| Usmle Review Notes (E-book) for Step 1, Step 2CK, Step 2CS and Step 3 Author & Copyright: Dr. Patel |
| Ebay-fame USMLE Review notes is now available at UsmleRockers at 33% reduced price for a limited period of time!!! Hundreds of notes already sold in Ebay with 100% positive feedback! |
|
| “These are my own notes. These notes helped me to get a score of 99 in Step 1 and 96 in Step 2CK. I used to get 90 on my four NBME practice tests. But after I went through these notes carefully I jumped from 90 to 99 on my actual USMLE step 1 exam. I also got 39- 40 out of 50 questions consistently correct on Kaplan Q-bank just after I went through these notes twice" - Dr. Patel |
| Dr. Patel was the first person to sell personal USMLE notes in Ebay. He started with only four notes (Microbiology, Immunology, Pathology & High Yield facts) in June 2007 . After he received great response and huge demand for his notes for other subjects, he added the other notes one by one. |
| USMLE STEP 1 Notes: Everyone has their own study style. What I have written here is what I believe and what I did for my own preparation. Four important steps to keep in mind when you start your preparation for USMLE: 1. Good review books [Princeton, Kaplan, BRS, Premier, Falcon, Lange, Lippincott, Rapid review; All are good] 2. Make sure you have understood and remember the concept [Group Discussion or Self Discussion] 3. Q-banks [Apply your knowledge and learn how they present concepts on the exam] 4. My Quick Review Notes Those who have more reading time (3-4 months): • Go through any one of review notes first. It takes around 2 months to complete your first review. Do some free questions in between to get an idea about how they ask question on the exam. It is very important to get that idea. Once you have an idea about how they ask question on the exam, it will become so easy for you about how to do your second review. • Your second review is nothing but making sure that you have understood and remember the concept. Group discussion is the best way. I studied alone for all three exams. When I was doing my second review, I questioned myself and answered them myself! Check how much information you have remembered in Microbiology, Immunology and Pharmacology by clicking on following link. FREE SELF DISCUSSION QUESTIONS. • If you are going to buy my Quick Review Notes, start using them once you finish your first review. Go through these notes at least two times for the best final result. • When will you start Q-bank? It is very important to remember concepts first. Do not waste your questions without finishing your second review. USMLE world, Kaplan, Rx USMLE, Score 95, Student consults; All are good Q-banks. The main purpose of Q-bank is to apply your knowledge and learn how they present concepts on the exam. When you do Q-bank, do it in time mode and select questions from all subjects. I started Q-bank one month before my exam but I finished Q-bank in less than three weeks. I did questions in the morning and quick subject review through my own notes in the evening. When you do qbank, review all explanations to get an idea about why right answer is right and why wrong answer is wrong. After you finish more than 500 questions, take one NBME to know your weakness. Then continue your qbank and review these notes again, and take one more NBME. After that do only q-bank until 7-10 days before your exam. • The last week review is very important. It will help you remember small straight forward points very well for the exam for example physiology & pharmacology graph and calculations, etc. I found last minutes review was extremely helpful. This is the reason why I made these notes. I reviewed my weak subjects in little bit more detail during last week.. Relax on the day before your exam. I didn't do anything the night before the exam. Go with confidence and write your exam. If you follow above schedule, I am sure that you will definitely do well on the exam. Those who have less reading time (3-4 weeks): • As you know, you have less time for reading, you must already had started q-bank. You must have already got an idea about how they present question on the exam so just go through my quick review notes (if you have bought these notes) and take NBME. There are only few pages in these quick review notes so you can go through them quickly. Go through these notes at least two times for the best final result. It is so important to know your weakness so you can improve it before your exam. If you want to get score above 95, you have to give weight to all subjects. Getting few questions wrong from any subject will drop your score down to 90. After NBME, review subjects in which you are weak and do some q-bank questions. Then take one more NBME. After that do only q-bank until 5-7 days before your exam. The last week review is very important. It will help you remember small straight forward points very well for the exam for example physiology & pharmacology graph and calculations, etc. I found last minutes review was extremely helpful. This is the reason why I made these notes. I reviewed my weak subjects in little bit more detail during last week.. Relax on the day before your exam. I didn't do anything the night before the exam. Go with confidence and write your exam. If you follow above schedule, I am sure that you will definitely do well on the exam. Subjects covered: Microbiology, Immunology, Pathology, Pharmacology, Behavior Science, Biochemistry, Cell Biology, Genetics, Histology, Buzz Words, High Yield facts. A buyer's comment about Step 1 notes: Thanks a bunch .. these look awesome! Your suggestions are really helpful as well. . I really appreciate it. I'm using first aid,the kaplan 7 book series w/ videos + med essentials, and qbook/ qbank/ pretest/usmle world for step 1 study over about 3 months. These notes look great, highlighting main points. Thanks for adding the neuro/ physiology as well . . I've been using BRS costanzo w/ kaplan videos but these are great high yield facts you're providing, and your handwriting is very easy to read. Best of luck to you in your work/ residency! How is this review notes different from other books for USMLE?
