Official 2016 Step 1 Experiences and Scores Thread

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Transposony

Transposony

Do or do not, There is no try
10+ Year Member
Joined
Nov 10, 2011
Messages
1,810
Reaction score
999
Last edited:
Sort by date Sort by votes
stepone2015 said:
Attributes associated with Turner's >>>>>>>>>>> gene involvement.
Click to expand...
It's 45XO, loss of paternal X (World Q). Attributes are more important, agreed, like bicuspid valve (World Q x 2), coarctation of aorta (World Q), streak ovaries (World Q), but can still get pregnant with a procedure..but you should still know the gene.
 
Last edited:
Upvote 0 Downvote
Is it weird that I'm taking 4-5 weeks to get through FA? I'm taking about 30 minutes per page. I feel like I'm going way too slow compared to people who somehow manage to get through it in like 1-2 weeks.
 
Upvote 0 Downvote
TheShaker said:
Is it weird that I'm taking 4-5 weeks to get through FA? I'm taking about 30 minutes per page. I feel like I'm going way too slow compared to people who somehow manage to get through it in like 1-2 weeks.
Click to expand...
I confess... I was only able to get through first aid once in my 5 week dedicated
 
Upvote 0 Downvote
worldbeater said:
It's 45XO, loss of paternal X (World Q). Attributes are more important, agreed, like bicuspid valve (World Q x 2), coarctation of aorta (World Q), streak ovaries (World Q), but can still get pregnant with a procedure..but you should still know the gene.
Click to expand...

I was actually referring to SHOX genes. 45 XO is like the basic thing about Turner's that's important.
 
Upvote 0 Downvote
After you take the test but before you get your score, are there any changes on your NBME page? Mine doesn't show a score report day or anything
 
Upvote 0 Downvote
I have taken the test on 28th of march. I think I hear on 20th of April.

NBME 18 : 232 (4 weeks)
NBME 17: 243 (10 days)
UWSA1: 259 (3 weeks)
UWSA2: 253 (3 days)

The exam was in no way related to the NBME 18, I don't know but I felt the exam is more like UWSA (clear questions, and most of them with direct answers, did not have a lot of behavioral), but the worst part for me was the pharmacology because I missed 2 opiate withdrawal cases!! 🙁( (in UW the emphases were on the "yawning" and pain presentation, but opiates also cause dilated pupil and diarrhea, I totally forgot that. Other parts was good I think.

There is a new concept "inverse agonist" I think people should know what it is. Me and one of my friends had a question and we both were left with this choice as an answer.

The breaks are more than enough, there were some media question, murmurs, and it was clear and easy. did not have a lot of pthology slides.

I hope my result will be good!!

Thank you all for the help.
 
Upvote 0 Downvote
Saloommamado said:
I have taken the test on 28th of march. I think I hear on 20th of April.

NBME 18 : 232 (4 weeks)
NBME 17: 243 (10 days)
UWSA1: 259 (3 weeks)
UWSA2: 253 (3 days)

The exam was in no way related to the NBME 18, I don't know but I felt the exam is more like UWSA (clear questions, and most of them with direct answers, did not have a lot of behavioral), but the worst part for me was the pharmacology because I missed 2 opiate withdrawal cases!! 🙁( (in UW the emphases were on the "yawning" and pain presentation, but opiates also cause dilated pupil and diarrhea, I totally forgot that. Other parts was good I think.

There is a new concept "inverse agonist" I think people should know what it is. Me and one of my friends had a question and we both were left with this choice as an answer.

The breaks are more than enough, there were some media question, murmurs, and it was clear and easy. did not have a lot of pthology slides.

I hope my result will be good!!

Thank you all for the help.
Click to expand...

AMG ? or IMG ?

Thanks for the write up and best of luck ! 🙂
 
Upvote 0 Downvote
ct303 said:
After you take the test but before you get your score, are there any changes on your NBME page? Mine doesn't show a score report day or anything
Click to expand...

I believe it's 3 thursdays after you take the test? anyone?
 
Upvote 0 Downvote
Saloommamado said:
I have taken the test on 28th of march. I think I hear on 20th of April.

NBME 18 : 232 (4 weeks)
NBME 17: 243 (10 days)
UWSA1: 259 (3 weeks)
UWSA2: 253 (3 days)

The exam was in no way related to the NBME 18, I don't know but I felt the exam is more like UWSA (clear questions, and most of them with direct answers, did not have a lot of behavioral), but the worst part for me was the pharmacology because I missed 2 opiate withdrawal cases!! 🙁( (in UW the emphases were on the "yawning" and pain presentation, but opiates also cause dilated pupil and diarrhea, I totally forgot that. Other parts was good I think.

