Official 2013 Step 1 Experiences and Scores Thread

Your USMLE Scores Increased, Guaranteed!
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Phloston

Phloston

Osaka, Japan
Removed
Lifetime Donor
Verified Member
10+ Year Member
Physician
Gold Donor
Joined
Jan 18, 2012
Messages
3,880
Reaction score
1,676
Members don't see this ad.
I figure now is a good time to jump-start this thread.

Even though some of us who had taken the exam in late-2012 are still awaiting our scores (amid the holiday delays) and could technically still post within last year's thread, it is after all mid-January now, so it's probably apposite that we move forward and hope for a great year.

:luck: Cheers to 2013 :luck:
 
Sort by date Sort by votes
ZzzZzzZzzZzzZzz said:
Hey guys,

I was wondering how others were spending their last 2 weeks studying for this exam? Would it be efficient to read through High Yield Neuro and High Yield Anatomy? I'm not the type that can read something and absorb the information; I do need to sit down and study it. That being said, I do have hesitations on both neuro and anatomy, but the NBMEs say other wise.



My progression

NBME 6: 218 (2 months out)
NBME 7: 238 (1 month out)
NBME 12: 240 (3 weeks out)
NBME 13: 254 (2 weeks out)
NBME 15 & 7 will take next week
Click to expand...


How did you make the jump from 240 to 254 in less than a week???
 
Upvote 0 Downvote
ZzzZzzZzzZzzZzz said:
I read up on my weak sections in first aid and minimized on careless errors on NBME 13. I had a tendency to mis-read questions.
Click to expand...

I'm having the same issues big time - mis-reading questions; or incorrectly associating stuff when I in fact know they are not associated (e.g. one time I confused Bromocriptine and Benztropine) - don't know how to improve on either of these...

I'm thinking slowing down would help with mis-reads... and sometimes, even when I read something over again, I still read it wrongly since my brain sees what it wants to see. that sucks big time.
 
Upvote 0 Downvote
How long does it take you guys to run through a block on usmlerx and review your answers compared to a same length block on uworld?

Trying to figure out how long it might take to go through the rx qbank, it takes me on average maybe 4 hours for a block on uworld :/
 
Upvote 0 Downvote
step1april2013 said:
how high yield are EKG's. Also has anyone ever gotten a question where they had to calculate axis of deviation
Click to expand...

I mean, I don't think you'll ever have to do anything too specific. Even for wards I have been told to do this:

loadbinary_019.gif


Look at lead aVF and lead I. Are they positive or some combo of +/-? memorize normal, Right deviation, and left deviation.

That should be enough to get you by.
 
Upvote 0 Downvote
birthdaycake said:
How long does it take you guys to run through a block on usmlerx and review your answers compared to a same length block on uworld?

Trying to figure out how long it might take to go through the rx qbank, it takes me on average maybe 4 hours for a block on uworld :/
Click to expand...

So far 2-3 hours but I am an extremely fast reader.
 
Upvote 0 Downvote
tiedyeddog said:
I mean, I don't think you'll ever have to do anything too specific. Even for wards I have been told to do this:

Look at lead aVF and lead I. Are they positive or some combo of +/-? memorize normal, Right deviation, and left deviation.

That should be enough to get you by.
Click to expand...

That's a damn good diagram. I think there's also some requirement for right axis deviation. Something like lead II has to be positive in order for it to be a true right axis deviation.

Edit: Got it mixed up. In order for it to be a true left axis deviation, lead II has to be negative.
 
Upvote 0 Downvote
step1april2013 said:
how high yield are EKG's. Also has anyone ever gotten a question where they had to calculate axis of deviation
Click to expand...

I didn't have any EKGs on my exam, but my buddy had a full 12-lead with very little context and was asked for the diagnosis.

Sent from my SAMSUNG-SGH-I717
 
Upvote 0 Downvote
when you do RX, do you read the whole FA page attached? Or just the relevant section on that page to the question
 
Upvote 0 Downvote
teratomas said:
when you do RX, do you read the whole FA page attached? Or just the relevant section on that page to the question
Click to expand...

Whatever I have time for, usually just the relevant section because the other concepts on the page will likely be tested in their own right.
 
Upvote 0 Downvote
bangarang said:
That's a damn good diagram. I think there's also some requirement for right axis deviation. Something like lead II has to be positive in order for it to be a true right axis deviation.

