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Flashcard 1 of 150

A 17-year-old male presents to the clinic due to lower extremity weakness

  • He reports difficulty climbing stairs and cramping of the lowering extremities 
  • He has no significant past medical history 
  • He has an uncle who was in a wheelchair at 35 years of age who passed away recently due to “heart problems” 
  • Examination is remarkable for weakness and atrophy of the proximal thigh muscles and pelvic girdle 
  • Laboratory studies reveal a creatinine kinase level of 1550 U/L

What is the most likely diagnosis and its management?

Answer

Diagnosis: Becker muscular dystrophy
Management: Supportive care

Explanation

Becker muscular dystrophy (BMD) is an X-linked recessive progressive neuromuscular disorder caused by mutations in the dystrophin gene. Dystrophin is a cytoskeletal protein that anchors the cytoskeleton of skeletal and cardiac muscle cells to the extracellular matrix. Lack of dystrophin causes excessive membrane fragility, dysregulation of calcium homeostasis, and oxidative damage. This eventually leads to the replacement of muscle fibers with connective and adipose tissue. BMD is less severe, less common, and generally presents later than Duchenne muscular dystrophy (DMD).
There is significant variation in the clinical presentation and age of symptom onset in BMD. Patients are usually ambulatory until 16 years of age. Some retain ambulation until old age. The initial signs of BMD are weakness of the proximal muscles of the lower extremities. This can manifest as difficulty climbing stairs, cramping during exercise, and gait changes. Other signs are atrophy of the proximal muscles, pseudohypertrophy of the calves, and Gower sign. Myocardial involvement is more common in BMB than DMD. Absence of myocardial dystrophin leads to atrophy, fibrosis, and fatty infiltration of the myocardium that can lead to cardiomyopathy and severe arrhythmias.
BMD should be suspected in males presenting with proximal muscle weakness with a family history of paralysis and elevated creatinine kinase (CK). CK in BMD is often > 5 times the upper limit of normal. Genetic analysis demonstrating a dystrophin gene mutation confirms the diagnosis. Management of BMD is primarily supportive with physical therapy, management of contractures, assist devices, and psychological support.

Workup : Genetic studies (dystrophin mutation)

Management : Supportive care

Miscellaneous : The most common cause of death in patients with Becker muscular dystrophy is heart failure from dilated cardiomyopathy.

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Flashcard 2 of 150

A 17-year-old male presents to the clinic for a sports physical

  • He is in grade 11 and is joining the basketball team. He is 190 cm tall and weighs 80 kilograms 
  • During the evaluation he mentions being embarrassed to take his shirt off in the locker room due to breast enlargement 
  • He has no known medical conditions and does not take any medications 
  • On examination he has moderate glandular tissue behind the areola bilaterally. He has sparse facial, body, and pubic hair. The testes are small and firm.

An abdominal ultrasound is shown below

What is the most likely diagnosis and its management?

Answer

Diagnosis: Klinefelter syndrome
Management: Testosterone supplementation

Explanation

Klinefelter syndrome is the most common sex chromosome disorder in males, affecting approximately 1 in 1000 men. It is caused by an additional X chromosome (47, XXY) which results from non-disjunction during meiosis. The phenotypic features of Klinefelter syndrome are caused by testosterone deficiency and usually present in adolescence.Affected men present with small tests, decreased facial hair and pubic hair, gynecomastia, and a small penis. Virtually all men with Klinefelter syndrome are infertile. Men are typically taller than average, slender, and have long legs. Some patients have cognitive deficits in language comprehension and executive functioning. The impairment is usually mild.
The diagnosis is usually established during adolescence or adulthood since clinical features are nonspecific in childhood. Patients with Klinefelter syndrome have decreased testosterone and elevated estrogen, FSH, and LH. The diagnosis is confirmed with karyotyping. Testosterone therapy is the cornerstone of management. Patients treated with testosterone have improved energy and libido, greater self-confidence, and increased bone density and muscle mass. Gynecomastia cannot be reversed with testosterone therapy and generally requires surgical management.

Workup : Serum testosterone, estrogen, FSH, and LH. Karyotyping

Management : Testosterone supplementation

Miscellaneous :Men with Klinefelter syndrome have a 20 to 50 times greater chance of developing breast cancer compared to men without Klinefelter syndrome.

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Flashcard 3 of 150

A one-week-old infant is brought to the emergency department due to poor feeding

  • The mother and infant recently moved to the United States from Ghana. He was born by spontaneous vaginally delivery at home 
  • The infant was initially doing well and breast feeding every 2 to 3 hours. Over the past day he has refused to feed and seems to have difficulty opening his mouth
  • The mother did not have any prenatal care and has never been immunized 
  • On examination he appears lethargic and has a weak cry. There is increase muscle tone in the upper and lower extremities. The jaw is clenched and difficult to open. The umbilical stump is erythematous with purulent discharge

What is the most likely diagnosis and its management?

Answer

Diagnosis: Neonatal tetanus
Management: Human tetanus immune globulin, metronidazole, supportive care

Explanation

Tetanus is a leading cause of preventable neonatal mortality in some developing countries. Neonatal tetanus is exceedingly rare in developed countries due to routine use of the tetanus immunizations and aseptic technique when handling the umbilical cord. It is caused by contamination of the umbilical stump with Clostridium tetani spores. C. tetani spores are found in human and animal feces, soil, and manure. The spores are highly resistant and can tolerate extremes of temperature and common disinfectants. The clinical manifestations of tetanus are mediated by tetanus toxin, a neurotoxin thatcauses the inactivation of inhibitory neurotransmission that normally suppresses motor neuron and muscle activity. This results in increased muscle tone and autonomic instability.
Neonatal tetanus typically occurs due to failure to use aseptic techniques when managing the umbilical stump and poor or no immunization of the mother. It usually presents between 5 and 7 days following birth. Clinical features include difficulty opening the mouth and refusal to feed in an infant that was previously able to feed normally. Facial muscle spasms can cause risussardonicus. As the disease progresses, muscle tone increases and opisthotonus develops. The diagnosis of tetanus is made based on the characteristic history and clinical findings.
Untreated neonatal tetanus is uniformly fatal. Mortality rates are still high despitemedical management. Management involves toxin neutralization, bacterial elimination, and supportive care. Human tetanus immune globulin is given to neutralize unbound toxin.
Metronidazole or penicillin, along with wound debridement are used to eradicate C. tetani.