Few Examples: Abruptio Placenta: painful bleeding, maternal hypertension or cocaine abuse Placenta Previa: painless bleeding, placenta implantation over cervical os Rheumatic fever: Type-2 HS (Hyper Sensitivity) Rheumatoid arthritis: Type-3 HS Carbamoyl phosphate in cytoplasm: pyrimidine synthesis Carbamoyl phosphate in mitochondria: urea cycle [both are different enzymes with similar name] Thiazide Diuretics: used in renal stone (hyper calciurea) Loop Diuretics: used in hyper calcemia Antibody Dependent Cellular Cytotoxicity (ADCC): IgG + NK cells - use CD 16 molecule (Fc receptor) to identify target cells. (NOT CD 56) NK cell mediated Cytotoxicity: CD 56 (No antibody involve. e.g. - lysis of infected RBCs) de Quarian thyroiditis: (subacute granulomatous): painful, mild hyperthyroidism Subacute Lymphocytic thyroiditis: painless, mild hyperthyroidism Berger's disease: hematuria following URTI, IgA deposition in mesangium Buerger's disease: (thromboangitis obliterates) - Male smoking cigarettes, involvement of toes Congenital inguinal hernia: total failure of processus vaginalis to fuse Hydrocele of spermatic cord: incomplete fusion of processus vaginalis Pericentral vein zone (zone 3) in liver contains P450 oxidase enzyme system & is most sensitive to Ischemic injury Periportal zone (zone 1) in liver is the most sensitive to toxic injury Pemphigus vulgaris: IgG against desmosomes (intracellular atttachment), (+) Nikolsky sign, oral lesion Bullous Pemphigoid: IgG against basement membrane, (-) Nikolsky sign Cortical necrosis of both kidney sparing medulla - DIC Sickle cell anemia - Affect medulla most severly - can cause papillary necrosis Hypokalamia - "U" wave on EKG Hyperkalamia - peaked T wave on EKG |
| Testimonials by Ebay buyers: Please check these feedbacks which Dr. Patel has received in Ebay. You will definitely consider buying his notes. Excellent notes and well organized.Received immediately.Will buy step 2 notes. Buyer: winyboywolf (360) Super fast delivery, beautiful notes, bonus advice on study tips! Thanks much!!! Buyer: sia530 (1) Well written notes, concise, captures the essence of what is needed for the exam Buyer: wantobuy0 (11) Super Fast Delivery! High Quality Notes! VERY Satisfied! A+++ Buyer: domino-kenner (88) Quick delivery. AMAZINGLY HY NOTES! Highly recommend this seller. Buyer: digianvittorio123 ( 2 ) very fast delivery, concise notes, direct to the point w/ helpful tips! Buyer: capahil23 (2) I luuurve these notes. More than I was expecting. Thank you!!! Buyer: yokicountry ( 48 ) Fast shipper, wonderful format, info as described!! Would buy again Thanks!! Buyer: ny1kia ( 18 ) very good seller, great in communication, very supportive Buyer: canthoboy ( 25 ) Excellent product; when you buy his materials, you get both a friend, & helper ! Buyer: agape6672 ( 71 ) |
| USMLE STEP 2CK Notes: USMLE Step 2 CK is more of a clinical exam. So they ask 'what is the diagnosis' (around 30% of questions) and 'Next best step in the management' of the patient by giving different scenarios in the exam. You must read the most complete notes which cover the first line of management of all diseases according to US clinical standard and not a general book which covers all possibilities for all diseases. Click here to go through the FREE SAMPLE REVIEW NOTES In the exam you will get most of the questions as follows: Which of the following is most likely diagnosis? What is the next step in management of this patient? Which of the following is best initial diagnostic test? Which of the following is most accurate diagnostic test? All kind of questions-answers you will get in these notes. • To give answer to this kind of questions, understand following concepts. Test with good sensitivity is the best initial test. For example, EKG has good sensitivity to diagnose and differentiate chest pain so it will be the best initial test for patient with chest pain. Test with good specificity is the best accurate test. For example, barium esophagus is the best initial test to diagnose and differentiate dysphagia due to obstruction or motility disorder but esophageal manometry is the most accurate test to diagnose dysphagia due to motility disorder. Other important points in choosing test are cost effectiveness and safety of test. • Same way in the treatment, look at