USMLE CK Smart Approach

Cheatsheet Content

1. Question Dissection Strategy Read the last sentence first: This identifies the question type (diagnosis, management, next best step). Scan for keywords: Look for patient demographics, chief complaint, duration, key symptoms/signs, lab values. Identify the "stem": The core clinical scenario. Note pertinent positives and negatives: Differentiate between helpful and distracting information. Formulate a differential diagnosis: Based on the stem, quickly consider common conditions. Filter options: Eliminate obviously incorrect answers. 2. High-Yield Concepts Epidemiology: Age, gender, risk factors for common diseases. Pathophysiology: Basic mechanisms of disease. Classic Presentations: Unique features of common conditions. Diagnostic Modalities: Next best test, most accurate test. First-line Treatments: Initial management, definitive treatments. Complications: Common sequelae of diseases or treatments. Screening Guidelines: USPSTF recommendations (e.g., mammography, colonoscopy). Ethics & Communication: Patient autonomy, confidentiality, informed consent. 3. Time Management Aim for $\approx 1$ minute per question: Practice pacing during blocks. Don't get stuck: If unsure after 30-45 seconds, make an educated guess and flag for review. Review flagged questions: Only if time permits at the end of the block. Trust your gut: Often your first instinct is correct, especially when time is short. 4. Common Traps & Pitfalls Distractors: Irrelevant information designed to mislead. "Most likely" vs. "Best initial": Pay close attention to wording. "Next step in management": Consider stability of the patient. Overthinking: Don't search for zebras when horses are common. Ignoring vital signs: Always assess patient stability first. Premature closure: Don't jump to conclusions before reading all information. 5. Systems-Based Approach (Key Areas) Cardiology MI management ($MONA \rightarrow Beta-blockers \rightarrow ACEi \rightarrow Statins$) Arrhythmias (AFib, SVT, V-tach) Heart failure (systolic vs. diastolic) Valvular heart disease Pulmonology Asthma/COPD exacerbations Pneumonia (community-acquired vs. hospital-acquired) Pulmonary embolism (diagnosis & management) Lung cancer screening & types Gastroenterology GI bleeding (upper vs. lower) Pancreatitis, Cholecystitis Inflammatory Bowel Disease (Crohn's vs. UC) Liver disease (cirrhosis, hepatitis) Nephrology Acute Kidney Injury (pre-renal, intrinsic, post-renal) Chronic Kidney Disease (stages, complications) Electrolyte imbalances ($Na^+, K^+, Ca^{2+}$) Endocrinology Diabetes (Type 1 vs. Type 2, complications) Thyroid disorders (hyper-, hypo-) Adrenal disorders (Cushing's, Addison's) Infectious Disease Common bacterial/viral infections Antibiotic choices HIV/AIDS (opportunistic infections) Neurology Stroke (ischemic vs. hemorrhagic, tPA criteria) Seizures, Epilepsy Headaches (migraine, tension, cluster) Hematology/Oncology Anemias (iron deficiency, B12, folate) Leukemias, Lymphomas Solid tumor screening Psychiatry Depression, Anxiety disorders Schizophrenia, Bipolar disorder Substance abuse Women's Health Contraception, Pregnancy complications Cervical/breast cancer screening Menopause Biostatistics & Ethics Sensitivity, Specificity, PPV, NPV Study designs (RCT, cohort, case-control) Ethical principles (beneficence, non-maleficence)