Step I NBME 3 or 4 today?

Started by Blesbok
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Blesbok

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I have exactly 2 weeks left until the big day and I plan on taking an NBME later today then another next friday.

Should I take 4 today and 3 next week or 3 today and 4 next week?

I heard 3 is harder so I was thinking about taking it next week, but then again I don't want to murder my confidence.
 
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I say 3 now and 4 later.

Since 3 is harder and if you don't get the score you like you can always push back.

I agree taking 3 later will only shoot your confidence down before the exam.
 
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some people say 4 is harder, it has more moleculr bio which people aren't used to, and i heard the questions were longer. i personally think hardness is all relevant, if ou know something it's kind of hard for a question to trick you, it's when you're not sure about the topic that's when you get tricked. i took 3 didn't think it was too bad i probably won't take 4 don't really have that much time left and i'd rather review my weak points.
 
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RussianJoo said:
some people say 4 is harder, it has more moleculr bio which people aren't used to, and i heard the questions were longer. i personally think hardness is all relevant, if ou know something it's kind of hard for a question to trick you, it's when you're not sure about the topic that's when you get tricked. i took 3 didn't think it was too bad i probably won't take 4 don't really have that much time left and i'd rather review my weak points.
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Did 3 have a lot of biochem pathways?
 
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RussianJoo said:
so you're doing three? good luck... also when you're done with it I want to know what you put down for the old guy on many different meds and what's more reduced in him renal clearance or liver function... I put liver function..
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I took 3 a while back ago....I found it difficult due to all the molecular stuff in it. So 4 has it too.....eh.:scared:

As for your question, I put liver function too. In the elderly, they lose phase I metabolism...that was my logic to my answer....don't know if its right tho..🙄
 
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overfiend06 said:
I took 3 a while back ago....I found it difficult due to all the molecular stuff in it. So 4 has it too.....eh.:scared:

As for your question, I put liver function too. In the elderly, they lose phase I metabolism...that was my logic to my answer....don't know if its right tho..🙄
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yeah i tried to remember how those drugs were cleared, if it was by liver or renal clearance but couldn't.. i really suck at pharm i hope i don't get a lot of pharm on my test..

but i remember reading somewhere that the older you get the higher your creatinine levels get because you lose of kidney clearance and there's increased muscle break down and that's why when perscribing antibiotics you have to adjust the dose in an elderly person... but i guess you lose more liver function then kidney function? man I can't wait to just settle into my practice and use only like 5 different drugs and not worry about remembering 400 drugs and drug interactions.. let the pharmacists deal with that bs.
 
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RussianJoo said:
so you're doing three? good luck... also when you're done with it I want to know what you put down for the old guy on many different meds and what's more reduced in him renal clearance or liver function... I put liver function..
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For the life of me, I can't think of the question you are talking about. Not the chart with pen G, was it?
 
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RussianJoo said:
yeah i tried to remember how those drugs were cleared, if it was by liver or renal clearance but couldn't.. i really suck at pharm i hope i don't get a lot of pharm on my test..

but i remember reading somewhere that the older you get the higher your creatinine levels get because you lose of kidney clearance and there's increased muscle break down and that's why when perscribing antibiotics you have to adjust the dose in an elderly person... but i guess you lose more liver function then kidney function? man I can't wait to just settle into my practice and use only like 5 different drugs and not worry about remembering 400 drugs and drug interactions.. let the pharmacists deal with that bs.
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After 50 your GFR starts to decrease by about 1mL/min/yr
 
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Oh, and ya, I decided to take 3, because I thought someone said it had a lot of biochem, but I think I made a mistake, because it had a lot of genetics/molecular bio, which I haven't studied yet and I think it would have been better to take it next week instead.

I got a 660, which according to NBME is a 250 and according to medfriends is a 254. My goal is a 250 and I have 2 weeks left before the exam, so I am content. 😀
 
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Blesbok said:
For the life of me, I can't think of the question you are talking about. Not the chart with pen G, was it?
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it was like a 72 year old guy and he's on like 3 different meds a statin i think a diabetic med and maybe a hypertension med.. and they asked something about the fact that he's old and the drugs build up in his body.. and the answer choices were due to poor liver glucoronidation, poor renal clearance and some others.. i picked the glucoronidation answer...
 
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Blesbok said:
Oh, and ya, I decided to take 3, because I thought someone said it had a lot of biochem, but I think I made a mistake, because it had a lot of genetics/molecular bio, which I haven't studied yet and I think it would have been better to take it next week instead.