the cost effectiveness and safety of the treatment. For example, atropine and pace maker, both are good to start heart in first degree heart block but we use pace maker as a last resort because atropine is more safe and as effective as pace maker and very easy to use (just give IV). • The most difficult question is the next best step in the management of this patient. It depends on the condition of the patient when patient arrives at the hospital / clinic or patient leaving the hospital / clinic [Stable, Unstable or discharging time]. For example, patient with chest pain admitted to the hospital and treated with Aspirin, Clopidogrel, Morphine and Angioplasty, now its time to discharge, which of the following is the best next step in the management of this patient? Choices are Stress test, Metoprolol, Captopril, and Furosemide. Answer is Metoprolol. Studies have shown that beta blockers have improved mortality rate in patient with recent MI so adding Metoprolol to patient’s regimen will be the best next step in the management of this patient. Another example, patient with upper GI bleed comes to ER, BP – 90/60, which of the following is the best next step in the management of this patient? Choices are Upper GI endoscopy, IV normal saline, fresh blood and Barium Esophagus. Answer is IV normal saline. First we need to stabilize the patient then we can order imaging studies. Fresh blood comes with its disadvantages like infectious diseases so not a good idea! • I hope you’ve got a better idea by now about how to give an answer to the step 2 CK questions. I have written best initial test, most accurate test, best initial treatment, most accurate treatment, next best step and first step in parenthesis in my notes so it will be easy for you to recognize and remember everything. • These notes are for exam purpose only so I have written them in a way they ask question on the real exam. In the real life, patient can present with many different ways and we deal them accordingly but always remember standard recommendation and current modification / new in the management. My Philosophy: • "Whatever you know, you know" - No one will remove that things from your mind so why worry about things you know • "Whatever you don't know, you don't know" - Try to read and understand new things at last minute (within last 2-3 days) will only increase your anxiety. This is the reason why I didn't read anything last night before my exam. So just relax on the day before your exam. I didn't mean that you should not read subjects in which you are weak. My weaknesses were physiology graphs, pharmacology calculations, behavior science mainly biostatistics and cell biology. I did go through these subjects one week before my exam but I didn't go and find new books to read them. I just read them from review books I had. Most of these points I covered in my quick review notes so I just referred my own review notes during last week. I spent more time with Pathology, Microbiology and Pharmacology. You will get more than 75% of questions from these three subjects so why waste more time with less high yield subject. You also need to keep one thing in mind that you are writing a medical exam, not a mathematics or Biochemistry (Ph.D.) or Cell Biology (Ph.D.) exam so you will not get more vague questions about these subjects. Just pay little bit more attention to questions related to these subjects when you do qbank. • Another important thing about what I believe regarding using different books is all books are same. Concepts are same in all different books. It is the matter of presenting them in an easy to understand way. Instead of using different books for review, I sticked with single review material for my first review. Then I made these notes and sticked with them. I have written these high yield notes with "CLUES" in the "BOLD". All concepts have written in an easy to remember way in these new notes. My suggestion for you is to use single review material for your first review and then use only my quick review notes later. Remember one thing that you are writing standardize test so no matter which review material you use, concept and answer will remain same in all books. "I AM 100% CONFIDENT THAT ONCE U BUY THIS MATERIAL U WILL NOT READ ANY OTHER MATERIAL FOR REVIEW." - Dr. Patel Subjects covered