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(Sorry, again, BUT PLEASE READ THIS MODEL CASE THAT THE NBME LOVES IN FORMAT) Dear Family, Again, the below is not copyrighted and is original, but it will seem like an actual USMLE step 1 case you will see because it resembles the format of what they feel is important for you to know. Please study it because you will face the same format and "feel" again and again in similar concepts: Case: A pediatric patient of yours named Valentine comes in with vague presentations involving sweating, poor feeding, respiratory issues, malaise, tantrums, trembling, confusion at times. History shows the following: Valentine has on your physical hepatomegaly, hyperlipidemia, and growth retardation, and his sugars are low. (NOW, NBME USMLE STEP 1 cases can be VERY VERY LONG…do you know what this child has? If not, I need to give more information….) More labs come back and you note that there is glycogen filling up in the body’s cells. Obtain a lipid profile. Modest elevations in very low-density lipoprotein cholesterol and triglyceride levels sometimes occur. Evaluate blood and urine for ketones, especially after a brief fast. Fasting ketosis is prominent. (NOW, I believe here a well-prepared student should tell me the diagnosis…but remember, the USMLE is about secondaries to the disease, so here is the diagnosis and the relevant secondaries that are within the NBME sphere of focus)

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Subject: Tommy's Concepts

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(Sorry, again, BUT PLEASE READ THIS MODEL CASE THAT THE NBME LOVES IN FORMAT)

Dear Family,

Again, the below is not copyrighted and is original, but it will seem like an actual USMLE step 1 case you will see because it resembles the format of what they feel is important for you to know. Please study it because you will face the same format and "feel" again and again in similar concepts:

Case: A pediatric patient of yours named Valentine comes in with vague presentations involving sweating, poor feeding, respiratory issues, malaise, tantrums, trembling, confusion at times. History shows the following: Valentine has on your physical hepatomegaly, hyperlipidemia, and growth retardation, and his sugars are low.
(NOW, NBME USMLE STEP 1 cases can be VERY VERY LONG…do you know what this child has? If not, I need to give more information….)
More labs come back and you note that there is glycogen filling up in the body’s cells. Obtain a lipid profile. Modest elevations in very low-density lipoprotein cholesterol and triglyceride levels sometimes occur. Evaluate blood and urine for ketones, especially after a brief fast. Fasting ketosis is prominent.
(NOW, I believe here a well-prepared student should tell me the diagnosis…but remember, the USMLE is about secondaries to the disease, so here is the diagnosis and the relevant secondaries that are within the NBME sphere of focus)

Answer

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