Official Pediatrics Shelf Exam Thread

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I used this new book called "Shelf Life Pediatrics". That's all I used. I was confident going in, but thought the shelf was much harder. In retrospect, the questions in this book were too easy. I should have used Uworld for questions and read either CaseFiles or Blueprints like most of my classmates did. Ended up with a 65; not too mad about it since my school only requires a 58 to pass. I'm sticking with Uworld only for questions in the future. Here are the flashcards I made for the shelf that I put on Cerego: https://cerego.com/sets/737363/learn
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Had this exam on Friday, got score back today: 89
Used BRS [MONEY!!!], pretest and uworld
Majority [75-80%] of questions came right from these sources. The other 20% were pure wtf/ best guess. No milestones or immunizations asked on mine which was really weird!
Overall, not as bad as the others.
 
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Read as much of this thread, would love some opinions on a few questions.

1) For people who have read both Case files and BRS. Is BRS really worth that much extra time over case files? In other words, do you think you'd be better off reading case files x2 vs BRS x 1.

2) Seeking any opinions on Shelf life pediatrics.

3) How can we get these kaplan lectures for peds that people are talking about? Do I have to buy that ridiculously expensive kaplan course -_- ?
 
Currently deciding between the following combos:

Option 1: BRS + Pretest + uworld

Option 2: Case files + pretest + uworld + shelf life
 
Delacroix22 said:
14 yo girl comes to ED 4 hours after 3 minute generalized tonic clonic seizure that occurred at a party. Sx began with bizarre behavior. Has low grade fever and cough for 3 days. On arrival she is arousable but confused, she does not answer questions appropriately and can’t follow commands. Temp 102. Exam shows mild resistance to neck flexion. DTR are brisk in all extremities. Babinski present bilaterally. CT of head without contrast shows mixed areas of hyperdensity and hypodensity in right temporal lobe. CSF shows:
Glucose 60mg/dL
Protein 45 mg/dL
Leukocyte 35/mm^3 (20% neutro, 80% lympho)
Erythro count 1250
What is the organism?

A) Arbovirus
B) B. burgdorfrei
C) CMV
D) Enterovirus (WRONG)
E) HSV
F) HIV
G) Listeria
H) R. ricketsii
I) T. gondi
J) VZV
Click to expand...

Herpes (E)ncephalitis
 
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Have my peds shelf in a little more than a month and just starting to study with UWorld and BRS. God damn the UWorld questions are difficult, yeah?
 
How does pretest compare to the shelf? I've probably got a little under 70% of the questions right on pretest but would like to score 80+ on the shelf.
 
Are there any other good pediatrics practice questions worth doing besides pretest & uw? How are the BRS Peds questions?
 
What's the highest grade possible on these? Is it out of a 100?
 
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Wanted to add another data point since there hasn't been a ton of new posts. Took the shelf a couple of weeks ago...

1. UWorld- By far the best resource. Had several shelf questions almost verbatim from it. Really is excellent for this rotation.
2. BRS- Incredible. Thanks @J DUB for the rec. Comprehensive and I could tolerate it a lot more than trying to sift through Blueprints.
3. Pretest- Also good. Didn't quite finish this, but thought its level of difficulty is good practice for the shelf.
NBME 1: 82
NBME 2: 90

Shelf: 99

Was worried after the NBMEs since I usually do well on those, but if you stick to the resources listed above, you will be in a great spot for the shelf. Also, there was a handful of questions from the NBMEs that popped up on the shelf with a couple of tweaks to try and throw you off. If you're limited on time, obviously go with the first two. Don't recommend Case Files for this one, and it hurts me to say that as I've been a staunch believer in the series. Like any shelf, there was some surgery questions that were softballs, medicine, and ob mixed in. Only 1-3 developmental, no vaccines.
 
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So almost all of my M4 friends at my school are telling me that case files + UW is enough for this shelf, but there is so little in case files I just do not see how that's possible.. Does anybody have any thoughts on case files? I feel like I do not have enough time to try to fit in BRS and struggle with the bullet point style... This is also my first rotation so I'm trying to figure everything else out along with how in the world to freaking study!
 
