"Obscure" USMLE Step 1 questions?

[Domenech]

Guys have you encountered any obscure stuff on your Step1 exams that you rather thought would not appear on your exam? I read AggieSean's experience and he quoted three things that appeared on his exam: Aeromonas Hydrophila, MecA gene, Scabies Rx. I searched for MecA gene in Kaplan and Warren Levinson's book but I didn't find it. It was there on wikipedia though, a full article. Again Aeromonas hydrophila is not dealt with in kaplan; Levinson only has 4 or 5 lines and that's it.

Although these would be rare, but still anything new you encountered and might want to share specifically here? For instance it took me the whole UWSA1 to realize number needed to treat should be studied at all costs

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[birdsofafeather]

wow, this post came back from the crypts.

any obscure questions from this year's exam?

i hope i don't get amino acid pka questions.

 

[engineeredout]

Had a question from kaplan which involved knowing that there is an alternative translocation for Burkitt's lymphoma which was t(2;8) instead of the standard that everyone has learned and thinks of: t(8;14).

REALLY???

Then another about knowing that the follicular hodgkins involved merging an Ig heavy chain gene with a bcl2 gene. Is this relevant in any way?

 

[bbydoc]

Had a question from kaplan which involved knowing that there is an alternative translocation for Burkitt's lymphoma which was t(2;8) instead of the standard that everyone has learned and thinks of: t(8;14).

REALLY???

Then another about knowing that the follicular hodgkins involved merging an Ig heavy chain gene with a bcl2 gene. Is this relevant in any way?

I can see which concept they are referring to...a heavy chain gene is expressed in greater amount and with it bcl-2, so you are overproducing a protein (bcl-2) which prevents the intrinsic pathway for apoptosis which means p53 cant induce apoptosis in response to DNA damage which is probably as bad as a cell with no p53...?
picky but I would have guessed this but t(2;8)??? at least I know now

 

[SB100]

I saw a UWORLD question about what types of radiation sunblock protects against

 

[XRanger]

I had a question where they show a molecular structure and asked what amino acid is this

 

[lord_jeebus]

Back in the day, I had a question about veterinary medicine, and a question about how to perform a certain cosmetic medical procedure. Both touched upon concepts within the scope of Step I, but the latter seemed particularly unreasonable, and several years and some Google research later, I still don't know the answer.

 

[justintime55]

25-year-old female presents with pruritic, urticarial, erythmatous rashes on upper back, arms (sparing the antecubital fossa), and legs...with polyarthalgia...no fever...

lab work-up reveals mild neutrophilia; no eosinophilia or other abnormal CBC values; ESR is NOT elevated.

physician prescribes cetirizine and hydroxyzine; symptoms resolve for 1-2 days, then re-appear. Physician then prescribes corticosteroids for 3 weeks. patient reports that rashes resolve, but she occasionally still reports pruritus.

Top differential?

[ this is a paraphrased vignette from my school's case-study prep course for MS-2s ]

 

[dozitgetchahi]

25-year-old female presents with pruritic, urticarial, erythmatous rashes on upper back, arms (sparing the antecubital fossa), and legs...with polyarthalgia...no fever...

lab work-up reveals mild neutrophilia; no eosinophilia or other abnormal CBC values; ESR is NOT elevated.

physician prescribes cetirizine and hydroxyzine; symptoms resolve for 1-2 days, then re-appear. Physician then prescribes corticosteroids for 3 weeks. patient reports that rashes resolve, but she occasionally still reports pruritus.

Top differential?

[ this is a paraphrased vignette from my school's case-study prep course for MS-2s ]

Mastocytosis?

 

[engineeredout]

Got a kaplan Q requiring knowing that a drug called "Febuxostat" is a xanthine oxidase inhibitor. Am I the only one who has never heard of this drug before?

 

[bbydoc]

Got a kaplan Q requiring knowing that a drug called "Febuxostat" is a xanthine oxidase inhibitor. Am I the only one who has never heard of this drug before?

came across this drug in katzung pharm under "treatment for gout" but didnt feel the need to commit this to memory as it is not in FA.

 

[drosenb3]

Just watch TV to remember febuxostat is Uloric, the commercial with the guy carrying around the green flask which I guess is supposed to be uric acid.

 

[drosenb3]

Just watch TV to remember febuxostat is Uloric, the commercial with the guy carrying around the green flask which I guess is supposed to be uric acid.

 

[birdsofafeather]

had a practice question where you had to know that you can get nephrogenic diabetes insipidus due to a hereditary defect in the aquaporin 2 channel in a previously healthy teenager.

 

[RapplixGmed]

The exam writers may be attempting to bring our attention to the fact that Histidine is an important buffering amino acid (more so than even the others, as it is one of the positively charged AAs,essential and key for major enzyme catalysis). This is really the only reason to integrate a basic memory recall question that.

Yup. I think it is important to remember that Histidine is the ONLY amino acid with a pKa at a physiologic pH. Forget all the other crap.

 

[Rollo]

had a practice question where you had to know that you can get nephrogenic diabetes insipidus due to a hereditary defect in the aquaporin 2 channel in a previously healthy teenager.

How was this question worded?

 

[birdsofafeather]

dont know if I am "allowed" to post it but it is in the usmle.org free 150 questions.

 

[unsung]

Can someone explain to me what's relevant to know about pKa? I pretty much suck at basic sciences. Please?

 

[SlaveOfTCMC]

Had a question from kaplan which involved knowing that there is an alternative translocation for Burkitt's lymphoma which was t(2;8) instead of the standard that everyone has learned and thinks of: t(8;14).

REALLY???

Then another about knowing that the follicular hodgkins involved merging an Ig heavy chain gene with a bcl2 gene. Is this relevant in any way?

yes the t(2:8) is rearranging the kappa light chain with c-myc

the t(8:22) is rearragning the lambda light chain with c-myc

Thesse were mentioned in passing in the Kaplan QBank on a Burkitt's question

 

[SlaveOfTCMC]

I saw a UWORLD question about what types of radiation sunblock protects against

Zinc oxide blocks UVAI, II and UVB

PABA esters block UVAB

Avobenzone blocks UVA I and II

 

[jfgavina]

acid/base titulation, did someone get one about this?

 

[kac714]

Zinc oxide blocks UVAI, II and UVB

PABA esters block UVAB

Avobenzone blocks UVA I and II

did you actually know that?? I had that question yesterday and thought "oh, no one will know that" but 45% got it right...

 

[SlaveOfTCMC]

did you actually know that?? I had that question yesterday and thought "oh, no one will know that" but 45% got it right...

fortunately, it was one of the obscure things that the clinical faculty @ my school decided to mention.