Solid advice. Thanks a ton. I feel like everything is minutiae at this point lol. The hardest thing for me right now are drugs. I love knowing the mechanisms, but I soon get lost with all the ridiculous names that have no meaning to me. To me that is minutiae that cannot be avoided. An example of other stuff that I am "memorizing" or perhaps relearning are the different type of rapidly progressive glomerulonephritis. Surely that isn't minutiae, but rather high yield that you need to know the difference between to stand a chance at answering many renal questions.
I don't know why, but for me if I don't constantly review this stuff, it quickly disappears from my brain. I wish I had a longer retention, but that is how it goes for me. I have pretty much switched to mainly Anki as my learning aid because it constantly forces me to make going over lecture and concepts an active recall exercise rather than passively reading. I was having too many problems trying to learn via passive reading (e.g. even less retention).
Trust me, I am not ignoring the big for the little. I am rushing as fast as I can to get a complete review of my medicine done before dedicated study starts. I feel like this will put me in a great position to really tackle the things I am weak on, instead of doing what I am right now which is relearning material I should already know. I should not be relearning anything new by the time I am in dedicated. I just hope I find enough time to finish this review in the next 3 weeks. I am very behind, but I think it is possible.
Personally I have chosen to ignore our lectures at this point except for what is applicable to the board. Fortunately (or maybe unfortunately) our school is currently throwing all the pharm at us, while calling it an "integration" course. The only thing I hate is that they have also chosen to throw a bunch of geriatric and pediatric stuff not suited to step in there as well. I know it is important to medicine, but it is not important to my current goals right now, so I have to choose to spend my time on learning things other than mini mental status exams for the elderly. Strangely in that geriatric info they ignored dementia, alzheimers, and other high yield topics that would be awesome for step prep, but I digress.
I'd be really careful thinking something isn't suited to to step -- people are often surprised at what shows up. MMSE would totally be fair game for step 1, though it's more likely to function as a way of eliminating distractors (ie. elderly pt whose is altered, recent MMSE 28/30. Blah blah lots of other info. You can bet alzheimer's dementia is one of the answer choices). All the step exams (including step 1) now include questions on quality improvement, safety, social sciences, etc., so even those seemingly fluffy lectures are step worthy. Sadly, a lot of people blow it in the behavioral science section. It's a huge chunk of your final score (on the order of 10-20 points of your 3-digit score).
Props to you for using anki - easily one of the best tools out there. Especially powerful for pharmacology. Another thing you may be doing but just in case: be sure to learn all the patterns for drug names. Know these absolutely cold. Then learn the handful of exceptions. Things like all the "olol" drugs are beta blockers and if the first letter is A-M, it's selective; N-Z is non-selective. "-chol" are cholinergics. "-opril" are the ACEIs. "-artan" are the ARBs. Etc. Etc. Makes it way easier. Beyond that you have the random chemo drugs, neuro drugs, and psych meds.
For types of RPGN, know the big picture - one type is antibodies against the GBM, another is immune complex deposition, and the other is WTF is happening/ANCA. 3 types, each very distinctive on IF. Then you just have to think of all the diseases that fall in each category, but if you know the mechanisms, it's easy enough to figure out. Beyond that, know what the IF looks like, know the crescents, and think about how renal failure looks clinically (elevated creatinine, sx of uremia, etc.). They can ask you for a diagnosis, they can ask for a mechanism, they can ask for the basics of treatment, they can integrate with other topics - that's about it. They can dress it up a zillion ways, but they can't change the underlying facts.
Try to think in broader strokes that are easier to learn and remember. Don't fall into that trap of trying to memorize all the causes of Type II RPGN - just know the mechanism is immune complex deposition and you're set. Make sure you watch the Pathoma videos so many times your eyes bleed.