I got a 660, which according to NBME is a 250 and according to medfriends is a 254. My goal is a 250 and I have 2 weeks left before the exam, so I am content. 😀
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strong work... yeah i got 550 on that one.. I just wish that some how i can submit these score estimators to the USMLE people and just ask them for a score thats like 10 points lower then my estimated score and not have to take the test... i'd be totally happy with 220ish.. that should be good enough to get anesthesia somewhere..
 
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Blesbok said:
Oh, and ya, I decided to take 3, because I thought someone said it had a lot of biochem, but I think I made a mistake, because it had a lot of genetics/molecular bio, which I haven't studied yet and I think it would have been better to take it next week instead.

I got a 660, which according to NBME is a 250 and according to medfriends is a 254. My goal is a 250 and I have 2 weeks left before the exam, so I am content. 😀
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That is an awesome score. Congrats!!

Good Luck on the real exam!!
 
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RussianJoo said:
it was like a 72 year old guy and he's on like 3 different meds a statin i think a diabetic med and maybe a hypertension med.. and they asked something about the fact that he's old and the drugs build up in his body.. and the answer choices were due to poor liver glucoronidation, poor renal clearance and some others.. i picked the glucoronidation answer...
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Glucoronidation is stage 2, which isn't as effected by age...
 
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RussianJoo said:
it was like a 72 year old guy and he's on like 3 different meds a statin i think a diabetic med and maybe a hypertension med.. and they asked something about the fact that he's old and the drugs build up in his body.. and the answer choices were due to poor liver glucoronidation, poor renal clearance and some others.. i picked the glucoronidation answer...
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I can't remember that question, but I don't think I put liver glucoronidation for any of them. I do remember putting decreased renal clearance on one or two of them, but one of them was the pen G question that had two charts, one with much higher AUC.
 
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How much pharm is there on these NBME exams? I haven't really studied much pharm and I plan to take an NBME pretty soon just to see where I'm at since I have 4 weeks to go.
 
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hasha100 said:
How much pharm is there on these NBME exams? I haven't really studied much pharm and I plan to take an NBME pretty soon just to see where I'm at since I have 4 weeks to go.
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I would say that 10% of the exam is pharm or pharm related. However, most of it isn't really hard. If you were a good student, you can probably get at least 50-75% of pharm questions without having restudied it.
 
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hasha100 said:
Cool. I think I was a good student. I'll probably take an NMBE (most likely version 1) this Monday. I hope to break 200.
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I think you will manage. I did suprisingly well on my first NBME after about a week of studying and I had reviewed very little pharm by that point, mostly just biochem and behavioral stuff.
 
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RussianJoo said:
number 4?
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Actually, I realized later that I took 4 last week, that is why I didn't remember that question you guys were asking about. I took 3 today. I answered decreased renal secretion to that one.


I just got done. Wait for it.... 770. I am F'in stoked. I have a week left and I am wondering if I should just push it forward.
 
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Blesbok said:
Actually, I realized later that I took 4 last week, that is why I didn't remember that question you guys were asking about. I took 3 today. I answered decreased renal secretion to that one.


I just got done. Wait for it.... 770. I am F'in stoked. I have a week left and I am wondering if I should just push it forward.
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U-N-R-E-A-L :clap:
 
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hasha100 said:
damn 770!!!! 😱 That's crazy. Awesome job man. What Step 1 score does that correlate to?
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263. If I get anywhere near that I will be more than happy. My original goal was 240 or above with a 250 being my optimal goal. I was hoping for like a 700 on this NBME at the highest, I wasn't expecting anywhere near that.
 
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Also, does anyone know what the answer to this one was?

A 45-year-old woman remembers being sexually abused as a child by her older brother. She draws on her childhood experiences to express intense emotions in her work as an actor. This use of her childhood experiences is most illustrative of which of the following coping mechanisms?
A. Denial
B. Displacement
C. Dissociation
D. Isolation
E. Projection
F. Reaction formation
G. Regression
H. Repression
I. Somatization
J. Sublimation



Was it displacement?
 
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Blesbok said:
Also, does anyone know what the answer to this one was?

A 45-year-old woman remembers being sexually abused as a child by her older brother. She draws on her childhood experiences to express intense emotions in her work as an actor. This use of her childhood experiences is most illustrative of which of the following coping mechanisms?
A. Denial
B. Displacement
C. Dissociation
D. Isolation
E. Projection
F. Reaction formation
G. Regression
H. Repression
I. Somatization
J. Sublimation



Was it displacement?
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yeah definitely sublimation.. congrats on the great score though you'll rape this test!!
 
