Jimson Weed?!?

[osli]

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OK, so I just missed the UW question on this. How did I manage to get through 2 years of school, FA, RR Path, BRS Phys, Roadmap Pharm, and half a dozen other resources on phys, path, biochem, and pharm, and have never heard of this before? I'm hoping I just overlooked it somehow, because it appears that a substantial percentage of others had no issues with that.

A guy in his garden cutting trees?

So I'm thinking organophosphates (fertilizer in the garden), but the eyes don't match. I'm scratching my head, thinking maybe snake or spider bite? Or maybe heat stroke or general hypovolemia? Or even acute MI brought on by the exertion? Trying somehow to figure out how the dilated eyes fit and what in the heck the answer choices would have to do with that.

But Jimson Weed!?! Are you kidding me?

The more important question... does USMLE expect you to make a similar leap in diagnosis, or is the difficulty on the real thing more in really understanding and applying mechanisms, side effects, physiology, etc.?

I have about 150 UW questions left. Now I'm expecting to get one that says "guy is at a party and collapses", and although my first thought might be something alcohol related I'm supposed to instead infer that this is a birthday party, held in a closet, with too many candles on the cake, and the guy is suffering from carboxyhemoglobinemia. 🙄

 

[anon-y-mouse]

OK, so I just missed the UW question on this. How did I manage to get through 2 years of school, FA, RR Path, BRS Phys, Roadmap Pharm, and half a dozen other resources on phys, path, biochem, and pharm, and have never heard of this before? I'm hoping I just overlooked it somehow, because it appears that a substantial percentage of others had no issues with that.

A guy in his garden cutting trees?

So I'm thinking organophosphates (fertilizer in the garden), but the eyes don't match. I'm scratching my head, thinking maybe snake or spider bite? Or maybe heat stroke or general hypovolemia? Or even acute MI brought on by the exertion? Trying somehow to figure out how the dilated eyes fit and what in the heck the answer choices would have to do with that.

But Jimson Weed!?! Are you kidding me?

The more important question... does USMLE expect you to make a similar leap in diagnosis, or is the difficulty on the real thing more in really understanding and applying mechanisms, side effects, physiology, etc.?

I have about 150 UW questions left. Now I'm expecting to get one that says "guy is at a party and collapses", and although my first thought might be something alcohol related I'm supposed to instead infer that this is a birthday party, held in a closet, with too many candles on the cake, and the guy is suffering from carboxyhemoglobinemia. 🙄

I remember that UW question, and I didn't know what it was, but I think the effects were all anticholinergic / atropine-like, so I answered based on those symptoms. In the poisoning and withdrawal questions I had, they made the symptoms ridiculously clear / obvious so you can figure out what it was... fortunately they're not going to make you fish too much to figure out what it is. I also got a whole bunch of "idiot swallows whole bottle of blah, how do you treat?" so be sure to know those.

 

[It'sElectric]

I remember that UW question, and I didn't know what it was, but I think the effects were all anticholinergic / atropine-like, so I answered based on those symptoms. In the poisoning and withdrawal questions I had, they made the symptoms ridiculously clear / obvious so you can figure out what it was... fortunately they're not going to make you fish too much to figure out what it is. I also got a whole bunch of "idiot swallows whole bottle of blah, how do you treat?" so be sure to know those.

I recall the question as well, and that's the exact line of reasoning I used too. Otherwise, I would've had no idea what the hell they're talking about. That was one of those questions where you just had to put the symptoms together and then check out the answer choices in order to know if you're on the right track.

Ridiculous, nonetheless.

 

[ZonaRidicularis]

z

 

[osli]

I think my frustration got the best of me. On first read through the question I thought "wtf" and then checked physostigmine because the symptoms seemed atropine-like. And then I started trying to figure out how in the frak atropine gets into trees in your garden. And then my mind went into trying to figure out if the symptoms could somehow fit CO poisoning (from a chain saw held right up to your mouth?), fertilizers, MI, heat stroke, hypovolemia, anything that might affect someone cutting trees in a garden.

At which point I gave up, market A, and went to the next question.

I'll try to remember on USMLE to make sure my "guess" at least fits some of the symptoms, even if I don't know the cause. 🙂