Diseases not in FA, Uworld, or Pathoma

[Foot Fetish]

I am doing Robbins Review of Pathology (the question book) alongside my classes, and I am noticing several diseases that are nowhere to be found in First Aid, Uworld, or Pathoma. For example, "distal acinar emphysema," "arrhythmogenic right ventricular cardiomyopathy," "pulmonary alveolar proteinosis" just to name a few...Should I be learning these (i.e. are they fair game for boards), or is there no chance they can show up?

Thanks

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[Surgeria]

I am doing Robbins Review of Pathology (the question book) alongside my classes, and I am noticing several diseases that are nowhere to be found in First Aid, Uworld, or Pathoma. For example, "distal acinar emphysema," "arrhythmogenic right ventricular cardiomyopathy," "pulmonary alveolar proteinosis" just to name a few...Should I be learning these (i.e. are they fair game for boards), or is there no chance they can show up?

Thanks

I think a person can learn that kind of diseases when he knows 100% FA + PATHOMA + UWORLD content, and when I say 100%, I meen 100%, every single detail in the ufap. Only after this I think you can go for that low yield things, considering this - do you know a person who knows ufap 100%? It's probably unreal in 2 years of med school. I have gone through all the slides and text from university of utah pathology slides, this helped me a lot, this drilled down many things and concepts that I was not getting from ufap + kaplea video course even boards and beyond, for example that in neural tube defect affecting cranium, there is no bone right? - this is the reason that there is also no brain, because brain can't grow when it is exposed to amniotic fluid (I guess because fluid is toxic?). So this is concept, not a low yield disease, this is about how body works, how things work in the body, processes. Pathology images and text for medical education - WebPath

 

[Foot Fetish]

Just thought I'd bump this for good measure.

I am continuing to learn a ton of things outside of UFAP, some of which seems super-duper low-yield. To give a few random examples, I learned:

..."byssinosis" refers to hypersensitivity pneumonitis in response to fabric/yarn...
...although syphilitic gummas are largely characterized by epithelioid histiocytes on histology, endarteritis obliterans (syphilitic vasculitis) is actually characterized by a PLASMA CELL infiltrate...
..."sympathetic ophthalmia" is a feared complication of eye trauma that may be prevented by enucleation of the traumatized eye...

These represent just a tiny fraction of the ultra low-yield tidbits I have been amassing in my brain. Part of me fears that I may be doing myself a disservice. Perhaps my time would be better spent repeatedly clobbering myself over the head with the contents of UFAP...but it just seems so -- plebeian. I crave the esoteric.

 

[mistafab]

Dude - from my perspective robbins is the absolute gold mine to cover everything in the test. That being said, good test taking strategy would make me focus on UFAP. My guess is that UFAP will cover 80-90% of all the material on step1. With that said, I'd guess most students will probably hit 60-70% of that material and purely guess on the higher level discrimination problems (the robbins stuff). So if you can get 90 to 95% of that UFAP stuff, and do better than chance at those higher level questions, then you will do exceedingly well.

TLDR : UFAP memorize

 

[freecitizen]

The reality is your going to have questions about things you have never heard of (e.g., alveolar proteinosis). Focus on making sure you know whats in Pathoma + FA + uworld well. From my experience with the step, the vast majority of questions that I know I got wrong were because I simply forgot the answer. A significant proportion of the exam is related to more common stuff. My recommendation to anyone is to focus on minimizing mistakes/forgetting 80-90% of the material rather than trying to learn the low yield stuff. This may be an extreme example but would you rather get 60% on 90% of the material and 90% on the low yield questions OR 90% on 90% of the material and 60% on the low yield information?

 

[byaaaaaaah23]

Those things are very low yield and I would not take up brain space with them at this point in the game. Once you are getting 100% on uworld blocks then maybe. For now, just nod your head once as you read things like that in recognition that they exist, and then move on to greener, more high yield pastures.