Workup : Neonatal tetanus

Management : Human tetanus immune globulin, metronidazole, supportive care

Miscellaneous :The Tdap vaccine during pregnancy provides protection to both the mother and infant. It should be administered during every pregnancy between 27- and 36-weeks’ gestation.

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Flashcard 4 of 150

A 2-week-old male is brought to the clinic due to poor feeding and constipation

  • He has lost 10% of his body weight since birth. His last bowel movement was two days ago 
  • His mother says that he has been sluggish and less reactive over the past several days 
  • He was born at 39 weeks gestation by spontaneous vaginal delivery and had no prenatal complications 
  • Vital signs are temperature 96 F, heart rate 130/min, respiratory rate 40/min, and SpO2 98% on room air 
  • On examination he has moderate hypotonia and appears apathetic. The anterior and posterior fontanelles are wide. He has a large tongue and a reducible umbilical hernia.

What is the most likely diagnosis and its management?

Answer

Diagnosis: Congenital hypothyroidism
Management: Thyroxine

Explanation

Congenital hypothyroidism (CH) is thyroid hormone deficiency at birth. It occurs in approximately 1 in 4000 live births. CH can be caused by defects in the development of the thyroid gland (thyroid dysgenesis) or defects in thyroid hormone synthesis (dyshormonogenesis). Most cases of CH (80%) are caused by thyroid dysgenesis (thyroid hypoplasia or agenesis). Other causes include iodine deficiency, maternal TSH receptor blocking antibodies, maternal anti-thyroid drugs, exposure to excess iodine, and large hepatic hemangiomas.
Infants with congenital hypothyroidism do not typically have any clinical manifestations at birth. This is due to transfer of maternal thyroxine in utero. Umbilical cord T4 concentrationsare 25% to 50% of those of normal infants. Congenital hypothyroidism screening is performed on all newborns in all 50 states. Most infants with a positive screening test can be treated prior to symptom onset. Infants who are not screened and treated early develop symptoms in the first months of life. Clinical manifestations of CH include hypotonia, poor feeding, lethargy, constipation, macroglossia, large fontanelles, dry skin, hypothermia, prolonged jaundice, and coarse facies.
The diagnosis of CH is established with thyroid function tests. Elevated serum thyroid stimulating hormone (TSH) and decreased T4 are characteristic of primary hypothyroidism. Treatment with levothyroxine should be initiated immediately after the diagnosis. Early treatment can optimize neurodevelopmental outcomes and prevent intellectual deficits. Thyroid function tests should be repeated every 1-2 weeks until normalization of TSH.

Workup : TSH, free T4

Management : Thyroxine

Miscellaneous : Infants with congenital hypothyroidism have an increased incidence of other congenital malformations such as neurodevelopmental disorders, cardiac malformations, and renal abnormalities.

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Flashcard 5 of 150

A 2-year-old female is brought to the clinic by her father due to vomiting and abdominal distension

  • Over the past few weeks, he noticed an increase in the size of her abdomen. She has complained of abdominal pain intermittently and had 2 episodes of non-bilious emesis this morning 
  • Prior to this she was in her normal state of health. She has no significant medical history 
  • Vital signs are temperature 97.6 F, heart rate 100/min, and respiratory rate 20/min 
  • Examination is remarkable for a non-tender, irregular, left lower quadrant mass that crosses into the right lower quadrant 
  • Laboratory studies reveal elevated urinary homovanillic acid and vanillylmandelic acid levels

What is the most likely diagnosis and its management?

Answer

Diagnosis: Neuroblastoma
Management: Depends on stage (surgical resection, chemotherapy, radiation, and immunotherapy)

Explanation

Neuroblastoma is an embryonal neuroendocrine tumor originating from neural crest progenitor cells. It is the most common extracranial solid tumor of childhood and the most common tumor of the sympathetic nervous system. The cause of neuroblastoma is not fully understood. It is associated with several chromosomal abnormalities including loss of chromosome 1p and 11q, gain of 17q, and copy number variation in 1q21. Risk factors include Turner syndrome, Beckwith-Wiedemann syndrome, neurofibromatosis Neuroblastomas can occur anywhere in the sympathetic nervous system including the sympathetic chain, adrenal glands, and paravertebral ganglia. Symptoms of neuroblastoma vary depending on the site of the primary tumor. All patients may have constitutional signs and symptoms such as failure to thrive, nausea, fever, and hypertension. Most neuroblastomas originate in the abdomen and present with an irregularly shaped firm mass that crosses the midline. Abdominal distention, pain, and constipation may also be present. Neuroblastoma at other sites can cause spinal cord compression, paralysis, and Horner syndrome.
Urinary catecholamine breakdown productshomovanillic acid (HVA) and vanillylmandelic acid (VMA) are often elevated. Imaging should be obtained to identify the location and extent of the primary tumor. MRI is the preferred imaging modality. A biopsy is required to confirm the diagnosis. Homer-Wright cells are small round blue cells that are classically seen in neuroblastoma. Genetic studies are also performed to evaluate for MYCN gene amplification and DNA ploidy.
Management of neuroblastoma is complex and varies depending on the tumor stage and results of genetic studies. Management options include surgical resection, chemotherapy, radiation, and immunotherapy.

Workup : Urinary/serum VMA and HVA, imaging (MRI/CT), biopsy, genetic studies

Management : Depends on stage (surgical resection, chemotherapy, radiation, and immunotherapy)

Miscellaneous : Neuroblastomas originating in the abdomen present with an irregular abdominal mass that crosses the midline, as opposed to Wilms tumor which typically presents with a mass that does not cross the midline.

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The gastrointestinal system represents roughly 5-9% of test items. The UMock USMLE® Step 1 prep course gives you a comprehensive and concise review of high-yield material to help you memorize, understand, and apply information to clinical scenarios pertaining to concepts of digestion and how one factor is affected by another, malabsorption syndromes, as well as the histopathology type of each location, and where the pharmacotherapies take action.

