This is why I am a bad test taker:

[pampiniformplex]

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[dyspareunia]

Despite what "poor test takers" will say, test taking ability comes with experience. The more questions you do the more accustomed you get to identifying distractors.

 

[Transposony]

The whole idea behind USMLE prep (and life) is to learn from your mistakes.

You cannot completely eliminate mistakes but minimize them by repetition.

Even the great Pholston made mistakes.

Remember, every Good test taker was once a Bad test taker!

 

[Bancrofti]

Just keep doing questions.

But remember, always keep in mind the primary cause. You made the diagnosis easy enough. Additionally, questions like this are where you can even bring in some old school test taking strategy in that if the question is that straight forward, you should say the answer to yourself before even looking at the answer choices. If you though multiple myeloma - plasma cell neoplasm - what do plasma cells do... then you wouldn't have had any issue. Think positive!

 

[Apoplexy__]

Even the great Pholston made mistakes.

Lmao this thought crosses my mind far too often.

OP, this is the type of the thing where you just go "Oh, I didn't realize that was an important testable issue. I guess it's conceivable that I should know origins of the neoplastic cells of all the leukemias. I'll make a note of that in FA and highlight where it says MM cells are plasma cells in FA. Well, time to move on then."

If you have the above thought process throughout an entire QBank, then you'll finish it having a very thorough understanding of how questions are asked in different topics. The most valuable thing you can do with QBanks is not to just remember what singular facts you got wrong -- you're just frantically patching up holes in your knowledge as they form. If you understand what deficit of thought process led you to getting the Q wrong (and then fix it), you'll probably get every other question on that subject right. In this case, the thought process you missed was needing to know what exact cells are neoplastic in various leukemias.

 

[pampiniformplex]

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[swoopyswoop]

Have you done Uworld Qs yet? I do on average 10-15% better on UWorld vs Rx and it's definitely not because UWorld is easier - it's because Rx is often poorly worded.

 

[Apoplexy__]

I think my problem may have been misinterpreted. I KNEW that information. I just constatly struggle with understanding what the question is asking. I knew that MM is a plasma cell issue, just like I knew that osteoclasts are responsible for bone resorption. But my problem is in figuring out what the question is asking- is it asking about the pathology because MM or disease X, or is it asking about the patient's current presentation, which in my mind for this question was the fracture. The fracture was caused by osteoclastic bone resorption, which in my mind made sense as the right answer.

Should I always be going back to the primary - MOST primary pathology? Am I overreading questions when I interpret them like this? I feel like this ******* test is making me go crazy. I've already done ~2,000 questions and I make the same type of thought-process mistake EVERY ******* DAY on at least 1-3 questions. Any advice...? For what it's worth, I struggled mightily on VR on the MCAT, but not as much on the other sections. And sadly, I got a T on the writing section, so maybe I can write but can't read for ****... /rant...

You're right, I did misunderstand your problem. I apologize for that.

From the question writer's point of view, the thought process should go like this: The patient's presentation = MM, and the pathology of the cells of MM is that of plasma cells. Picking F is saying that the pathology of the cells of MM is that of osteoclasts. I know that's not what you meant picking F, but the question was asking about the pathology of MM, not bone resorption. The biggest thing that pointed to the "pathology" in the question stem referring to MM instead of bone resorption was the high BUN/Cr secondary to Bence-Jones proteinuria. Yes, it was a poorly-written terminology, and that's not your fault. I think there's something to what swoopyswoop is saying.

Over-thinking is an annoying problem, and my advice would be to just try and be sure that the answer choices you narrow it down to apply rigorously to each and every single bit of info in the stem. Sometimes two answer choices can fit for all but one tiny bit, especially if you overthink things. Read carefully, think thoroughly.

 

[Fatalis]

@OP
go with what FIRST comes to mind
the second I read the vignette you posted I had MM in mind, then when the question was asked I said to myself [BEFORE looking at the answer choice]: any answer choice that contains antibody production, you pick that one. Answer choice C agreed with what I thought, skimmed over the rest and stuck with answer choice C.
So a few things to think about
1) confidence; become confident with coming up with your own answer before a list of options is presented. if what you think matches an answer choice it is usually the correct one because your mind wont be cluttered with the distractors
2)Most of the time you are NOT being tricked [although RX has poorly worded questions...too often sometimes that really drives me nuts bc they test on word play rather than concepts]. With that said, go with what the you feel is the answer
3) This question is too easy? Sometimes you are given really easy questions; they appear all the time. If you think the question is too easy, re-read it again, perhaps you forgot to read something but dont read between the lines. Ex. dude with sickle cell, osteomyletis= you want to go for the answer that deals with salmonella; it is almost like a knee jerk reflex
4)torn between 2 answer choices? Think like a detective. State to yourself answer choice F is true until proven that C is correct. Then you look for info using ONLY the vignette. Then say to yourself, well if they they were talking abut bone resorption they would give me at least ca2+ or po4 values or even pth so answer choice F is least likely to be correct [of course you can make the argument that the abnormal kidney values can mean CRF=> decrease vit d, etc etc...but that is a whole other story]
Always remember you are learning from questions so that when test day comes you dont make the same mistake! Also we all make stupid mistakes....really stupid mistakes, it is apart of learning!

 

[thehundredthone]

Even the great Pholston made mistakes.

If he's so great why can't you spell his name huh? He is a phols god.

Conrad Fischer (I know, I know) said answer what the question is asking, not what you think the question is asking. This one is asking about the overall, but you think it's asking about the Xray finding maybe because that's been mentioned on a separate line by itself.

 

[notbobtrustme]

I am currently going through Rx and just got the following question (QID 5004):

71 yo female presents with femur fracture- she has hypercalcemia, high BUN, high Cr, low Hct. Skeletal survey shows circular lesions in the skull.

Diagnosis? Multiple myeloma, easy enough. But the question asks: "What is the normal function of the cells whose pathology led to the above presentation?"

The osteoclasts are normal, they aren't the cause of the lytic bone lesions. The question is pretty clear, IMO. Which cell type has gone wrong and what does it normally do?

 

[BlueArc]

The whole idea behind USMLE prep (and life) is to learn from your mistakes.

You cannot completely eliminate mistakes but minimize them by repetition.

Even the great Pholston made mistakes.

Remember, every Good test taker was once a Bad test taker!

Love this.

 

[pampiniformplex]

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[notbobtrustme]

Thanks for the advice and support, everyone. I think I need to start doing what some of you suggested and come up with an answer in my head before I look at the answer choices, especially for slam-dunk questions like this where I tend to overthink it.

God this **** sucks.

ya it happens to all of us. have you just started questions? I'd say the first 300-500 questions, I was making rookie mistakes but as time goes on, you get more familiar with the wording/style and **** improves.

just keep plugging away at it.