Meningitis

Most common cause of neonatal meningitis is:

G - GBS - number 1 cause

E - Ecoli - number 2 cause

L - Listeria - number 3 cause

If the child is 3-2 years age and not vaccinated - H. Influenza

If the child is 3 months - 2 years old - and vaccinated - Strep Pneumonae is the most common cause

More on Meningitis and USMLE Step 1 High Yield info - check out www.tutia.com.  You can find study partners as well.  

Herniation of Nucleus Pulposus

Herniation of Nucleus Pulposus

Most common direction of herniation is posteriolateral

Attacking multiple choice questions

USMLE is based on multiple choice questions.  There are about 322 multiple choice questions.    So knowing how to approach them is one of the key to successfully passing USMLE Step 1.  These tips will help you while practicing review questions as well. 

·         Read the question carefully and form a mental picture.  

·         Remember the key words

·         Understand the question

·         Come up with an answer before looking at the answer choices.    Many of us make the mistake of scanning the answers first.  This will lead you into a pit. 

·         Analyze and compare the answer choice against your answer.  Mentally recall the question and link back to the question. 

·         Mark the best answer.  Always mark the best answer.  There could be more than once choice but pick the BEST answer. 

Pemphigus Vulgaris vs Bullous Pemphigoid

Pemphigus vulgaris
- desmosonal - autoantibodies
- painful blisters
- common places - oropharynx and skin

Bullous Pemphigoid
- hemidesmosomal - autoantibodies
- rare on oral mucosa
- blistering with pruritus
- can be drug induced

Maternally Inherited Mitochondrial Diseases

1) Leber's optic neuropathy
2) Pearson Marrow-Pancreas syndrom
3) Male infertility

How to study for USMLE Step 1

Getting a 99 on USMLE is possible.  The harder you work at it, it will reward you in big way.   People before us have done it and people after us are going to do it as well.  So here is the chance for you to shine.  You have sacrificed so much to come to this phase of life.   Give your best for this.  If you fail, you will suffer.  The score will hunt you for the rest of your medical career.  So here is your chance to give your very best for YOU!

Before you start studying for step 1, answer these questions.  Take few hours and think clearly.  I find that doing yoga helps me relax and set goals.  Take a seat at a clean desk.  Get a note pad and a pen.  Start answering these questions and be honest. 

• What is my goal at the end of this year?
• What is my goal at the end of next year?
• Who am I studying for?
• Do I want to make the best doctor and why?  
• What score do I want on USMLE Step 1?  
• How would I feel when I have achieved this?
• Are there anything preventing me from getting this score?  
• Do you have all the resources?  
• Make a schedule and write down daily routines. 
• Do I have a study buddy?  If not, how am I going to make sure that I am target?
• Am I giving my very best?

Make sure you write down your answers and look at them daily.  Writing the answers is the best way to get to your goal.  Don`t cheat yourself by orally answering them.   

Here is what you need to have it in your memory before the exam:

·         Kaplan books, videos, qbank

·         USMLE world

·        Kaplan Q book

·        First AID book and questions

·         High Yield Neuroanatomy

·         High Yield Pathology

·         High Yield Histology

·         Goljan Pathology – do the questions as well. 

Here is a simple study guide to follow.  Follow these steps and achieve your 99 on your USMLE step1.  I am average student but following a process helped me stay on target. 

2 weeks – Physiology

2 weeks – Anatomy (embryo as well)

2 weeks – Biochemistry

2 weeks – Pharmacology

2 weeks – Pathology

2 weeks – Microbiology, Behavioural sciences, Genetics

As you study along, do qbank, USMLE world, and any other question bank that you can find.  Take notes as you along.  There is nothing like your own notes.  Don`t take notes the first time you read something.  Take notes of things you can`t remember and review it again and again. 

Last 3 weeks do as stimulated questions (in blocks).  Mock the exam day.  Review the materials that you are having hard time remembering. 

Days before exam try to relax and mock the exam day.  Make snacks to keep you energized. 

2-3 days before the exam, review the First Aid and nothing else.  Tell yourself you can do this.  Do stimulated questions. 

Day before exam – have fun and relax.  Maybe watch your favourite movie.  Do some yoga or exercise. 

The morning of the day before the exam - Eat a healthy breakfast and relax your mind.  Picture yourself getting 99 and walking out of that exam room excited and satisfied. 

In the center – Just take deep breaths and tell yourself, you can do it. 

Do the first two block simultaneously.  Taking break after the first block is not recommended.  Take a break before you start the third block.  Stretch and eat a snack and drink lots of water.  Write something on the marker board to encourage you.  Do the next two blocks and take a break.  Don`t eat something heavy because it will make you sleepy.  Make sure you are energized.  Keep your mind stimulated by writing down positive things about you on the marker board.  Do the next two blocks and take break.  Do the last block and you are done!!!

Congratulate yourself and walk confidently out of that exam room.