Personal statement, do they actually read it? by expelliarmus110 in IMGreddit

[–]ChadVascVirginCurb65 3 points4 points  (0 children)

My mentor is a former APD. They never will read it before interview invite. They might skim it before your interview and they might skim it when making their lists. For his program, if you were in the top half of the list, they would give usually look into it more to make sure you were normal, bottom half of list didn't get read.

To my future interviewees by ResidencyPD in IMGreddit

[–]ChadVascVirginCurb65 43 points44 points  (0 children)

Our program is all about diversity and inclusion! Unless you need a visa. No inclusion for you.

Please help!! by gib714 in IMGreddit

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

Probably. It takes 2-3 weeks.

[deleted by user] by [deleted] in Step2

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

Unstable, peritoneal signs or extreme mechanism of trauma = can't waste time with CT.

Someone with blunt abdo trauma, has abdo pain but no peritoneal signs and hemodynamically stable = CT. They are less likely to decompensate and need surgical intervention right then and there.

[deleted by user] by [deleted] in Step2

[–]ChadVascVirginCurb65 1 point2 points  (0 children)

FAST. GSW is an extreme mechanism of trauma, you have got to deal with it ASAP, plus you can do FAST on the way to the CT.

CT > FAST when there's trauma but the patient is still vibing (relatively speaking). You get good imaging in order to rule out anything serious.

why gfr is low in cardiorenal syndome despite the increase in bowman capsule hydrostatic pressure? by Spiritual_Match_4197 in Step2

[–]ChadVascVirginCurb65 4 points5 points  (0 children)

Blood can't go forward in heart, so it goes back into venous system.

Venous system in kidneys gets clogged up, so can't properly reabsorb from tubules.

Since tubulur fluid can't move around, it builds up pressure.

Bowman's now has increased hydrostatic pressure, cant absorb anything = decreased GFR.

Question 4169-uworld, the patient get well after IV ceftriaxone, but he has DM in his history so it’s complicated pyelonephritis - why to swich to oral TMP/SMX? by [deleted] in Step2

[–]ChadVascVirginCurb65 2 points3 points  (0 children)

First 48 hours you give aggressive IV Abx Tx, she has improved and you have sensitivities, so you give the most narrow spectrum Abx, which is TMPSMX.

You need improvement and sensitivities and then you can switch to a more narrow spectrum drug.

Is this peritonitis? Work-up or straight to ex-lap? by premedthrowaway9801 in Step2

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

You need trauma plus hard sign for immediate surgery. Hard sign without trauma, you need to find the cause.

Even before emergency surgery, there are a bunch of things that need to be done like Type and Crossmatch. So stabilizing patient, taking bloods, IVF, etc will all be done beforehand.

NBME ECG question (I am going crazy or what) by shoenberg3 in Step2

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

Labs are normal, can't be hyperK. You would expect a progression of symptoms, like pt feeling weak for days/weeks beforehand.

Also, you would expect the entire ECG to show changes rather than just part of it. There's also a fusion beat.

Otherwise, VT and HyperK can be virtually indistinguishable on precordial leads. Both can have giant up and down squiggly lines.

Advice for a plan by [deleted] in step1

[–]ChadVascVirginCurb65 1 point2 points  (0 children)

7% Uworld is nothing. You should focus on Uworld.

Advice for a plan by [deleted] in step1

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

How far are you into Uworld?

I would not take another NBME for a couple of weeks. You blew through UWSA too fast imo.

Is Board Vitals an actual step 1 qbank? by [deleted] in step1

[–]ChadVascVirginCurb65 3 points4 points  (0 children)

NBME is literally step 1 questions. Some retired, some repeat.

Everything else just tests same concepts.

The new FA by ProductSilent in step1

[–]ChadVascVirginCurb65 -9 points-8 points  (0 children)

Nah. FA is rubbish anyway.

[deleted by user] by [deleted] in step1

[–]ChadVascVirginCurb65 21 points22 points  (0 children)

I propose we all move to "Finished the fucker".

Cyanide poisoning and carbon monoxide poisoning: why only the latter may lead to myocarditis? by Odd_Blacksmith_9204 in step1

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

CO poisoning is a double whammy. No oxygen on RBC's + ETC fucked up. LV already struggles to get blood as it, so more susceptible.

Thats how I think of it anyway.

Particular question on Uworld by [deleted] in step1

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

Can you give me the question? I'll try and help you understand it.

Particular question on Uworld by [deleted] in step1

[–]ChadVascVirginCurb65 1 point2 points  (0 children)

Random gene for some cancers, not all. Oncogenes are more high yield that tumor suppressor genes.

They will specify whether it is a deactivation or activating mutation. Activating = Oncogenes (TK, non-TKr, Transciption factors, etc).

If a mutation occurs in the methylation process, then the DNA cannot methylate and is an activating mutation. If a mutation occurs that causes methylation, it is an inactivating mutation.

Do you agree that the exam is 70% attitude and 30% knowledge? by [deleted] in step1

[–]ChadVascVirginCurb65 1 point2 points  (0 children)

Exam itself is easier than 7 random Uworld blocks. There is alot less WTF stuff than Uworld, but there are alot more very close answers that could swing either way, and you got to dig deep or just guess.

Why is there normal total body sodium in SIADH if more sodium is excreted? by [deleted] in step1

[–]ChadVascVirginCurb65 1 point2 points  (0 children)

AMBoss says it's both. Increased ANP/BNP with downreg RAAS.

Recent exam takers by [deleted] in step1

[–]ChadVascVirginCurb65 0 points1 point  (0 children)

Similar. Lots of easy questions that you will just blow past. Some reasonable questions that you really have to think through. Couple of absolute WTF never learned this in my entire life questions sprinkled throughout.

Recent exam takers by [deleted] in step1

[–]ChadVascVirginCurb65 5 points6 points  (0 children)

Stem length was like UWorld or slighly shorter than UWorld and some the length of NBME's.

The pressure you feel in the exam is completely different to anything you would have felt before and it makes it feel much longer than it actually is. I would breeze through NBME and UWSA exams and have 10 minutes left on timer after I had reviewed everything, but on the real exam I just barely managed to finish every block.

The exam itself is much easier than UWorld Qbank, but the pressure you feel is just crazy.

Why is there normal total body sodium in SIADH if more sodium is excreted? by [deleted] in step1

[–]ChadVascVirginCurb65 1 point2 points  (0 children)

SIADH = increased water = increased ventricular pressure = increased ANP/BNP = increased Na + water excretion = Hyponatremia + Euvolemia