There is a new concept "inverse agonist" I think people should know what it is. Me and one of my friends had a question and we both were left with this choice as an answer.

The breaks are more than enough, there were some media question, murmurs, and it was clear and easy. did not have a lot of pthology slides.

I hope my result will be good!!

Thank you all for the help.
Click to expand...

All the best for ur results!:happy:
Did u come across step 2 ck- like questions?
 
Upvote 0 Downvote
TBV said:
I believe it's 3 thursdays after you take the test? anyone?
Click to expand...

This was my experience: took the exam on Thursday, 3/10 and received my score 3 Wednesdays later on 3/30.

I had read online that if you take the exam on Wed, Thurs, or Fri, you'll receive your score 3 Wednesdays later. If you took the exam on a Monday or Tuesday, you'll receive the score 4 Wednesdays later (as the 1st Wed is part of your test week).
 
Upvote 0 Downvote
Saloommamado said:
I have taken the test on 28th of march. I think I hear on 20th of April.

NBME 18 : 232 (4 weeks)
NBME 17: 243 (10 days)
UWSA1: 259 (3 weeks)
UWSA2: 253 (3 days)

The exam was in no way related to the NBME 18, I don't know but I felt the exam is more like UWSA (clear questions, and most of them with direct answers, did not have a lot of behavioral), but the worst part for me was the pharmacology because I missed 2 opiate withdrawal cases!! 🙁( (in UW the emphases were on the "yawning" and pain presentation, but opiates also cause dilated pupil and diarrhea, I totally forgot that. Other parts was good I think.

There is a new concept "inverse agonist" I think people should know what it is. Me and one of my friends had a question and we both were left with this choice as an answer.

The breaks are more than enough, there were some media question, murmurs, and it was clear and easy. did not have a lot of pthology slides.

I hope my result will be good!!

Thank you all for the help.
Click to expand...

It's amazing to me how much it varies. I took it 5 days prior and mine was very similar to NBME 17 and 18. And vague. Not clear whatsoever, haha. Then again it's all very subjective.

I agree with the inverse agonist point. Luckily my pharm professor made a point to stress this concept. Thank goodness.
 
Upvote 0 Downvote
@fri4583

Thank you !

Because I had already done the CK I can clearly say that there is no CK type question. except one question, it was about PCP pneumonia in HIV patient and it asked what is the first step in management! and still I could not answer it confidently, I was between Chest X Ray and broncho alveolar lavage, and I chose the lavage. I don't know if it is right 🙁

@breadlover72

I'm really not comfortable with this variation... but what to do! I hope it'll match the 259 hhhhhhhhh 😀
 
Upvote 0 Downvote
Saloommamado said:
@fri4583

Thank you !

Because I had already done the CK I can clearly say that there is no CK type question. except one question, it was about PCP pneumonia in HIV patient and it asked what is the first step in management! and still I could not answer it confidently, I was between Chest X Ray and broncho alveolar lavage, and I chose the lavage. I don't know if it is right 🙁

@breadlover72

I'm really not comfortable with this variation... but what to do! I hope it'll match the 259 hhhhhhhhh 😀
Click to expand...


According to uptodate, if sputum induction was nondiagnostic (or not an answer choice), then fiberoptic bronchoscopy with BAL is the next recommended step


Sent from my iPhone using SDN mobile app
 
Upvote 0 Downvote
An inverse agonist is an agent that binds to the active site like an agonist but induces the opposite (say decreases activity when an agonist increases activity). This is notably different than an antagonist because it does not merely block the effect of the agonist it actually is inducing an effect that is opposite. As a side note, for an inverse agonist pharmacology to be applicable a receptor must have constitutive activity without an agonist at baseline so that an agonist increases response and an inverse agonist decreases it.

Examples are tricker: naloxone is a partial inverse agonist. Agouti related peptide and agouti signaling peptide are examples of agonist and inverse agonist that binds to melanocortin receptors. GABAa receptors have potential for this as well. Basically there are not a lot of examples that are well known so I suspect they would test us by giving an example of diagram and is saying what it is.


Sent from my iPhone using SDN mobile app
 
Upvote 0 Downvote
400px-Inverse_agonist_3.svg.png

I think this image explains it well. (note that partial agonists work like non-competitive antagonists)
 
Upvote 0 Downvote
Saloommamado said:
........... it was about PCP pneumonia in HIV patient and it asked what is the first step in management! and still I could not answer it confidently, I was between Chest X Ray and broncho alveolar lavage, and I chose the lavage. I don't know if it is right 🙁
Click to expand...

IMHO you would never do a BAL without doing the CxR first since:

1. You always do CxR if you are suspecting pneumonia.
2. You always do a non-invasive test before an invasive test.

So, the order of test would be : CxR > Sputum Induction > BAL

However, if they were asking for a diagnostic test then BAL would be the best answer.
 