 

[Newyawk]

Since youre shooting for a 270, you should be learning those diseases now because you wont be seeing them again during dedicated. Those low yield questions will not be difficult - you simply have to know the diagnosis. I never went to class and just barely used slides (robbins) to supplement during the year and i got one question on Step wrong that was super easy and was taught during the year. A friend of mine who didnt do well on Step claimed she wouldve known the answer to that Q because they went over it in class. I had a few other very low yield diseases on my Step that I made educated guesses on and got right. The choices were easily ruled out.

Basically - try your best to store that stuff now so if it ever comes up youre at least familiar with it.

 

[68PGunner]

I'm going to make a basketball analogy here. There's no reason to know the triangle offense when Step 1 only tests on the fundamentals of dribbling, passing, shooting jumpers, and 3-4 scenarios from the pick-and-roll. Stephen Curry is the MVP of the league because his fundamentals are 100% flawless. Focus on the fundamentals.

 

[Foot Fetish]

I'm going to make a basketball analogy here. There's no reason to know the triangle offense when Step 1 only tests on the fundamentals of dribbling, passing, shooting jumpers, and 3-4 scenarios from the pick-and-roll. Stephen Curry is the MVP of the league because his fundamentals are 100% flawless. Focus on the fundamentals.

I agree that Step 1 overwhelmingly focuses on the fundamentals, but by all accounts there is always a small percentage of questions that are not in any of the traditional review resources, i.e. the classic "wtf questions" that everyone mentions. Is it foolish to devote any time trying to learn the esoteric details that might encompass those types of questions? Perhaps. However, it just doesn't sit well with me to think that I might end up missing a question that I could have gotten had I just read through Goljan or Robbins. Either way, I think we can all agree that fundamentals are what produce large scores. The people scoring in the 260's may not have gotten those "wtf" questions, but they most certainly didn't slip up on any of the bread and butter questions, which is what you were saying. The folks scoring in the 270's might be a different story perhaps. I feel like esoteric knowledge becomes a real edge at that point.

 

[mw18]

I agree that Step 1 overwhelmingly focuses on the fundamentals, but by all accounts there is always a small percentage of questions that are not in any of the traditional review resources, i.e. the classic "wtf questions" that everyone mentions. Is it foolish to devote any time trying to learn the esoteric details that might encompass those types of questions? Perhaps. However, it just doesn't sit well with me to think that I might end up missing a question that I could have gotten had I just read through Goljan or Robbins. Either way, I think we can all agree that fundamentals are what produce large scores. The people scoring in the 260's may not have gotten those "wtf" questions, but they most certainly didn't slip up on any of the bread and butter questions, which is what you were saying. The folks scoring in the 270's might be a different story perhaps. I feel like esoteric knowledge becomes a real edge at that point.

I kinda feel like there are say 5,000 of the esoteric details and 10,000 UFAP details. But 85-90% of the test comes from the 10,000. So you can waste your time trying, but you may only learn 500 of the 5,000 and you're hoping they ask that. The numbers aren't in your favor.

 

[Henry101]

However, it just doesn't sit well with me to think that I might end up missing a question that I could have gotten had I just read through Goljan or Robbins.

YMMV but I read Robbins with a highlighter and highlight all those tiny diseases with important histology. I think that way, once I do know FA and Pathoma down cold in March, I can just fly through the chapters and quickly review those tiny diseases.

 

[Newyawk]

I agree that Step 1 overwhelmingly focuses on the fundamentals, but by all accounts there is always a small percentage of questions that are not in any of the traditional review resources, i.e. the classic "wtf questions" that everyone mentions. Is it foolish to devote any time trying to learn the esoteric details that might encompass those types of questions? Perhaps. However, it just doesn't sit well with me to think that I might end up missing a question that I could have gotten had I just read through Goljan or Robbins. Either way, I think we can all agree that fundamentals are what produce large scores. The people scoring in the 260's may not have gotten those "wtf" questions, but they most certainly didn't slip up on any of the bread and butter questions, which is what you were saying. The folks scoring in the 270's might be a different story perhaps. I feel like esoteric knowledge becomes a real edge at that point.

More speculative statements from the dude with the inappropriate username. If you're this knowledgeable about an exam you haven't taken yet I can only imagine what kind of information you'd purport to know after taking it just once!

