MCW Class of 2010, Part 3

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I wonder if the path final is going to consist of questions of similar difficulty to the midterms or if they will choose easier questions. Hopefully there will be more "main idea" questions than there were on the other exams.
 
indo said:
I wonder if the path final is going to consist of questions of similar difficulty to the midterms or if they will choose easier questions. Hopefully there will be more "main idea" questions than there were on the other exams.
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Based on the phys final, they'll be of even greater difficulty, coupled with some real zingers from Raff.
 
TheProwler said:
Based on the phys final, they'll be of even greater difficulty, coupled with some real zingers from Raff.
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i hope it will be 50% infectious disease and 50% heme/onc, both of which I hate.
 
Last year they had some exact questions from some previous exams we had. The questions were all the same detail they expected during the rest of the year, but for the final, I just didn't care.
 
Ashers said:
Last year they had some exact questions from some previous exams we had. The questions were all the same detail they expected during the rest of the year, but for the final, I just didn't care.
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Didn't they just do the exact questions because we did so poorly on those particular block exams? Like pity points.
 
I probably should have looked at the questions I got wrong then. ugg.
 
Ashers said:
Yeah, doesn't mean I got them right the 2nd time though. I was so over studying by that exam. I BARELY kept my grade. Hehehe... I love buffers.
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Yeah, I don't have a whole lot of buffer. the guy I can study with can get a 70% and still honor the class. argh.
 
wow, I actually got a pretty decent grade in pharm. of course, now this means I'll have to try to do pretty well on the final.....
 
what is the pharm final worth?
 
indo said:
what is the pharm final worth?
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There's some complicated discussion in the syllabus about being roughly 2 points per lecture from the 4th block and about .75 points per lecture from the preceding three blocks. I'm not about to multiply out how many lectures that is, so I'm guessing about two exams' worth. It's not like knowing my grade target will make me more likely to be able to hit it. If it did, I could just set appropriate goals and honor everything, right?
 
samenewme said:
It's not like knowing my grade target will make me more likely to be able to hit it.
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It does for me, because in micro, neuro, and CTB, I managed to hit my target grade on the final with only a small amount of room to spare. I missed the target in phys and biochem, but not by much. Those two finals were just grueling though.
 
52 lectures before this block and 19 in this block gives:

39 points plus 38 points= 77 points.

hmm.
 
I bet ours is about 108 too. I bet it is scored per hour of lecture rather than per lecture. There are some single lectures that occupied 3 hours or 7 hours etc. I'll just assume we'll get 108 points too. Thanks!


My big sib got 103/108 on the final. Holy cow.
 
indo said:
I bet ours is about 108 too. I bet it is scored per hour of lecture rather than per lecture. There are some single lectures that occupied 3 hours or 7 hours etc. I'll just assume we'll get 108 points too. Thanks!


My big sib got 103/108 on the final. Holy cow.
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Yeah, it's by hours of lecture; antibiotics has a crap-load of questions.

103/108 is pretty good.

My big sib told me he got 100% on their final, but he still didn't honor the class.

Oh, and make sure to pay attention to Dr. Kochar's cases/answers.
 
indo said:
My big sib got 103/108 on the final. Holy cow.
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haha, that won't be me. Someone got like a 99.5% on last year's final. I saw it posted in the Stavri Joseph Hallway, so I thought I'd take a look. I remember being pre-med and touring MCW and seeing a biochem exam and being quite sure that "I'll be smarter once I get to that point." Well, I was totally wrong. I looked at the pharm final last year and knew I wouldn't be smarter when I got to that point, and I just wanted to cry. :laugh:

I'm making it thus far though...
 
Okay, so I have a whole bunch of step 1 review stuff and some third year books, case files for OB, blueprints for psych, etc. Anyone want them? The cost is that you have to come get them, since I'm car-less at the moment. Otherwise, free to a good home. Let me know.
 
Xandie said:
Okay, so I have a whole bunch of step 1 review stuff and some third year books, case files for OB, blueprints for psych, etc. Anyone want them? The cost is that you have to come get them, since I'm car-less at the moment. Otherwise, free to a good home. Let me know.
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do you have any question/answer books? I'd be interested in those.
 