Edit: Got it mixed up. In order for it to be a true left axis deviation, lead II has to be negative.
Click to expand...

I slightly recall reading that somewhere. This diagram backs up that lead II should be negative in left deviation, if you consider the whole vector of depolarization.
ecg_axis.jpg
 
Upvote 0 Downvote
Why are the uwsa over predicting? I thought uworld questions in general were supposed to represent the more difficult subset of step 1 questions 🙁(((
 
Upvote 0 Downvote
birthdaycake said:
Why are the uwsa over predicting? I thought uworld questions in general were supposed to represent the more difficult subset of step 1 questions 🙁(((
Click to expand...

It's not that the questions are less difficult on the UWSAs it's that the curves are more generous. For me:

UWSA1--73% correct--245 (1 week ago)
NBME 11--91% correct---252 (1 day ago)

I know I scored better on the NBME so UWSA1 likely didn't "over predict" me. However, just look at the disparity between the % correct and the 3 digit scores between the two exams. 7 three digit point increase for an extra 18% correct points to a generous UWSA curve.
 
Upvote 0 Downvote
John Lannister said:
I've heard they tend to either over or undershoot based upon how good you are at Uworld vs NBME. I've heard this for both UWSA1 and UWSA2.
Click to expand...

Goober11 said:
It's not that the questions are less difficult on the UWSAs it's that the curves are more generous. For me:

UWSA1--73% correct--245 (1 week ago)
NBME 11--91% correct---252 (1 day ago)

I know I scored better on the NBME so UWSA1 likely didn't "over predict" me. However, just look at the disparity between the % correct and the 3 digit scores between the two exams. 7 three digit point increase for an extra 18% correct points to a generous UWSA curve.
Click to expand...

I guess what I meant is that I could recall people mentioning one seemed more like their real test, and was just trying to gauge which would be better to take first. But seems like it doesn't matter

and yeah I'd take those scores right about now! When's your test, Goober?
 
Upvote 0 Downvote
blaqmamba said:
I guess what I meant is that I could recall people mentioning one seemed more like their real test, and was just trying to gauge which would be better to take first. But seems like it doesn't matter

and yeah I'd take those scores right about now! When's your test, Goober?
Click to expand...

June 14, I am grateful for where I am at but I know there is still work to be done. From my UWSA1 experience and reading the experiences of others on the board SA 1 seems to be the more accurate exam. In my case I think #1 was accurate, 7 point increase in 7 days early (more potential to increase score) in my dedicated study period makes me believe UWSA #1 was a solid predictor.
 
Upvote 0 Downvote
ZzzZzzZzzZzzZzz said:
Hey guys,

I was wondering how others were spending their last 2 weeks studying for this exam? Would it be efficient to read through High Yield Neuro and High Yield Anatomy? I'm not the type that can read something and absorb the information; I do need to sit down and study it. That being said, I do have hesitations on both neuro and anatomy, but the NBMEs say other wise.



My progression

NBME 6: 218 (2 months out)
NBME 7: 238 (1 month out)
NBME 12: 240 (3 weeks out)
NBME 13: 254 (2 weeks out)
NBME 15 & 7 will take next week
Click to expand...

Probably one of the largest jumps I've seen in a long time.
 
Upvote 0 Downvote
Anyone know if Rx has a decent amount of glycogen-storage and lysosomal-storage disease Qs, or where I can see more questions on them? I feel that UW doesn't really have too many
 
Upvote 0 Downvote
Took the exam on Friday, 5/10. It was hard for sure. Much harder than I thought it was going to be. Not sure how to explain it but the test does get in your head a little bit...sometimes things are just as they appear and sometimes things are nothing like they appear.

I'm a normal person, not a gunner. Just want to pass that is all, anything above passing is great, anything above average is awesome!

I thought it was a weird experiences, it sort of confuses you on the things you thought you knew. Especially with strange answer choices and easy stems. You see it and think oh I got this...then you read the answer choices and you are like WTF. Or answer choices that doesn't seem to have any right answer? Behavioral sciences were hard....a lot harder than I thought it was going to be. No easy calculations and stuff you see on Uworld....give you a bunch of numbers and you have to sort through which ones are important. Didn't get any pharm calculations though. So don't go in thinking anything is easy because they can make it hard lol..............even a concept you thought you had down they can find a why to make it very difficult to get.

