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MD-PGY2
4 years ago

'Crush Step 1' Book is solid, check it out if you like explanations vs. just memorizing

So I randomly started using this book called 'Crush Step 1' recently, and am super impressed with the quality of info, and haven't seen anything about it on here, wish I had found it earlier in my medical education.

For example, it never made sense to me why AFP would be elevated in hepatocellular carcinoma, here is the explanation from the 'Crush' book: 'Of note, AFP acts as the fetal form of albumin. Its level is elevated in primary HCC and metastatic disease to the liver and in yolk sac tumors. In neural tube defects, the AFP level is also elevated in the mother’s blood because the fetal skin is not fully intact, and AFP leaks into the mother’s circulation. In Down syndrome, the levels are decreased, presumably because the size of the fetus and yolk sac are decreased.' (So messed up liver function, less albumin production, so body starts making fetal version of albumin = AFP. BAM!)

Here is the link to amazon, and there are also some illegal pdfs floating around if you know what I mean:

Crush Step 1 Pdf Download

Here is another example: you know that formula for cardiac output that is rate of O2 consumption / art. O2 - venous O2? It's never made sense to me. 'Crush' explanation: 'Imagine with a low cardiac output, the blood is moving more slowly through the tissues, giving them more time to extract oxygen, leading to a large arterial-venous oxygen content difference (large denominator). Conversely, with a high cardiac output, so much oxygenated blood is being circulated through the tissues that the tissues do not need to extract all the oxygen from the blood each time it passes through.'

EDIT: a few people have messaged me about sending them a copy of the PDF, but I've been using mine for a while now, so it's covered in my class notes, offensive mnemonics that I've made up, and my name (because I occasionally write things like 'you can do this! you will pass the Step, ellieohsnap' (<insert real name here) to myself in the margins. Nerdy, I know.)

Anyway, a couple of people have told me that if you google 'crush step 1 pdf' you should find a link to it on one of the first few pages of results. Hope this helps!

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