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Male Reproductive System Content Review 9% - 13%

 

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  • Diseases of the Penis
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Female Reproductive System Content Review 9% - 13%

 

In the reproductive system, the UMock USMLE® Step 1 prep course covers the male and female reproductive system as well as pregnancy, childbirth, and the puerperium. The course provides high-yield topics concentrated on clear and concise explanations to help you understand and apply concepts to clinical scenarios associated with the hormonal pathways of the male and female reproductive systems.

The course integrates concepts with high quality microscopic views and diagnostic images to help you improve recall of normal and abnormal processes in disease and apply it to clinical scenarios like you’ll see on the exam.

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  • Breast
  • Vulva & Vagina
  • Uterine Cervix
  • Uterine Corpus
  • Fallopian Tubes
  • Disorders of Pregnancy
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Endocrine System Content Review 9% - 13%

 

The UMock USMLE® Step 1 prep course combines concise high yield topics with detailed diagrams covering normal and abnormal processes of endocrine-specific pathologies and physiologies. The course helps you gain a clear understanding of how to apply concepts to clinical scenarios for keeping hormone levels in balance, diagnostic testing, treatment, and management.

The course includes descriptive illustrations, microscopic views, images, and graphs highlighting heavily test exam content to help you gain a full understanding of applying concepts for normal and abnormal processes of the endocrine system.

  • Endocrine Pancreas
  • Endocrine of Pituitary
  • Endocrine of Thyroid Gland
  • Endocrine of Adrenal Glands
  • Endocrine of Parathyroid Glands
  • Multiple Endocrine neoplasia (MEN) Syndrome
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Dermatology Content Review 6% - 10%

 

In Dermatology, the UMock USMLE® Step 1 prep course gives you concise, high yield topics to help you understand how to apply basic concepts to clinical scenarios in comparing similar pathologies based on the morphology and distribution of conditions.

Every topic is covered for both normal and abnormal body-system processes with high quality microscopic views and gross images to help you visually understand the application of medicine specific to diseases in skin and subcutaneous tissue.

  • Pruritus
  • Urticaria
  • Common Rashes
  • Infestations
  • Bites & Stings
  • Hair Disorders
  • Common Neoplasms
  • Acneiform Eruptions
  • Common Skin Infections
  • Cuts, Scrapes, & Burns
  • Foot and Leg Ulcers
  • Nail Disorders
  • Disorders of Mucous Membranes
  • Autoimmune Blistering Diseases
  • Therapeutic Principles in Dermatology
  • Dermatologic Urgencies and Emergencies
  • Cutaneous Manifestations of Internal Disease
  • Dermatologic Problems of Special Populations
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Nervous System Content Review 4% to 7%

 

Exam items covering the nervous system represent about 4-7% of test questions. The UMock Step 1 Prep Course clearly explains gross anatomy and neuroanatomy and normal and abnormal processes from this area, including

  • Embryonic development
  • Fetal maturation
  • Perinatal changes
  • Neural tube derivatives
  • Cerebral ventricles
  • Neural crest derivatives
  • Organ structure & function
  • Cell & tissue structure & function
  • Repair
  • Regeneration
  • Changes associated with life stages
  • Infectious
  • Immunologic
  • Inflammatory disorders
  • Neoplasms
  • Cerebrovascular disease
  • Disorders related to spinal cord
  • Spine
  • Spinal nerve roots
  • Cranial & peripheral nerve disorders
  • Neurologic pain syndromes
  • Degenerative disorders
  • Global cerebral dysfunction
  • Neuromuscular
  • Metabolic disorders
  • Paroxysmal disorders
  • Sleep disorders
  • Traumatic & mechanical disorders
  • Increased intracranial pressure
  • Congenital disorders
  • Disorders of the eye & eyelid
  • Disorders of the ear
  • Movement disorders
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Rheumatology and Musculoskeletal Content Review 6% - 10%

 

The UMock USMLE® Step 1 prep course provides the most valuable exam information with a complete and concise review of high-yield topics to help you quickly understand and apply knowledge to clinical scenarios covering the diagnosis of joint pathologies, and anatomical paths of distal branches and the muscles that they innervate.

The course features detailed tables and high quality radiologic and gross images to help you conceptualize the application of medicine for normal and abnormal body system processes and pathologies in rheumatology and the musculoskeletal system.

  • Diseases of Skeletal Muscle
  • Diseases of Bone
  • Diseases of Joints
  • Soft-Tissue Tumors
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Behavioral Science Content Review 8% to 13%

 

Behavioral science accounts for roughly 8-13% of exam questions. The UMock USMLE® Step 1 prep course helps you clarify difficult concepts in the mind-body relationship, and understand how to apply DSM-IV and DSM-5 diagnostic criteria in the manifestations of psychological disorders to various clinical scenarios with a high-yield, concise review of concepts covering every topic for normal and abnormal processes.

The course includes descriptive diagrams, tables, and images to provide a concentrated review of material to help you fully understand the application of behavioral science to clinical medicine.

  • Sexuality
  • Learning Theory
  • Beginning of Life
  • Anxiety Disorders
  • Aggression & Abuse
  • Psychosomatic Medicine
  • Somatic Symptom Disorders
  • Obsessive-Compulsive Disorders
  • Trauma & Stressor-Related Disorders
  • Substance-related Disorders
  • Sleep & Sleep-wake Disorders
  • Psychological Therapies
  • Family, Culture, & Illness
  • Psychiatrics Disorders in Children
  • Aging, Death, & Bereavement
  • School Age, Adolescence, & Adulthood
  • Psychoanalytic Theory & Defense Mechanisms
  • Depressive Disorders & Bipolar Disorders
  • Schizophrenia Spectrum & other Psychotic Disorders
  • Clinical Assessment of Patients with Behavioral Symptoms
  • Biological Assessment of Patients with Psychiatric Symptoms
  • Neurocognitive, Personality, Dissociative & Eating Disorders
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Embryology Content Review 11% - 15%

 

In Embryology, the UMock USMLE® Step 1 prep course presents high-yield content in a concise format that helps you understand and quickly recall concepts in human development and congenital malformations, and apply the connection between embryological knowledge and clinical medicine. The course further clarifies key facts and concepts to help you maximize comprehension and visual understanding in applying concepts with high quality diagnostic, radiographic, and clinical images.

