I am an MS2 going through FA with my class material. I was under the assumption that FA more or less "had it all," as far as little details are concerned. If this is the case, what's the point of annotating? Are people annotating EXTRA information, or just helpful information to reinforce what's already in FA (like mnemonics and stuff). I've never been much of an annotater in the past, as I usually do just fine by reading books and not taking notes/highlighting/etc, but everyone seems to unanimously agree that annotating into FA is necessary. So, what kind of info actually needs to be annotated in there? I hope this makes sense
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Step I Annotating in FA
Started by Aclamity
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FA is high yield. It will remind you of the big picture items, but in reality you need to know the mechanism underlying the big picture. People tend to annotate (or atleat I have been) the underlying mechanisms in shorthand so that if I am weak on it, every time i go through FA I test myself on it.
For example, you know someone in high altitude will have their ABG's thrown off.
FA would tell you that they will be alkalotic in the acute phase, but that EPO will eventually drive the production of RBCs to increase oxygen load.
What the detailed would be is you develop initially low o2 saturation due to lower atmospheric pressure of oxygen which stimulates your carotid body to increase respirations producing a metabolic alkalosis. Eventually the low O2 state will drive EPO up and increase RBC count. In long term, the kidneys will compensate by decreasing bicarb to bring pH near normal. Another mechanism that has come to light is the fact that alkalosis causes a transcellular shift of hydrogen out potassium in which stimulates phosphoenolpyruvate in glycolysis to produce more 2,3-BPG from 1,3-BPG which causes a right shift of the oxygen curve to aid in oxygen delivery (to correct the left shift from alkalosis).
For example, you know someone in high altitude will have their ABG's thrown off.
FA would tell you that they will be alkalotic in the acute phase, but that EPO will eventually drive the production of RBCs to increase oxygen load.
What the detailed would be is you develop initially low o2 saturation due to lower atmospheric pressure of oxygen which stimulates your carotid body to increase respirations producing a metabolic alkalosis. Eventually the low O2 state will drive EPO up and increase RBC count. In long term, the kidneys will compensate by decreasing bicarb to bring pH near normal. Another mechanism that has come to light is the fact that alkalosis causes a transcellular shift of hydrogen out potassium in which stimulates phosphoenolpyruvate in glycolysis to produce more 2,3-BPG from 1,3-BPG which causes a right shift of the oxygen curve to aid in oxygen delivery (to correct the left shift from alkalosis).
I annotated nothing. People tend to put way too much unneeded info in FA and then get bogged down with too much information. I ended up with a 250.
ya i annotate for mechanism or if i think the way FA presents it is in some way unclear.
This is exactly how I view it. By adding to much details I'm gonna lose focus on the material the book presents.
thanks guys, that makes sense and that's what I was thinking of doing. my school doesn't "teach to the boards" and we learn a lot of extraneous material, so I'm not sure if I need to add anything into FA (for example, I might learn about some virus and all its symptoms in class, but FA only mentions a few of those symptoms. should I ADD into that or just study what's in FA?)
