annotating usmleworld

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15+ Year Member
Apr 11, 2007
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I have been annotating USMLE world into First Aid...but I was just wondering if some details in the answer explanations are not worth taking notes on??

Usmleworld is not NBME, so is it safe to say that not every little detail in their explanations are worth obsessing about?

Basically, when I read through the expanations, for the most part I get most of the concepts. But here and there, are a few random subjects and maybe a few obscure details. Is it worth annotating this into FA? Ie. ADH has V1 and V2 receptors. Or there are different types of proteinurias - functional, orthostatic, etc., or the metabolism of ethylene glycol...etc.

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I certainly think you should take note of at least two of the things you mentioned, personally.

Re: ADH and V1 vs. V2 receptor: Vasopressin will stimulate both V1 (at the vessels) as well as V2 (at the collecting ducts in the kidney) while DDAVP (also called Desmopressin) will stimulate V2 much more than V1, which is why Desmopressin is useful for enuresis (nighttime bed wetting). Desmopressin has much less side effects as well due to the selective nature.

Re: the metabolism of ethylene glycol: ethylene glycol obviously causes a wide AG metabolic acidosis, but it also breaks down to oxalic acid, which produces crystals. I haven't ever seen a question written that tests this knowledge of crystal formation and the ability to trace the finding back to ethylene glycol consumption/ingestion (maybe this is what you're referring to with the UWorld question, though you didn't specifically say), but when we were going through our renal block we had two professors emphasize this little tidbit.

I'm not familiar with the various types of proteinurias so I can't state whether or not those would be good to know; however, I'll be reading up on those tonight. Also, take the above advice with a grain of salt because I'm an MS2 who has yet to take Step 1. My personal plan is to attempt to glean any extra information I can because if it helps me get one or two extra points on Step 1 I consider it worth it.
i also faced this problem ,wanted to write a lot into FA.
time yourself.for eg if u think u will finish one block in 3-4 hours .then complete it in 3-4 hours both taking the test and review + annotating .
take notes of anything that u feel is imp .and yes everything in uworld is super imp.recent test takes have told that uworld is very high yield.
and if u think u missed some minute points dont worry they repeat alot as incorrect option explanations.