  • Skeletal System
  • Muscular System
  • Upper Limb
  • Lower Limb
  • Body Cavities
  • Pregnancy
  • Teratology
  • Head & Neck
  • Prefertilization Events
  • Human Development - Week 1
  • Human Development - Week 2
  • Embryonic Period
  • Cardiovascular System
  • Placenta & Amniotic Fluid
  • Embryology of the Ear
  • Embryology of the Eye
  • Embryology of the Nervous
  • Embryology of the Digestive
  • Embryology of the Respiratory
  • Urinary System
  • Female Reproductive System
  • Male Reproductive System
  • Integumentary System
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Women’s Health and Pregnancy Content Review 3% to 5%

 

The musculoskeletal system accounts for roughly 3-5% of the exam. Learn everything covered on this section of the exam for normal and abnormal process with the UMock Step 1 Prep Course:

  • Tendon
  • Repair
  • Joints
  • Usage
  • Muscles
  • Cartilage
  • Arthritis
  • Infectious
  • Regeneration
  • Blood supply
  • Gross anatomy
  • Neoplasms
  • Embryonic development
  • Organ structure & function
  • Changes associated with life stages
  • Cell & tissue structure & function
  • Ligaments & fascia
  • Traumatic & mechanical disorders
  • Mechanism of the action of drugs
  • Fetal maturation & perinatal changes
  • Inflammatory & immunologic disorders
  • Adverse effects on the musculoskeletal system
  • Degenerative & metabolic disorders of bone
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Histology Content Review 8% to 13%

 

Histology makes up about 8-13% of questions on the exam. The UMock USMLE® Step 1 prep course offers a high-yield review condensed concepts format to help you better understand the relationship between cell structure and function to biological tissues, and effectively apply concepts to clinical scenarios on the exam. The course includes high quality micrographs, illustrations, and tables to further enhance your ability to quickly recall concepts and how they apply in clinical practice.

  • Cell Histology
  • Extracellular Matrix
  • Epithelia & Glands
  • Connective Tissue
  • Blood & Hemopoiesis
  • Histology Cartilage & Bone
  • Histology Muscle
  • Nervous Tissue
  • Circulatory System
  • Histology of Lymphoid
  • Histology of Endocrine
  • Histology of Skin
  • Histology of Respiratory
  • Histology of Digestive
  • Urinary Glands
  • Female Reproductive
  • Male Reproductive
  • Special Senses
  • Cavity and Alimentary Tract
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Anatomy Content Review 11% to 15%

 

In Anatomy, the UMock USMLE® Step 1 prep course presents the most important high-yield facts you need to memorize for the exam, and helps you understand and apply clinical correlations of the structure and organization of the body to clinical scenarios such as fractures, trauma, and injuries. The course is illustrated with high quality descriptive images of anatomic relationships to further enhance your ability to apply knowledge to concepts.

  • Perineum
  • Vertebral Column
  • Spinal Cord & Spinal Nerves
  • Autonomic Nervous System
  • Lymphatic System
  • Chest Wall
  • Anatomy of the Heart
  • Abdominal Wall
  • Kidney, Ureter, Bladder, & Urethra
  • Suprarenal Glands
  • Abdominal Vasculature
  • Abdominal Viscera
  • Anatomy of the Pelvis
  • Spleen
  • Female Reproductive
  • Male Reproductive
  • Anatomy of the Upper Limb
  • Anatomy of the Lower Limb
  • Anatomy of the Head
  • Anatomy of the Neck
  • Anatomy of the Eye
  • Anatomy of the Ear
  • Pleura, Tracheobronchial Tree, & Lungs
  • Sigmoid Colon, Rectum, & Anal Canal
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Neuroanatomy Content Review 9% to 13%

 

In Neuroanatomy, the UMock USMLE® Step 1 prep course provides high-yield concepts in a clear and concise presentation to help you thoroughly understand and apply concepts in clinical scenarios covering different pathways and tracts, patterns, distribution territories, and the results of lesions.

In Neurology, the UMock USMLE® Step 1 prep course offers a clear and concise approach to helping you understand and apply concepts to clinical scenarios with high yield concepts covering the relationship between nerves and neurotransmission, and neurologic disease

The course features high quality illustrations, detailed tables, and radiologic images for both normal and abnormal processes to help you better understand how to apply concepts for diagnosis, treatment and management of neurologic diseases.

  • Cerebellum
  • Neurohistology
  • Cranial nerves
  • Auditory System
  • Vestibular System
  • Cerebral Cortex
  • Visual System
  • Gross Anatomy of the Brain
  • Tracts of the Trigeminal system
  • Meninges & Cerebrospinal Fluid
  • Development of the Nervous System
  • Olfactory, Gustatory, & Limbic
  • Autonomous Nervous System
  • Neurotransmitters & Pathways
  • Diencephalon: Thalamus & Hypothalamus
  • Blood supply of the Central Nervous System
  • Tracts & Lesions of the Spinal Cord & Brainstem
  • Tracts & Lesions of the Spinal Cord & Brainstem
  • Basal Nuclei & the Extrapyramidal Motor System
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Legal and Ethics Content Review 6% to 10%

 

The UMock USMLE® Step 1 prep course gives you a clearly explained review of high-yield topics to help you understand how to apply, and make a decision in clinical scenarios involving calculated risks, promoting the patients’ best interest, and respecting the patient’s decisions about their own health. Topics from the course include:

  • Minors
  • Abortion
  • Refusing Care
  • Confidentiality
  • Informed Consent
  • Abuse & Neglect
  • Reportable Diseases
  • Ethical Principles
  • Healthcare Legislation
  • Capacity & Competency
  • Physician Assisted Suicide
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Biostatistics and Epidemiology Content Review 4% to 6%

 