in the notes: SURGERY, PEDIATRICS, PSYCHIATRY, OBGYN & INTERNAL MEDICINE You definitely need to know these facts to get a score above 90!!!!! Comment from a buyer of my Step 2Ck notes: Hello, I have received all three e mail, all in good order. HY are also written in hand but for some odd reason I like hand written material better then typed. I think it's because of ability to draw graphs and connect the dots that's somewhat limited when you use MS Word. Do not really understand people who complain about it. Anyhow if you do get a chance, give me your two cents regarding how to prepare for USMLE Step 2 CS. I am foreigner attending med school in USA so that makes me somewhat less confident in my ability to perform well especially for the exam that's unpredictable to begin with. What did you use, what works etc. Thanks a lot and I will contact you if I feel that I could benefit from your USMLE 1 notes too. Extracts from the ebook: Few samples of highly tested topics in exam Chest Pain: Myocardial Ischemia / Myocardial Infarction: Substernal squeezing chest pain [not reproduce by palpation, not change with change in position, not pleuritic] Pericarditis: chest pain [relieve by leaning forward] Costochondritis: chest pain [reproduce by palpation] Dissecting aortic aneurism: tearing chest pain radiate to back Pneumonia: pleuritic chest pain Pulmonary embolism: pleuritic chest pain, dyspnea, tachypnea Esophageal spam (“nut cracker disease”): h/o GERD, gastritis, pain occur after eating, normal EKG Stable angina: chest pain after exertion Unstable angina: chest pain at rest [ST Depression] [D E] Myocardial Infarction: chest pain at rest [ST Elevation] Prinzmetal angina: chest pain at rest [ST elevation – Transmural Ischemia] [due to coronary artery spam. Pain may relieve by little exercise like patient gets up and walking and pain relieve because exercise causes increase in Adenosine which is a potent coronary vasodilator] [Best diagnostic test – Angiography shows No atherosclerosis] [Treatment: Ca++ channel blockers (CCB), Nitrates] [Not Aspirin and -blockers] Patient with Stable/Unstable angina and MI should receive Aspirin, Nitrates and b-blockers (if no contraindications like Asthma, etc.) Patient should also receive oxygen (if oxygen saturation is low) and morphine (if patient is still having pain) Unstable Angina (clot is forming): above 2 steps + Heparin (not thrombolytics) + Statins MI (clot is already formed): above 2 steps + Thrombolytics (If certain criteria meets) + Statins + Low molecular weight Heparin (If not contraindicated) + ACE inhibitors (only If CHF due to acute MI) + Lidocaine (only If ventricular arrhythmias) Thrombolytics (If it is not contraindicated, if Angioplasty is not available) Within 12 hrs of the onset of MI. > 1 mm ST segment elevation in two contiguous EKG. New LBBB (Left Bundle Branch Block). Best Initial test: EKG Most accurate diagnostic test: Angiography (Ischemia) / Cardiac Troponin & CK-MB (Infarction) [Both begin to elevate in 4-6 hrs] [Cardiac Troponin remains elevated for 1-2 wks] [CK-MB remains elevated for 2-3 days] [best test to check re-infarction within a week – CK-MB because it disappears in 2- 3 days] Most accurate treatment for MI / Unstable angina: Angioplasty Most important is to know when you will do diagnostic test and when you will start treatment. Answer what they asked like best initial / most accurate If patient comes with chest pain for last 1-hr and still having pain, what will you do first or best initial test? – EKG If patient comes with chest pain for last 1-hr and still having pain, EKG shows ST depression / ST elevation, what will you do now? – Start treatment (all patient should receive above treatment depends upon what they have like Unstable angina or MI or stable angina or Prinzmetal angina If patient comes with chest pain off & on and no pain now in your office, what will you do first? – Stress test (EKG may not show anything cause no pain now) __________________________________________________________________ • Classic presentation of Acute Appendicitis [pain start in mid epigastric region and then shifted to RLQ, positive rebound tenderness, Psoas sign, Rovsing’s sign, etc], next step? ® Appendicectomy • Above presentation, On Abdominal exploration, Appendix is normal but ileum is inflamed (Crohn’s ileitis), next step? ® Proceed with Appendicectomy and close the abdomen • Above presentation, On Abdominal exploration, Appendix is normal but ileum & cecum are inflamed, next step? ® Do nothing and close the abdomen [when cecum is inflamed, Appendicular stump doesn’t heal and it can cause fecal fistula which leads a hemicolectomy] • Female patient without classical presentation of appendicitis, next step? ® USG • Classic presentation of appendicitis but 6-7 days old pain, mass on abdominal palpation, diagnosis? ® Appendicular mass, next step? ® IV fluid, bowel rest, IV antibiotics, serial examinations • If above scenario, 24-hrs after starting treatment, patient is getting worse (spiking fever, tachycardia, increase in localize tenderness), next step? ® CT scan (Appendicular abscess) ® Tx : CT guided drainage _________________________________________________________ * Mallory Weiss Tear ® continuous retching followed by large painless bloody vomiting (mucosal tear), best diagnostic test? ® Endoscopy – Tx: resolve itself / laser photocoagulation * Boerhaave Syndrome ® continuous retching followed by severe chest pain, Crepitation in the neck, air in mediastinum on CXR (Esophageal rupture – distal third, posterolateral segment (no serosa) is the most common site), best diagnostic test?® Gastrografin swallow ® Emergency Surgical repair. • Temporal Arteritis (Giant Cell Arteritis) – Unilateral pounding headache, Visual changes , Jaw claudication , scalp tenderness – High dose Prednisone (Best Initial / 1st step in management) DI – elevated serum osmolarity Primary Polydipsia (Psychogenic) – both serum & urine diluted SIADH – elevated urine osmolarity Selective mutism – speak normally in other situation or at home Autism - < 3 yrs. of age, repetitive behavior, marked hearing impairment Undetected hearing impairment – hereditary, repeated ear infection, symptoms same as autism but detected at later age compare to autism. Anticoagulation in healthy patient with atrial fibrillation (AF) without any risk factors (HTN, DM, etc) – Aspirin only Hemodynamically stable AF patient – Diltiazam or Metoprolol Hemodynamically stable VF patient – Lidocaine or Amiodarone Tx of Kawasaki disease – Aspirin + Immunoglobulin Management of Hypotension in patient with DI – IV normal saline First step in management of Hyperkalemia – IV Calcium gluconate Most effective way to remove K+ from body – hemodialysis Most rapid way to lower serum K+ – Insulin + glucose Herpes simplex keratitis – corneal vesicle & dendritic ulcers Herpes zoster ophthalmics – burning & itching in periorbital area & vesicle on distribution of ophthalmic nerve branches Cardiogenic shock – low CO & High PCWP ARDS – Normal PCWP Septic shock – High CO , Low PCWP & Normal mixed venous O2 Hypovolemic shock – low CO, low PCWP, low mixed venous O2 High PCWP & low CVP – LV dysfunction High PCWP & high CVP – Cardiac temponade Respiratory distress & high CVP – Tension Pneumothorax Croup – give trial of epinephrine before intubation Acute epiglotitis – Laryngoscopy – intubation then IV ceftriaxone. DM + ear infection & granulation, organism? – Pseudomonas |
| USMLE Step 2 CS...Easy to Pass tips! People say that USMLE step 2 CS is a very easy exam because its passing rate is higher than USMLE step 1 & step 2 CK . Before Aug 2007, passing rate for step 2 CS was 89% for FMG and 96% for US graduates. After Aug 2007, Board increased passing standard for CIS & ICE component and soon after that, passing rate was decreased by 9% for FMG on first result and it is still decreasing but it is still 95% for US graduates! This notes cover Calculation to PASS, Communication Skills, History Questions, Physical Examination and Patient's Note Writing See a sample of the CS notes here: Weaknesses of Foreign Medical Graduates: How to show empathy How to give reassurance and respond back to standardize patient's (SP) question How & When to use transition sentences How to do closing How to finish physical examination in less than 5 mins How to write patient notes efficiently to get more points My notes cover: Calculation to PASS [My strategy] Communication Skills [easiest way to show Empathy, give Reassurance & do Closing] History Questions [easiest way to ask history without any mistake] Physical Examination [Easy way to explain