What's something you KNOW you will miss on the test? Maybe we can help.

[golfman]

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What is something you guys just know you'll miss on the test? Maybe if we write down what we struggle at, somebody who has some neat way of remembering things can help us out.

I, for some reason, have tons of trouble with histology of the liver, like what is going to happen histologically in alcoholic hepatitis vs. fatty liver vs. Hep B vs. Cirrhosis vs. intrahepatic cholestasis, PBC, etc... I always struggle with those. Get those suckers all confused.

If anyone has any advice on how to remember any of those, or neat charts, much appreciated.

Anything you guys struggle with? Maybe some of us can help. Or maybe we'll just get a huge long thread of things that confuse us and no help. 🙂

 

[username456789]

For some damn reason I can never keep VHL and Tuberous Sclerosis straight. I mean key things like "TSG 'VHL' on Chromosome 3" or "b/l RCC" for VHL, but in general there are just a ton of -omas associated with both. No matter how many times I go over the lists and write it out and such, I couldn't tell you right now what the specific lesions are associated with each for some reason. They seem to occupy the same part of my hippocampus.

We really never learned either of these in class, they were thrown in as an afterthought. So they never really stuck.

 

[knuckles]

VHL = chromosome 3. just remember it's 3 words - von hippel lindau = ch 3

 

[golfman]

For some damn reason I can never keep VHL and Tuberous Sclerosis straight. I mean key things like "TSG 'VHL' on Chromosome 5" or "b/l RCC" for VHL, but in general there are just a ton of -omas associated with both. No matter how many times I go over the lists and write it out and such, I couldn't tell you right now what the specific lesions are associated with each for some reason. They seem to occupy the same part of my hippocampus.

We really never learned either of these in class, they were thrown in as an afterthought. So they never really stuck.

This may be quite lame, but for TS I think of this cheer "RAH, RAH, RAH, ZITS, FITS, and NITWITS"

R= Rhabdomyoma (Cardiac)
A= Angiomyolipoma (kidney)
H= Hamartomas

Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation


And here's one I just googled for VHL

HIPPEL:
H:HEMANGIOBLASTOMA (This is the keyword, in my opinion, for this one).
I: Increased Renal Cancer
P: Pheochromocytoma
P: Port Wine Stain (News to me, I didn't know that)
E: Eye disfunction (Also news to me)
L: Liver, pancreas, kidney cysts
Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation

 

[username456789]

VHL = chromosome 3. just remember it's 3 words - von hippel lindau = ch 3

Gah sorry, brain fart, I definitely knew it was 3!

Long day. These kind of dumb mistakes are dangerous though.

 

[username456789]

This may be quite lame, but for TS I think of this cheer "RAH, RAH, RAH, ZITS, FITS, and NITWITS"

R= Rhabdomyoma (Cardiac)
A= Angiomyolipoma (kidney)
H= Hamartomas


And here's one I just googled for VHL

HIPPEL:
H:HEMANGIOBLASTOMA (This is the keyword, in my opinion, for this one).
I: Increased Renal Cancer
P: Pheochromocytoma
P: Port Wine Stain (News to me, I didn't know that)
E: Eye disfunction (Also news to me)
L: Liver, pancreas, kidney cysts
Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation

Haha, nice, I'll try those out, thanks.

 

[golfman]

Hey I messed it up a bit, I changed it in my original reply. I don't know if it'll help anybody else but me.

 

[username456789]

Hey I messed it up a bit, I changed it in my original reply. I don't know if it'll help anybody else but me.

The one you came up with is actually very helpful, thanks. Unfortunately I can't help much with your topics.

 

[knuckles]

I know I'll screw up a question on arches/pharynges/clefts

 

[MoscowAbe]

Those nephrotic/nephritic syndrome findings on LM + IF are a b***h.

 

[match2011]

This may be quite lame, but for TS I think of this cheer "RAH, RAH, RAH, ZITS, FITS, and NITWITS"

R= Rhabdomyoma (Cardiac)
A= Angiomyolipoma (kidney)
H= Hamartomas

Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation


And here's one I just googled for VHL

HIPPEL:
H:HEMANGIOBLASTOMA (This is the keyword, in my opinion, for this one).
I: Increased Renal Cancer
P: Pheochromocytoma
P: Port Wine Stain (News to me, I didn't know that)
E: Eye disfunction (Also news to me)
L: Liver, pancreas, kidney cysts
Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation

very good, thanks

 

[PokerDoc]

I know I'll screw up a question on arches/pharynges/clefts

try learning them by the innervations.. 5, 6, 7, then 10 (for 1, 2, 3, and 4+6 respectively) then for the vagus nerve know that 4 controls mostly swallowing and 6 controls mostly speaking.

then from there you sort ofknow what nerves innervate what so if you cant think of the answer at least you have a starting point.