I believe there is a Step 1 CK question book. There may also be a peds pre-test book, but I'm waiting for the owner of that one to get back to me about whether he wants them back or if he's on board with my donation adventures... I'm donating a lot of stuff. I'm going more minimalist for my next apartment... plus, I have too much stuff.
 
Xandie said:
Okay, so I have a whole bunch of step 1 review stuff and some third year books, case files for OB, blueprints for psych, etc. Anyone want them? The cost is that you have to come get them, since I'm car-less at the moment. Otherwise, free to a good home. Let me know.
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I'm in for any psych/neuro books you have. PM me your address (and maybe a phone number 😍 ) and we'll work on logistics.
 
Xandie said:
Okay, so I have a whole bunch of step 1 review stuff and some third year books, case files for OB, blueprints for psych, etc. Anyone want them? The cost is that you have to come get them, since I'm car-less at the moment. Otherwise, free to a good home. Let me know.
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It feels so good to be done with all the things you mentioned. I have 1.5 months left of 3rd year. Yeah!! 😀
 
Xandie said:
I believe there is a Step 1 CK question book. There may also be a peds pre-test book, but I'm waiting for the owner of that one to get back to me about whether he wants them back or if he's on board with my donation adventures... I'm donating a lot of stuff. I'm going more minimalist for my next apartment... plus, I have too much stuff.
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I just left you a voicemail (from the cell # in your Facebook). I can come by and pick up a book today if that's convenient for you.
 
Xandie, do you have any books I should have before I start my OB/Gyn unit?
 
Agent Splat said:
you'll want her Case Files.
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Cool. Is that for the shelf?

Is there anything I need to do to be even semi-functional in my first clerkship?
 
indo said:
Cool. Is that for the shelf?

Is there anything I need to do to be even semi-functional in my first clerkship?
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OB H&Ps can be a little different. Make sure you get ahold of the note templates so you know what you need for notes/H&Ps for various situations (post op C-section, Labor progress note, etc).

More generally, just remember your basic physical exam for all situations and try to have a set pattern/order so you don't miss things. If you haven't gotten Maxwells pocketbook yet, get it before you start on the wards.
 
And yes, Case files is for the shelf.

And this is rare, but Dr. Lund is one of the few clerkship directors that actually admits to liking it...says it does a good job preparing for the OB shelf.
 
indo said:
Yep. I should probably start getting up at 4am, ehh?
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The easiest thing is to just go to bed early. I've totally screwed myself over for medicine this month on pedscation. I haven't seen 11pm this often since M1 year.

Agent Splat said:
OB H&Ps can be a little different. Make sure you get ahold of the note templates so you know what you need for notes/H&Ps for various situations (post op C-section, Labor progress note, etc).

More generally, just remember your basic physical exam for all situations and try to have a set pattern/order so you don't miss things. If you haven't gotten Maxwells pocketbook yet, get it before you start on the wards.
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If you go to St. Mary's you don't have to do any formal typed up H&Ps that you turn in, and they have a form that you just fill in the blanks. Most M3s should have all the little forms on their PDAs (M3s also have games -- I played more games on OB/gyn than any other rotation.) I second Maxwells. Just don't lose it while you're on Psych and don't need it at all (same goes for your stethoscope too).

Agent Splat said:
And yes, Case files is for the shelf.

And this is rare, but Dr. Lund is one of the few clerkship directors that actually admits to liking it...says it does a good job preparing for the OB shelf.
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Case Files rocks; Blue Prints was also good (the actual text sucks). I used it for psych and OB/gyn. I need to start reading it for peds.
 
Alright, here's the deal: Denise has the step 1 books (she scooped you, Prowler, sorry), Indo gets the OB book (and the novel I'm about to write below about how to be stellar on OB), Stringbean gets the psych book. Stringbean, Indo, if you could pass those books on to other SDNers I would really appreciate it. Just send me a PM and we can set up a time for things to be passed on... god I'm soooo glad to be done.