As above, UWorld is great for this shelf. You could probably get by with just that + pretest +any teaching + wards experiences and do fine. Even then it's arguable that you even need Pretest, it just helps add some of the random that you will likely encounter on the shelf. BRS just seems to be comprehensive enough to cover most of what you come across on the shelf. It actually is pretty similar to World in some of the content. Wouldn't waste your time with Case Files as it is pretty bland and doesn't really add anything not found in world.

Honestly, being your first shelf, it will be tough because you haven't had some of the other clerkships that you will see pop up on the shelf that you can't really prepare for outside of already having studied it before. Just how it goes, and try and improve as you gain more experience.
 
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Can anybody out there comment on the comparison in question difficulty between UW and the shelf? I've been doing pretty well on UW, but I'm having a really hard time reading through BRS (still have read a lot of the chapters).... I've also done some pre-test, but I cannot stand some of those questions.

If you're doing well on UW would it be fair to assume that you would do okay on the shelf? Also are these really scaled to a mean of 70? At my school you get an automatic marginal if you score <64 meaning over 16% would automatically marginalize.. Seems like BS. Took an NBME about a few days ago and got a 78 (I think), would like to do a little better and it seems like most people say the real thing is harder. I definitely made three stupid mistakes in it (read the question too fast), so I'm not sure how much that would have bumped my score.
 
Kapooya said:
Can anybody out there comment on the comparison in question difficulty between UW and the shelf? I've been doing pretty well on UW, but I'm having a really hard time reading through BRS (still have read a lot of the chapters).... I've also done some pre-test, but I cannot stand some of those questions.

If you're doing well on UW would it be fair to assume that you would do okay on the shelf? Also are these really scaled to a mean of 70? At my school you get an automatic marginal if you score <64 meaning over 16% would automatically marginalize.. Seems like BS. Took an NBME about a few days ago and got a 78 (I think), would like to do a little better and it seems like most people say the real thing is harder. I definitely made three stupid mistakes in it (read the question too fast), so I'm not sure how much that would have bumped my score.
Click to expand...
I found UWorld to be similar to the shelf in terms of difficulty. Didn't use other resources so can't comment on those personally, but had a lot of friends use BRS with good results as well. Pretest seems like overkill from what I've heard.

The mean of 70 is from several years ago and no longer applies. Current means range between 74-78 depending on if your school uses the national average or internal averages for their own students. Standard deviations vary depending on what sample you're using, but a score <64 is essentially 1-2 SDs below the mean. Also, the NBME recently changed the way they report shelf exams so that your new score is the equated % correct. Check out the PDF attached to this post. Hopefully this will standardize some of the random numbers that got thrown around when talking about shelf scores previously (ex. raw score, % correct, scaled score etc).
 

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  • NBME Clinical Science Score Scale Change.pdf
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Blueprints + Pretest + Uworld?
what about toronto notes, casefiles.
 
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Took it a few days ago -- for the most part it was fair; however, there were a few questions (4-6 or so) that I didn't see in the resources that I used:

- BRS Pediatrics (1x)
- UW Peds (1x through, 90% correct)
- About 1/2 of Pediatrics Case Files (I only read the cases that I felt I needed more reinforcement in)
- About 1/4 of PreTest before I nearly threw the book away because there were so many errors/typos
- NBME Peds Self Assessments #1 (score=82; 4 wks out) and #2 (score=98; 2 days out)

This was my first rotation and it was 8 weeks long. I read BRS cover to cover 1x throughout the rotation and felt that it was a must have (can't comment on Blueprints since I've never looked at it). UW was a good reinforcement of many of the topics in BRS, but I also felt that UW had too many questions on the same topic, but I could just be imagining things. PreTest was a waste of time in retrospect and the explanations were garbage, but YMMV.

Overall I felt like the shelf was relatively difficult in the sense that many times I felt like I didn't have a solid basis for why I chose an answer choice. I guess I'll see when the results come back (in a few days); will update my post when I get my score. Good luck!

