B Polyglactin Vicryl mesh is absorbable within months and especially in the bridging position, and lends itself to unacceptably high recurrence rates. It should only be used as a purposeful temporary cover or bridge with the intention of permanent hernia fix in the future. C Mesh should be used as tissue reinforcement to decrease hernia recurrence rates. E Though the idea of not using permanent mesh in a contaminated environment has recently been challenged, it is safest to use a biologic mesh, with very low recurrence rates in combination with component separation without worry of subsequent mesh explantation.
Provide your email to see your results and get exclusive discounts on additional board review questions. Over challenging Surgery Shelf Board Review Questions targeted for use during clerkship rotations. The surgery questions included in these question banks have been hand selected by faculty who have taught for the Shelf Exams in the past and who have taken the Surgery Shelf Exams themselves.
BoardVitals is trusted by more than leading medical institutions including Harvard, Yale, Mt. Sinai, and Duke. When I used this bank for the first time, I said to myself 'oh wow' because I was missing little bits and pieces which I filled in with BoardVitals.
These questions are hard but very similar to questions on NBME exams. The NBME initially will calculate an objective raw score for each exam. This is compared to the national exam for each specific exam at the time it was taken and translated into a national percentage for each student i. It is important to realize that there is always subjectivity when deciding which resources one should use for the shelf exams. In this section the goal is to try and lay out the most objectively useful resources that arguably should be considered by ALL students preparing for their surgery shelf exam:.
This Website Stepwards. Much of the content on here has been created during the process of preparing for the surgery shelf exam, and is fundamentally useful in helping students prepare for the test.
Fundamentally it is very hard to come up for a reason why a student would not take these exams as preparation for the surgery shelf. Understanding the core principles of acute trauma management is key to this section. CT abdomen, non-contrast head CT vs. MRI, etc. The key part to the trauma pillar of the shelf is becoming extremely versed in the guidelines of trauma management. Part of the difficulty of the surgery shelf exam is the shortage of time on the test.
You want to become very comfortable with trauma case scenarios so that you are not overthinking the question but predicting the step-wise approach to the patient as you read the vignette. Sample Study Plan A sample study guide during an 8-week rotation should look something like this:.
The mistake most students make as they prepare for the surgery shelf is to focus too much on one aspect of the exam and forget or lack awareness of the other part. The rest of the climb is on the wards and the medical management of surgical patients. Our favorite happens to be Step Up to Medicine. Pestana has built a very simple and comprehensive framework that delivers an incredible amount of high-yield information with a small volume of text. There are associated audio-recordings of his that can be used as well.
Another highly recommended resource is the OnlineMedEd videos and question bank. There is little value in asking friends who have previously taken it. Our memories of the test are often skewed toward the questions that gave us the most difficulty. Look no further than the boring but incredibly useful NBME website.
It provides an objective system-by-system breakdown of the test, and is certainly worth the 2 minutes it takes to read. Like most 3rd year shelf exams, you will only have 2 hours and 30 minutes to complete difficult questions, many with infuriatingly long stems. At 90 seconds per question, you will have no choice but to move fast.
After all, when we internalize diagnoses and algorithms deeply enough, and combine them with our own clinical experience and intuition, the result is just that: feel. My last piece of general advice is to keep common sense in mind in all situations. It is so easy to get bogged down by esoteric questions that we forget the basics. This dude needs fluid resuscitation!
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