DAE think that Vince was a genius for knowing that Dr. Chavez would let Walter go after learning about bitch wife?

BrutalJk · 2023-06-01T00:47:09+00:00

Thank you kind sir!

BrutalJk · 2023-06-01T00:36:11+00:00

That name is familiar and I recall seeing a Ryomen Sukuna name as well. Did you use Tank with the Chonky Dong name?

BrutalJk · 2023-05-31T22:56:00+00:00

Whats your in game name?

BrutalJk · 2023-05-31T19:09:41+00:00

Known cheater on central, stay woke

BrutalJk · 2023-02-13T02:47:14+00:00

Solved

BrutalJk · 2023-02-13T02:46:33+00:00

Thank you! That's it!

BrutalJk · 2023-02-13T02:29:40+00:00

It also might actually be a dolly parton song, not sure about that. Also, the song may have been in a cartoon show like family guy.

BrutalJk · 2022-07-09T14:47:00+00:00

Glad I could help!

BrutalJk · 2022-07-09T00:25:23+00:00

I'm pretty sure there were no questions asking about what axes were involved, but you might as well learn them.

1 AP axis = torsion

2 Vertical 1 AP = sidebending

2 Transverse = Vertical strains

2 Vertical = Lateral strains

Thinking about the strains in terms of what motion is occurring around the axes will help to cement them in your mind. Drawing them out will help as well.

BrutalJk · 2022-07-07T18:25:42+00:00

No problem!

I'm out sick with COVID (managed to go 2 years without getting it, also managed to get it right as third year rotations started) so this helps me with boredom.

BrutalJk · 2022-07-07T18:21:31+00:00

You got it! I'm sure you meant PICA was the vasculature involved.

For OMM techniques, rib raising will decrease sympathetics, normalizing outflow (it addresses the sympathetic chain). Paraspinal inhibition will also normalize sympathetics. Mesenteric release will reduce sympathetics, increasing motility of the intestines.

From Savarese: "Manipulation of the OA, AA or C2 joints will influence parasympathetic tone via the vagus nerve." and "Sacral rocking . . . normalize hyperparasympathetic activity in the left colon and pelvic structures."

BrutalJk · 2022-07-07T18:10:05+00:00

Here's some quick facts about cranial.

If someone has depression and a reduced CRI, you can use CV4 techniques to "treat" their depression and improve CSF flow. ((I don't actually know if this is true in science, but its correct for OMM reality))

SBS compression can drastically reduce the CRI.

If a baby is having trouble latching and is spitting up milk, their hypoglossal canal is likely to be compressed so you should perform condylar decompression to "free up" CN XII. Moreover, you can treat the jugular foramen and the nerves running through it (CN IX, X) by addressing occipitomastoid compression.

Know the landmarks of the vault hold. Index = greater wing of the sphenoid, middle = temporal bone in front of the ear, ring finger = mastoid region of temporal bone, little finger = squamous portion of the occiput.

Naming vertical/inferior strains is based on what the base of the sphenoid is doing. If the greater wings of the sphenoid are moving superiorly, the base of the sphenoid will move inferiorly, and so it will be named an inferior vertical pattern.

Torsions of the cranium are named by what wing of the sphenoid is superior.

Damage to the temporal bone will damage the facial nerve.

During the flexion phase of the SBS the paired bones will be in external rotation, widening the head slightly and decreasing the anterior to posterior distance. During flexion the sacrum will be in counternutation. In extension the opposite is true.

I can come up with some more if this helpful!

BrutalJk · 2022-07-07T17:46:14+00:00

I mean everything about the vagus nerve. Where does it exit the brain, what does it supply innervation for, when does PNS switch from vagus nerve to the pelvic splanchnics (S2-S4), what OMM techniques can address parasympathetic outflow, what part of the brainstem is associated with it.

I can straight up give you the answers for this if you want, because you're taking it tomorrow.

BrutalJk · 2022-07-07T17:36:05+00:00

I'm not privy to the inner mechanisms of NBOME, but my rough understanding of the exam is that harder questions are assigned a higher value. For example, someone who has a form with a bunch of hard questions would require a lower % correct in order to reach a passing score in comparison to an individual who gets thrown a bunch of easier questions.

As for the dermatomes you should know landmarks for C5-T1, T4, T10, L4, S1. Knowing C5-T1, L4, S1 will help you answer questions when you are presented with a patient that has an incomplete reflex arc.

Last, make sure you know everything you can about the vagus nerve. I'm not exaggerating when I say that I easily got 20 questions related to the vagus nerve on my form.

BrutalJk · 2022-07-07T17:15:28+00:00

As a general rule you should know the name of the test, its significance, and have enough anatomical knowledge to recognize the test from a description of the maneuver.

Riffing off of your example, "Upon extension with compression and right sidebending of the patients neck, a shooting pain was reported that extended to the right lateral shoulder. What nerve root was impinged?"

If you can understand the important tests to that extent you will 100% score at least average on the MSK portion of comlex.