 

[DJ Khaled's Pet Tiger]

I agree that Step 1 overwhelmingly focuses on the fundamentals, but by all accounts there is always a small percentage of questions that are not in any of the traditional review resources, i.e. the classic "wtf questions" that everyone mentions. Is it foolish to devote any time trying to learn the esoteric details that might encompass those types of questions? Perhaps. However, it just doesn't sit well with me to think that I might end up missing a question that I could have gotten had I just read through Goljan or Robbins. Either way, I think we can all agree that fundamentals are what produce large scores. The people scoring in the 260's may not have gotten those "wtf" questions, but they most certainly didn't slip up on any of the bread and butter questions, which is what you were saying. The folks scoring in the 270's might be a different story perhaps. I feel like esoteric knowledge becomes a real edge at that point.

Depends how miserable you want to make yourself

 

[Foot Fetish]

I can only imagine what kind of information you'd purport to know after taking it just once!

Yeah, unlike you, I will only have to take it once 😉

 

[DJ Khaled's Pet Tiger]

Yeah, unlike you, I will only have to take it once 😉

Lols shots fired

 

[Newyawk]

Lols shots fired

Yeah, unlike you, I will only have to take it once 😉

I scored in the 99th percentile

 

[ActinicKeratosis]

The strategy suggested in this thread seems like an epic waste of time. First Aid, Pathoma, and UWORLD is all you need.

 

[Foot Fetish]

The strategy suggested in this thread seems like an epic waste of time. First Aid, Pathoma, and UWORLD is all you need.

Fair enough. Though I just want to say that, having completed 40% of UWorld, I realized that UWorld itself has a ton of obscure, low yield info in the answer explanations. For example, Leber Hereditary Optic Neuropathy, Bloom Syndrome, Zellweger Syndrome, etc...these diseases are the epitome of esoteric, but technically they are covered by Uworld. When people say you should know everything in UW, are they including these obscure tidbits buried in the answer explanations , or are they just referring to the primary question objectives?

 

[ActinicKeratosis]

Fair enough. Though I just want to say that, having completed 40% of UWorld, I realized that UWorld itself has a ton of obscure, low yield info in the answer explanations. For example, Leber Hereditary Optic Neuropathy, Bloom Syndrome, Zellweger Syndrome, etc...these diseases are the epitome of esoteric, but technically they are covered by Uworld. When people say you should know everything in UW, are they including these obscure tidbits buried in the answer explanations , or are they just referring to the primary question objectives?

Sure learn those diseases if they are in UWORLD but the overall return on investment from learning all of these other esoteric diseases is extremely low.

 

[Newyawk]

Sure learn those diseases if they are in UWORLD but the overall return on investment from learning all of these other esoteric diseases is extremely low.

Again, it all depends on what the student is aiming for. You are guaranteed to have info not covered in UFAP on your exam. The question is, is it worth it to cover as much low yield as possible? It depends. Are you aiming for a 270 like this kid has made abundantly clear? Then no, you probably cant get away with ignoring them entirely. That being said, the low yield should only be addressed once you are certain you will master the high yield. Additionally, there are lower yield facts in other subjects like micro that could be considered higher yield than these diseases (parasites, for example). Perhaps one would be better served memorizing the most obscure side effects than studying these diseases. At the end of the day theres one thing for sure: most of us are just speaking from the experience of one exam.

 

[JamesPotterMS-3]

Again, it all depends on what the student is aiming for. You are guaranteed to have info not covered in UFAP on your exam. The question is, is it worth it to cover as much low yield as possible? It depends. Are you aiming for a 270 like this kid has made abundantly clear? Then no, you probably cant get away with ignoring them entirely. That being said, the low yield should only be addressed once you are certain you will master the high yield. Additionally, there are lower yield facts in other subjects like micro that could be considered higher yield than these diseases (parasites, for example). Perhaps one would be better served memorizing the most obscure side effects than studying these diseases. At the end of the day theres one thing for sure: most of us are just speaking from the experience of one exam.

I agree with this completely. Robbins really isn't a great resource to study for Step 1, even if you are aiming for a 270.