Biostatistics and Epidemiology covers roughly 4-6% of exam questions. The UMock USMLE® Step 1 prep course clarifies difficult concepts with a concise review of high-yield concepts. The course eliminates excessive detail to help you memorize and understand how to efficiently identify and extract the most important information, and apply your knowledge to concepts and formulas. The course includes high quality graphs and tables that clearly illustrate the most important and heavily tested concepts you need to know how to apply for the exam, including:

  • Research Methods
  • Hypothesis Testing
  • Descriptive Statistics
  • Differential Statistics
  • Assessing the Evidence
  • Correlational & Predictive Techniques
  • Statistics in Medical Decision Making
  • Epidemiology & Population Health
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Biostatistics and Epidemiology Content Review 4% to 6%

 

Biostatistics and Epidemiology covers roughly 4-6% of exam questions. The UMock USMLE® Step 1 prep course clarifies difficult concepts with a concise review of high-yield concepts. The course eliminates excessive detail to help you memorize and understand how to efficiently identify and extract the most important information, and apply your knowledge to concepts and formulas. The course includes high quality graphs and tables that clearly illustrate the most important and heavily tested concepts you need to know how to apply for the exam, including:

  • Research Methods
  • Hypothesis Testing
  • Descriptive Statistics
  • Differential Statistics
  • Assessing the Evidence
  • Correlational & Predictive Techniques
  • Statistics in Medical Decision Making
  • Epidemiology & Population Health
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UMock ABP Content

Internal medicine Surgery Pediatrics
Obstetrics Gynecology Phychiatry
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Internal medicine

 
  • Gastrointestinal System
    • Introduction to gastroenterology
    • Diseases of the esophagus
    • Malabsorption
    • Diseases of the colon
    • Diseases of the anus and rectum
    • Diseases of the biliary tree
    • Diseases of the liver
    • Diseases of the pancreas
  • Endocrine System
    • Introduction to endocrinology
    • Thyroid disease
    • Hypothalamic-pituitary axis
    • Adrenal disease
    • Parathyroid disease
    • Diabetes
  • Oncology
    • Oncology review
    • Cancers by organ system

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Surgery

 
  • Basic concepts on reproduction
    • Female reproduction
    • Male reproduction
    • Fertilization
    • Infertility
    • Managing infertility
    • Contraception
  • Antenatal risks and complications
    • Spontaneous abortion
    • Ectopic pregnancy
    • Gestational trophoblastic disease
    • Placenta previa
    • Abruptio placenta
    • Incompetent cervix
    • Hyperemesis gravidarum
    • Anemia
    • Gestational diabetes mellitus
    • Hypertensive disorders
    • Cardiac disorders
    • Torch infections
    • HIV/AIDS
    • Chorioamnionitis
    • Group B streptococcus
    • Sexually transmitted infections
  • Neonatal nursing care
    • Newborn assessment
    • Immediate newborn care
    • Physical assessment
    • Pain assessment
    • Physiological changes and nursing care
    • Newborn safety
    • Newborn nutrition
    • Client education
  • Intrapartal risks and complications
    • Premature rupture of membranes
    • Cord prolapse
    • Fetal distress
    • Vena cava syndrome
    • Preterm labor
    • Precipitous labor
    • Uterine rupture
    • Amniotic fluid embolism
    • Uterine inversion
    • Intrauterine fetal demise
    • Dystocia
  • Postpartum risks and complications
    • Postpartum infections
    • Thromboembolic disorders
    • Coagulopathies
    • Postpartum hemorrhage
    • Uterine atony
    • Uterine subinvolution
    • Retained placenta
    • Hematoma and lacerations
  • Neonatal risks and complications
    • Preterm neonate
    • Small for gestational age
    • Large for gestational age
    • Transient tachypnea
    • Birth injuries / trauma
    • Hypoglycemia
    • Neonatal abstinence syndrome
    • Fetal alcohol spectrum disorder
    • Erythroblastosis fetalis
    • Mnemonics and explanation
  • Antepartum nursing care
    • Prenatal assessment
    • Physiological maternal changes
    • Psychosocial responses
    • Signs of pregnancy
    • Common discomforts of pregnancy
    • Fetal and maternal well-being assessment
    • Nutritional needs
    • Client education
  • Intrapartum nursing care
    • The labor process
    • Premonitory signs of labor
    • Electronic fetal monitoring
    • Fetal heart rate patterns
    • Paced breathing techniques
    • Stages of labor
    • Pharmacological anesthesia
    • Pharmacological analgesia
    • Obstetric procedures
  • Neonatal risks and complications
    • Preterm neonate
    • Small for gestational age
    • Large for gestational age
    • Transient tachypnea
    • Birth injuries / trauma
    • Hypoglycemia
    • Neonatal abstinence syndrome
    • Fetal alcohol spectrum disorder
    • Erythroblastosis fetalis
    • Mnemonics and explanation
  • Postpartum nursing care
    • Expected maternal changes

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Pediatric nursing Content Review

 
  • Pediatric disorders
    • Integumentary problems
    • Neurological problems
    • Eyes, ears and throat problems
    • Respiratory problems
    • Cardiovascular problems
    • Gastrointestinal problems
    • Genitourinary and renal problems
    • Hematologic problems
    • Oncologic disorders
    • Musculoskeletal problems
    • Infectious diseases
    • Mnemonics and explanation
    • Image citations
  • Pediatric nursing care
    • Considerations
    • Illness and hospitalization
    • Restraints
    • Death and dying
    • End of life care
  • Pediatric assessment
    • Pain assessment
    • Health history interview
    • Physical assessment
  • Growth and development
    • Growth patterns and trends
    • Summary of developmental theories
    • Physical growth and development
  • Health promotion
    • Nutrition, dental health, sleep and rest
    • Childhood and adolescent immunizations
    • Promoting safety
    • Play and age-appropriate activities

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Drug interactions Content Review

 
  • Overview
  • Pharmaceutical Drug Interactions
  • Pharmacodynamic Drug Interactions
  • Other Types of Drug Interactions
  • Pharmacokinetic Drug Interactions
    • Absorption
    • Distribution
    • Metabolism
    • Elimination

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Pharmacogenomics Content Review