Upvote 0 Downvote
Hello i want to start out by giving a brief history about me b4 i go on to the experience of 269.. My name not relevant.. I send my experience to FB experience page via msg as i prefer to stay anonymous. I saw these posts and thought why not help.
My background is imp to know because i took 1.5 yrs to give MLE. It is more than most because of few reasons:
- I was very weak in study in MBBS and my scores always low. I barely pass it many times.
- I had few problem in my famly and my father had business which was in trouble in 2008 recession.. my father then had a heart attack and died in 2010. My famly was in bad positions n i was the eldest so i kinda did job in pharmaceutical store at nite along wit my medical school. Because of this i had limited time and hence i couldnt prepare too well in medical college. I have mom and sister.. and very few money left after dad. Mom was housewife and didnt know any job and we made due with whatever little we had left after his demise
- Fortunately I had done my medical college from a government college in UP (my home state) and it was free. So that was not issue. Always my seniors help me and gave me their books.

I don't want this to be a sob story. I wanna help. The usmle forum has helped me lot and I want to help others. Ppl dont help others just like that.. especially in studies. But in usmle forum i see people do. So i want to give back.

So it all started with graduation. Many may know especially from Lucknow area.. we hav limited seats for PG. Many people take by donation too. It is tough competiton and i didnt have money. I had many apprehensions of USMLE as i didnt have money. Also i have never gone to USA. I dont even hav money 2 go there. I decided i will work very hard give step 1 n 2ck and if both are above 260 then only will go as else it is just money drain and u never get any outcome of residency. 230 i believe should b minimum below that i donk know.. if u have jack (i.e. setting) of ur family then go with low score <230..else not worth. I worked like an animal for 1.5 years.. i did job as MO and studied..to gather some money and also study. I gather good amount. Over a lakh and half (that was amount left after the step 1 exam fee which sucked 100s of $ of mine for 8 hr exam. I sometimes feel i should run prometric center instead of MLE..they must be getting good cut.. i dont think less than 20-30% they pocket out of the fee.. so atleast..like 15-20 K approx..lolz)..

Anyways on to my preps:

By default know that i knew very little of all subjects...mostly i knew less than u..
I will make my experience in a way that is maximum helpful to u.. also btw i thank all torrent n sharing sites.. Piratebay ki zindabad.. Mega.co.nz namah shivay.. Jai shree Mediafire baba...lolz.. grin emoticon
I didnt pay single paisa above the official fee..all link and photocopy/xeroxed tongue emoticon Sorry i m thrifty:

Anatomy: Very important. Do pelvis/Perineum etc well..
I used: BRS Gross Anatomy + Kaplan + Grey's for student
(ofcourse in everything i used FA & below mention Qbanks too.. by default even if i dont write know it) (kaplan is ok here)

Physio: BRS + Costanzo (both same..like big n small robins) + kaplan (kaplan is ok here too) Know it well. and know it with flow charts from all books. do the tables well. up/down arrow question are very common in exam.

Biochem & Molecular Bio: Kaplan is good.. i did HY Molecular too.. Biochem is asked less and pathways r not too helpful and low yield..still dont miss it.. u may miss 3-4 questions of gross biochem (though all exam different so dont go by my words)

Micro: Memorize.. its called being "Rutta-logist" in my med college. Meaning..masters in brute force memory. No logic just mug.. end of story

Pharm: ditto tongue emoticon

Patho: Big daddy of USMLE.. Pathoma u all pray like anything.. but know that it is quite superficial.. good no doubt.. but not remotely enough for 250s and 260s.. i did goljan too..word to word..dot for dot.. i found couple errors too.. very few..but if u read well enough u find errors even in gold standard books. Btw.. later 1 of the 3 errors i found was in errata. i didnt know they had one until later on in preps.. pathoma and goljan images r good too.. understand how dr. sattar teaches the histo and all. i did both. goljan is indepth..many places he goes too far. lot of nonsense also he made me mug up which was never asked.. but u know better over prepared than under.. better to go to a gun fight with missile than to go with knife. U understand right ? in texasthey drae guns in oldern times..like 2 ppl in movies..they do 1 2 3..draw..then one shoots first and other dies. so if u go that place.. what u want in that fight ? knife ? gun ? missile ?
missile > gun > knife;;;; Goljan + Pathoma > Goljan > Pathoma. its my opinion.. u wanna do less.then u do less..upto u..