I also found it helpful that branchial arch one is like all M's (meckels, mandible, malleus, mandibular ligament, muscles of mastication, masseter, mylohyoid, maxillary artery, mandibular and maxillary branches of CN 5 etc.

for the clefts: id only even bother remembering #1 which is the external auditory meatus.. the others dont do anything except cause branchial cysts since theyre all supposed to be obliterated.

and for the pouches: im sure you know the important ones 3 and 4.. im not worrying about 1 and 2, if they are dick enough to ask about those I know i can cross of the answers relating to 3 and 4 and have a 50% shot at it.. cant learn everything.

 

[PokerDoc]

This may be quite lame, but for TS I think of this cheer "RAH, RAH, RAH, ZITS, FITS, and NITWITS"

R= Rhabdomyoma (Cardiac)
A= Angiomyolipoma (kidney)
H= Hamartomas

Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation


And here's one I just googled for VHL

HIPPEL:
H:HEMANGIOBLASTOMA (This is the keyword, in my opinion, for this one).
I: Increased Renal Cancer
P: Pheochromocytoma
P: Port Wine Stain (News to me, I didn't know that)
E: Eye disfunction (Also news to me)
L: Liver, pancreas, kidney cysts
Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation

I've never seen port wine stain a/w VHL.. id almost guarentee step 1 will never give us PWS without it being sturge weber

 

[kryptik]

What is something you guys just know you'll miss on the test? Maybe if we write down what we struggle at, somebody who has some neat way of remembering things can help us out.

I, for some reason, have tons of trouble with histology of the liver, like what is going to happen histologically in alcoholic hepatitis vs. fatty liver vs. Hep B vs. Cirrhosis vs. intrahepatic cholestasis, PBC, etc... I always struggle with those. Get those suckers all confused.

And with malaria for some reason, probably because FA didn't go over it well. I also don't really understand definitive host / intermediate host and in which worms/diseases we need to worry about those in, but hopefully that doesn't come up.

If anyone has any advice on how to remember any of those, or neat charts, much appreciated.

Anything you guys struggle with? Maybe some of us can help. Or maybe we'll just get a huge long thread of things that confuse us and no help. 🙂

For the malaria read that part in CMMRS, its presented pretty well

 

[golfman]

For the malaria read that part in CMMRS, its presented pretty well

Thanks I'll check it out.

 

[hoqhuuep]

try learning them by the innervations.. 5, 6, 7, then 10 (for 1, 2, 3, and 4+6 respectively) then for the vagus nerve know that 4 controls mostly swallowing and 6 controls mostly speaking.

You mean 5, 7, 9, 10? 😉

 

[PokerDoc]

You mean 5, 7, 9, 10? 😉

haha just seeing if you were paying attention, btu yeah.. i flipped the 9 upside down.. look at the time stamp, i just woke up!

 

[1nycdoc8]

Thanks for your TS mnemonic, you should submit it to FA...

You don't have one for NF1 do ya? hahah that one is a pain the butt as well.

This may be quite lame, but for TS I think of this cheer "RAH, RAH, RAH, ZITS, FITS, and NITWITS"

R= Rhabdomyoma (Cardiac)
A= Angiomyolipoma (kidney)
H= Hamartomas

Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation


And here's one I just googled for VHL

HIPPEL:
H:HEMANGIOBLASTOMA (This is the keyword, in my opinion, for this one).
I: Increased Renal Cancer
P: Pheochromocytoma
P: Port Wine Stain (News to me, I didn't know that)
E: Eye disfunction (Also news to me)
L: Liver, pancreas, kidney cysts
Zits= Facial Angiofibroma (adenoma sebaceum)
Fits= Seizures
Nitwits= Mental ******ation

 

[doc29]

I can never remember Embryologic derivatives and Retroperitoneal/intraperitoneal organs...

 

[okt3]

I can't seem to wrap my head around Spindle muscle control. Ia, Ib afferent, efferent and Golgi tendon and First Aid confuses me even more on this topic. Maybe someone can simplify this for me, I'd appreciate that!

