Dr. Austin Price | Action Potential Mentoring, LLC
@action_ap
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Vascular Surg PGY4 - I help med students crush the USMLE/COMLEX, get research pubs, and match into their goal specialty
Coaching Program ➡️
Joined June 2020
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This year, my mentees matched: Cardiothoracic/Thoracic Surgery (Integrated path), Gen Surg, Triple board certification Peds + Neuro + Developmental, Interventional Radiology, Derm, FM, IM, OBGYN, Anesthesia, PM&R, Child Neuro, Ophtho, Neurology & Psych.
What a year
#MedTwitter
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Unspoken Residency Rule:
Never rat on your co-resident.
Someone forgot DVT prophylaxis in their admission orders? Fix it. No need to make a big deal about it. Let them know in private instead of putting them on blast 💥
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How to Call a Consult as a Resident 📲🤙
Tbh, I just got one of the most organized consults I’ve ever received, so I wanted to write a quick thread on how this medicine resident did it 👍
(Will share at the end what she did that really stood out)
🧵 /
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Unspoken Residency Rule:
Never rat on your co-resident.
Someone forgot DVT prophylaxis in their admission orders? Fix it. No need to make a big deal about it. Let them know in private instead of putting them on blast 💥
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Ultimate Cardiac Thread for USMLE Step 2 CK
- This thread will help you become a MONSTER at cardio on the NBME's / IM shelf / Family Med shelf
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Unspoken Residency Rule:
Never rat on your co-resident.
Someone forgot DVT prophylaxis in their admission orders? Fix it. No need to make a big deal about it. Let them know in private instead of putting them on blast 💥
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The 56 Highest Yield Concepts for USMLE Step 2 & 3
- Pulmonary embolism
- Cardiac tamponade
- Tension pneumothorax
- Coronary artery disease
- Heart failure
- Arrhythmias/ACLS
- AKI vs CKD
- Electrolytes
- Nephritic vs Nephrotic
- Pulmonary Nodules & Cancers
- Asthma vs COPD
-…
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Let's make this go viral for everyone studying for the USMLE.
- The Top 10 Dreaded Highest Yield Images -
(I'll give clinical scenario, image & management of some of the most high yield/tricky images you'll see on test day!)
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The "Curve Breaking" Internal Medicine USMLE Step 2 / Shelf Review Guide🧵
This section is 50-60% of your Step 2. Unlimited sauce incomingggggg
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Unspoken residency rule:
If a consult or new admit comes in within 5 minutes of check-out time, (ex: 5:55pm) volunteer to take care of the consult so the person who’s been there all day can go home on time (since you’re going to be at the hospital for the next shift anyways!)…
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If you become a doctor, you cannot be mediocre. This is your contract with society.
-wise words of my attending
#MedTwitter
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Writing a Case Report as a Med Student (MASTER GUIDE)
👍Bookmark to save this thread for later
🧵/
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Never knew this -
Insulin stops working at <86F. This is why many hypothermic patients are hyperglycemic.
Interesting phenomenon I've seen in real life, but never had a reason for it...
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Surgery Shelf / Step 2 CK Cheat Sheet
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“TAILS” is the mnemonic I use for Microcytic anemias (MCV < 80)
- Thalassemia
- Anemia of chronic disease
- Iron deficiency anemia
- Lead poisoning
- Sideroblastic anemia
Helps all the time on practice questions when your brain freezes up 🥶
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THE VIDEOS ARE COMING. Gonna release them all at once tonight.
Guaranteed points.
🎯🎯🎯 if you’re aiming for 270, welcome.
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I need 7 more surgeries to have met all the ACGME criteria to graduate as a vascular surgeon 🥹😳🤯
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Mini Lysosomal Storage Diseases Crash Course (mental shortcuts I use to save time on the USMLE)
Baby has weakness...
--> if baby WITHOUT cherry red spot = Krabbe
--> if baby WITH cherry red spot and NO hepatosplenomegaly = Tay-Sachs
--> if older child WITH cherry red spot AND…
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Just gonna drop this here 🥸
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Want to give a shout out to everyone that is the first doctor/medical professional in their family. The journey is tough.
#MedTwitter
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Got my vascular boards tomorrow! Wish me luck 🏆
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Just gonna drop this here 🥸
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If your HR > SBP = consider shock in USMLE question
Super ez but I wish someone told me this when I was an M2 or M3
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You should not walk into your USMLE Step 1-3 without knowing everything there is to know about ITP.
Its so high yield that its free points on your exam
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Okay I just came up with a fire mnemonic (by accident) while updating my 2024 OBGYN/Repro USMLE Review:
Turner Syndrome = 1,2,3,4
1 horseshoe kidney
bi(2)cuspid valve
Tanner Stage 3
short 4th metacarpal
Dang. Ez memory hook I'm def gonna include in the review video! :)
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You're gonna want to save this if the algorithms for UTI treatment always confuse you:
Uncomplicated UTI Tx:
- Nitrofurantoin, trimethoprim-sulfamethoxazole or fosfomycin. Use fluoroquinolone if other options can’t be used.