Behavioural.. i tried..million things.. finally it worked.. i even got star in this in real test..started preps first NBME i was in fail category for this cry emoticon last one 17 i gave.. i was in right side the bar.. wen u give nbme see it.. there are bars kinda thing in online. it help u understand what is important and what is not.
did: brs, hy, kaplan, fischer, hy biostat, uw biostat.. lot of stuff

Qbanks:
UW
KapQbank
Rx

Methodology:

Repeatition is key for all of above
u memorize well...hippocampus work well that way. U read once in 1 month.. or 3 times in 10 days.. out of these 2..second works well.
Dont waste too much time in first read.. go for kill..fast fast.. remember i took 1.5 yrs.. but when u have f*cking nonsense slum dwellers to treat who eat ur brain even in part time job u will go mad.. its exhausting..my 1.5 year is like 7 month without being MO..
Do FA with explanations.. anything and everything u dont know..u find in other books.. in qbanks.. in mbbs books.. online.. wilki.. google.. youtube.. anything.. but understand well...many thing..like Mechanic's hands.. gottron plaque. itz just given like that.. no proper form of understanding.. i found many explanation in other books... online in youtube search 99.9% explanations r easily findable. they explain exact in video why gottron is gottron and how to d/d with other hand stuff..

NBME i did 3 online.. i didnt have more money.. oh yeah.. somewhere above i said only usmle i paid.. i m not gonna edit above..its too long.. i gave to nbme too for 3.. i paid 60$ one..
nbme 12 : 241 (2 months or so ago)
nbme 16 : 260 (2 week/10days ago kinda)
nbme 17 : 266 (4 days before exam)
(i think these were scores.. its been a while.. like 5-6 weeks since exam..so i may have forgotten.. 1-2 marks max variation than above.. i dont remember well..mostly it was this much only)

Mental composure :
Its a mind game.
believe in urself.
believe that system is fair and hard worker will be rewarde.
usa is not land of thugs..they respect hard working honest people
dont be down ever. if lack of motivation go see movie n start again

What i would have done i a different way:

- be faster
- start questions earlier in prep not after first read. its not theory exam. do ques in first read.
- got nbme 12 16 17 directs in exam few 6-7 ques. would do all nbme but finding answers is tough.
- not worry of what ppl say. that affect me lot. the criticism. more below
- think of all question from a clinical/case point of view
- see more pics. exam had like f*cking total 70-80 or more. i thought this is insane. i expected like 20 or so like nbme. real deal has more.

I dont regret anything first of all.. i came from rough times. I dont want ur sympathy..dont write below oh he had such misfortune.. i done want ur pity.. i dont like that.. i m a man..will stand up for myself.. i say all of the above just to inspire u with my life story.. also i ask this page admin to not use my name as i dont want ppl to know..Just think like this.. if u have more than me.. just think.. if this kid with nothing can do it.. why cant i ? if u have proper house..no need to do job..think urself lucky.. coz life is tough for others..and still they make it.. U my friend..if u have better condition. u gotta do more. u gotta break 270 barrier. Believe in urself..

When i gave it my friends laughed.. some nasty people said behind back.. he takes money from others even to buy bus ticket..what he will go to usa ? People ridicule and say.. he took 1 year still havnt given exam.. he was always stupid even in college..just passed.. he will take 10 years still wont get residency.. Let the naysayers say all they want.. let them criticize u.. U can and u will make it.. when ppl criticize.. dont take t heart instead think.. one day..one day..these dinguses will know that u cant speak bad about anyone like that.. u dont kow what other people have to face.. u dont know my hardship. then why make such mean comments ?

If u r at home reading on ur computer and r wondering..dont worry buddy.. USMLE is tough road. If u just started. Wait and see the road ahead. It is brutal out there. U gotta work and do it well. U will be lonely. u may feel down. people will doubt u. ur friends will doubt u. ur family will doubt u. even u urself will doubt u.. but u gotta keep pushing. rocky balboa once said:
"It ain’t about how hard you hit. It’s about how hard you can get hit and keep moving forward; how much you can take and keep moving forward. That's how winning is done !"
All my life i have been hit. its just that... life is tough.. but i m tougher ! smile emoticon

u may forget it all after first read when u come see it again. it happened to me..i went back to first subject after entire first read n it felt like alien language. i didnt remember even 20-25%. it will happen t u too. just keep slogging. eventually it will stick. i did almost 10x passes of materials listed above except qbanks where i did uw 3 times and rest all once.