 

[kryptik]

I can't seem to wrap my head around Spindle muscle control. Ia, Ib afferent, efferent and Golgi tendon and First Aid confuses me even more on this topic. Maybe someone can simplify this for me, I'd appreciate that!

muscles have an intrinsic property of contracting when stretched.
muscle spindles are in parallel with the muscle fiber so that when the muscle is stretched north and south, the spindle is also stretched north and south, the spindle then relays this stretch to the spinal cord via Ia fibers and the spinal cord inturn sends an input via alpha fibers to the muscle being stretched to contract

Golgi on the other hand are in series with the muscles and sense the tension in the tendons such that when tension is too much it signals the muscle fiber to "let go" so it's not injured

this is a crude explanation but i hope it helps and someone can add/correct it

 

[okt3]

muscles have an intrinsic property of contracting when stretched.
muscle spindles are in parallel with the muscle fiber so that when the muscle is stretched north and south, the spindle is also stretched north and south, the spindle then relays this stretch to the spinal cord via Ia fibers and the spinal cord inturn sends an input via alpha fibers to the muscle being stretched to contract

Golgi on the other hand are in series with the muscles and sense the tension in the tendons such that when tension is too much it signals the muscle fiber to "let go" so it's not injured

this is a crude explanation but i hope it helps and someone can add/correct it

THanks Kryptik. This makes sense...But do you know the role of Gamma-fibers and Ib then??

 

[kryptik]

THanks Kryptik. This makes sense...But do you know the role of Gamma-fibers and Ib then??

Ib is the fibers the golgi uses to send info about tension to the spinal cord, ie afferent not sure about the gamma-fiber

 

[DocDanny]

I don't get anti arrythmics.

My school did a very poor job of teaching them, rushing through all of them in 50 minutes during a lecture we had 7 months ago.

I can't keep the classes straight. And I don't actually understand their differences, only thta they act on different ion channels.

 

[tideleonheart]

I don't get anti arrythmics.

My school did a very poor job of teaching them, rushing through all of them in 50 minutes during a lecture we had 7 months ago.

I can't keep the classes straight. And I don't actually understand their differences, only thta they act on different ion channels.

I think Class 1 are the hardest to remember for me. Once i get through class 1, the others are not that bad. So I'll just explain how I see class 1's:

Class 1's are sodium channel blockers. Think about the action potential of the cardiac muscle. The upstroke (phase 0) is influx of sodium, so phase 0 is slowed.

And here's where it gets interesting. 1A, 1B, and 1C all do something slightly different for phase 3. An easy way to remember it though is:
1A = Above normal
1B = Below normal
1C = Constant
^ that is referring to the action potential DURATION. You'll have to look at FA 280 for that picture. I know I didn't try to explain everything going on, but maybe that little tip will help a bit.

 

[1nycdoc8]

I always have issues with remember what diseases are AD, AR, X linked R, even X linked D ones....

I have a few weeks so I think I just have to sit down and make a list or something but if anyone can help me out with this that'd be great. I'd hate to have a long vignette, figure out the dz but then to just have a "how is it inherited" thing at the end and not have a clue...

 

[TexasTriathlete]

This thread has some real potential.

 

[PokerDoc]

I always have issues with remember what diseases are AD, AR, X linked R, even X linked D ones....

I have a few weeks so I think I just have to sit down and make a list or something but if anyone can help me out with this that'd be great. I'd hate to have a long vignette, figure out the dz but then to just have a "how is it inherited" thing at the end and not have a clue...

Ok, i think FA is AWESOME for this, you dont need to make a new list, and as youre memorizing them you can also go through what each order actually does.. go to the biochem section and memorize them there.

But a few pointers to help you along the way:

-most STRUCTURAL defects are AD and most enzymes defects are AR

-dont quote me on this but i've noticed a pattern of x linked recessive for almost all of the immunodeficiencies.

-if all else fails and you have no idea, but its a child who dies in infancy, assume its recessive inheritance.

 

[PokerDoc]

I really suck at bone diseases (i know i know, thats what she said).. but seriously.. how do you keep them all straight.

If you were like 'what is osteopetrosis' sure I can answer that, but obviously thats not how its asked.. you get some vague clinical picture and you have to be able to trace the pathogenesis back to its origin, for some reason, Im having difficulty with that.. I keep crossing on osteomalacia and pagets and sometimes even osteopetrosis if im not given a 'give away' in the question stem like ALP elevated only.

