January 10, 2011 Dear 2nd Year students, Congratulations on choosing the Doctors In Training Step 1 Review Course

to help you study for your USMLE Step 1 and COMLEX Level 1 exams! We are confident that our Step 1 2011 review course will help you reach your peak potential score. Today begins Part I of the Step 1 review, so we have a few tips as your test date gets closer: Below you will find 15 questions with specific page references to First Aid for the USMLE Step 1, 2011 edition. Fifteen new questions will arrive every Monday and Thursday from now until May 5. Even if you arent doing anything else to study right now, you should be doing these questions. Spend about 10-12 hours a week reviewing and studying for the USMLE, but do not neglect your present coursework. Find a study partner to keep you on-track and make your learning more active rather than simply reading to yourself. Quiz each other with these questions and pimp each other with new one as you go through First Aid together. Try to go through First Aid at least once prior to the start of Part II of the Doctors In Training Step 1 Review in order to get the most out of the course. If you would like a FREE personalized study plan tailored to your needs, just call our student advisors at 817-796-0583 for an appointment to have one created for you.

Remember, if you are not satisfied with Doctors In Trainings review course for any reason, you have until the second day of lectures to get all but $70 back. Read more about our refund policy here. Doctors In Training is here to help you excel on Step 1. If you have any questions, please visit DoctorsInTraining.com to chat live with a Student Advisor. You can also email support@doctorsintraining.com, or call 817-870-2730 M-F from 8:30am to 6:30pm CST. Sincerely, Brian Jenkins, MD

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1. A patient who recently suffered a brain hemorrhage as a result of a motor vehicle accident is now complaining of difficulty concentrating. You perform a full neurological exam and suspect that her symptoms may be due to a frontal lobe lesion. How would patient symptom complaints differ between a parietal and a frontal lobe lesion? (FA p403) 2. A newborn with ambiguous genitalia has been diagnosed with 17-hydroxylase deficiency. You begin to think about how this deficiency will affect many of her body systems, including her sexual development. Which hormones are the precursors of estrogen? What enzyme catalyzes this reaction? (FA p291) 3. What is the adult remnant of the following fetal structures? (FA p119, 125 and 134) Fetal Structure Adult Remnant Gubernaculum (female) Processus vaginalis (male) Foramen ovale Notochord

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4. A patient has recently been diagnosed with more than one endocrine neoplasia. He has cancer of the pituitary, parathyroid and pancreas. What types of pancreatic tumors are often seen in MEN 1? (FA p303) 5. Which neoplasm is most commonly responsible for the following paraneoplastic effects? (FA p229) Syndrome or Effect Neoplasm ACTH Cushings syndrome PTH-related peptide hypercalcemia Erythropoietin polycythemia ADH SIADH 6. A patient with an epilepsy diagnosis is pregnant with her first child. She is concerned that her child may also have seizures. What are the most common causes of seizures in children? In adults? In the elderly? (FA p426)

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7. A 42-year-old obese male presents with a complaint of severe pain in his right knee. He believes he injured it while dancing at his cousins wedding last night. You suspect gout. How would you differentiate between gout and pseudogout upon exam of synovial fluid aspirate? (FA p384) 8. At the completion of an annual physical exam in a 40-year-old male smoker, you are providing some patient education on atherosclerosis. Which risk factors might you discuss with this patient? What are the most common locations for atherosclerosis? (FA p270) 9. An extremely tall and thin white male presents to your office. As your review his past medical history, you note a diagnosis of Marfans syndrome. What is the most common site of a berry aneurysm? In addition to Marfans syndrome, what other risk factors are often associated with berry aneurysms? (FA p405)

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10. A type 2 diabetic with a HgbA1c of 10% (86 mmol/mol) presents to your clinic with many complaints. You are concerned about the effect of the patients long term hyperglycemia. What diabetic complications can be attributed to sorbitol induced osmotic damage? What enzyme converts glucose to sorbitol? (FA p104) 11. A 30-year-old Asian female presents to your clinic with a variety of complaints. Upon completion of her exam you are suspicious of Takayasus arteritis. What were likely some of the patients presenting complaints? (FA p278) 12. What medications would you consider giving to a patient with an ejection fraction of 30%? (hint: consider the determinants of ejection fraction and the drugs that would affect these determinants) (FA p255, FA p475, FA p280 FA p281)

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13. A G1P1 female presents to the minor emergency room with her newborn. She is very concerned about her yellow baby. As you are conducting your exam, you recall that the underlying cause of physiologic jaundice in the newborn is what? How is it treated? (FA p332) 14. Amyloidosis and sarcoidosis are associated with which cardiomyopathy? What are some other diseases or conditions associated with this cardiomyopathy? (FA p273) 15. A 32-year-old who was recently prescribed a sulfa drug for a UTI now presents to the emergency room with numerous blistering skin lesions. IgG antibodies against desmosomes can cause which potentially fatal autoimmune skin disorder? What is the difference between a desmosome and a hemidesmosome? (FA p388-389)

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