Paul coehlo (i hope his name i wrote properly) said & i believe that:
"When you want something really bad, all the universe conspires in helping you to achieve it"

I needed this one victory in life.. i needed some new hope.. I needed a good score. Without score there is nothing. Dont be fooled. all US programs good ones know.. that the observorships and all its ok..its good..like adjuvant value..like u have Hyperlipidemia and u do exercise.. sure it helps.. but u cant cure autosomal dominant hyperlipidemia without statins. Score is statins and those elective and observersip is like exercise is adjuvant. This a friend who finish residency and now attending told me.. when ppl come saying they paid xyz thousands for elective and act as if its something big they did.. we as professionals dont saying anything to their face and just say awesome..awesome. but we all know.. what was their achievement in doing that really ? i mean u went to hospital and saw other people.. filled 5 damn forms.. is that really achievement ? did u do something path breaking ? did world change ? does it prove u r better than other candidates coz u had money to throw and did an elective which other couldnt.. i mean really how does it make a doctor better than another by basically doing some small work here and there in some hospital and then getting 220 ? it means nothing.. it means u arent smart and didnt get a score but for some reason were lucky to do an observorship. See match statistics.. USCE is over hyped. Scores are 100x more than observorship. Dont trust me ? go ahead do wat u may.. i m just trying to help.. also i started CK now.. read preface of MTB books my fischer.. whether u like him or not..he is quite truthful and says it bluntly.. he wrote same thing.. IMGs give too much credence to US clincal/research experience.. sure after exam over go get some US Clinical/research experience. but dont think it is alternative to hard work and good scores. Anyways.. wat i mean is work hard harder and hardest.. u can do it.. give this test importance it is not a joke.. its ur life's final and ultimate exam..final chapter..then its all good smile emoticon

Have faith in god.. if u r aeithist..Have faith in yourself.. u will do great.. just work n work n work.. u can and will make it.. coz u know what::
if i can.. then i think anyone can.. Dont be a victim of destiny.. create your own destiny. Hope u get inspired by my story.that is my only purpose.. thats y i have just helped..not even given my name. Not doing for ur praise only for help. just wrote my heart's true feeling. smile emoticon
Do well !
Click to expand...

Saw this on the USLME experiences page. While it's important to take note of his study methods, I think what he had to say about his personal experience, in general, is way more important. I sympathize with these IMGs man.
 
Upvote 0 Downvote
Can anybody tell me if I'm doing the right thing here? I'm starting to feel the heat. I'm planning to finish my first pass of FA and Pathoma by the end of this month, at which I'll be about 5 weeks out. I'm planning to spend 4 weeks doing UW, doing about 100 questions per day with the last week to work out any kinks.

Is 4 weeks enough time to dedicate to UW? My memory is already slipping on earlier sections so I know I'm going to have to go back and get another pass, I don't know if I'll have time during the time I'm going through UW.

Any input? Is this realistic or is it a bad idea?
 
Upvote 0 Downvote
TheShaker said:
Can anybody tell me if I'm doing the right thing here? I'm starting to feel the heat. I'm planning to finish my first pass of FA and Pathoma by the end of this month, at which I'll be about 5 weeks out. I'm planning to spend 4 weeks doing UW, doing about 100 questions per day with the last week to work out any kinks.

Is 4 weeks enough time to dedicate to UW? My memory is already slipping on earlier sections so I know I'm going to have to go back and get another pass, I don't know if I'll have time during the time I'm going through UW.

Any input? Is this realistic or is it a bad idea?
Click to expand...

I think you can do this. I think you'll find you can do FA and uworld on the same day. I plan to do about 100 questions per day and have pharm review and work through first aid
 
Upvote 0 Downvote
TheShaker said:
Can anybody tell me if I'm doing the right thing here? I'm starting to feel the heat. I'm planning to finish my first pass of FA and Pathoma by the end of this month, at which I'll be about 5 weeks out. I'm planning to spend 4 weeks doing UW, doing about 100 questions per day with the last week to work out any kinks.

Is 4 weeks enough time to dedicate to UW? My memory is already slipping on earlier sections so I know I'm going to have to go back and get another pass, I don't know if I'll have time during the time I'm going through UW.

Any input? Is this realistic or is it a bad idea?
Click to expand...
I will suggest you start uworld earlier, i mean while youre studying pathoma and first aid, you can do atleast 5-15 question each morning before you start your daily studying, most people i spoke to that have taking the step 1 exam always regret not starting qbanks earlier. Goodluck with your preparation and i hope you ace the boards
 
Upvote 0 Downvote
Saloommamado said:
@fri4583

Thank you !

Because I had already done the CK I can clearly say that there is no CK type question. except one question, it was about PCP pneumonia in HIV patient and it asked what is the first step in management! and still I could not answer it confidently, I was between Chest X Ray and broncho alveolar lavage, and I chose the lavage. I don't know if it is right 🙁

@breadlover72

I'm really not comfortable with this variation... but what to do! I hope it'll match the 259 hhhhhhhhh 😀
Click to expand...