 

[IMGUSMLEStep1]

I always have issues with remember what diseases are AD, AR, X linked R, even X linked D ones....

I have a few weeks so I think I just have to sit down and make a list or something but if anyone can help me out with this that'd be great. I'd hate to have a long vignette, figure out the dz but then to just have a "how is it inherited" thing at the end and not have a clue...

http://forums.studentdoctor.net/showpost.php?p=9763510&postcount=36

 

[kryptik]

can someone explain to me why A is 100% sensitivity and C is 100% specificity in the diagram at the bottom of page 53 in BS section of FA.

sensitivity deals with those with the disease so why is it in the part of the graph that corresponds to "No disease"? thanks

 

[PokerDoc]

can someone explain to me why A is 100% sensitivity and C is 100% specificity in the diagram at the bottom of page 53 in BS section of FA.

sensitivity deals with those with the disease so why is it in the part of the graph that corresponds to "No disease"? thanks

all the graph is really trying to show is that sensitivity and specificity are a tradeoff.. improve the test in one and you will lose in the other. As for 'no disease' thats just showing, as the sensitivity starts declining in that area of the graph you are going to start increasing your false positives again. Its not a well explained graph but thats what theyre 'trying' to show. At the apex of that curve 0 false positives.. the second you go either way on the curve, false positive rates start going up again. (same thing with false negatives on the specificity side)

 

[kryptik]

thanks poker, am starting to get it

 

[WashMe]

can someone explain to me why A is 100% sensitivity and C is 100% specificity in the diagram at the bottom of page 53 in BS section of FA.

sensitivity deals with those with the disease so why is it in the part of the graph that corresponds to "No disease"? thanks

This is because they drew the sensitivity line just at the left hand side of the tail for the diseased people (i.e. just at the point where 100% of the diseased people people fall above the cutoff for the test, thus being identified). The same logic applies for the specificity line and the non-diseased group. Of course, this doesn't always fall in a given portion of the distribution that isn't being considered. It would have been nice if they hadn't made it fall right at the mean for the "no disease" group, because it draws focus away from the intent of the line.

 

[1nycdoc8]

http://forums.studentdoctor.net/showpost.php?p=9763510&postcount=36

Thanks! This is from IMG's post at that link, I hope you don't mind if I put it here-

X-linked recessive: the mnemonic in First Aid (Be Wise, Fool's GOLD Heeds Silly Hope)

X-linked dominant: hypophosphatemic rickets, Retts, and Fragile X

Autosomal recessive:
these are mostly metabolic diseases:
1. glycogen storage diseases
2. hemochromatosis
3. phenylketonuria
4. albinism
5. mucopolysaccharidoses except Hunter's
6. Sphingolipidoses except Fabry's

+ Hemoglobinopathies (thalassemias and sickle cell anemias)
+ ARPKD (obviously)

Autosomal Dominant:
these are mostly structural proteins: achondroplasia, hereditary spherocytosis, Marfan's syndrome,

neoplastic syndromes (Familial adenomatous polyposis, Hereditary hemorrhagic telangiectasia, MEN, Neurofibromatosis 1 and 2, Tuberous sclerosis, VHL disease)
This is especially true for those involving oncogenes, because only one activated oncogene is required to produce a neoplasia.

2 others you need to know: Familial hypercholesterolemia, Huntington's disease

-Albright's hereditary osteodystrophy (pseudohypopth) is also AD

Ha if people want to keep adding to this that'd be cool!

 

[sswang00]

I can never remember the male/female homologues for embryo! On FA pg 135

Genetical tubercle and labioscrotal swelling I can remember but the rest I keep forgetting
I have the most trouble with remembering what the urogenital sinus forms

 

[IMGUSMLEStep1]

I can never remember the male/female homologues for embryo! On FA pg 135

Genetical tubercle and labioscrotal swelling I can remember but the rest I keep forgetting
I have the most trouble with remembering what the urogenital sinus forms

Just remember that the urogenital sinus develops into glands.

In males it's the prostate and bulbourethral.
In females it's the Bartholin and urethral/paraurethral glands

 

[BenCarson]

Thought would share this with you. My pharm prof said we should know this connection between Metformin and reduced B12 absorption as side effect. he said it's important for the test though it has not been cover by review materials.