- Culture ONLY if initial treatment fails
Complicated…
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2 things you can treat with 100% O2 for the USMLE:
- Cluster headache
- Carbon Monoxide poisoning
💨🤝
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Answer a 31% UWorld question in 3 seconds by simply knowing that Folinic acid is aka Leucovorin.
Never know when a random fact will help you
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You will match where you’re meant to be 🤝
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Top 5 NBME Heme/Onc TQ's (& a SHITLOAD of derivative TQ's) for USMLE Step 2 CK
- bookmark
- like
- retweet to help others
If y'all would like, I can record some content covering these concepts too for on the Youtube channel? Lmk in comments, if so :)
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Itching after a exercise/shower:
If rash --> cholinergic urticaria. Tx - H1 blocker
If no rash --> polycythemia
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USMLE Step 2 CK / Neuro Shelf Exam: Highest Yield Nervous System Cheat Sheet
(27 tricky facts that I personally missed while studying!)
- like
- Bookmark
- Repost if you would like part 2!
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Here’s your reminder to sit down & study:
- Pulmonary embolism
- Cardiac Tamponade
- Tension pneumothorax
It’ll pay off at some point down the road :)
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"USMLE Curve Disrespecting" Family Medicine Ultimate Thread
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USMLE Algo:
- if high orotic acid + elevated NH3 = urea cycle disorder
- if high orotic acid + elevated MCV = orotic aciduria
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Chronic Lymphocytic Leukemia
(6 Tips that you need to know for the USMLE/COMLEX)
+ 2 fun facts🎉
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Your fav PGY4 Vascular Surgery Resident’s first solo Lap Chole 💪✅🤙
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~~ Top 20 Things To Learn from NBME 12 for the USMLE Step 2 CK ~~
(One of the hardest NBME in my opinion)
DO NOT READ THIS IF YOU HAVEN'T TAKEN NBME 12 YET AS IT WILL MASSIVELY INFLATE YOUR SCORE ;)
lmk in the comments if you'd like to see more of these styles of threads!
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HEPATORENAL SYNDROME
Step 1 Physio Integration: splanchnic vasodilation due to NO --> renal hypoperfusion --> RAAS --> renal vasoconstriction = AKI
**Questions almost always have a hx of GI bleed or SBP, but can be spontaneous in late-stage disease
Step 2 / 3 integration:
Dx:…
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How I set up my daily notes while rounding on patients:
~ 7 columns ~
1) Name/room#/Past medical history (cropped out of photo for privacy)
2) Primary problem we are treating
3) Vitals
4) intake/outputs
5) labs 🧪
6) Important medications (for us:…
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USMLE algo-
hypoglycemia +...
--> urinary sugars = galactosemia (if right at birth) or hereditary fructose intolerance (if once weaned off milk)
--> NO ketones = fatty acid disorder (either MCAD or carnitine deficiency). Look next at acylcarnitine levels. If they're…
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Idc what your USMLE score is. If you’re a dick I don’t want you at my program.
That’d be my vibe as a Program Director 💯
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Fire
#USMLE
Mnemonic from my girlfriend:
"Lynch the 21 year old C.E.O."
- Lynch syndrome should begin colonoscopy screening at 21 years old
- CEO stands for: Colon cancer, Endometrial cancer and Ovarian cancer
#MedTwitter
#MedEd
#COMLEX
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Anterior nose bleeding on the USMLE:
Step 1) Nostril pinching to compress Kiesselbach plexus x10 minutes
Step 2) If doesn’t resolve → topical vasoconstriction with oxymetazoline (applied with squirt bottle or cotton pledget)
Step 3) If still doesn’t resolve → silver nitrate…
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On the USMLE, to consider which tests are sensitive or specific , a good rule of thumb: the more invasive the test is, the more specific it is.
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For Signals on ERAS:
If you’d like my formula for knowing which programs to signal on ERAS, I’m happy to share a post I made today, from our Action Potential community with you.
Drop a comment letting me know you’d like it, & ill DM it to ya👍
#Match2024
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I’ll never forget my chief resident I had as a PGY1.
Made my life beyond absolutely miserable 24/7.
I dreaded work every single day.
Almost changed programs / specialties just to get away - it was that unbearable & unsustainable.