Transposony said:
IMHO you would never do a BAL without doing the CxR first since:

1. You always do CxR if you are suspecting pneumonia.
2. You always do a non-invasive test before an invasive test.

So, the order of test would be : CxR > Sputum Induction > BAL

However, if they were asking for a diagnostic test then BAL would be the best answer.
Click to expand...

Saloommamado said:
@Transposony

The question exactly said: what is the first step in "diagnosis"? That's why I chose BAL. Your reasoning is definitely right.
Click to expand...


While the question style is definitely intimidating and CK-type, I believe it can still be answered using step 1 knowledge/resources only.
Just opened my FA15 page 148, where it clearly reads "Diagnosed by lung biopsy or lavage." So BAL has to be the answer.
Now this makes me realize the importance of understanding in depth each and every word mentioned in FA!!

Good that you got the answer right. Maybe FA's lines were hidden somewhere at the back of your mind!!
 
Upvote 0 Downvote
I remember having a question on ethylene glycol poisoning. The patient was found after quite a long time, and his investigation showed acidosis and renal failure. The question was what will you do after giving activated charcoal?

I answer renal dialysis. there was "fomepizole" as another option.

Here is the American Academy of clinical toxicology guidelines:

[Traditional treatment of ethylene glycol poisoning consists of sodium bicarbonate, ethanol, and hemodialysis. Fomepizole is a new agent with a specific indication by the U.S. Food and Drug Administration for the treatment of ethylene glycol poisoning.4,6,7,13,14 Ethanol and fomepizole are thought to act as inhibitors of alcohol dehydrogenase and therefore prevent the formation of acidic ethylene glycol metabolites,4,6,7,13 but only fomepizole has demonstrated this ability.7 If patients are diagnosed and treated with these products early in the course of poisoning, hemodialysis may be avoided. Once severe acidosis and renal failure have occurred, however, hemodialysis is necessary.]

But I'm still confused. 😀

P.S: I don't want to make people worry about the exam, me myself I did not like when people talk about the test like it's from other planet hhhhhhh, this questions I'm mentioning were very few and I'm just curious about their answers. 90% of the questions were clear and direct. And from Uworld of course.
 
Upvote 0 Downvote
Saloommamado said:
I remember having a question on ethylene glycol poisoning. The patient was found after quite a long time, and his investigation showed acidosis and renal failure. The question was what will you do after giving activated charcoal?

I answer renal dialysis. there was "fomepizole" as another option.

Here is the American Academy of clinical toxicology guidelines:

[Traditional treatment of ethylene glycol poisoning consists of sodium bicarbonate, ethanol, and hemodialysis. Fomepizole is a new agent with a specific indication by the U.S. Food and Drug Administration for the treatment of ethylene glycol poisoning.4,6,7,13,14 Ethanol and fomepizole are thought to act as inhibitors of alcohol dehydrogenase and therefore prevent the formation of acidic ethylene glycol metabolites,4,6,7,13 but only fomepizole has demonstrated this ability.7 If patients are diagnosed and treated with these products early in the course of poisoning, hemodialysis may be avoided. Once severe acidosis and renal failure have occurred, however, hemodialysis is necessary.]

But I'm still confused. 😀

P.S: I don't want to make people worry about the exam, me myself I did not like when people talk about the test like it's from other planet hhhhhhh, this questions I'm mentioning were very few and I'm just curious about their answers. 90% of the questions were clear and direct. And from Uworld of course.
Click to expand...

Thanks for the feedback dude! But I think we learned that you wanna give fomepizol


Sent from my iPhone using SDN mobile app
 
Upvote 0 Downvote
Saloommamado said:
I remember having a question on ethylene glycol poisoning. The patient was found after quite a long time, and his investigation showed acidosis and renal failure. The question was what will you do after giving activated charcoal?

I answer renal dialysis. there was "fomepizole" as another option.

Here is the American Academy of clinical toxicology guidelines:

[Traditional treatment of ethylene glycol poisoning consists of sodium bicarbonate, ethanol, and hemodialysis. Fomepizole is a new agent with a specific indication by the U.S. Food and Drug Administration for the treatment of ethylene glycol poisoning.4,6,7,13,14 Ethanol and fomepizole are thought to act as inhibitors of alcohol dehydrogenase and therefore prevent the formation of acidic ethylene glycol metabolites,4,6,7,13 but only fomepizole has demonstrated this ability.7 If patients are diagnosed and treated with these products early in the course of poisoning, hemodialysis may be avoided. Once severe acidosis and renal failure have occurred, however, hemodialysis is necessary.]

But I'm still confused. 😀

P.S: I don't want to make people worry about the exam, me myself I did not like when people talk about the test like it's from other planet hhhhhhh, this questions I'm mentioning were very few and I'm just curious about their answers. 90% of the questions were clear and direct. And from Uworld of course.
Click to expand...