Just waiting for scores now...hopefully I passed 🙂
 
Upvote 0 Downvote
TheOcean said:
Took the exam on Friday, 5/10. It was hard for sure. Much harder than I thought it was going to be. Not sure how to explain it but the test does get in your head a little bit...sometimes things are just as they appear and sometimes things are nothing like they appear.

I'm a normal person, not a gunner. Just want to pass that is all, anything above passing is great, anything above average is awesome!

I thought it was a weird experiences, it sort of confuses you on the things you thought you knew. Especially with strange answer choices and easy stems. You see it and think oh I got this...then you read the answer choices and you are like WTF. Or answer choices that doesn't seem to have any right answer? Behavioral sciences were hard....a lot harder than I thought it was going to be. No easy calculations and stuff you see on Uworld....give you a bunch of numbers and you have to sort through which ones are important. Didn't get any pharm calculations though. So don't go in thinking anything is easy because they can make it hard lol..............even a concept you thought you had down they can find a why to make it very difficult to get.

Just waiting for scores now...hopefully I passed 🙂
Click to expand...

Congrats on finishing

Phloston said:
Probably one of the largest jumps I've seen in a long time.
Click to expand...

Hopefully it wasn't a fluke, I am planning on taking NBME 15 and 11 next week. May I ask what you did the final two weeks of studying?
 
Upvote 0 Downvote
How many days are people giving themselves between their block of UW and when they sit the exam? If you could also specify if it will be your 1st, 2nd or 12th pass that you be great too. Thanks!
 
Upvote 0 Downvote
JP2740 said:
Page 518 reproductive. Guys, am I crazy? Why does it say the primary spermatocyte has 46 sister chromatids? Isn't it 46 chromosomes at that point (all that occurred prior was mitosis)?

And for secondary spermatocyte, it says 23 sister chromatids... isn't it 46 sister chromatids that end up being separated into 2 cells, 23 each?
Click to expand...

I look at it like this. The primary spermatocyte has two copies of two duplicated chromosomes. This is why they put the 2N, 4C above the figure, bc although there are four chromosomes (4C), only two of them are different (2N). So in the primary spermatocyte X-X counts as 1 and Y-Y counts as 1.

The two secondary spermatocytes that come from the primary each contain 23 sister chromatids (like saying 23 pairs), but since each pair came from the same chromosome, they only count it as 1N. Hence the 1N, 2C. 1 pair of the same 2 chromosomes (X-X).

The spermatid is the splitting of this (X-X) into X and X. Giving 2 sperm which are no longer in pairs of 23. Just 23 single.

This is the way I think of it let me know if I'm mistaken.
 
Upvote 0 Downvote
Hey
I'm 7 weeks out and was wondering if I should do DIT at this point or just memorize FA? I've already read FA once about 3 months ago while still in school and have most of it annotated from lec material/Kaplan qbank. Any thoughts?
Thanks!

Edit: my benchmark as per NBME 6 was 192 (2 weeks ago). Big gaps in prep so far as I'm preparing for my wedding right after the usmle but if I put it together for the next 7 weeks do you think I can hit 240+? I would be the happiest bride eveeeeeer!
 
Last edited:
Upvote 0 Downvote
Goober11 said:
How many days are people giving themselves between their block of UW and when they sit the exam? If you could also specify if it will be your 1st, 2nd or 12th pass that you be great too. Thanks!
Click to expand...

I have 60% left on my 2nd time through. I've been doing 3 blocks a day, only reading the questions I am hesitant on and those I get wrong. I'm trying truck through it, giving myself a couple days to review my flagged questions. We'll see if I can stick to the schedule
 
Upvote 0 Downvote
can someone help me figure out alcoholic fatty change in the liver... I have written down that alcohol dehydrogenase and acetylaldehyde dehydrogenase create excess NADH in the process of metabolizing ETOH. The excess NADH then increases FFA synthesis. Is that correct? Does NADPH play a role?

Thanks
 
Upvote 0 Downvote
Today is the day before my dedicated studying period starts - sat the practice test at prometric and got a 91%. By estimation, I think this puts me well in the range of my target score (would be very happy with 240+, but shooting to break 250). I feel like for maybe 10% of the ones I get right though (between this and UW), they're questions I'm really iffy on and just kind of go with my gut. Do any of y'all think there's harm that would be done with productive dedicated time studying? If I just stayed where I currently was (and felt more confident with my answers) that would be worthwhile to me - I just don't want to lose whatever I have going for me now
 
Upvote 0 Downvote
Can someone please explain to me the mechanism behind tetany induced by low magnesium? For some reason I can't find an adequate explanation online. I'm guessing it's similar to hypocalcemic tetany and has something to do with being a divalent cation, but I'm honestly not even sure of the exact mechanism of hypocalcemic tetany either (why does a decrease in calcium increase membrane permeability to sodium?).
 