 
  • Precision Medicine
    • Biomarkers
    • Polymorphisms
    • Polymorphism Nomenclature
    • Linkage Disequilibrium
    • Tag-SNPs
    • Phase II Polymorphisms
    • Other Testing
    • Dosing Recommendation Resources

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Critical care nursing Content Review

 
  • Fundamentals of critical care
    • Definition of critical care
    • Healthy work environment
    • Rapid response team
    • Code management
    • Basic life support
    • Chains of survival
    • Adult cardiac arrest algorithm
    • Cardiopulmonary resuscitation
    • Advanced cardiac life support
    • 2020 BLS and ACLS updates
    • Code medications
    • EKG/ECG monitoring
    • Hemodynamic monitoring
    • Ventilatory assistance
    • Airway management
    • Mechanical ventilation
  • Cardiovascular disorders
    • Basic dysrhythmias
    • Carotid artery disease
    • Pulmonary hypertension
    • Sudden cardiac death
  • Respiratory disorders
    • Acute lung failure
    • Acute respiratory distress syndrome
    • Coronavirus disease
    • Intracranial hypertension
    • Herniation syndromes
    • Status epilepticus
  • Hematologic and immunologic disorders
    • Disseminated intravascular coagulation
    • Tumor lysis syndrome
    • Heparin-induced thrombocytopenia
  • Gastrointestinal disorders
    • Acute GI bleeding
    • Variceal bleeding
  • Endocrine disorders
    • Diabetic ketoacidosis
    • Hyperglycemic hyperosmolar state
    • Hypoglycemia
  • Shock, sirs and mods
    • Types
    • Stages
    • Significant laboratory tests
    • Shock-specific assessment and interventions
    • Systemic inflammatory response syndrome
    • Multiorgan dysfunction syndrome
    • Mnemonics
    • Image citations

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Nursing pharmacology Content Review

 
  • Fundamentals of nursing Pharmacology
    • Basic principles
    • Drug regulation
    • Drug labels
    • Medication errors
    • Nursing responsibilities
    • Drug calculation
  • Drugs acting on the nervous system
    • CNS depressants
    • Muscle relaxants
    • Analgesics
    • Antimigraine agents
    • Anesthetics
    • Neuromuscular blocking agents
    • Antiseizure agents
    • Antiparkinsonism agents
    • Psychotherapeutic agents
    • Adrenergics
    • Muscarinic/ cholinergic/ cholinomimetic
    • Parasympathomimetic agents
    • Muscarinic antagonists/ anticholinergic
    • agents/ parasympatholytics
  • Antimicrobial agents
    • Key terms
    • Antibiotics
    • Antituberculous agents
    • Antifungal agents
    • Antiprotozoal agents
    • Anthelminthics
    • Ectoparasiticides
    • Antiviral agents
  • Drugs affecting the reproductive system
    • Women's health drugs
    • Men's health drugs
  • Drugs affecting the Cardiovascular system
    • Antihypertensive agents
    • Drugs for heart failure
    • Antiarrhythmic agents
    • Antianginal agents
    • Antihyperlipidemic agents
  • Drugs affecting the blood
    • Key concepts
    • Drugs affecting the formation of clots
    • Drugs used to treat anemias
  • Drugs acting on the respiratory system
    • Key concepts
    • Drugs used for managing upper respiratory system disorders
    • Drugs used for asthma and COPD
  • Drugs affecting the endocrine system
    • Key concepts
    • Antidiabetic agents
    • Glucose elevating agent
    • Drugs for thyroid disorders
    • Drugs affecting calcium levels
    • Drugs affecting hypothalamic and pituitary function
    • Drugs for adrenal cortex disorders
  • Drugs acting on the gastrointestinal tract
    • Key concepts
    • Drugs controlling gastrointestinal secretions
    • Antidiarrheals
    • Laxatives
    • Antiemetics
    • Drugs for inflammatory bowel disease
    • Drugs for irritable bowel syndrome
    • Other medications affecting the
    • gastrointestinal tract
  • Drugs acting on the renal system
    • Key concepts
    • Diuretics
    • Anti-infectives for the urinary tract
    • Antispasmodics
    • Drugs for benign prostatic hyperplasia
  • Drugs affecting the musculoskeletal system
    • Drugs for gouty arthritis
    • Skeletal muscle relaxants
    • Drugs for osteoporosis
  • Drugs for disorders of the eyes and ears
    • Common eye medications
    • Drugs for glaucoma
    • Drugs for macular degeneration
    • Common ear medications

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Nursing Skills and Therapies Content Review

 
  • Common tests and procedures
    • Specimen collection
    • Urine studies
    • Stool studies
    • Blood studies
    • Microscopic examinations
    • Fluid analysis tests
    • Radiologic studies
    • Ultrasonography
  • Intravenous therapy
    • Intravenous infusion
    • Blood transfusion
  • Promoting nutrition
    • Nutrition
    • Macronutrients
    • Micronutrients
    • Major minerals
    • Trace minerals
    • Malnutrition
    • Dietary guidelines
    • Nutrition across the lifespan
    • Texture-based therapeutic diets
    • Disease-based therapeutic diets
    • Vegetarian diets
    • Dysphagia and aspiration
    • Enteral nutrition
    • Parenteral nutrition
  • Perioperative nursing
    • Purposes of surgery
    • General classifications
    • Anesthesia
    • Preoperative phase
    • Intraoperative phase
    • Postoperative phase
  • Complementary and alternative therapies
    • Energy therapies
    • Biological-based therapies
    • Whole medical systems
    • Mind-body interventions
    • Manipulative and body-based methods
    • Mnemonics and explanation
    • Image citations

