Well I think the conceptualization takes longer, so you gotta be willing to put in a little more time. I think it helps to read a topic say in FA then in Goljan maybe even the audio. Then see if you can close the books and explain it out to yourself or draw out a flow chart in ur head. The nice thing about this stuff is that one organ system is bound to be connected to another, so when you hit the associated symptom in another section, make the connection and start expanding what you previously learned.
Soon enough if the question even mentions a word like hypercalcemia, your brain will immediately go looking for PTH->if not->PTHrp/lung cancer, if not -> sarcoid or multiple myeloma, if not -> Vit A/D tox, etc.
I think it comes down to just linking as many concepts and letting the details fall into place. Although memory is still a huge part of this test, having a working knowledge, Goljan style, is really helpful.
