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UWorld Test-Taking Strategy: Acid-Base
A healthy 45 year–old male travels to Switzerland for a mountain climbing trip. During the trip, he stays in a high-altitude camp in the mountains at over 14,000 feet above sea level. After 6 days, he has blood drawn as part of a research study. Which of the following arterial blood gas values would you expect to see with this sample:

  pH  PaO2 (mm Hg) PaCO2 (mmHg) Plasma HCO3
A: 7.25 98 21 11
B: 7.32 60 55 31
C: 7.38 70 40 22
D: 7.49 60 20 15
E: 7.50 96 30 17
F: 7.6 72 50 32


When I was studying for Step 1, I would initially panic when I saw questions like this, thinking, "Not only are you asking me to pick between six answers, you’re asking me to work through several variables to arrive at the correct choice!"

Now, as a tutor, I see a similar form of anxiety in my students when they encounter questions like these or the dreaded up/down arrows often seen in Endocrinology. However, what I am here to show you is that with some very simple test-taking strategies, you can make questions like these a strength when taking Step 1. Let’s break it down into a series of steps: 

USMLE Question Breakdown: Cardiac Causes of Syncope
Syncope is a common topic for a USMLE Step 2 CK question vignette as it has a wide differential diagnosis with endless possibilities for test questions based on pathology, diagnostic workup and management. The question below highlights the reasoning needed to solve a complex three-step question similar in style to the questons you will see on your actual exam.
USMLE Question Breakdown: Pathophysiology of Pharmacologic Side Effects
One of the best ways to be well-rounded in your USMLE prep is to maximize learning from your Qbank. By actively learning as much as possible from questions, you not only strengthen your fund of knowledge but also further hone your testing strategies over time.

As such, it's our goal to help you further your USMLE prep through our blog by presenting you with the kind of detailed question breakdown you would experience in your work with one of our tutors. So, without further ado, let's tackle a great example of a two-step USMLE Step 1 question:

One of the more important aspects of Step 1 and subsequent USMLE examinations is understanding principles of health maintenance. This is a great time for test makers to assess your knowledge as it pertains to disease screening and the outpatient management of common chronic diseases like hypertension or dyslipidemia.

The question below is a great example of how the USMLE can integrate biochemistry, pharmacology, and pathophysiology into one question on the management of dyslipidemia. It also highlights that students can take many paths to acheiving a correct answer and the utility of thinking through all answer choices.

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