Update (9/19), received score: 99%-tile (not sure what raw score was, we weren't given those)
 
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Asked a lot of people for help during this... so figured I'd post my experience. I used BRS mainly, didn't know all of it obviously, but decently well enough.. did UW, I hated case files, did some pretest too, but not sure how much I retained. Got an 86 on the shelf which was 91% percentile according to my school. Good enough for honors!!! GL! Let me know if you have any questions.

Thought the shelf itself was pretty tough, I didn't think I did that well.
 
Is pretest worth doing for extra questions?
 
I read the organ system chapters of NMS pediatrics and did pretest once - scored 99
I agree with others who said pretest is kind of a waste of time. I would stick to qbank if you want to do questions and the NMS book comes loaded with questions as well
 
BRS Peds is from 2004 .. so is this still a good choice? I don't see any newer edition on amazon.
 
anyman said:
BRS Peds is from 2004 .. so is this still a good choice? I don't see any newer edition on amazon.
Click to expand...

Yes, for the millionth time.


I thought the test was a bit tough. Ended up with a raw of 84 (=85th%ile) not terrible, considering the life stuff that was going on haha.

Very little development (1 question), immunizations (1?). There was a lot of knowing how to distinguish between two similar conditions, like different heart defects and how they present. I didn't have any exact questions from the NBME practice tests, but most of the themes on the practice test were represented on the actual test. That applies for uworld questions as well. Good luck all!
 
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I have the peds shelf exam coming up in a few days and have some questions from NBME form 2 I hope you guys can help me with

1. 11-year old girl brought in for well-child. Mom worried about daughter's early puberty. Says daughter began breast development at 9, and first pubic hair at 9.5 years, and menarche 2 days ago. She is Tanner stage 4. Exam shows no abnormalities. Most likely diagnosis?
a) Adrenocortical tumor
b) Idiopathic precocious puberty (chose this, was wrong)
c) Pituitary tumor
d) True precocious puberty
e) Normal development.

I think it's E but I'm not sure. Can someone explain this one to me?


2. 3 yo boy brought to ED b/c of 4-days of lethargy, severe vomiting, diarrhea. Unable to keep fluids down, no urine for past day. Has lost 2 lbs in 2 weeks. Temp is 101.8, pulse 135, RR 30, BP 85/60. Exam shows sunken eyes, tacky oral mucosa, dry lips. No rash. Lungs clear. 1/6 midsystolic ejection murmur is heard. Abdominal exam normal except for hyperactive bowel sounds. Labs show Na+ (145), Cl- (105), K+ (4.5), HCO3- (12), urea nitrogen (40), creatinine (1.3). Urine specific gravity (1.035), glucose negative, protein 1+, bacteria negative. What is the most likely cause of patient's renal failure?
a) bacterial toxin (chose this, was wrong)
b) immune complex nephropathy
c) impaired renal perfusion
d) obstructive uropathy
e) renal vein thrombosis

I think this is hemolytic-uremic syndrome but I'm not sure. That's why I chose A. Is the answer impaired renal function? Please explain this to me!

Thanks
 
purpledragon1 said:
I have the peds shelf exam coming up in a few days and have some questions from NBME form 2 I hope you guys can help me with

1. 11-year old girl brought in for well-child. Mom worried about daughter's early puberty. Says daughter began breast development at 9, and first pubic hair at 9.5 years, and menarche 2 days ago. She is Tanner stage 4. Exam shows no abnormalities. Most likely diagnosis?
a) Adrenocortical tumor
b) Idiopathic precocious puberty (chose this, was wrong)
c) Pituitary tumor
d) True precocious puberty
e) Normal development.

I think it's E but I'm not sure. Can someone explain this one to me?

yup, normal development. Puberty onset <8 in girls is abnormal. Started with thelarche --> adrenarche--> menarche is normal too.

