Last week. I feel I forgot a lot of psych. We do psych then neuro rotation at my school and then we have the shelf exams back to back so I'm 4 weeks out from the psych wards. Do you guys think I could look at FA for step 1 and drill those into my brain as a good use of time last week? Any ideas good review resources to look at 1-2 days. Would be really really appreciated.
Psych Shelf Exam
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no, FA will not be good enough to help you with the rotation or the shelf, forget that
the psych shelf is far more difficult than people seem to expect
the psych shelf is far more difficult than people seem to expect
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If you're gonna do it in 1-2 days then no. But FA for psych + UW works. It's actually a pretty hard test
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Took this a few weeks ago and keep on meaning to post my experience since this thread helped me quite a bit.
General Impression: This was my first shelf exam so I probably am overestimating how difficult it was. That being said I did not think it was as easy as some people told me. I felt like the most challenging thing about it was that there was a number of non-psychiatry related questions on there that I didn't study. For that reason it is probably a much easier test after you have had a few rotations, especially neurology. FA Psych tries to cover these neuro diseases, but doesn't do a good job on all of them. For that reason, I would recommend taking a look at the pediatrics chapter of Blueprint Neurology to brush up on congenital illnesses. for reference I got a 90 on this shelf.
Resources: ranked from most useful to least
1. UWorld + incorrects: longer question stems than actual test
2. FA Psych x2: As I said above, I would supplement this with the peds chapter of Blueprints Neurology
3. Lange Q&A: I think this is worth doing if you have time. Do UWorld and FA psych first of course. The question stems are short so you can crank through it fast, and it covers topics in more minute detail than UWorld. I would definitely say it was more useful than doing UWorld questions a second time.
4. NBME 3 (I think): helpful in that it clued me in on topics which would be tested that I wasn't studying; I felt like it did a fair job of approximating the difficulty of the actual test
General Impression: This was my first shelf exam so I probably am overestimating how difficult it was. That being said I did not think it was as easy as some people told me. I felt like the most challenging thing about it was that there was a number of non-psychiatry related questions on there that I didn't study. For that reason it is probably a much easier test after you have had a few rotations, especially neurology. FA Psych tries to cover these neuro diseases, but doesn't do a good job on all of them. For that reason, I would recommend taking a look at the pediatrics chapter of Blueprint Neurology to brush up on congenital illnesses. for reference I got a 90 on this shelf.
Resources: ranked from most useful to least
1. UWorld + incorrects: longer question stems than actual test
2. FA Psych x2: As I said above, I would supplement this with the peds chapter of Blueprints Neurology
3. Lange Q&A: I think this is worth doing if you have time. Do UWorld and FA psych first of course. The question stems are short so you can crank through it fast, and it covers topics in more minute detail than UWorld. I would definitely say it was more useful than doing UWorld questions a second time.
4. NBME 3 (I think): helpful in that it clued me in on topics which would be tested that I wasn't studying; I felt like it did a fair job of approximating the difficulty of the actual test
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91 raw (which is 96-99 percentile depending on order)
1) pre-test, psych
2) pre-test, ob-gyn, domestic abuse chapter
3) pre-test, peds, child abuse and adolescent chapters
4) lange (do NOT obsess over the chapter about tests. i did that.)
i listened to emma in the car. there are some mistakes and it's dsm4.
[i didn't use uworld because it doesn't work as well as other sources for me.]
1) pre-test, psych
2) pre-test, ob-gyn, domestic abuse chapter
3) pre-test, peds, child abuse and adolescent chapters
4) lange (do NOT obsess over the chapter about tests. i did that.)
i listened to emma in the car. there are some mistakes and it's dsm4.
[i didn't use uworld because it doesn't work as well as other sources for me.]
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Where did you find out the percentiles depending on the order? my school just releases our raw scores, so I'm trying to figure out where I stand
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https://www.ttuhsc.edu/som/documents/policies/SOMOP30.01.A.pdf
This is the source I always use. There may be a better one, but I have never looked further.
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Was so close, got 86 raw which was 82nd percentile...enough to get the chance of honoring the rotation.
Read through First Aid Psychiatry Clerkship once at the beginning of the rotation (6 weeks), then again near the end.
Did all of Lange 1000 questions. Don't bother doing the Ethics chapter or the intelligence tests because they're not worth it.
Did the three NBMEs.