Made me a much more caring/cognizant…
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USMLE Step 2 fact most students don’t know:
Child with acute-onset ear pain. Otoscopy shows large, reddish vesicles on tympanic membrane
Dx: bullous myringitis
Caused by mycoplasma pneumoniae
Tx: macrolide
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Cheat sheet for working up an AKI on the USMLE-
~Prerenal~
Physical exam evidence of volume depletion? Yes --> give fluids
~Intrinsic~
UA w/ sterile pyuria = AIN
UA w/ granular casts/epithelial cells = ATN
UA w/ hematuria = glomerulonephritis
~Postrenal~
Normal UA = urinary…
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Don’t get confused with IgA nephropathy vs PSGN on the USMLE
IgA nephropathy:
- Few days after URI (PSGN is a few weeks)
- Normal complement (PSGN has LOW complement)
Both can have HTN/Hematuria/+protein, +RBC casts, elevated Cr
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THE Highest Yield USMLE Post you'll read today (tying together PFO, ASD, Carcinoid syndrome & VIPoma):
(This took me over an hour to put together 🔥💯)
***PFO vs ASD***
- BOTH are interatrial defects, BOTH can cause paradoxical strokes from DVTs and BOTH can be associated with…
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Step 1 pass rates going down quickly. Anyone could have predicted this would happen
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USMLE Step 2 fact most students don’t know:
Child with acute-onset ear pain. Otoscopy shows large, reddish vesicles on tympanic membrane
Dx: bullous myringitis
Caused by mycoplasma pneumoniae
Tx: macrolide
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If you’re in the medical field & you don’t exercise 3+ times per week, I literally don’t know what to tell you.
We must strive to be an example for our patients.
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NBME Form 9 is the one you take if you need a kick in the ass to study harder
🤝
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Most sensitive & specific lab test for chronic pancreatitis --> LOW FECAL ELASTASE
Step 2CK. Need to know.
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For Step 2 CK:
Internal Medicine
Surgery/EM
Family Med
Pediatrics
OBGYN
Neuro/Psych
Order I’d tackle cumulative review
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NSAIDs confusion on renal questions:
If analgesics + hematuria = renal papillary necrosis
If analgesics + proteinuria (but no hematuria) = analgesic-induced nephropathy
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THE VIDEOS ARE COMING. Gonna release them all at once tonight.
Guaranteed points.
🎯🎯🎯 if you’re aiming for 270, welcome.
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PART 2: Ultimate Tier USMLE Images Test Questions
Prepare to be mindblown with High Yields.
Read below⬇️ Let's make this one go viral too!
(will tag Part 1 at end)
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DO YALL WANT MORE USMLE STEP 2 THREADS & VIDEO REVIEWS THIS WEEKEND?? LMK
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There’s something about reading medical content on Twitter that makes it stick better than a review book haha kind of a weird study hack I guess?😂
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Yoooooo another mentee pulling the NUMBERS 🥵🎉🙌
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Good ol’ on call days smh 📟
- trauma
- emergency gen surg
- kidney transplant
- liver transplant
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On Step 2, when in doubt on cardio questions the answer is ECHO
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I need 7 more surgeries to have met all the ACGME criteria to graduate as a vascular surgeon 🥹😳🤯
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It’s definitely still possible to match at programs that aren’t classically “friendly” to your applicant status.
If there’s never been an IMG match there, be the first.
If there’s never been a D.O. match there, be the first.
That’s what I did 💯
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USMLE Checkpoint:
You're probably not ready for 270+ land if you can't explain the interaction of glycyrrhetinic acid (in licorice) and compare it to primary aldosteronism.
Yes, I've seen this tested numerous times. Will explain in the comment below incase anyone wants to…
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Highest Yield Associations and Interesting Tie-ins for USMLE Step 2 CK & Shelf Exams ** 💪📈🚀
(clinical correlations for IM / Surgery / Immuno)
w/ 6 of my best Test Taking Tips & Examples to help you succeed :)
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Have been doing this for a number of years now, but this might have just been my biggest win. Ever.
Stats: graduated in 2006
Matched: Internal Medicine at Emory
A MENTEE 18 MF YEARS POST GRAD JUST MATCHED🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥
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USMLE FREE 120 Q’s
You’re literally insane if you don’t do these.
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GEOGRAPHIC PREFERENCES
(ERAS 2023)
🔖 Bookmark this thread for later
- link for step-by-step ERAS walkthrough at the very end-
🧵 /
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Matching to a program that is a good fit for you is astronomically more important than matching at a “big name” institution.
Not even a comparison in my opinion.
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Interview Tip:
Before each interview, google the name of the hospital you’re interviewing at and click “News” at the top of Google.
