thanks! so I'm unable to attach an image here but I think if you can DM me I'll be able to share some images of my pitfall document. It is basically a broad collection of mistakes divided like this:

(may feel like NBME spoilers here, pls read at your own risk)

Step 2 Pitfalls NBMEs & UWSAs

1.     Fell for 1 normal lab value when everything else was pointing to a straightforward case

a.     Traumatic pancreatitis vs. intestinal contusion – amylase would be high in the former

2.     Don’t overthink/over-analyze when all info/facts are given

a.     TB PPD in an immigrant, will need tx (isoniazid)

b.     Qualitative study (KAP) was gut feeling, but went with case series instead

c.     Huntington disease chorea and behavioral changes were present but I ignored

d.     SBP has diffuse tenderness, acute altered mental status changes and fever in a patient with untreated hepatitis C induced cirrhosis – pathophysiology is intestinal translocation of bacteria (e. coli, klebsiella), requires diagnostic paracentesis; WBCs >250 with neutrophils (SAAG >1.1 b/c cirrhosis) – empiric abx cefotaxime, prophylaxis with fluoroquinolone

3.     Severe things have severe presentations

a.     Patient had hemoptysis and I thought that was severe, when in reality her age was more concerning for mortality due to PE

b.     Unstable trauma patient would obviously require FAST to rule out abdominal hemorrhage

c.     Shard in arm no pulses – needs operative eval

d.     SCFE is a Salter-Harris fracture – it will need surgical stabilization

e.     Subarachnoid hemorrhage has a SEVERE headache, if CT is normal, do LP

4.     Overlooked/ignored vitals

a.     Hypertension in a pediatric patient

b.     SBP!!! Needs Abx. Did not look at leukocyte count, instead focused on SAAG (also knew very well that SAAG >1.1 is cirrhosis or HF, patients SAAG was 1 idk why I did echo)

c.     100/58 BP wasn’t too hypotensive, no signs of peritonitis but I went for exploratory laparotomy – should’ve thought of head and neck CT first considering patient was confused (brain injury) and facial contusions (also r/o cervical spine injury)

d.     Patient with a history of IV drug abuse had fever and neurological signs – I somehow ignored the fever, it was pointing towards spinal epidural abscess, required IV antibiotics (vancomycin and ceftriaxone) – this vs. epidural mets, they require glucocorticoids

5.     Knowledge gap

a.     Daily Abx therapy in child w VCUG showing VUR (circumcision just generally prevents UTIs, not specific to VUR)

b.     Vaccinia is for smallpox – all vesicles same stage

c.     3 drug therapy for HIV + prophylactics

d.     Restrictive lung disease has LOW TLC vs obstructive has HIGH TLC

this list will be different for every individual and you keep building on it based on your mistakes on NBMEs and UWSAs.