 

[lymphocyte]

Fair enough. Though I just want to say that, having completed 40% of UWorld, I realized that UWorld itself has a ton of obscure, low yield info in the answer explanations. For example, Leber Hereditary Optic Neuropathy, Bloom Syndrome, Zellweger Syndrome, etc...these diseases are the epitome of esoteric, but technically they are covered by Uworld. When people say you should know everything in UW, are they including these obscure tidbits buried in the answer explanations , or are they just referring to the primary question objectives?

I actually had a question on one of those low-yield topics. And some of the diseases are good to know for clinical practice, like Leber's or arrhythmogenic right ventricular cardiomyopathy. Doesn't matter. The best way to get a respectable score is to absolutely nail the easy questions, and the best way to do that is to utterly master UFAP. Step 1 is designed to have high discriminatory power among the response items, so you'll get it if you know it--otherwise, probably not. This is why so many people walk out of it thinking "not too bad" and get a mediocre score. It's also why people who do well walk out thinking that they bombed the test. The difference between the two groups is how much they appreciate the subtle differences between the answers.

Swanson DB, Case SM, Ripkey DR, Clauser BE, Holtman MC. Relationships among item characteristics, examine characteristics, and response times on USMLE Step 1. Acad Med. 2001;76(10 Suppl):S114-6.

 

[Elessar]

Fair enough. Though I just want to say that, having completed 40% of UWorld, I realized that UWorld itself has a ton of obscure, low yield info in the answer explanations. For example, Leber Hereditary Optic Neuropathy, Bloom Syndrome, Zellweger Syndrome, etc...these diseases are the epitome of esoteric, but technically they are covered by Uworld. When people say you should know everything in UW, are they including these obscure tidbits buried in the answer explanations , or are they just referring to the primary question objectives?

FYI Zellweger syndrome is in FA. Just goes to show it's a lot harder than it sounds to "memorize everything in First Aid"...

 

[Foot Fetish]

FYI Zellweger syndrome is in FA. Just goes to show it's a lot harder than it sounds to "memorize everything in First Aid"...

Well I'll be damned. So is "Refsum disease."
Anyone who says Step 1 is not a test of memorization is absolutely delusional.

 

[Newyawk]

Well I'll be damned. So is "Refsum disease."
Anyone who says Step 1 is not a test of memorization is absolutely delusional.

Go ahead and memorize everything in FA. Dont bother delving deeper into any topics. See how that turns out for you

 

[Foot Fetish]

Go ahead and memorize everything in FA. Dont bother delving deeper into any topics. See how that turns out for you

I never said I won't delve into other topics. I think memorizing FA should be a baseline.

 

[Newyawk]

I never said I won't delve into other topics. I think memorizing FA should be a baseline.

Also, dont take FA as a representation of the actual exam.

 

[ERDOC555]

Interesting thread, I'd say this answer depends on your goals.

Anyone can UFAP their way into a 250 pretty easily, but I feel that once you get to scores of 260+, low yield becomes high yield as it's the random esoteric minutia that separates the hundreds of people who have UFAP down perfectly.

Obviously know everything in UFAP before you start memorizing Robbins, but once you've mastered UFAP might as well try to fill in the extraneous details that your fellow test takers will never learn.

 

[Newyawk]

Interesting thread, I'd say this answer depends on your goals.

Anyone can UFAP their way into a 250 pretty easily, but I feel that once you get to scores of 260+, low yield becomes high yield as it's the random esoteric minutia that separates the hundreds of people who have UFAP down perfectly.

Obviously know everything in UFAP before you start memorizing Robbins, but once you've mastered UFAP might as well try to fill in the extraneous details that your fellow test takers will never learn.

If only you had the opportunity to memorize minutiae in robbins AFTER mastering UFAP. Most people have to go through material multiple times to master something.

 

[4thtimeretaker]

I know this thread is old, but if it is standard to know these these obscure pathologies that are only found in Robbins and no where else in all medical schools? I feel like this is very inefficient, especially if students are just cramming and dumping and forgetting it all later. Why would medical schools add this information in?