usmle 1

To remember about SVT, all you need to remember is the cause and you know the symptoms and treatment!

SVT occurs due to accessory conduction pathway through the AV node.

A - ABCD

Adenosine

Beta blockers

Calcium channel blockers

Digoxin

V - Vagal maneuvers

Valsalva

Ice immersion

Carotid massage

SVT: Start Vagal Treatment - - > If fails, use pharmacotherapy (ABCD drugs)

The P in Pvst reminds us that it presents with Palpitations in a hemodynamically stable patient (HR: 160-180/min)

*PVST: Paroxysmal supraventricular tachycardia

Interesting fact: In an asthmatic patient with SVT, you can’t give adenosine or beta blockers. The drug of choice in an asthmatic patient is therefore, diltiazem (A calcium channel blocker)

That’s all!

-IkaN

Personality disorders as memes

Because this is how I learn things

There are lots of mnemonics for remembering the clusters (which have fallen out of use anyway) but I prefer one that make sense to me because it uses the A, B and C for awkward, bratty, and cowardly

Cluster A Personality Disorders (”awkward”):

Paranoid:

Schizoid:

Schizotypal:


Cluster B Personality Disorders (”Bratty”):

Antisocial:

Borderline:

Histrionic:

Narcissistic:


Cluster C Personality Disorders (”Cowardly”):

Avoidant:

Dependent:

OCPD:

Step 1 Pre-Dedicated Study Plan

I think I finally have my pre-dedicated study plan down! After much persuasion from some friends who have already started, I am switching over primarily to UWorld. I plan to use Kaplan and USMLE-Rx to practice for my class exams so I don’t feel like I’m completely wasting it. 

Based on my calculations, I need to do 22 UWorld questions/day to finish a first pass before dedicated. These questions are HARD, but keeping up with making flashcards of the information I was shaky on is even harder. I think I might start using a word document as well? Genetics is sometimes hard to translate into flashcard form.  

As far as First Aid, I’m using the anki brosencephalon deck. I’ve been introducing all my friends to this. An awesome person, by the username brosencephalon, shared his giant First Aid flashcard deck with the online world and last I heard he was hired by Osmosis for being awesome (they wanted to use his deck, also he deserves all the monies). I’ve been doing 75 new cards a day and after some trouble, I figured out a method that works for me. I pick one new subject and then go through the cards with the relevant FA chapter open. I’m very visual so I learn a lot better this way. I plan to do an Anki related post soon for anyone interested! 

I feel guilty about not utilizing Osmosis questions, picmonic, or USMLE-Rx more. There are so many resources and I can’t help but worry I’m missing out on something. I do plan to use Osmosis Step 1 study plan starting in February though. Hopefully that will help me organize when to watch pathoma and sketchy videos. Right now I’m trying to focus on at least some solid part of the plan. So, to summarize, right now I need to do:

1. 22 UWorld questions

2. 75 new anki + reviews

3. Make flashcards off of new qbank facts

4. 50 qbank flashcards

5. ???

6. Profit (hopefully)

youtube

Here y’all go! A comprehensive video on how I studied for Step 1. Hit me up with any questions you have here or on my youtube channel in the comments, and don’t forget to subscribe! 

Developmental Milestones

Infant

From Birth-12 months of age

1 month–they can lift up their head

2 month–they can smile in response to faces

4-6 months–form a bond with caregiver, and can recognize familiar faces

6 months–develops stranger anxiety, they can sit up, roll over, and they can pass toys from one hand to the other 

8 months–They crawl

9 months–they develop object permanence (they know objects that are hidden are still there), separation anxiety develops

10 months–they can stand, and develop pincer grasp 

12 months–they can point at objects 

12-18 months–they can walk without assistance

Certain reflexes will disappear as they get older:

3 months: Moro reflex disappears (Moro reflex: when they are startled, they extend their arms and legs)

4 months: Rooting reflex disappears (when you stroke the side of a baby’s cheek, they look for nipple) 

6 months: Palmar reflex disappears (infant reflexively grasp fingers placed in its hand)

12 months: Babinski reflex disappears (in response to brushing the sole of the baby’s foot, the big toe dorsiflexes) 

What I Learned Today

So heparin is a great drug- so long as it’s not causing you to bleed to death. It’s also not so great if you’re being tested on it. 

One of the most common things they ask about heparin is: how do you reverse it’s effects?

Well the answer is protamine sulfate. Today it’s made from recombinant DNA.  But, do you know what protamine sulfate was originally made from???? 

Fish sperm. 

That’s right. In 1874 Some guy called Friedrich Miescher was researching fish sperm and discovered protamines. Some time in the 1930′s someone was doing some research and they realized “HEY! This slows the absorption of insulin!” which is cool but the thing that was even cooler is that they discovered that it reverses heparins anti-coagulation effects. 

And thus PROTAMINE SULFATE as a drug was born! 

This is also why it should be avoided in people who are allergic to fish. 

youtu.be
DNA and RNA Viruses Mnemonic for USMLE Step 1

To all my microbiology studiers out there. I found this video when I was studying for the virology block of my micro class, and this + sketchy micro was an absolute GODSEND. If you’re struggling with remembering the structures and families of the viruses or prefer flow charts over big tables, CHECK THIS DUDE OUT. I could listen to him talk viruses to me all day. 

Here’s a look at how I implemented it into my First Aid (pages 148, 150).

Hope someone finds this helpful!

When we are under stress, our body produces cortisol. 

Effects of cortisol can be remembered by mnemonic BIG FIB:

B--Increases Blood Pressure via upregulation of Alpha 1 receptors. 

IInsulin resistance

GGluconeogenesis

F–Decreases Fibroblast activity which leads to formation of stria

IImmunosuppresion 

  • Cortisol/glucocorticoids increases synthesis of Lipocortin which inhibits Phospholipase A2 leading to a decrease in Leukotriene and Prostaglandin formation
  • Cortisol inhibits IL-2–T cell apoptosis
  • Cortisol inhibits leukocyte adhesion
  • Cortisol inhibits histamine and serotonin release 
  •  Cortisol decreases eosinophil number

BBone destruction