Alright, OB advice! So... the biggest thing in OB is knowing how to take a history, since you won't do exams on your own, unless you're doing dopp-tones or measuring the fundus, which is pretty easy. That being said, the best place for dopp-tones after 12 weeks (when the uterus gets out of the pelvis, no point listening before that, really) and before you can do Leopolds to actually find the baby's heart is usually right under the belly button, a few cm off to the left. No idea why, but I almost always hear tones there. As far as the fundal measurements, it's from the symphysis to the fundus of the uterus, and it should be about 1cm per week. It hits the umbilicus at 20 weeks. Don't do fundal height or dopp-tones on your own until you're sure the resident is okay with it--most times they'll watch you do it a few times and then trust your skills, but you don't want to examine the woman twice, especially since the fundal height gets a little personal, with pressing the tape measure down onto the symphysis.

Now, for the history: it's basically the same for OB office visits and admissions to L&D. The five cardinal questions: any bleeding, loss of fluid (LOF), contractions (if so, how far apart), is the baby moving, pre-eclamptic symptoms (headache, RUQ pain, edema). If they're on L&D, when was their cervix last checked and what was it? What was the presentation of the baby and how was that determined (sometimes vertex babies end up being breeches, which is of course a whole different ballgame). When's their due date and how was it determined (LMP, 1st trimester U/S, 3rd trimester U/S will be the most common). Then all previous pregnancies and what the outcomes were (what type of delivery, what gestational age, any complications). Regular medical and surgical history, meds, allergies, yada yada. Social history should include the marital status, situation of the birth father, and support system for the baby. Physical exam for L&D includes the FHTs, toco, presentation of baby, and cervical check, pretty much... but again, don't do the exam. You should look at the FHTs and toco and be able to tell the resident about them.

For gyn, it's just a normal symptom-guided history. The gyn history is really important, so any history of whatever's going on (usually pelvic pain or dysfunctional uterine bleeding). Remember pelvic/abdominal pain may have non-gyn causes, but always list gyn at the top of your differential unless it's really not.

Lastly, this is how OB/gyn presentations go:
Ms. So-and-so is a xx-year old GxPxxxx (TPAL: term, preterm, abortions, living children) who presents with such-and-such. (If she's in labor, Gs&Ps should be followed by "at xx weeks by first-trimester U/S").

I'm trying to limit this to actual advice about what to do, and not write a treatise on common causes of things/interesting snippets... it's hard! But I will say this, because if you say "no s/sx of pre-eclampsia", you might get the following questions. Pre-eclampsia is most common in first pregnancies, young woman, and a first pregnancy with a different partner (ie a woman who has never had pre-eclampsia with her previous babies gets it, it's likely that it's a new father). Treatment is blood pressure control (iv labetalol, magnesium) and delivery of the baby. Magnesium toxicity is manifested by pulmonary edema and hyperreflexia, so if you have a lady on mag, check those two things in the exam. Seizures can occur post-partum as well, I want to say up to 24 hours (I don't feel like looking it up), so you're not out of the woods post delivery.

Alright, I think I'm done with my typing diarrhea. Hopefully it helps someone!

Post-partum discussions go as follows: how's the bleeding? (should be like a normal period), pain control, plans for post-partum contraception (progesterone-only pills if breast feeding). The exam consists of an abdominal exam (uterine fundus should be firm and below the umbilicus). Post-vaginal deliveries go home on day 2, c/s on day 4.
 
^^^What she said. I would print that out if I hadn't done OB/gyn yet.

H&Ps on OB/gyn seemed complex at first, and so did the notes because they have a whole other set of acronyms (Dr. Lund will beam it to you during one of the first lectures; I never got it since the St. Mary's crew was late). H&Ps were my favorite part of OB (gyn my fav part was the actual surgeries). The women are generally healthy, so they don't take too long, and it's a focused physical.
 
Ashers said:
^^^What she said. I would print that out if I hadn't done OB/gyn yet.