Upvote 0 Downvote
RIPSanto said:
can someone help me figure out alcoholic fatty change in the liver... I have written down that alcohol dehydrogenase and acetylaldehyde dehydrogenase create excess NADH in the process of metabolizing ETOH. The excess NADH then increases FFA synthesis. Is that correct? Does NADPH play a role?

Thanks
Click to expand...

You're right about alcohol dehydrogenase and acetyldehydrogenase causing an increase in NADH (by using the body's NAD+). This increase in NADH is going to favor the conversion of DHAP (a substrate from glycolysis) to G3P (this step requires NADH which becomes NAD+). G3P+3 Fatty acids makes a triglyceride molecule. So that takes care of why alcohol increases the synthesis of TG in the liver but normally an increase in synthesis is met by an increase in TG release out of the liver through VLDLs up to a certain extent. It turns out that alcohol inhibits this step too so not only are you making MORE TGs, you're also not sending them out of the liver. BTW, this is a reversible change.

here's a question I came across a while back: what kind of foods would you want a pt with an alcoholic fatty liver to avoid?
Fats, Carbs or Proteins?
 
Upvote 0 Downvote
Zuhal said:
You're right about alcohol dehydrogenase and acetyldehydrogenase causing an increase in NADH (by using the body's NAD+). This increase in NADH is going to favor the conversion of DHAP (a substrate from glycolysis) to G3P (this step requires NADH which becomes NAD+). G3P+3 Fatty acids makes a triglyceride molecule. So that takes care of why alcohol increases the synthesis of TG in the liver but normally an increase in synthesis is met by an increase in TG release out of the liver through VLDLs up to a certain extent. It turns out that alcohol inhibits this step too so not only are you making MORE TGs, you're also not sending them out of the liver. BTW, this is a reversible change.

here's a question I came across a while back: what kind of foods would you want a pt with an alcoholic fatty liver to avoid?
Fats, Carbs or Proteins?
Click to expand...

Carbs
 
Upvote 0 Downvote
BeastInfection said:
Can someone please explain to me the mechanism behind tetany induced by low magnesium? For some reason I can't find an adequate explanation online. I'm guessing it's similar to hypocalcemic tetany and has something to do with being a divalent cation, but I'm honestly not even sure of the exact mechanism of hypocalcemic tetany either (why does a decrease in calcium increase membrane permeability to sodium?).
Click to expand...

Hypomagnesaemia classically leads to hypocalcaemia bc magnesium is necessary for PTH release. Resultant hypocalcaemia causes tetany.
 
Upvote 0 Downvote
Hey guys,

Anyone know how Crohns disease causes Cholesterol stones?? Does it have something to do with Bile reabsorption?

Thanks 🙂
 
Last edited:
Upvote 0 Downvote
Can any of you guys/gals who took the exam recently comment on the calculations you were required to do? Were they pretty straightforward (i.e. given a set of data, calculate positive predictive value) or more abstract? Any crazy renal calculations like those in Kaplan Qbank?
 
Upvote 0 Downvote
Does the step ask tricky questions like, "antibodies with high specificity, to which of the following, are diagnostic for rheumatoid arthritis?"

a. centromeres
b. double stranded DNA
c. citrullated proteins
d. Fc portion of IgG
e. mitochondria
f. basement membrane
 
Upvote 0 Downvote
docnotsopc said:
Hey guys,

Anyone know how Crohns disease causes Cholesterol stones?? Does it have something to do with Bile reabsorption?

Thanks 🙂
Click to expand...

Crohn's --> mainly terminal ileum pathology --> bile salt reabsorption problems (bile is reabsorbed in ileum. NOTE: B12 is reabsorbed in ileum too) --> decreased bile salts in bile formation --> cholesterol stones
 
Upvote 0 Downvote
Jonari said:
Does the step ask tricky questions like, "antibodies with high specificity, to which of the following, are diagnostic for rheumatoid arthritis?"

a. centromeres
b. double stranded DNA
c. citrullated proteins
d. Fc portion of IgG
e. mitochondria
f. basement membrane
Click to expand...