2. 3 yo boy brought to ED b/c of 4-days of lethargy, severe vomiting, diarrhea. Unable to keep fluids down, no urine for past day. Has lost 2 lbs in 2 weeks. Temp is 101.8, pulse 135, RR 30, BP 85/60. Exam shows sunken eyes, tacky oral mucosa, dry lips. No rash. Lungs clear. 1/6 midsystolic ejection murmur is heard. Abdominal exam normal except for hyperactive bowel sounds. Labs show Na+ (145), Cl- (105), K+ (4.5), HCO3- (12), urea nitrogen (40), creatinine (1.3). Urine specific gravity (1.035), glucose negative, protein 1+, bacteria negative. What is the most likely cause of patient's renal failure?
a) bacterial toxin (chose this, was wrong)
b) immune complex nephropathy
c) impaired renal perfusion
d) obstructive uropathy
e) renal vein thrombosis

I think this is hemolytic-uremic syndrome but I'm not sure. That's why I chose A. Is the answer impaired renal function? Please explain this to me!

Impaired renal perfusion-- this pt is super dehydrated (clinical s/sx: sunken eyes, tacky mucosa, dry lips) due to vomitng + diarrhea. Spec grav confirms it (at my hospital we consider >1.025 dehydrated, not sure of actual cut offs).

Thanks
Click to expand...

answers in quote
 
Just finished my pediatrics clerkship and received the results of the shelf exam. As I had gotten a great bit of guidance from this (and other) threads, I thought I'd post my experience.

I used BRS pediatrics as my comprehensive source (there were many questions on my shelf that came directly from this book) and completed both the UWorld and Pretest questions. I kept with my strategy of getting through these sources as fast as possible to highlight knowledge gaps and re-reviewing my knowledge gaps regularly. I was able to get through multiple passes of all of these sources using my strategy.

I thought the shelf exam had questions ranging from almost all the topics in the BRS book. Compared to the other shelf exams (medicine, surgery, OB), I thought there were more questions to which the answer choice was a diagnosis rather than picking the "next most appropriate" test/workup. With that being said, I'd estimate at least 20% of the questions wanted the next step in the diagnostic algorithm (all the ones in UWorld are great!). However, this may have just been an anomaly of this particular shelf exam. There were very few questions on which I could not narrow the answer down to two choices. I also thought this exam would have been harder had I not had medicine prior to the pediatrics clerkship.

My score: > 99th percentile (100th percentile) - raw 93

Good luck to everyone taking this shelf!

TtheB
 
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Would really appreciate some advice on how to use BRS. Peds is my first rotation as a third year and I started reading BRS. I find myself doing mostly passive reading and not really taking any notes. Don't really know if that's the right way to go about it....any input would be greatly appreciated!
 
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premed2000 said:
Would really appreciate some advice on how to use BRS. Peds is my first rotation as a third year and I started reading BRS. I find myself doing mostly passive reading and not really taking any notes. Don't really know if that's the right way to go about it....any input would be greatly appreciated!
Click to expand...

It's tough to read that book, especially if it is your first block (everything in the book might seem important...). My advice, read it fast the first time just so that you've seen everything at least once. After your first quick read, start doing UWorld (or Pre-test if you must...). This should suggest to you important themes and topics, and now you can go through BRS a second time in a more thorough fashion.

Good luck!
 
premed2000 said:
Would really appreciate some advice on how to use BRS. Peds is my first rotation as a third year and I started reading BRS. I find myself doing mostly passive reading and not really taking any notes. Don't really know if that's the right way to go about it....any input would be greatly appreciated!
Click to expand...

The bolded stuff in brs is extremely high yield. Uworld and pretest are good too. The practice NBME exams predicted my final shelf score pretty well, too.
 
Took this a week ago. Got a 90 on it, whatever that equates to...probably >96 percentile. Studied for about 3 weeks by doing all of UW and reviewing. BRS was actually a good text but only got through half. Nevertheless still probably the best text for a shelf exam I've encountered. If you have enough time it wouldn't hurt to read the whole thing. Also did the 4 NBMEs which I highly recommend. The shelf was very similar to the NBME and lots of it was pretty much internal medicine. Not much to say, was moderate difficulty.

