USMLE Consult

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alternatego

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has anyone in this forum tried this question bank?

I got a 30% off discount with Goljan 3rd ed but I haven't decided if its worth the money.

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USMLE forums rates it higher than USMLE Rx, that is surprising.
http://www.usmle-forums.com/usmle-s...176-what-best-usmle-step-1-question-bank.html

I remember trying out some questions that came with the RR Pharm book I bought and it seemed like they were asking questions straight from the book text. Kinda like how Rx does with the FA sometimes...

http://www.usmleasy.com/
^ This is another q bank that I saw some questions from in Medscape, they were really challenging questions. Their thing is owned from the same publishers as Pre-Test...has anyone used this qbank??
 
I'm under the impression no one in SDN has tried U Consult before hmmmm

Thanks jpudge12, I had already seen that poll, I just didn't know if I could trust it.
 
Seems like Goljan promotes Consult quite a bit.

Not sure if he's being genuine in his recommendation or if it's just because his name is affiliated with the qbank and it benefits him to get people to use it.
 
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I just finished doing some questions on liver path from Rapid Review using USMLE consult. IMO, it helps to do the questions after you go over a chapter, which helps to solidify some of the info. The questions come straight from the books that they are part of e.g. pathology in this case. The pictures come straight from the book as well. I would NOT use this to study for step 1, but maybe while going through coursework, or just testing yourself to see how much you retain. the questions are basic and not super clinical.
 
Yeah, I think those are a different set of questions though, they just use the same USMLE Consult interface.
 
I've decided to go for USMLE Rx as there's not enough feedback about U Consult. I'm still going to do RR's practice questions though, them being free and all
 
I thought I could give people an update on USMLE Consult QBank:

I just did their 30-question free-trial, timed.

In question FOUR of thirty, I ALREADY found an error.

The vignette is of a child falling off of a bike, injuring his wrist, and he is unable to contact his thumb to his 5th finger, etc. etc. Then the question asks about loss of sensation.

Do you already see the problem here?

Distal median nerve lesions (at the wrist) don't result in loss of opposition, PROXIMAL ones do (e.g. with a supracondylar fracture). Distal lesions just result in diminished flexion of the lateral fingers and attenuated wrist flexion with ulnar deviation.

The other questions were also poor, and this is their FREE-TRIAL, which would be their best questions!

I can say, without a doubt, that even the worst questions in USMLE Rx (I've done ~2000 so far) are still better than the ones I just did on Consult. There is also no option to cross out answer choices, which I was not a fan of. I must say that I am an aficionado of the Qbank method for score augmentation, and I literally, regardless, am going to pass on Consult.

I had considered Weapon as an experimental possibility as well, but they don't even have a free-trial, let alone the fact that they have Kaplan-esque prices in the absence of any confirmed reputation. Therefore, I'm not even going to take the risk, considering Consult was that bad and I would have kicked myself if I had even purchased a month.
 
The vignette is of a child falling off of a bike, injuring his wrist, and he is unable to contact his thumb to his 5th finger, etc. etc. Then the question asks about loss of sensation.


Distal median nerve lesions (at the wrist) don't result in loss of opposition, PROXIMAL ones do (e.g. with a supracondylar fracture). Distal lesions just result in diminished flexion of the lateral fingers and attenuated wrist flexion with ulnar deviation.

Why wouldn't you lose opposition of the thumb at the lost of the median nerve at that area? Doesn't the recurrent median nerve supplies the thenar muscles (opponins pollis?). Doesn't that branch off after the carpel tunnel.

I will quote wikipedia http://en.wikipedia.org/wiki/Median_nerve#Injury
At the wrist
Injury by compression at the carpal tunnel causes carpal tunnel syndrome.
Severing the median nerve causes median claw hand (also called the "Benedictine hand").
In the hand, thenar muscles are paralyzed and will atrophy over time.
Opposition and flexion of the thumb are lost.
Sensory is lost:
Palm - 3 1/2 Fingers
Dorsal - Finger tips
 
Yeah, I was pretty disappointed by the quality of their 30-question trial, and I'd imagine that those would be 30 of their best questions. After doing those 30, it was an easy choice to not buy their bank.
 
Why wouldn't you lose opposition of the thumb at the lost of the median nerve at that area? Doesn't the recurrent median nerve supplies the thenar muscles (opponins pollis?). Doesn't that branch off after the carpel tunnel.

To save you the extra time, just look at the chart on p. 409 of First Aid 2012.
 
To save you the extra time, just look at the chart on p. 409 of First Aid 2012.

The chart is incomplete. Loss of opposition of the thumb can also occurs at the distal site b/c of the recurrent median nerve is distal to the wrist. I'm sure most anatomy sources will agree.
 
The chart is incomplete. Loss of opposition of the thumb can also occurs at the distal site b/c of the recurrent median nerve is distal to the wrist. I'm sure most anatomy sources will agree.

With respect to the USMLE Step1, the nerve lesions follow the patterns found in First Aid. If you were to see a proximal median nerve lesion on the exam, and lack of opposition vs lateral finger / wrist flexion w/ ulnar deviation were the answers, the former would be right. It's not that there are never exceptions. There are. Just realize that the classic presentations are what will get tested (MOST LIKELY), and there's no reason to screw yourself over because you know too much (literally).

I've learned that lesson using USMLE Rx already. For example, I got some question that involved this guy with Crohn's who had acute sclerosing cholangitis. That's keeping in mind that FA says ASC is classically found in ulcerative colitis. In USMLE Rx's explanation, they said that ASC can occur in Crohn's AND UC, but that it's just more common in UC. I've probably encountered ~20 questions on Crohn's vs UC so far, and ~6-7 have hammered the ASC as UC, not Crohn's, in either the stem or the answer. It's not that on the real exam ASC couldn't get caught up in a Crohn's question, it just means that it will most likely be seen in a classic UC question, and if there's an exception, it would probably be a good reason.
 
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