This is worded very poorly.
Anti-cyclic citrullinated peptide Ab is more specific than anti-IgG Fc Ab for rheumatoid arthritis.
That's not what the question is asking though. It says "Ab with high specificity to what Ag.." not "Ab with high specificity for RA." Doesn't make much sense.
I'd still put C though.
 
Upvote 0 Downvote
Jonari said:
Does the step ask tricky questions like, "antibodies with high specificity, to which of the following, are diagnostic for rheumatoid arthritis?"

a. centromeres
b. double stranded DNA
c. citrullated proteins
d. Fc portion of IgG
e. mitochondria
f. basement membrane
Click to expand...

incubusfanclm said:
This is worded very poorly.
Anti-cyclic citrullinated peptide Ab is more specific than anti-IgG Fc Ab for rheumatoid arthritis.
That's not what the question is asking though. It says "Ab with high specificity to what Ag.." not "Ab with high specificity for RA." Doesn't make much sense.
I'd still put C though.
Click to expand...

Choice D is referring to rheumatoid factor. You've gotta know RF is an IgM directed against the Fc of IgG. Choice C is also seen in RF, but it's not as specific.
 
Upvote 0 Downvote
Jonari said:
Does the step ask tricky questions like, "antibodies with high specificity, to which of the following, are diagnostic for rheumatoid arthritis?"

a. centromeres
b. double stranded DNA
c. citrullated proteins
d. Fc portion of IgG
e. mitochondria
f. basement membrane
Click to expand...

Definitely C. Why's that tricky? I may be missing something here..
 
Upvote 0 Downvote
Phloston said:
Choice D is referring to rheumatoid factor. You've gotta know RF is an IgM directed against the Fc of IgG. Choice C is also seen in RF, but it's not as specific.
Click to expand...

Pretty sure Anti- cyclic citrullinated peptide antibodies are more specific than RF. RF isn't very specific (~90% for anti ccp)

edit: 👍
Zzmed said:
Choice C actually is more specific but not as sensitive as D.
Click to expand...
 
Upvote 0 Downvote
Zuhal said:
You're right about alcohol dehydrogenase and acetyldehydrogenase causing an increase in NADH (by using the body's NAD+). This increase in NADH is going to favor the conversion of DHAP (a substrate from glycolysis) to G3P (this step requires NADH which becomes NAD+). G3P+3 Fatty acids makes a triglyceride molecule. So that takes care of why alcohol increases the synthesis of TG in the liver but normally an increase in synthesis is met by an increase in TG release out of the liver through VLDLs up to a certain extent. It turns out that alcohol inhibits this step too so not only are you making MORE TGs, you're also not sending them out of the liver. BTW, this is a reversible change.

here's a question I came across a while back: what kind of foods would you want a pt with an alcoholic fatty liver to avoid?
Fats, Carbs or Proteins?
Click to expand...

Nice explanation, thanks

MLT2MT2DO said:
Carbs
Click to expand...

If you know that's the answer, would you mind explaining it? No idea in choosing between those :X
 
Upvote 0 Downvote
loveoforganic2 said:
If you know that's the answer, would you mind explaining it? No idea in choosing between those :X
Click to expand...

Have a look at FA Biocem under Ethanol metabolism.

When you consume alcohol --> increased NADH. Period.
By increasing NADH, there are some reactions that are favored to one direction. (the ones that use NADH for cofactor). These are:
DHAP --> G3P, pyruvate --> lactate, oxaloacetate --> malate
So, everything is an intermediate of glycolysis leading to fasting hypoglycemia.

So, you restrict carbs. Proteins or fats have nothing to do with ethanol metabolism.
 
Upvote 0 Downvote
You must log in or register to reply here.

Similar threads

Transposony
Official 2024 Step 1 Experiences and Scores Thread
Replies
0
Views
2K
Transposony
Transposony
D
Step 1 and Level 1
Replies
1
Views
2K
DOcSto
D
C
Step 1 tutor available!
Replies
0
Views
890
chauhanjugalkishor
C
A
USMLE Step 1 resources for sale
Replies
0
Views
2K
accurate_branch20
A
G
  • Question Question
USMLE Out of time and not ready for Step 1. Have I screwed up?
Replies
0
Views
419
genteel-mug-sting
G
Top