- Joined
- Mar 5, 2011
- Messages
- 326
- Reaction score
- 25
I'm 3 weeks from my test date and about 85% done with Uworld (timed/random), trend is low 70%->low 80%. I know Uworld is supposed to be textbook of sorts, but it tends to go into a lot of detail regarding topics that could generally be answered pretty easily. Does the real test have a lot of questions focusing on nitpicky phys/pathophys that I wouldn't be able to answer without studying the Uworld explanations in detail? Some examples:
1. Question about hyperammonemia in liver failure. Asks for which metabolic intermediate is likely deficient in pt's brain. My thought process: crappy urea cycle->excess NH4->accumulation of glutamate since it is used to transport NH3 to liver->glu can be derived from NH3 & aKG, so I pick aKG. Explanation gives me a giant diagram about the glutamate/glutamine cycle (which I've never heard of), 3 enzymes, and a bunch of stuff about astrocyte glutamine recycling.
2. Question about fetal lung maturity. Q stem gives me lecithin:sphingomyelin ratio of 2.1. Asks which component in amniotic fluid exerts greatest effect on this ratio. Steroids is burned into my head, so I reflexively knee-jerk that answer. Explanation gives me an essay about the zones of the fetal adrenal gland and CRH/ACTH stimulation from placenta.
3. Questions regarding DNA nucleotide excision/base excision/mismatch repair. Remembering the common disease associations and general purpose of each pathway (at the level of detail in First Aid) is straightforward, but Uworld gives big diagrams explaining each intermediate step in detail.
Would these types of associations and thought processes be sufficient for the test or will Step I questions require me to go the extra step and ask for minutiae/detailed mechanisms?
1. Question about hyperammonemia in liver failure. Asks for which metabolic intermediate is likely deficient in pt's brain. My thought process: crappy urea cycle->excess NH4->accumulation of glutamate since it is used to transport NH3 to liver->glu can be derived from NH3 & aKG, so I pick aKG. Explanation gives me a giant diagram about the glutamate/glutamine cycle (which I've never heard of), 3 enzymes, and a bunch of stuff about astrocyte glutamine recycling.
2. Question about fetal lung maturity. Q stem gives me lecithin:sphingomyelin ratio of 2.1. Asks which component in amniotic fluid exerts greatest effect on this ratio. Steroids is burned into my head, so I reflexively knee-jerk that answer. Explanation gives me an essay about the zones of the fetal adrenal gland and CRH/ACTH stimulation from placenta.
3. Questions regarding DNA nucleotide excision/base excision/mismatch repair. Remembering the common disease associations and general purpose of each pathway (at the level of detail in First Aid) is straightforward, but Uworld gives big diagrams explaining each intermediate step in detail.
Would these types of associations and thought processes be sufficient for the test or will Step I questions require me to go the extra step and ask for minutiae/detailed mechanisms?