Sent from my Nexus 6P using SDN mobile
 
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had 92 raw on this shelf
materials used
BRS x1
MTB3 x1
Casefiles x1
pretest x1
kaplan Qbank x1
Uworld x2

BRS, Uworld and the practice NBMEs were of highest yield IMO
 
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Please help with NBME question.

NBME 4 question:

essentially a kid comes in with anaphylactic shock after being stung by a bee. Vitals 97.7, HR 130, RR 28, BP 65/60. Wheezing, stridor, full body rash. Epinephrine + methylprenisolone are given. What is the next step?

a) cromolyn sodium
b) dopamine
c) fluids
d) lidocaine
e) norepinephrine
 
fulminantgangrene said:
Please help with NBME question.

NBME 4 question:

essentially a kid comes in with anaphylactic shock after being stung by a bee. Vitals 97.7, HR 130, RR 28, BP 65/60. Wheezing, stridor, full body rash. Epinephrine + methylprenisolone are given. What is the next step?

a) cromolyn sodium
b) dopamine
c) fluids
d) lidocaine
e) norepinephrine
Click to expand...
C looks pretty good
 
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Just got my score back, thought I'd share my honest experience.

I took ~3 weeks to study:
1) BRS Pediatrics: I got through about 1/2 of this beast. I read the main chapters that aren't covered as well by Step 1 material that I had a vague memory of already, so I focused on Emergency Care, Derm, Adolescent, Preventative, etc.
2) Firecracker: I did about 50 peds questions almost daily.
3) UWorld: I did all 380 Peds questions 1x on timed/non-tutor, and went back through all the incorrects 1x.
4) NBME/CSMSs: I took form #2 about a week out (scored 77), and then form #3 maybe 3 days out (scored 83). There are 4 forms available. Definitely recommend- I saw a couple repeats (not verbatim, but same random concept) on the real thing.

Scored 92 raw/>99th %ile

Good luck!
 
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Is it possible to get above 5th percentile on peds shelf if I ran out of time and left 15 questions blank out of 110?
 
aldol said:
Is it possible to get above 5th percentile on peds shelf if I ran out of time and left 15 questions blank out of 110?
Click to expand...

It is possible but not realistic, especially if you did not even have a chance to bubble the same letter for those 15 questions (like "C" for all 15).

If any of you find yourself in this situation with 1 minute left and 15 questions to go, at least bubble a letter in for all questions with the minute left - odds are you will get more points that way than focusing on any single question.
 
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so i have heard that there are some adult medicine quesitons on peds shelf. is it worth doing some internal questions for peds shelf?
 
I just did a practice NBME (Form #1) and I scored an 18, which approximates to a score of 68.

Does anyone know if this score at the mid-point of 3rd year (i.e., now) is likely to be above the 5th percentile?

Genuinely wondering if I am on track to pass this shelf or not.

Happy Thanksgiving everyone :)
 
ButteredLobster said:
I just did a practice NBME (Form #1) and I scored an 18, which approximates to a score of 68.

Does anyone know if this score at the mid-point of 3rd year (i.e., now) is likely to be above the 5th percentile?

Genuinely wondering if I am on track to pass this shelf or not.

Happy Thanksgiving everyone :)
Click to expand...
It's quarter 2 and a 68 is listed as 23rd %ile
 
ButteredLobster said:
The numbers change depending on when the rotation is done / shelf administered.

Appreciate the help though!
Click to expand...
Yeah, the report has a chart that shows the percentiles for every score for each quarter. We get our score to plot on the chart. There are 4 quarters and we are in quarter 2 right now, which is what I gave you. I took it in quarter 1, where a 68 would have been ~27th percentile, when it is 23rd for the 2nd quarter.
 
Ophthoseidon said:
Yeah, the report has a chart that shows the percentiles for every score for each quarter. We get our score to plot on the chart. There are 4 quarters and we are in quarter 2 right now, which is what I gave you. I took it in quarter 1, where a 68 would have been ~27th percentile, when it is 23rd for the 2nd quarter.
Click to expand...

Ahh, gotcha. Thanks!
 
How are Case Files 4th edition and Pretest 13th edition compared to the newest versions?
 
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