A 4-year-old boy is brought to the emergency department after being seen shaking on the floor. He had been playing with a video game when the episode began. He has no prior history of seizures or neurologic disorders. The episode resolved after 2 minutes.
>>>What is the most likely diagnosis for this patient?
>>>What is the most appropriate treatment for this condition?
>>>What are the side effects of the drugs associated with treatment?
>>>If the boy were in class answering a question and suddenly stopped for 30 seconds, then continued with his explanation, what would be the diagnosis and treatment?
>>>Which two commonly used seizure medications may cause Stevens-Johnson syndrome?
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A bright medical student is studying for the USMLE Step 1 in the library basement. Although he feels that he would much rather be enjoying the company of his friends who have decided to go to the beach that day, he knows that he has to finish his studying first. In order to empty the thoughts of the beach from his mind, he chooses to focus on his studying of behavioral sciences and smirks when he looks over the ego defenses.
>>>What two things qualify an ego defense as a reaction to psychological stress?
An ego defense must be automatic and unconscious.
>>>What are some examples of mature ego defenses?
Some mature ego defenses include Sublimation, Altruism, Suppression, and Humor. As a mnemonic, one can remember the phrase “Mature women wear a SASH.”
>>>What ego defense is this medical student using?
The medical student is using suppression. He is voluntarily withholding the idea of going to the beach from his conscious awareness by focusing on behavioral sciences. The difference between suppression and repression is that suppression is a voluntary process. It is therefore important to note that suppression is an exception to the rule that ego defenses must be unconscious.
>>>What are some examples of immature ego defenses?
Examples of immature ego defenses include acting out, denial, projection, reaction formation, regression, repression, and splitting, among others.
>>>What ego defense would the medical student be using if he could not handle the stress of studying for the examination and instead chose to go to the beach every day?
By involuntarily withholding the idea of taking the test as a reaction to his stress, the student would be exhibiting classic repression, the basic mechanism underlying all others.
This case study was contributed by Rakesh Razdan Ahuja, class of 2010, Yale University School of Medicine; in association with Le TT, Takiar V, eds: First Aid Cases for the USMLE Step 1. New York: McGraw-Hill, 2009.
This practice case study is representative of the studies available in the First Aid™ Cases for the USMLE Step 1. First Aid™ Cases for the USMLE Step 1 features 400 well-illustrated cases to help you relate basic science concepts to clinical situations. Each case includes drawings or clinical images with Q&As that reinforce key concepts. Get more Step 1 study help at USMLE-Rx.com.
In a post this past January, I highlighted some important reasons to use a question bank to study for Step 1 and gave my advice for selecting a question bank. I’ll include this advice again below; however, instead of talking about why you should choose a question bank, I’d like to briefly address the question of when you should start using one. Ideally, as you are proceeding through your preclinical classes, you will be using resources to cue you in as to which topics are important for Step 1 and, therefore, will make an effort to really learn these topics. Typically, 2nd year is the time you start focusing on systems pathophysiology.
By Walter Wiggins
With this post, we’d like to give you an overview of the timelines for the USMLE and the Match this year. Obviously, there will be variation in some of these dates for different institutions, but our hope is to take a little stress off of you by presenting you with a general timeline to guide your preparation for the three steps of the USMLE and this year’s residency Match. Deadlines will be in red text with the exact date of the deadline listed, for clarity.
Are you in the beginning stages of preparing for the family medicine shelf exam? What patients did you see on rotations? Do you have the right books and core knowledge? This blog post will review important tips and study methods designed to help you ace the family medicine shelf.
It’s important on the family medicine rotation to familiarize yourself with the broad topics you may encounter on the shelf exam. Personally, I found it very useful to create my own clinical case vignettes while diagnosing patients on rotations in the outpatient clinic.
Often, the family medicine shelf has subspecialty topics such as migraines, dermatology, physical medicine, and rehabilitation, which may all be incorporated into your core family medicine rotations.
A few months back, Vamsi and Jaysson posted a great article on iPad use in the hospital. However, their focus was on the use of iPads during residency. While they hit on some great points about order entry and care coordination, we’ll go over concerns specific to med students in this post.
At this point in time, only a few schools are taking major steps to integrate iPad use into their curricula. However, with the rising prevalence of e-textbooks and iPad-friendly electronic medical records (EMR) systems, students at many schools may benefit from using an iPad as an educational supplement in the classroom and on the wards.