USMLE-Rx Step 2 Qmax Challenge #21516

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 2 Qmax Challenge #21516A 32-year-old G1P1 woman presents to an outpatient gynecology clinic with a complaint of stale, white vaginal discharge for the past 4 days. She is sexually active with a monogamous partner of 8 years. She denies vaginal spotting, genital pruritus, or dysuria. A vaginal speculum examination reveals a copious amount of malodorous, grey-white discharge. A sample is obtained, and on potassium hydroxide preparation a strong fishy odor is detected. A photomicrograph is shown in the image.

Which of the following is the optimal treatment for this patient?

A. Treat her and her partner with oral fluconazole and test for other sexually transmitted diseases
B. Treat her and her partner with oral metronidazole and test for other sexually transmitted diseases
C. Treat her with oral fluconazole
D. Treat her with oral fluconazole and test for other sexually transmitted diseases
E. Treat her with oral metronidazole
F. Treat her with oral metronidazole and test for other sexually transmitted diseases

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

How to Succeed on the Pediatric Clerkship

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By Mark Ard

I spent hours searching the internet, combing blogs, and harassing 4th years to figure out how to tackle my first rotation. Below is what worked for me to honor the course.

Apply these tips as you will…

  • Get a decent-sized review book. Something like First Aid for the Wards is great for the big picture, but when you’re on a specific rotation, you want something a bit beefier. First Aid for the Pediatric Clerkship at 600 pages on an eight-week rotation was tough, but that’s the length I’d suggest. Boards and Wards, Toronto notes, Kaplan Lecture Notes… There are a ton of rotation-specific review books.
  • Find a comprehensive source. Ask your attending/resident what they use. We are talking 1,000+ page range. Harriet Lane Pediatrics was what I used, but check your library or online access list to see if you get any for free. Also, use the one in your clinic, on the ward, or at the library. Basically never carry it more than 10 feet.
  • Get quality digital references. UpToDate, Epocrates, Medscape, etc. Download them to a tablet. Use a tablet, not a phone. People think you’re texting on a phone, but you must be learning on a tablet.
  • Use journals. Ask your attending/resident. Never pay for access. Use what your school offers. We had Pediatrics In Review, and it was a great resource. See the post I wrote about using Evernote on the wards.
  • Get multiple-choice questions. There are plenty of Q&A books and online banks like USMLERx, Kaplan, UWorld.
  • Get a casebook. You want your prototypical patient who presents classically. Some schools subscribe to case programs like Med-U that are awesome but can be time consuming.

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Mnemonic Monday: The Krebs Cycle

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By Haley Masterson

Mnemonic courtesy of First Aid for the USMLE: Step 1

USMLE-Rx Step 2 Qmax Challenge #21515

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 2 Qmax Challenge #21515A 42-year-old G2P2 obese woman is seen at an outpatient gynecology clinic with a 2-day history of thick, curd-like white discharge with intense vaginal swelling, burning, and itching. She has required treatment for similar symptoms four times in the past 2 years. A speculum examination reveals thick, white cottage cheese-like vaginal discharge and erythematous vaginal mucosa. Gram stain of a sample of the discharge is shown in the image.

Which of the following would predispose the patient to recurrence of these symptoms?

A. Cervical neoplasia
B. Diabetes
C. Herpes simplex virus infection
D. Hypercholesterolemia
E. Multiple sexual partners
F. Unknown HIV infection

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

Patient Safety and Quality Improvement for IMGs: High Yield Takeaways

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By Edison Cano

In my last post, we started talking about the importance of PSQI. In this post, I want to emphasize some High Yield PSQI topics and how you might see them on boards and on the wards. These are based on the Patient Safety Primers from the Agency for Healthcare Research and Quality, if you would like to dive deeper.

Safety Culture
Building a safety culture has become the cornerstone of PSQI, and it centers on creating and encouraging a commitment to safety at every level. Key parts include a “blame-free” environment, in which errors or events can be openly discussed and addressed. No yelling, no blaming! Board questions here usually center on a mistake someone made. Look for answers that are straightforward and unassuming. Sometimes this means admitting you made an error or anonymously reporting an error or almost event. Be careful not to assume anything about your team. Think twice about anything that says, “It must have been…” (more…)

USMLE-Rx Step 1 Qmax Challenge #3613

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3613A 57-year-old man presents to his internist because of abnormal bleeding following a routine dental cleaning. Over the past several months he has experienced symptoms of headache, dizziness, fatigue, decreased vision, and occasional epistaxis. He has also begun noticing “lumps” on his armpits and groin region. The spleen tip is palpable on physical examination. Laboratory tests show a hemoglobin level of 11 g/dL, blood urea nitrogen of 25 mg/dL, calcium of 9.1, and total protein of 15 g/dL. Immunofixation shows high levels of IgM. Results of bone marrow biopsy are shown in the image.

Which of the following is the most likely explanation for the patient’s symptoms?

A. Heavy-chain disease
B. Monoclonal gammopathy of undetermined significance
C. Multiple myeloma
D. Primary amyloidosis
E. Waldenström’s macroglobulinemia

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

Master Step 1 by Becoming an Incremental Learner

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By Mark Ard

Step 1 was a beautiful beast. That was my original thought as I scoured the internet for pearls of wisdom about this majestic milestone. Shortly into first year, still before our first round of exams, I could explain the logistics of the test and the statistics of students’ performance for various specialties, even its r-value compared to the MCAT. Clearly, I knew thyne enemy. But I wanted more; I wanted to know the mindset necessary to put in the grueling work ahead, to learn how to avoid burn out, and mostly to enjoy being a student.

In my search for guidance, I discovered chess master and former U.S. Junior Champion Josh Waitzkin, inspiration for the movie “Searching for Bobby Fischer.” In his book, “The Art of Learning,” Josh gets at the core of how to approach study and intellectual growth while maintaining wholeness and a lifelong love of learning.

He explores the concept of “entity vs incremental theorists” as formulated by developmental psychologist Carol Dweck. Just like chess students spend countless hours learning the fundamental concepts of the game and incorporate their growing body of knowledge into practice to dominate the board, so second year medical students dive into review books and question banks, testing their mettle against NBME exams until one final eight-hour display of mental aptitude and endurance on a board of their own. Hopefully, understanding the difference between these two thinking types will help you progress on your journey towards Step 1 mastery. (more…)

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