H&Ps on OB/gyn seemed complex at first, and so did the notes because they have a whole other set of acronyms (Dr. Lund will beam it to you during one of the first lectures; I never got it since the St. Mary's crew was late). H&Ps were my favorite part of OB (gyn my fav part was the actual surgeries). The women are generally healthy, so they don't take too long, and it's a focused physical.
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The OB and Gyn histories seem complex at first (as do the notes) but once you get about a week in everything kind of clicks and they become second nature. The tough part about the rotation is really trying to figure out how to become part of the team and learning how the flow of the L&D floor works and how to be where you need to be and when you need to be there to catch babies.

Oh, and rounding in the morning is frickin' bananas. In the bad way.
 
DoctorFunk said:
The OB and Gyn histories seem complex at first (as do the notes) but once you get about a week in everything kind of clicks and they become second nature. The tough part about the rotation is really trying to figure out how to become part of the team and learning how the flow of the L&D floor works and how to be where you need to be and when you need to be there to catch babies.

Oh, and rounding in the morning is frickin' bananas. In the bad way.
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are you guys rounding as a team there? at Joe's it's every student for themselves in a race to beat the residents at writing a note. Luckily it's easy to get lost in the shuffle and nobody notices if you don't get a note on one of the run-o-the-mill NSVDs. Or maybe they do notice and they aren't telling us. Which would be very possible.

bay rum aftershave smells good. it's like getting super pirate-drunk without actually being drunk.
 
Agent Splat said:
are you guys rounding as a team there? at Joe's it's every student for themselves in a race to beat the residents at writing a note. Luckily it's easy to get lost in the shuffle and nobody notices if you don't get a note on one of the run-o-the-mill NSVDs. Or maybe they do notice and they aren't telling us. Which would be very possible.

bay rum aftershave smells good. it's like getting super pirate-drunk without actually being drunk.
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I mostly think they don't notice, unless you are conspicuously doing other things when you should be rounding. Students on the rotation at Joe's with me would often stroll in well after everyone had been rounded on when they knew the other med students involved in clinic deliveries would have the majority of those patients covered.

I want to sniff you.
 
TheProwler said:
Dammit, Denise.
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It's 4:30 AM on a Friday and here I am feeling pity for you, Prowler. You get a consolation prize. I'll give you a full set of Kaplan Step 1 books (including a nifty question book) if you want them. I only ask that you do the whole "pass it along" thing when you're done rawking Step 1.
 
DoctorFunk said:
It's 4:30 AM on a Friday...
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Since you were up that early, did you feel the earthquake in all it's glory?

It woke me up, and I was like, "Weird, this feels like an earthquake, and I went back to sleep." Apparently the days are gone when I could sleep through measly 5.4 quakes centered 350 miles away.
 
Ashers said:
Since you were up that early, did you feel the earthquake in all it's glory?

It woke me up, and I was like, "Weird, this feels like an earthquake, and I went back to sleep." Apparently the days are gone when I could sleep through measly 5.4 quakes centered 350 miles away.
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Whaaa? Earthquake, that's unpossible! Do you have a link to a story about it? I definitely didn't feel anything.
 
DoctorFunk said:
It's 4:30 AM on a Friday and here I am feeling pity for you, Prowler. You get a consolation prize. I'll give you a full set of Kaplan Step 1 books (including a nifty question book) if you want them. I only ask that you do the whole "pass it along" thing when you're done rawking Step 1.
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Very nice. I am quite interested in this consolation prize. Check your Facebook wall.
 
Gimlet said:
THE END IS NEAR!

Interesting, though. I definitely didn't feel anything, but my wife was up working out in the basement at that time...wonder if she noticed anything.
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she was working out at 4:30??? now that's dedication.
 
And to make you feel even better, Funk's consolidation prize bears remarkable similarity to the original prize.

Now, Stringbean, about our rendezvous...
 
xandie, will you give prowler the book so I can get it from him? That way you dont have to spend any more time.

Thanks for all the tips and advice! I saved all of that and printed it.
 
I don't see anyone unless they come find me, or I can stick it in your open box when I get back to school May 1. I just need to know your actual name, unless it says "Indo" on your open box.
 
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