Stay up to date with the things that are going on in that program / hospital. It makes for good small talk to show you’ve thoroughly investigated…
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2 things you can treat with 100% O2 for the USMLE:
- Cluster headache
- Carbon Monoxide poisoning
💨🤝
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Drug Induced Lupus
SHIPP
S-ulfasalazine
H-ydralazine
I-soniazid
P-rocainamide
P-henytoin
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Skin conditions & associated conditions:
Acanthosis nigricans = DM / GI malignancy
Skin tags = DM / Pregnancy / Crohns disease (if perianal)
Porphyria cutanea tarda / Cutaneous leukocytoclastic vasculitis due to cryoglobulinemia / Lichen planus = Hep C
Dermatitis…
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If someone has restless leg syndrome:
Next step —> work them up for iron deficiency anemia on the USMLE
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In an NBME question - When you’re unsure if it is a PE or MI —> look at the vitals. Tachycardic + tachypneic + respiratory alkalosis = PE
Note: this is NOT always the case in real life obviously, but will help tremendously on USMLE.
🧵🧵/
#ActionPotentialMentoring
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Always support the likes/retweets on my posts. I see the same names frequently and it always brings me a smile when it’s someone’s name I recognize purely from social media.
Networking is real.
Students, program directors, other residents. Love it
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7 Bacteria that are tough to Gram Stain:
1) Legionella (intracellular, can use Silver stain just like w/ pneumocystis!)
2) Chlamydia (also intracellular, also no peptidoglycan in cell wall)
3) Rickettsia (intracellular)
4) Treponema (too thin to be seen - try dark field…
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To shortcut your learning of antibiotics:
Focus on if each abx covers
☑️G+ &/or G-
☑️ MRSA
☑️ Pseudomonas
+
☑️ Toxic side effects
Boom 💥 You got over 65% of questions they can ask you on antibiotics in 4 steps
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Immunology Crash Course for the USMLE
(Top 12 concepts to know in my humble opinion)
**These are ONLY on topics I've missed personally throughout Step 1 & 2 prep**
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Wanted to share something crazy
Have a mentee that got 3 interviews already & she hasn’t even submitted her Step 2 scores yet to ERAS! Lmao
Just goes to show the power of connections & a bomb application 💯
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On the USMLE, to consider which tests are sensitive or specific , a good rule of thumb: the more invasive the test is, the more specific it is.
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Guys. I’m now a chief resident 😸
(well not technicallllly chief for 3 more weeks, but I’m officially the chief for the remainder of PGY3 year since my seniors are out on vacay lol)
PGY4 season bouta beginnnnnnn🔥
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UWorld Self Assessment 1&2 have been VERY tough curves this year.
Lot of students frustrated after taking them.
You’re not alone.
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Mi novia😍❤️ my fav OBGYN 😘
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Have seen this equation get a few students points on the USMLE
Mentzer index = MCV/RBC count
<13 = B-Thalassemia
>13 = Iron def. anemia
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If this post gets 1 like, I will drop a review of 10 of the highest yield psych concepts for USMLE today :)
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Top 10 Psych Concepts for the USMLE / COMLEX:
(also helpful for psych shelf exam)
Retweet/like/bookmark/comment to show support if you want more crash course guides like this :) they take awhile to put together
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Always support the likes/retweets on my posts. I see the same names frequently and it always brings me a smile when it’s someone’s name I recognize purely from social media.
Networking is real.
Students, program directors, other residents. Love it
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How to Read a Research Paper Faster:
1) Find paper
2) Copy & Paste Discussion + Conclusion into ChatGPT
3) Ask ChatGPT to make it “optimized for the general public” or “condense it and explain it to me as if I was 10 years old”
4) Now, you have the gist of the paper.
5) Dive in
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It’s sickening how many students I’ve coached personally that have gotten a question on their ACTUAL USMLE on this page of First Aid
You better believe that I will be covering this in a YouTube video soon ;)
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Don’t cheat. Pathetic & unacceptable for a medical professional to not hold yourself to the highest ethical standard.
We ARE the examples for others. We are leaders in society.
Absolutely unacceptable to yourself, to others & to your patients.
I won’t ever work with a…
I’ve gotten DMs asking “How could the USMLE prove they cheated? High scores alone don’t prove that!”
-and-
“How do I know my high score won’t be flagged as evidence of cheating just because of where I took the test?”
Lemme explain how I think these cheaters were caught.
(🧵)
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So many med students go through unimaginable stressors when studying for the USMLE…parent dying, sickness of their own, unstable living situation..
I’m proud of you. Yes, you.
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Have seen this equation get a few students points on the USMLE
Mentzer index = MCV/RBC count
<13 = B-Thalassemia
>13 = Iron def. anemia
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Most sensitive & specific lab test for chronic pancreatitis --> LOW FECAL ELASTASE
Step 2CK. Need to know.
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Who would like my 8 step method to improve focus in med school? Like & comment “focus” and I’ll dm it to ya :)
There’s no catches whatsoever.
I literally just typed up the 8 step checklist I mentally go through when sitting down to work. It’s very easy and you can do all 8…
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