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1. A
2. C
3. idk I also missed this one; not D though
4. I
If you're not sure why these are the correct answers let me know and I can post a brief explanation
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I'm starting Surgery tomorrow and I'm really confused. I have the Kaplan Surgery Lectures and the Kaplan Surgery Notes that go accordingly. What is the difference between these and the Pestana Audio and Lecture notes????? I know Pestana does the Kaplan lectures so I'm totally lost.
I'm hoping they are the same so I don't have to go try to track down the Pestana stuff. I've been searching online for like an hour and can't find anything.
Can someone maybe send me the Pestana audio and notes? That would be really awesome
There's a lot of buzz about Medicine being heavy on the shelf. Is simply UWORLD enough to cover those bases? and if so which questions are worth reviewing?
Pain in right hip and flank following MVC. Abrasions, echymoses over right flank Urinalysis shows gross blood. What do you do?
CT abdomen w/ contrast, renal angio, or cystoscopy?
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Recurrent vomiting bright red blood and near syncope for 3 hours. Low BP, high pulse. Epigastric tenderness. What do you do?
Rapid infusion of normal saline or endoscopy?
I thought it would be endoscopy because you're pretty certain of the source of the bleed (pestana), but I guess the answer would be resus first?
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Dyspnea, myalgia, flank pain during transfusion. Urine is dark, blood in the surgical drain. Which test would you do to diagnose this? ABG, blood culture, measure Hb concentration, repeat type and cross, screen for DIC?
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LLQ pain, fever, tender w/ rebound, leukocytosis, fever. Xray w/ nonspecific gas pattern. Sounds like diverticulitis. I thought with the peritoneal signs you would do an ex lap. But that was wrong. The question asks for next step in diagnosis. So would you just do a CT anyway?
Recurrent vomiting bright red blood and near syncope for 3 hours. Low BP, high pulse. Epigastric tenderness. What do you do?
Rapid infusion of normal saline.
Always follow your ABCs. Stabilization always takes place before definitive management.
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Dyspnea, myalgia, flank pain during transfusion. Urine is dark, blood in the surgical drain. Which test would you do to diagnose this? ABG, blood culture, measure Hb concentration, repeat type and cross, screen for DIC?
This is an acute hemolytic transfusion reaction. Usually due to ABO mismatch. Repeat type and cross will confirm (probably a clerical error). Checking for DIC is also something you would do as it effects management, but the presence of DIC doesn't confirm the diagnosis.
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LLQ pain, fever, tender w/ rebound, leukocytosis, fever. Xray w/ nonspecific gas pattern. Sounds like diverticulitis. I thought with the peritoneal signs you would do an ex lap. But that was wrong. The question asks for next step in diagnosis. So would you just do a CT anyway?
People don't get ex-laps before confirmatory tests unless they are medically unstable. The CT scan is the next step. Keep in mind the questions are often phrases "next step in diagnosis." You don't need an ex-lap to diagnose diverticulitis. You might need one to treat it. You would also give antibiotics prior to surgery.
Pain in right hip and flank following MVC. Abrasions, echymoses over right flank Urinalysis shows gross blood. What do you do?
CT abdomen w/ contrast, renal angio, or cystoscopy?
Recently got my scores back. A few thoughts
A) 92 raw, 95% scaled. This exam gets a lot of hype, but its bark is worse than its bite. Similar to any other shelf exam.
B) Pestana Book aka Kaplan Surgery notes was by far the best resource for this exam. Must know everything in this book
C) For my administration, there was a lot of orthopedics I felt wasn't covered well in review books. On your own here as far as what to read.
D) This is by far the worst thread I have read so far on this website. A lot of people here are asking for the audio and video, instead of contributing. I have used these threads in a positive manner all year to help me and my colleagues prepare for shelf exams, and none have been this poor. I was passed down the video from someone at my school, and it is honestly a waste of your time. You would be much better off memorizing the Pestana book instead.
got some questions about nbme 2
1. lady with 1 wk of nausea, scleral icterus, and right sided abdominal cramps; already had lap chole 2 mo ago but no intra-op cholangiography; T bili 8, Direct 5, alk phos 650, ALT/AST normal
Cause of jaundice? i put primary biliary sclerosis (wrong) and other choices were choledocholithiasis, cirrhosis, pancreatic cancer, or postop bile leak
Maybe postop bile leak was the ans b/c the others don't make sense with the LFTs, but would appreciate if someone could explain
2. woman undergoing ex lap for chronic pelvic pain. already consented with husband as witness, but after receiving narcotics, she gets panics and doesn't want operation anymore. What do you do?
I put reconfirm with husband, give benzo, and proceed to operation b/c I thought she wouldn't have decision making capacity after getting the narcs, but that was wrong
other choices: cancel op, consult psych, proceed with op as planned, or proceed with op after giving opioid antagonist
3. 15 yo boy with small right pneumothorax. next step in eval?
I put CT chest since you could look for apical blebs (incorrect)
other choices: observation, PFTs, VQ scan, bronch
Thanks Strive. Why would the atrial myxoma improve the murmur when lying on the R side?atrial myxoma
Can someone help me with these Clinical Mastery Questions?
1. 45 yo man with low grade fever and 15 lb weight loss .... has a low pitched, rumbling diastolic murmur heart at the apex; the murmur disappears when the pt lies on his R side. Hb concentration is 10g/dl. Most likely dx?
AI (wrong)
AS (no)
Atrial Myxoma?
Pericarditis?
VSD (no)
2.
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Finally got a chance to make up for my piss-poor performance on my psych shelf. Got a 97 on this shelf (unsure if raw/scaled).
Got my grade back for this shelf: 96 raw, 96% scaled to 100
I used the Pestana book x 3 , Kaplan surgery step 2 ck videos (taught by pestana, probably overkill with the book but I did them anyway, probably don't need these), Uworld and Kaplan Qbank surgery questions, I read a topics as needed in NMS surgery (the textbook) to prepare for the oral boards my school gives.
I had IMED before this and there were def some random IMED questions
Did IM help you? Because just reading pestana, uw, and kaplan doesn't seem like it would give you the breathe of knowledge you need for the shelf.
IM did help but there were some random questions that I couldn't have really prepared for, there was even a question on childhood tumors, I did think that pestana helped quite a bit though, i went through it three times over a 12 week period, the last run was a few days before the actual shelf
I used the pestana book from amazon, I didn't look at the pdfs.did you use the book from amazon or the pdf