SP what you are going to do] Patient's Note Writing [Increase your chance to pass ICE component easily] No matter which review material you are using for step 2 CS, you will definitely see the difference in these notes and your review material. I can say confidently that you can improve yourself tremendously than what you are right now. Your confidence will definitely increase. Comment I received about my notes: The discussion helped a lot, in fact I have to say it was because of your notes that I was smart to get a few quick PEs out of the way in every case and managed to grab a few quick easy points that I may not have otherwise. Still I must say it is an experience quite unlike what the books and notes prepare you for, hopefully it is a once in a lifetime experience :) How did the 3rd step go for you? I am sure you came out shining and my best wishes for the results, please do keep in touch as I am now going to use the notes and get to working on my first step too! Dr. Patel, The discussion helped a lot, in fact I have to say it was because of your notes that I was smart to get a few quick PEs out of the way in every case and managed to grab a few quick easy points that I may not have otherwise. Still I must say it is an experience quite unlike what the books and notes prepare you for, hopefully it is a once in a lifetime experience :) How did the 3rd step go for you? I am sure you came out shining and my best wishes for the results, please do keep in touch as I am now going to use the notes and get to working on my first step too! |
| CONTACT US: Leave a comment at the bottom of this page You can also contact the author directly here. |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Click here to read the complete testimonials and 100% positive feedback that Dr.Patel has received in Ebay 33% Reduced price at UsmleRockers. Click here to compare with Ebay Price. Limited Period Offer.Buy now to save money!!! |
| You can download these E-books immediately after you purchase. After you make the payment, without closing the browser, click on "Complete Purchase" button which will take you to the download page. |
USMLE STEP 3 Notes:
These notes are ideal for MCQs (weigh 75% of USMLE step 3)
As a busy resident, you don't get enough time for preparation and that's why these notes are very
useful which cover all important topics that are most likely on real exam and are only 151 pages.
Those who have already bought Dr.Patel's Step 2CK notes need not buy his Step 3
notes again.
Many of my buyers asked me if I have anything for CCS. I have made two power point presentation to
get a general idea about CCS. Get the free samples here. The approach I have presented in the
slide show might not be the most accurate approach in the management of the patient but I used it for
my exam and I have passed this exam. Remember one thing that CCS give you score according to the
most acceptable step you are
taking in the patient's management, not according to the most accurate way. I received my score
between borderline performance and higher performance for CCS so I am happy with my result. I hope
you will find this power point presentation helpful for your step 3 CCS preparation. Your feedbacks are
most welcome.
These notes are ideal for MCQs (weigh 75% of USMLE step 3)
As a busy resident, you don't get enough time for preparation and that's why these notes are very
useful which cover all important topics that are most likely on real exam and are only 151 pages.
Those who have already bought Dr.Patel's Step 2CK notes need not buy his Step 3
notes again.
Many of my buyers asked me if I have anything for CCS. I have made two power point presentation to
get a general idea about CCS. Get the free samples here. The approach I have presented in the
slide show might not be the most accurate approach in the management of the patient but I used it for
my exam and I have passed this exam. Remember one thing that CCS give you score according to the
most acceptable step you are
taking in the patient's management, not according to the most accurate way. I received my score
between borderline performance and higher performance for CCS so I am happy with my result. I hope
you will find this power point presentation helpful for your step 3 CCS preparation. Your feedbacks are
most welcome.
