USMLE Step 1 Exam Prep – 4 High-Yield Brachial Plexus Tips For The Step 1 Exam

While many people preparing for their USMLE Step 1 exams tend to focus on the tougher subjects like Pathology and Pharmacology, it is imperative that you do a good review of your Anatomy material because you are guaranteed to get a few really easy questions. If you take just a little bit of time to go through the high-yield anatomy notes from your review books or course, you are going to get an easy 5-7 points on your exam, which as you may know can be the difference between a sub-200 score and an above-200 score.

In order to make this process as easy for you as possible, I am going to outline five common injuries that are related to the brachial plexus, which is a very high-yield USMLE topic.

Here we go:

Median Nerve Injury – this commonly results from an injury to the supracondyle of the humerus, and results in a loss of the following:

– forearm pronation

– wrist flexion

– finger flexion

– thumb movement

And it also results in a loss of sensation to the thumb, lateral aspect of the palm, and the first 2.5 fingers.

Radial Nerve Injury – this occurs commonly when there is an injury to the shaft of the humerus, and results in the following:

– loss of triceps reflex

– loss of brachioradialis reflex

– loss of carpi radialis longus

These symptoms lead to the commonly known “wrist drop”, as well as a loss of sensation to the posterior antebrachial cutaneous and the posterior brachial cutaneous nerves.

Ulnar Nerve Injury – this occurs with injury to the medial epicondyle of the humerus, and causes the following problems:

– impaired flexion and adduction of the wrist

– impaired adduction of the ulnar two fingers and the thumb

There is also a loss of sensation to the medial aspect of the palm, as well as loss of sensation to the medial half of the ring finger and the pinky.

Axillary Nerve Injury – occurs as a result of injury to the surgical neck of the humerus and/or an anterior dislocation of the shoulder, resulting in the following:

– complete loss of deltoid movement

– loss of sensation over the deltoid muscle as well as the skin covering the inferior aspect of the deltoid

These are four common brachial plexus related injuries, and are very likely to present themselves on your USMLE Step 1 and/or Step 2 CK exams. Be aware that they will be disguised as clinical vignettes, but also refer back to your basic knowledge in order to choose the most accurate answer.

ACT Or SAT? Five Tips to Pick the Right College Entrance Exam

The SAT and ACT are both respected, nationally-recognized tests. Historically, there’s been a geographic divide between the two; nowadays, very few colleges require or prefer one test over the other. So which one should you take? Well, since you can’t really say one test is any easier than the other, that all depends on your skills and preferences. Basically, you should go for the one you’ll score higher on!

Here are some tips to help you make your decision:

1. Who says size doesn’t matter?

The ACT is a shorter test. The SAT takes a whopping 3 hours, 45 minutes, while the ACT comes out to a hefty 2 hours, 55 minutes, making the SAT about 30% longer than the ACT. Either way, you’re stuck taking a long test. If you have a ridiculously short attention span, then the ACT might be right for you, but realistically, after nearly 3 hours, why sweat an extra 50 minutes?

2. When in doubt, just guess… right?

The SAT has a guessing penalty – minus a quarter of a point for each incorrect response. Not so with the ACT. Guess away! So you should answer every question on the ACT, but on the SAT, you should just leave the answer blank when you can’t eliminate at least one answer choice. Does this make the SAT “harder”? Not really. With the right strategies, you can even make the SAT’s guessing penalty work to your advantage.

3. It’s a bird! It’s a plane! It’s superscore!

The SAT reports each of your three “subscores” separately-one each for critical reading, writing, and mathematics. So, many colleges will combine your best three subscores from all the times you’ve taken the SAT to make a “superscore.” In the past, schools would not do this with the ACT. Recently, however, many schools have begun to make ACT “superscores” too.

4. What is the difference anyway?

Both tests have a grammar, reading comprehension, essay and math portions. The ACT has an extra “science” section, but don’t worry. I used quotes because it’s really just another test of your reasoning skills – not much chemistry, physics or biology knowledge needed. Broadly speaking, the ACT tests skills that you (should have) learned in high school, while the SAT tries to evaluate your innate problem-solving abilities.

For example, the ACT math section tests a few topics that typically aren’t covered until pre-calculus. While the SAT leaves out these topics, its math problems generally have more complicated setups.

The ACT’s essay is optional, but some colleges require it anyway. Its essay topics are always questions of school policy, while the SAT’s essays deal with more abstract moral or philosophical issues.

In the critical reading sections, the SAT’s vocabulary is harder, but the ACT taxes your critical reading and analysis skills. The ACT English section gives you a couple of long passages with grammar and critical reading questions mixed together; the SAT tests reading and grammar separately.

5. You can’t know if you like it till you’ve tried it!

How do I know which test is better for me? Try them! Take some free practice tests online and see which one fits your fancy. Both the SAT and ACT offer practice questions or tests on their official websites.