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Blesbok said:
Damn. I need to make sure to look over those defense mechanisms. That is the one part of psych that I suck at and they seem to be pretty high yield.
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yeah i think i got one or two of them on my exam.. but there's like less then 10 of them if you read them 3 times each you should be able to know them, and it will take like 20min tops.
 
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On NBME 3, what did people say that picture of a colon in a woman with occult bleeding was? At first I thought it was a tubular adenoma (cause it was a thingie on a stalk) but then the gross surface of the colon looked villous-y so I was thinking the stalk thing might have been adenocarcinoma arising from a villous adenoma.
 
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dilated said:
On NBME 3, what did people say that picture of a colon in a woman with occult bleeding was? At first I thought it was a tubular adenoma (cause it was a thingie on a stalk) but then the gross surface of the colon looked villous-y so I was thinking the stalk thing might have been adenocarcinoma arising from a villous adenoma.
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I said villous adenoma I think. But I really couldn't tell if it had a stalk from the angle the picture was taken at. It looked like it was raised, but to me it didn't look like it had a stalk.
 
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Blesbok said:
I said villous adenoma I think. But I really couldn't tell if it had a stalk from the angle the picture was taken at. It looked like it was raised, but to me it didn't look like it had a stalk.
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So we have one for tubular and one for villous.. the funny part is that the "correct answer" (from the 800 NBME guy, who is about 95% correct) was adenocarcinoma. wtf.

I could buy it was any of the 3 really.
 
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dilated said:
So we have one for tubular and one for villous.. the funny part is that the "correct answer" (from the 800 NBME guy, who is about 95% correct) was adenocarcinoma. wtf.

I could buy it was any of the 3 really.
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Ya, I really hate when they ask you about pictures like that where in real life you would get it in a second because you would be able to look at it in 3d. I am not a big fan of electronic histology.
 
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I put villous because i think I remember seeing the same pic on UW and i put tubular on there and it was wrong and i think they had villous because it's more commonly for villous to transform into adenocarcinoma. I also had that pic on the real exam and they didn't have adenocarcinoma as an answer choice but had different descriptions of adenomas and since it's so big it's probably malignant and villous are the most common adenomas to transform so that's what i put down... but i could have easily been wrong.
 
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I put tubular adenoma, to the bottom left you could see the stalk. It's like they had the adenoma pulled up and back.


NBME 3 q's..

What was the answer on the spanish speaking patient with the 6 year old daughter?

The erythromycin p450 inhibition q kinda threw me off. I put the line where the concentration increased with a little curve if that makes any sense...
 
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hi guys,
-well, I took form 3 couple of days ago, and I put tubular adenoma-you can see the stalk=my opinion🙂, I also put renal excretion-I remember that in Goljan audio he makes some noise about "killing the old people because we don't adjust the dose due to decreased renal excretion", whatever, ..and yeah, I also put sublimation😀. So wtf..I don't understand how I got a 450😱. ..had to postpone my exam since I'm aiming for something higher-I suck on behavioral, that was totally under borderline, and I think form 3 had a "long bar" regarding behavioral. I thought that getting a score over 90 would be much easier. Got the wrong impression, I guess:laugh:.
so, I don't know, is it realistic to get in like 4 weeks from 450 to >600? :scared:
My biggest mistake was that I used an old BRS pathology from BRS Schneider pathology instead of Goljan's pathology..lazy!👎
 
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Blesbok said:
Also, does anyone know what the answer to this one was?

A 45-year-old woman remembers being sexually abused as a child by her older brother. She draws on her childhood experiences to express intense emotions in her work as an actor. This use of her childhood experiences is most illustrative of which of the following coping mechanisms?
A. Denial
B. Displacement
C. Dissociation
D. Isolation
E. Projection
F. Reaction formation
G. Regression
H. Repression
I. Somatization
J. Sublimation



Was it displacement?
Click to expand...

NM. I brain farted.
 
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I just looked at the picture again and I would change my answer to tubular adenoma. I didn't notice that the thing is actually folded over and the stalk is actually below it.
 
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Also, what was the answer to this one?

Two inbred mouse strains, A and B, express different alleles only at a minor histocompatibility locus on the Y chromosome. Which of the following mice would accept a skin graft from a male (AxB)F1 mouse with a strain A father and a strain B mother?

A. (AxB)F1 female (A mother, B father)
B. (AxB)F1 female (A father, B mother)
C. (AxB)F1 male (A mother, B father)
D. (AxB)F1 male (A father, B mother)


I put D, but the whole question just seems too complex for such an easy answer. Maybe I am just trying to overthink it when I really shouldn't.
 
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