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Autoimmune Content Review

 
  • Autoimmune Disorders
    • Symptoms
    • Detection
    • Treatment
  • Rheumatoid Arthritis
    • Clinical Features
    • Diagnosis
    • Non-Pharmaceutical Treatments
    • Pharmaceutical Treatments
    • Patient Counseling
  • Psoriasis
    • Overview
    • Presentation
    • Treatments
    • Pharmaceutical Treatments
  • Celiac Disease
    • Cause
    • Clinical Features
    • Non-Pharmaceutical Treatments
    • Pharmaceutical Treatments
  • Multiple Sclerosis
    • Clinical Features
    • Non-Pharmaceutical Treatments
    • Pharmaceutical Treatments
    • Symptom Control Treatments
    • Patient Counseling
  • Sjogren’s Syndrome
    • Overview
    • Clinical Presentation
    • Dry Mouth Treatments
    • Dry Eye Treatments
  • Myasthenia Gravis
    • Symptoms
    • Treatment
    • Drugs that Exacerbate Myasthenia Gravis
  • Systemic Lupus Erythematosus
    • Disease Course
    • Activating Factors
    • Drug Induced Lupus Erythematosus
    • Clinical Features
    • Non-Pharmaceutical Treatments
    • Pharmaceutical Treatments
  • Raynaud’s Phenomenon
    • Overview
    • Presentation and Symptoms
    • Pharmaceutical Treatment
    • Drug-Induced Raynaud’s

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The Respiratory System Content Review

 
  • Overview
    • Gas Exchange
    • Other Organs Involved
  • Anatomy and Function
    • Upper Respiratory Tract
    • Lower Respiratory Tract
  • Drug Delivery
    • Systemic Delivery
    • Localized Delivery
  • Lung Capacities
    • Spirometry
  • Homeostatic Acid-Base Balance
    • Identifying Lab Values
    • Acidosis
    • Alkalosis
    • Clinical Features
    • Respiratory Compensation
    • Renal Compensation
    • Anion Gap

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Pulmonary Vascular Resistance Content Review

 
  • Overview
    • Poiseuille’s Law
    • Mechanisms
    • Pathophysiology
    • Clinical Presentation
  • Regulation of Pulmonary Vascular Resistance

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Pulmonary Hypertension Content Review

 
  • Overview
    • Classifications
  • Clinical Features of Pulmonary Arterial Hypertension
    • Symptom Classifications
    • Treatment / Cure
  • Pathophysiology
    • Imbalance of Endogenous Vaso-modulators
    • Imbalance of Cell Regulation
    • Diagnosis
  • Non-Pharmaceutical Treatments
  • Pharmaceutical Treatments
    • Immunizations
    • Supportive Therapies
    • Soluble Guanylate Cyclase Stimulator
    • Phosphodiesterase-5 Inhibitors
    • Receptor Agonists and Proteinoids
    • Endothelin Receptor Antagonists
  • Pulmonary Fibrosis
    • Overview
    • Clinical Features
  • Drug Interactions
    • Soluble Guanylate Cyclase Stimulator: Riociguat
    • Phosphodiesterase-5 Inhibitors
    • Prostacyclin Receptor Agonists and Prostacyclin Analogs
    • Endothelin Receptor Antagonists

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Obstructive Diseases Content Review

 
  • COPD
    • Overview
    • Classification
    • Causes
    • Diagnosis
    • Clinical Features
    • Asthma Classifications
    • Non-Pharmaceutical Treatments
    • Pharmaceutical Treatments
    • Theophylline, Leukotriene Receptor Antagonists, mAbs
    • Additional Treatments
    • Special Patient Populations and Circumstances
  • Emphysema
    • Overview

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Cystic Fibrosis Content Review

 
  • Overview
    • Pathophysiology
    • Incidence
    • Inheritance
    • CFTR Mutation
    • Clinical Features
    • Non-Pharmaceutical Treatments
    • Pharmaceutical Treatments
    • Patient Counseling

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Acute and Critical Care Content Review

 
  • Overview
    • Acute Care
    • Intensive Care Unit
  • Venous Thromboembolism
    • Causes
    • Deep Vein Thrombosis
    • Clinical Presentation
    • Comorbidities
    • Prevention
  • Ventilators
    • Ventilator-Induced Lung Injury
    • Ventilator-Induced Infections
  • Common Conditions in the Intensive Care Unit
    • Pain
    • Delirium
    • Agitation
  • More Drugs used in the ICU and the Operating Room
    • Anesthetics
    • Neuromuscular Blocking Drugs
    • Hemostatic Drugs
  • Pulmonary Embolism
    • Adverse Side Effects

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The Heart Content Review

 
  • Anatomy and Function
  • Flow of Blood

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Dyslipidemia Content Review

 
  • Non-Pharmaceutical Treatments
  • Pharmaceutical Treatments
    • Concerns
    • Lomitapide
    • Mipomersen
    • Ezetimibe
    • Statins
    • Fish Oils
    • Peroxisome Proliferator Receptor Alpha Activators
    • Bile Acid Sequestrants
    • Proprotein Convertase Subtilisin Kexin Type 9 Inhibitors
    • Niacin
  • Overview
    • Classifications
  • Diagnostic Criteria
    • Clinical Features

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Hypertension Content Review

 
  • Overview
  • Clinical Features
    • Pathophysiology
    • Compensation
  • Diagnostic Criteria
  • Treatment
    • Non-Pharmaceutical Treatments
    • Special Populations
    • Pharmaceutical Treatments
  • Vasodilators
    • Drug Interactions
    • Patient Counseling
  • Calcium Channel Blockers
    • Drug Interactions
    • Patient Counseling
  • Renin-Angiotensin Aldosterone System Inhibitors
    • Drug Interactions
    • Patient Counseling
  • Diuretics
    • Thiazide-Type
    • Potassium-Sparing
  • Beta-Blockers
    • Drug Interactions
    • Patient Counseling
  • Alpha-Receptor Modulators
    • Alpha-2 Adrenergic Agonists
    • Alpha Blockers
  • Acute and Critical Hypertensive Care

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Ischemic Heart Disease Content Review

 
  • Overview
  • Clinical Features
    • Pathophysiology
  • Diagnostic Criteria
  • Non-Pharmaceutical Treatments
  • Pharmaceutical Treatments
    • Antiplatelet Agents
    • Nitroglycerin
    • Antianginal Therapy