Possibly an experimental to also judge what people thought and where/when they'll use it. It seems like renal dialysis had to be the right answer given the renal failure and length of time. Had he just been unconscious with acidosis bicarb/fomep might have been right, they probably would have emphasized the acuity.


Also for those of you recent test takers, do you think it's worth going through NBME 12+13 just to see those questions, or better to pound out UW incorrects/Rx questions?





Edit: http://www.aafp.org/afp/2002/0901/p807.html and
http://www.hindawi.com/journals/emi/2013/638057/

Basically if they are not in renal failure, give fomepizole and it should be enough. If they are, probably still give but also dialyze.
 
Last edited:
Upvote 0 Downvote
LostinLift said:
Possibly an experimental to also judge what people thought and where/when they'll use it. It seems like renal dialysis had to be the right answer given the renal failure and length of time. Had he just been unconscious with acidosis bicarb/fomep might have been right, they probably would have emphasized the acuity.


Also for those of you recent test takers, do you think it's worth going through NBME 12+13 just to see those questions, or better to pound out UW incorrects/Rx questions?





Edit: http://www.aafp.org/afp/2002/0901/p807.html and
http://www.hindawi.com/journals/emi/2013/638057/

Basically if they are not in renal failure, give fomepizole and it should be enough. If they are, probably still give but also dialyze.
Click to expand...
But which one first? lol
 
Upvote 0 Downvote
yeah i think you would want to stabilize the patient first...which you did by giving charcoal and next step would be managing his renal status and acidosis. after that would be fomepizole?
 
Upvote 0 Downvote
LostinLift said:
Also for those of you recent test takers, do you think it's worth going through NBME 12+13 just to see those questions, or better to pound out UW incorrects/Rx questions?
Click to expand...

I had to take NBME 12 as a diagnostic during my last semester of basic sciences. I got a 217 on it without even looking at anything at that point. I dunno about 13 but 12 seemed wayyyyy too simple compared to the real thing.
 
Upvote 0 Downvote
One of the trends I've seen with step 1 questions nowadays is that they give us a long, extremely clinical oriented stem, intimidating lab values and findings, only to ask a very simple question of basic science at the end.
In my opinion, what they were basically trying to test in this question is whether we know the antidote to ethylene glycol or not. As a general rule, whenever there's intoxication of something, you give the antidote (if there's a specific antidote for that particular poison). We all know that the established antidote for ethylene glycol is fomepizole. So give it.
I am only expressing my idea so please don't blame me if I'm proven wrong. Lol
 
Upvote 0 Downvote
Honestly, I would go with fomepizole as well for the initial treatment and dialysis afterwards. FA lists both as treatments for ethylene glycol poisoning so it could go either way, but I just don't see the point of waiting to administer an antidote to this patient's toxicity until after he undergoes dialysis.
 
Upvote 0 Downvote
If found relatively quickly then fomepizole but remember one of the major indications for hemodialysis is acidosis. So if acidosis and renal failure already set in then I think the correct answer would be hemodialysis. In the real world if acidosis and renal failure they would give fomepizole while doing dialysis.
 
Upvote 0 Downvote
Just wanted to share my experience.

IMG from Mexico
Did Step 2 first, 252.

For Step 1, I prepared for 6 months, studying around 3 hours daily, Mon thru Fri. I started with Kaplan Lecture Notes for Anatomy, Pharm, Behavioral, Immuno and Micro, then BRS for Physiology, Goljan for Path. After those books, I reviewed everything with FA. Then, 2 months of UWorld, finished with around 72%. No NBMEs or UWSA because I had no more ca$h after UWorld. My experience on exam day was really good, considered S1 far easier than S2 (but it might be because of my inclination towards pathology), even managed to finish early.

Waited 4 weeks for the results, got 255. I really thank the many people who share experiences here because it helped me shape my study schedule, polish some details and learn a lot of obscure facts that no book has and that the exam tends to ask. Good luck to everybody else and please feel free to ask anything else 😀
 
Upvote 0 Downvote
Can anyone confirm the re-scaling of the UWSA's? I just took UWSA 1 and got 232 pre-dedicated and I'm hoping it's more accurate than a 10-20 point overestimation, It just seems weird because I've seen people taking NBMEs and getting 86% correct for a 239 and the curve for UWSA is less harsh. Maybe it's because UWorld is more difficult than NBME?
 