Reviewed Step 1 Psych and Neuro especially the pharm sections. Also the genetics that can cause intellectual disability (e.g. Fragile X, ASD, Down's, Fetal Alcohol Syndrome)
For the test, I didn't get questions on differentiating between the different SSRIs.
Know side effects of drugs really well and how to treat them.
Know pharmacology and treatment of diagnoses cold as well as timeline.
Know EEG findings for certain diagnoses (e.g. delirium).
Step 1 material-beware!
Read through First Aid Psychiatry Clerkship once at the beginning of the rotation (6 weeks), then again near the end.
Did all of Lange 1000 questions. Don't bother doing the Ethics chapter or the intelligence tests because they're not worth it.
Did the three NBMEs.
Reviewed Step 1 Psych and Neuro especially the pharm sections. Also the genetics that can cause intellectual disability (e.g. Fragile X, ASD, Down's, Fetal Alcohol Syndrome)
For the test, I didn't get questions on differentiating between the different SSRIs.
Know side effects of drugs really well and how to treat them.
Know pharmacology and treatment of diagnoses cold as well as timeline.
Know EEG findings for certain diagnoses (e.g. delirium).
Step 1 material-beware!
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80 percent raw with approx. 50th percentile. GG.
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99-100th percentile based on the document found on SDN.
6 week shelf, what I did:
-watched Emma holiday on the first day of my rotation. A lot of her stuff is DSM-IV and outdated but is a good review for the wards.
-read FA for psychiatry in the first 2 weeks; reviewed some of the chapters in the last few days before the exam
-Pretest questions during week 6
-Lange questions except for the practice tests at the end (so around like 500 questions), around week 3-4
-UWorld questions, week 4-5
-3 NBME's, during the 5th and 6th week (scores of 92, 86, 92)
I thought our test was similar difficulty to the NBME's, which I thought were hard. The question style and approximate distribution of topics were similar to NBME's as well.
I thought pretest questions were great! I think they're way better than Lange questions.
Things that the resident I worked with taught me that were helpful:
1. Be mindful of timelines. For substance-induced disorders, make sure you determine what came first, the mood disorder causing the patient to drink, or the patients drinking that caused the mood disorder, etc.
2. A great way to determine schizoaffective disorder is if AFTER tx the patient still has some baseline psychotic sx (still hearing voices, mild delusions), but the mood sx went away.
6 week shelf, what I did:
-watched Emma holiday on the first day of my rotation. A lot of her stuff is DSM-IV and outdated but is a good review for the wards.
-read FA for psychiatry in the first 2 weeks; reviewed some of the chapters in the last few days before the exam
-Pretest questions during week 6
-Lange questions except for the practice tests at the end (so around like 500 questions), around week 3-4
-UWorld questions, week 4-5
-3 NBME's, during the 5th and 6th week (scores of 92, 86, 92)
I thought our test was similar difficulty to the NBME's, which I thought were hard. The question style and approximate distribution of topics were similar to NBME's as well.
I thought pretest questions were great! I think they're way better than Lange questions.
Things that the resident I worked with taught me that were helpful:
1. Be mindful of timelines. For substance-induced disorders, make sure you determine what came first, the mood disorder causing the patient to drink, or the patients drinking that caused the mood disorder, etc.
2. A great way to determine schizoaffective disorder is if AFTER tx the patient still has some baseline psychotic sx (still hearing voices, mild delusions), but the mood sx went away.
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Yes, although the patient did need to be intubated, throwing in a BZ antagonist like Flumazenil will not be indicated here. Per Up To Date:
"A variety of dosing schedules can be used. We generally give IV diazepam, 5 to 10 mg IV every 5 to 10 minutes, until the appropriate level of sedation is achieved. In severe withdrawal, select patients may require massive doses (>500 mg diazepam) to achieve initial control of symptoms, and continued aggressive use of benzodiazepines thereafter (>2000 mg diazepam over 48 hours)."
Hey guys .. . .I'm throughly confused on what sexual dysfunctions( besides erectile dysfunction, vaginismus etc) besides whatever is on the first aid psych book. I mean there aren't that many . . .its all like on 1 page, but I have been noticing more sexual dysfunction questions in my FM too. Do you guys have like a good list?
Also what about diseases like Klinefelters? Turners? Kallman?
Also what about diseases like Klinefelters? Turners? Kallman?