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Arrythmias Content Review

 
  • Overview
    • Clinical Features
    • Pathophysiology
  • Arrythmia Diagnostic Criteria
    • Normal Sinus Rhythm
    • Abnormal Sinus Rhythm (Arrythmia)
  • Arrythmias
    • Antiarrhythmics
    • Class I Antiarrhythmics
    • Class III Antiarrhythmics
    • Class IV Antiarrhythmics

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Myocardial Infarction Content Review

 
  • Overview
  • Clinical Features
  • Diagnostic Criteria
  • First-line Pharmaceutical Treatments
    • Fibrinolytics
    • P2Y12 Inhibitors
    • Glycoprotein Receptor Antagonists
  • Second-Line Pharmaceutical Treatments

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Heart Failure Content Review

 
  • Overview
  • Clinical Features
    • Pathophysiology
    • Compensation
  • Diagnostic Criteria
    • Classifications
    • Exacerbating Factors
  • Non-Pharmaceutical Treatments
  • Pharmaceutical Treatments
    • Nitrate/Hydralazine
    • Ace Inhibitors
    • Angiotensin Receptor Blockers
    • Loop Diuretics
    • Aldosterone Receptor Antagonists
    • Adrenergic Receptor Antagonists

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Shock Content Review

 
  • Overview
  • Classifications
    • Pathophysiology
  • Hypovolemic Shock
  • Cardiogenic Shock
  • Anaphylactic Shock
  • Neurogenic Shock
  • Treatments

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Intro to Infectious Diseases Content Review

 
  • Intro to Infectious Diseases
    • Overview

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Intro to Infectious Diseases Content Review

 
  • Identification of Bacteria
    • Shape Classification
    • Gram-Stain Classification
  • Antibiotic Selection
    • Empiric Treatment
    • Data Collection
    • Antibiotic Susceptibility
    • Combination Antibiotic Treatment
  • Common Infections
    • Sites of Infection
  • Treatment Evaluation
  • Antibiotic Use for Surgeries
    • Pre-Operative
    • Intra-Operative
    • Post-Operative
    • Procedure Based Antibiotics
  • Meningitis
    • Overview
    • Clinical Features
    • Pharmaceutical Treatment
  • Peritonitis
    • Primary Peritonitis
    • Secondary Peritonitis

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From students with top scores on the ABP

The team behind UMock ABP with Perfect scores

Perfect scores

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Anushka

Yale University

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Anjali

Yale University

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Casey

Neurologist

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Mike

Orthopedic Surgery

Each subject review was written by students from Yale University with perfect exam scores. Each subject is condensed into an exceptionally easy-to-learn format with engaging content to more effectively retain concepts.

Anushka

Perfect Score

She graduated magna cum laude from Yale University with a B.S. in Molecular, Cellular, and Developmental Biology. She is currently a fourth-year medical student. She received perfect scores on the MCAT (528/528) and SAT (1600/1600), and has extensive experience for the MCAT, SAT, and AP exams. At Yale, she conducted genetics research and was the recipient of multiple research fellowships. During high school, she was a two-time finalist (top 20) in the U.S. National Chemistry Olympiad and was one of 80 students worlwide selected to attend the prestigious Research Science Institute (RSI) at MIT.

Scores:

  • MCAT: 528 / 528
  • SAT: 1600 / 1600
  • AP Biology: 5 / 5
  • AP Chemistry: 5 / 5
  • AP Physics C: 5 / 5
  • AP Calculus: 5 / 5
  • AP English Language and Composition: 5 / 5
  • AP English Literature and Composition: 5 / 5

Anjali

Perfect Score

She graduated magna cum laude from Yale University with a B.S. in Molecular, Cell, and Development in Biology and distinction in her major. Anjali Walia is a fourth-year medical student. She was also elected to the prestigious Phi Beta Kappa honor society. She achieved a perfect score (528/528) on the MCAT. At Yale, she published pulmonary research and led numerous reproductive justice advocacy efforts. She was finalist (Top 20) of the U.S. Chemistry Olympiad and obtained a perfect score on the SAT (1600/1600).

Scores:

  • MCAT: 528/528
  • SAT: 1600/1600
  • AP Biology: 5
  • AP Chemistry: 5
  • AP Physics I: 5
  • AP Physics C: 5
  • AP Computer Science: 5
  • AP Calculus: 5
  • AP English Language and Composition: 5
  • AP English Literature and Composition: 5

Casey

Perfect Score

Casey Vickstrom graduated summa cum laude from Northwestern University in 2014 with a B.A. in Biological Sciences. He is a third-year medical student in the MD/PhD program at the Medical College of Wisconsin, having completed his PhD in Neuroscience in 2020. His research focused on neural circuits and endocannabinoids related to anxiety and depression. He aims to study mechanisms of neurological diseases to identify new therapeutic targets. Casey has extensive tutoring experience for Step 1 and plans to pursue a career in neurology or related specialties. In his free time, he enjoys skiing, soccer, and spending time with family, friends, and his dog.

  • Education:
  • Northwestern University B.A.Honors
  • Medical College of Wisconsin
  • Medical Scientist Training Program (MD/PhD) at present
  • Score:
  • Step 1 - 265/300
  • ACT - 35/36
  • AP Biology - 5/6
  • MCAT - 515/528
  • Biology / Organic chem - 131/136
  • Physical Sciences - 127/136
  • Reading - 127/136

Mike

Perfect Score

  • Education:
  • Georgetown University, B.S.
  • Medical school/Residency:
  • Rutgers Robert Wood Johnson Medical School, M.D.
    Orthopedics Surgery
  • MCAT: 528 / 528
  • USMLE Score:
  • Step 1 - Pass
  • Step 2CK - 245
  • Step 3 - 252
  • SAT Subject Test –
  • Biology (Molecular): 780 / 800
  • Mathematics Level 2: 780 / 800
  • Mathematics Level 1: 750 / 800
  • SAT with Essay: 2330 / 2400
  • Reading: 800 / 800
  • Writing: 770 / 800
  • Math: 760 / 800
  • Chem/Phys: 131 / 136
  • CARS: 131 / 136
  • Bio/Biochem: 130 / 136
  • Psych/Soc: 130 / 136
  • AP Biology: 5 / 5
  • AP Statistics: 5 / 5
  • AP Calculus: 5 / 5
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