Upvote 0 Downvote
plasmodium said:
Faced the beast. Def made some dumb mistakes, but I think this is inevitable. Doubt I reached my goal, but it's truly impossible to speculate. Glad it's over, and I will elaborate once I receive the truth. For those wondering, my exam was a mix of every type of question, of all levels of difficulty ranging from the relative simplicity of NBME 11 to the complexity of NBME 18, along with plenty of UWorld/UWSA-esque questions peppered throughout. Hands down the hardest test I've ever taken, but also the most interesting challenge of all the tests I've taken. It was fair, but incredibly ambiguous. I had no problems with timing personally; the blocks felt like 7 incredibly difficult UWorld-NBME blended type blocks, and I treated them as such.

Can someone clarify the source that states there are experimental questions on the exam? I'm starting to believe the whole idea is just a product of hive-mind word-of-mouth and that they don't exist. Can't find discussion about them anywhere on the NBME website.

Shout out to the crew for the support all the way through. @tasar1898 @walakin25 @Transposony @Tri723 @masaraksh @drimo786

More shoutouts to come once I get my score. Received a lot of help on this board and I appreciate everyone's willingness to share their knowledge. 🙂
Click to expand...
Real deal: 260+

Feels incredible. I'm now officially open for questions, AMA! I will be posting a writeup soon. Congratulations to everyone receiving their scores!

Thanks again @tasar1898, @walakin25, @Transposony, @Tri723, @masaraksh, @drimo786, and also @ATypicalLymphocyte, @HereWeGo21, @cabergoline2, @cs24, @Xurros, @danube123 for enduring my countless questions and for offering superb advice!
 
Last edited:
Upvote 0 Downvote
plasmodium said:
Real deal: 260+

Feels incredible. I'm now officially open for questions, AMA! I will be posting a writeup soon. Congratulations to everyone receiving their scores!

Thanks again @tasar1898, @walakin25, @Transposony, @Tri723, @masaraksh, @drimo786, and also @ATypicalLymphocyte, @HereWeGo21, @cabergoline2, @cs24, @Xurros, @danube123 for enduring my countless questions and for offering superb advice!
Click to expand...

Treasure that feeling 🙂 Awesome to hear hard work paying off! Any recommendations for us in the last 2 weeks of our prep? I'm planning on finishing UW, taking nbme 18, UWSA1/2, and the practice test at prometric in addition to another FA run, finishing pathoma/notecards, and sketchy pass.
 
Upvote 0 Downvote
LostinLift said:
Treasure that feeling 🙂 Awesome to hear hard work paying off! Any recommendations for us in the last 2 weeks of our prep? I'm planning on finishing UW, taking nbme 18, UWSA1/2, and the practice test at prometric in addition to another FA run, finishing pathoma/notecards, and sketchy pass.
Click to expand...
Thanks 🙂 Don't make any changes in your approach in the few weeks/days leading up to your test. Trust your preparation and have faith in your NBME scores. Stick to familiar resources and focus on healthy mental practices (e.g. going outside every now and then, taking breaks, getting adequate sleep) to stay motivated and focused. NBME scores should tell you the general range within which you are capable of scoring, but test day performance will determine exactly where within that range you are capable of scoring on that given day. Therefore, state of mind and confidence are very important for this exam.
 
Upvote 0 Downvote
Ophthoseidon said:
Can anyone confirm the re-scaling of the UWSA's? I just took UWSA 1 and got 232 pre-dedicated and I'm hoping it's more accurate than a 10-20 point overestimation, It just seems weird because I've seen people taking NBMEs and getting 86% correct for a 239 and the curve for UWSA is less harsh. Maybe it's because UWorld is more difficult than NBME?
Click to expand...

I can't confirm directly (because I took the damn thing two years ago), but word from the current MS2s here is that UWSA scaling seems to be a bit a less generous than in the past. I don't know how accurate it is, though. The other thing I've heard is that the NBME scaling seems harsh, but I always figured it was because they were easier than the real thing and that they took that into account in creating the scale.
 
Upvote 0 Downvote
This is a nice experience by an IMG.. worth reading for sure..


I hope its ok to share this.. I am active on the FB groups of USMLE and I saw this page there which was sharing recent experiences of high scorers.. i really liked it as I am using a similar method of studying and hoping for a 260+.. at least a 250+ for sure.. 🙂
 
Upvote 0 Downvote
You must log in or register to reply here.

Similar threads

Transposony
Official 2024 Step 1 Experiences and Scores Thread
Replies
0
Views
2K
Transposony
Transposony
D
Step 1 and Level 1
Replies
1
Views
3K
DOcSto
D
C
Step 1 tutor available!
Replies
0
Views
2K
chauhanjugalkishor
C
A
USMLE Step 1 resources for sale
Replies
0
Views
3K
accurate_branch20
A
G
  • Question Question
USMLE Out of time and not ready for Step 1. Have I screwed up?
Replies
0
Views
2K
genteel-mug-sting
G
Top