer. Does anyone know what the receptor type was supposed to be for the question with the woman with hyperthyroidism?

    The question was basically 25 yo woman comes in w/ palpitations and insomnia, 5kg weight loss, pulse 125/min. Exophthalmos, thyromegaly, hand tremors.
    Serum studies
    TSH < .1uU/mL
    T4 18 ug/dL
    T3 250ng/dL

    Sx are cuased by hormones acting on which of these receptors?

    I put G-protein coupled receptor. Was thinking Graves disease, Ab against TSH receptor...apparently that was wrong?
  44. lira126

    lira126

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    this was a dirty question. They were asking for the DIRECT cause of the symptoms. In this case it was the excess T3 acting on the nuclear thyroid hormone receptors.
  45. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING Bronze Donor

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    Ohhhhh damn that was a dirty question. Thanks.
  46. NickNaylor

    NickNaylor Daisy the Dog

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    ya im mirin

    Sent from my Nexus 7
  47. Kanye West

    Kanye West

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    Thought this test was pretty tough..

    Can anybody help me with the answers to:
    - renal tubular acidosis patient w. defect in renal amniogenesis...What is their source of ammonia?

    - Pt. with H.pylori...what would decrease recurrence? (smoking?)

    - Floppy baby w/ defect in inhibitory neuron (glutamate? glycine?)

    - ADHD behavioral program...more common in boys...boys and girls separated randomly in 2 groups...type of treatment allocation? (stratification/alteration/open/outcome adapted/stratification?)

    - why deoxygenated blood can carry more CO2 than oxygenated blood

    - sexually active 26 y/o w/ lump on rectal area...severe pain, no bleeding, inconsistently uses condoms (anal carcinoma, anal fissure, external hemorhoid, HPV, skin tag)

    Thanks!
  48. mastmastdonan

    mastmastdonan

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    I put stop smoking for the h. pylori question, glycine for floppy baby, and the female with the picture I put hemorrhoids. pretty sure those were all correct

    the other ones you posted I got wrong also.. sorry not much help there
  49. Kanye West

    Kanye West

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    Thanks. I think the study one is stratification. And the one about o2 and co2 is because deoxygenated blood can buffer better...

    Just took nbme 7. Huge difference..jumped 10 points. Felt a lot more straightforward. I wonder which is more predictive. Thoughts?
  50. Jamiu22

    Jamiu22

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    "A 2-month-old male infant is brought to the emergency department by his mother because of a 2-day history of generalized tonic-clonic seizures, myoclonus, and hiccuping. His mother says he has fed poorly and has been floppy since birth. .......................Which of the following neurotransmitter receptors most likely contains the defect?"



    I just read the question about the floppy baby... I initially thought about a listless baby, so maybe he ingested canned goods or honey that contained botulinum toxin - pointing towards a neuromuscular junction issue (acetylcholine)... but then again the vignette says that the baby had tonic-clonic seizures... which leads more towards something like tetany (Glycine or GABA)... and maybe the reason why the baby's floppy is because it's always so tired??

    Why would the vignette point to two different things? do we get questions like that on the actual step... or am I the only one viewing the question that way....
    Last edited: 06.25.13

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