Questions with long labs

[Doc2b82]

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Hey guys so while I am studying for Ck one thing that keeps really bothering me is some of these questions that have these super long lists of lab values.

How do any of you tackle these long lists? During the actual exam we dont really have time to go through each value and look them up in the lab. So then what is the best way to tackle these questions without wasting too much time on them?

Appreciate any input anyone can give! Thanks

 

[Doc2b82]

no tips suggestions rants?

 

[Modeselektor]

I don't even read them unless the symptoms call for it, or I need to exclude one of the options. After a while you get a pretty good idea of what an abnormal lab value is and you know what to look out for. If it's really bothering you, put the values into anki and memorize them.

My mental dialogue when I answer a question goes somewhere along the lines of.

[old/young] [insert race] [dude/gal] blah blah blah, w/e, don't care, diabetic, yeah, okay, w/e, abdominal pain, mhmm, sure buddy, no one cares, increased respiratory rate. blah blah blah blah, next best step.

labs:
who cares
who cares
w/e
w/e
sure,
acidosis,
anion gap.
w/e
Potassium elevated
w/e
so what

answers:

IV fluids, insulin

next.

 

[Modeselektor]

Long labs are there to catch people. If you don't recognize the case, you'll get trapped looking up all the labs, and slowed down for other questions. It seems to be the dirty trick the CK questions writers utilize. The only way is to recognize the type of case and what labs you actually need to look at to confirm it.

 

[mercaptovizadeh]

From your clerkships you should have a basic feel for what normal lab values are for standard labs (i.e. CBC, BMP). Oftentimes the "out there" labs like PTH level or prolactin level will have normal ranges in a parenthesis next to the value).

You need to assemble a list of possible diagnoses for the clinical symptoms/imaging, then just scan the lab values you need to confirm. E.g. patient coughing recently, 100 pack-year history of smoking, now with abdominal pain, constipation, AMS, polyuria. You need to recognize that he likely has lung cancer and hypercalcemia, then check the PTH and PTHrP to figure out whether he has metastatic cancer in the bones driving bone resorption (thus low PTH and PTHrP), or whether his squamous cell carcinoma is secreting PTHrP to drive calcium out of the bones in an endocrine fashion (thus low PTH and high PTHrP).

 

[Doc2b82]

Thank for all your inputs. I always get caught up in the long labs and find myself going through each one just to make sure I am not missing anything but doing that I realize I waste so much time so it helps to see how other students are approaching this.

 

[thehundredthone]

As mentioned above, first look at the labs that are pertinent to the clinical situation. Both normal and abnormal pertinent labs are important. Then if time permits, a cursory glance through the rest should suffice. With time and practice you can learn to do both at once.

 

[Recettear]

In my opinion the best way to take the test is to read the question and the answers first so you know what you're looking for. This is especially important with long questions. I usually even try to pick an answer before knowing anything else.

Once you do this, read the case and labs keeping in mind the question and answers.

This strategy saves a lot of time. At least for me.

 

[res1cue]

One thing I do is take the lab values I may need frequently but dont have memorized and write them down at the start of the exam.

That way you dont have to pull up the screen, its right in front of you. Takes a few seconds, but can save a lot of time. Most of CBC/BMP you should probably know from clerkship

 

[Doc2b82]

Thanks guys for the replies. This gives me a better idea of what to do and how to tackle these questions. They always intimidate me and I get so preoccupied looking through the labs that I almost cant process the question at hand.