Q) Case: This is a tough tough subject but a HY one: You have an older patient named Robert who comes to you with mild depression and dementia. (BE CAREFUL, DISTRACTORS ARE ALZHEIMER'S, etc.). But I tell you that during PE, I touched his facial nerve and it twitched. And his PE reveals some muscle spasms (tetany). HE also presents with mild KIDNEY disease....
So if I ask what mineral(mineral, specifically) is deficient which is specifically related to his tetany and presentation, which one will you PICK? What dx? (HINT: this is not dementia)

A) Calcium is deficient. Think of the link with the kidney and its regulation with Vit D which is needed for Ca. I saw this exact CASE during one of my on call nights!


Q2) What typical sign is found on ECG which confirms your suspicion?

A2) The QT interval is lengthened. This is CLASSIC..

(Again, CONCENTRATE ON THE FORMAT, of the above case and secondaries. These are NOT from KAPLAN or NMS or big publishing house. They are from solely my experience as a teacher which I FIRMLY believe are better suited for you for STEP 1 and the clinics, because they do not go TOO light or TOO deep into the material...like the story of Goldilocks and the BEARS, the soup is just right. NOW STUDY STUDY STUDY STUDY, until you collapse!! Do it NOT for yourself, but for your future PATIENTS WHO NEED YOU!