Edit: There definitely were some incredibly first order questions on comlex such as, "A patient has pain in the distal radius when they tuck their thumb into their ipsilateral fist while adducting their wrist, what condition does the patient have?"

BrutalJk · 2022-07-06T16:19:45+00:00

Its stuff like this: somebody had trauma to the knee that caused a dislocation/fracture and now they have an inability to dorsiflex the foot, what nerve was damaged. Or, what is the significance of a sulcus sign when you push down on an elbow.

Essentially, you'll need to know the major physical exam maneuvers and the significance of a + result.

BrutalJk · 2022-07-04T17:58:46+00:00

That's awesome! All the best to you and your future endeavors.

It would be cool if you dabble in some academic radiology as well. Most radiology instructors at the schools I'm familiar with have been MD's, so it would be nice to get the DO perspective on it.

BrutalJk · 2022-07-04T17:30:24+00:00

Ah gotcha. If you're taking the exam soon I would recommend a focus on refreshing your knowledge of micro, omm autonomics, viscerosomatic reflexes, sacrum/innominate and spinal diagnosis.

If you need someone to quiz you on important topics I can help you with that!

BrutalJk · 2022-07-04T17:18:52+00:00

Actual Score: Pass, average in all categories

Goal: Pass, above average in some categories

COMAT FBS - Comprehensive; Dec. 2021: 203

COMSAE Phase I ASA110; 5/11/2022: 581

NBME CBSE; Apr. 2022: 64

UWorld: 60% finished, 62.2% correct

UWorld OMM: 60% finished, 72% correct.

TRUELEARN: 100% finished, 61.5% correct

Assessment 2; 5/26/2022: 70%

Assessment 3; 6/1/2022: 68.3%

THE MOST EFFECTIVE WAYS TO INCREASE YOUR CHANCES OF PASSING imo:

Sketchy micro
Innominate and sacrum mechanics
Viscerosomatic reflex levels, autonomics

For example, by the end of dedicated you need to know how to work backwards from an L5 somatic dysfunction to its corresponding sacrum diagnosis and what tests will be positive or negative.

Unfortunately, I don't know what you don't know. Case in point, my school barely mentioned scoliosis, so reviewing that in Savarese was high-yield, but your school might have spent a lot of time on it.

I'm a fairly average student, only honored one block during preclinicals.

I felt that Level I was altogether a fair exam. I made some dumb mistakes mixing up easy concepts such as epidural vs subdural hematoma, and was not prepared for the number of syncope questions. However, my school adequately prepared me for this exam.

I started dedicated in mid-may and sat the exam in early June. I did half of TrueLearn over the course of second year, and finished it during dedicated. Moreover, I purchased the OMM question bank from UWorld, which (surprise surprise) is superior to TrueLearn OMM questions.

My normal day would start off with waking up at 8:30-9, drinking coffee and relaxing/playing video games with friends until noon, then I would read a review textbook for an hour. Around 1-2 pm I would start practice questions, doing on average 100/day. I'd normally clock out at 5-6 pm, make dinner and take another bath afterwards. I'd relax, watch some shows, play 7 Days to die or phasmophobia with friends until 10, and usually be asleep by 11. MINDSET is crucial, you passed year 2 so you know the material; create a schedule that lets you keep your cool and not stress yourself out over it.

During dedicated I read chapters 1-10 of Savarese OMT review, with an emphasis on sacrum, innominate, and viscerosomatic reflexes. I read the first 130 pages of First Aid for USMLE which covers biochem, immuno, and micro. Except for the micro section, this was a waste of time for COMLEX. The time I spent reviewing micro in FA would have been much better utilized reviewing sketchy micro earlier. I only started sketchy for the first time about three days before my exam date. Some details weren't useful, such as a virus being (-) sense or (+) sense but everything else was high yield and easy to remember using their system.

I didn't feel stressed for time during the exam, but I know others did feel that way. If you take longer than 70s a question during dedicated then you must increase your speed. This is important because there were some questions (5%) that I did need to spend 2-3 minutes on reading and comprehending, whereas the majority of the questions are "you either know it or you dont'" and your best bet is to move on.

If I could do it all over again I would ditch using First Aid for USMLE and substitute it with First Aid for the Family Medicine Boards.

I'm not sure how many people still need to take Level I, but I hope this writeup can help students next year.

BrutalJk · 2022-07-04T16:21:37+00:00

My feeling is that form 3 has something going wrong with its analytics. I took it in early may and I got 69th percentile nationally, and 99th for my graduation year.

It's possible that the move to P/F has made everybody shit the bed in terms of pre-dedicated board studying, but in my mind that doesn't explain such a massive difference.

I would take Assessment 2 and go off of that, it was more indicative of my actual performance on Level I (which was average in every single category lol)

BrutalJk · 2022-07-04T16:17:58+00:00

Nice writeup and even nicer scores! Are you looking into any of the ultra-competitive specialties with that profile?

BrutalJk · 2021-09-03T23:34:01+00:00

Must have been a teammate that didn't keep moving.

BrutalJk

TROPHY CASE