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I made a free Psychiatry shelf review video (with accompanying slides). Feedback/suggestions welcome.
www.divineinterventionpodcasts.com
www.divineinterventionpodcasts.com
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Also added a bunch of free, high yield, relatively comprehensive review videos for the other clerkships (medicine, psych, surgery, peds, and OBGYN). Thoughts/feedback welcome. The website is www.divineinterventionpodcasts.com
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I believe in the "less is more" theory, and just used UW and First Aid. Got a raw score > 85. For some reason I did feel that my shelf was more "ambiguous" than the practice NBMEs; however, I wouldn't have changed my study methods.
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I agree with this
Just did UW and FA 1x each, listened to online Med ed in the car
Scored 92 raw
Shelf was tough, but if you learn the concepts from UW and memorize the specific criteria for the major pathologies in FA you will do well. Everything you need to know is in UW+FA
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Have any DO students used the COMQUEST bank for psych?
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Comquest blows but it was somewhat helpful for psych. Questions similar to comats but error ridden. Make sure to check everything with up to daye
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Someone else then commented that they thought the answer was H) Sertraline, but the correct answer on my report is C) Clonazepam ... (did the reports not give correct answers back then?)
Can anyone explain to me how you can prescribe clonazepam to someone already taking butalbital? Is it just because the latter is only taken occasionally? Clonazepam was the first choice I ruled out.
Thanks!
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Sertraline is the wrong answer partly because it will take weeks to do anything, not to mention, you're not treating GAD or MDD. This is an acute grief/stress reaction.
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I'm not an expert on the use of butalbital for migraine. For these kinds of questions, you can generally assume what the patient is currently taking is prescribed and monitored appropriately. Also fair to say the patient isn't "snowed" and if she were she wouldn't be complaining of insomnia.
Barbies don't have the same safety margin that benzos do, regardless, there is no absolute contraindication to using both where appropriate, provided as I've said, the dosages are reasonable, the patient is well-monitored, not abusing, polypharm is reasonable, they're not having side effects/snowed, etc.
Barbies don't have the same safety margin that benzos do, regardless, there is no absolute contraindication to using both where appropriate, provided as I've said, the dosages are reasonable, the patient is well-monitored, not abusing, polypharm is reasonable, they're not having side effects/snowed, etc.
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Benzos have a very bad rap for a lot of reasons, but they're actually pretty safe in very low doses for very short periods of time.
The sertraline is pointless short term or acutely.
I won't touch biofeedback here, that also takes some time to see any good benefit.
Carbamazepine, clonidine, imiprimine, make zero sense to me.
Olanzapine will knock people out, but using antipsychotics for sleep alone, it's insane to expose a patient to all the possible side effects for what is likely a time-limited issue that can be addressed with so many other drugs for sleep that aren't are hard core.
Phenobarbital is also ridiculous here.
Seems you caught onto all this, except that staring down at sertraline vs clonazepam, the latter is much more reasonable for acute treatment of what you could expect to be time-limited anxiety-related insomnia.
This makes more sense if I think you realize that it's not particularly dangerous to use both the benzo and the other drug in this case.
Lots of docs wouldn't do this, but for the purposes of a shelf exam, from the shelf's POV, it's not that dangerous, and it isn't.
The sertraline is pointless short term or acutely.
I won't touch biofeedback here, that also takes some time to see any good benefit.
Carbamazepine, clonidine, imiprimine, make zero sense to me.
Olanzapine will knock people out, but using antipsychotics for sleep alone, it's insane to expose a patient to all the possible side effects for what is likely a time-limited issue that can be addressed with so many other drugs for sleep that aren't are hard core.
Phenobarbital is also ridiculous here.
Seems you caught onto all this, except that staring down at sertraline vs clonazepam, the latter is much more reasonable for acute treatment of what you could expect to be time-limited anxiety-related insomnia.
This makes more sense if I think you realize that it's not particularly dangerous to use both the benzo and the other drug in this case.
Lots of docs wouldn't do this, but for the purposes of a shelf exam, from the shelf's POV, it's not that dangerous, and it isn't.
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Honored the psychiatry shelf using OME, FA for Psych, Case Files, select chapters of Lange Q&A, Emma Holliday, and UWorld. There was more neuro on the exam than I was expecting, but as long as you have the precise definitions and timeframes for each psychiatric problem down, you’ll be golden.
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First Aid >>> Lange, but there are other resources too for those who want to honor/prep for a sub-I.
A lot of neuro/IM overlap so if you want to honor you need to go beyond FA in my opinion.
A lot of neuro/IM overlap so if you want to honor you need to go beyond FA in my opinion.
