Steven I McLaughlin DVM, MPH, DACVPM
17 minutes


If your main show for boards prep is a comprehensive database of practice questions like Zuku has, this year, this is not the main show, but it's really useful. The ICVA these are the people that write the NAVLE®. They produce these 200 question self-assessment tests, and these are made out of retired NAVLE® questions that have been taken out of NAVLE®'s circulation, and they thought they were good enough and valuable enough that they stuck it in an assessment. You do one of these assessments in the final week or two before your boards. It's a pretty good ballpark how you're going to do on the test. But even more important, I think these are study gold, everybody. I recommend everybody do one or two of these over the summer before your senior year. Do like 10 or 15 questions a day out of 15 questions might be four or five you don't know. Your homework that day, while still fresh, is quick and dirty, go to your good friend, Dr. Google, and just try to hone in roughly what those couple of questions might have been about. OK? And it's not that you're going to see those exact four questions on your NAVLE®. But by golly, man, if they thought that those topics and those diseases and those concepts were so valuable and important that they preserve them and put them in an assessment, that's an enormous wake up call. Oh, hmm. Maybe I need to know a little bit about. HYPP periodic paralysis in horses.  Hmm. Maybe I need to know a little bit about limping guinea pigs, subcutaneous hemorrhages on necropsy. What's that scurvy? OK, really valuable.


Looks like I've got a question here. Does NAVLE® have a function to flag questions so you can return to them later? Yes, they do. You can mark questions to return to them later. Zuku we have the same thing. I strongly recommend you do not leave any questions blank. OK? Every time you hit a question, answer it as best you can and keep moving. So let me see if I can convince you guys of a reason to prepare for boards, which isn't just you've got this horrible hurdle. Who here sitting in this room right now does not need a little tune up on the big five endocrine diseases of dogs and cats? Who does not need a tune up on Cushing's, Addison's, diabetes mellitus, hyper/hypothyroid, anybody not need that? Yeah. And one guy raises his hand. Nobody likes that guy. OK, and he's going to internal medicine. Good luck. We all need that right? I think a far more motivational way to think about your boards is it's an awesome opportunity and an excuse to tune up on stuff you want to know anyway in the clinics. Triage the information for actionable stuff that you would want so you can recognize cases and have a rough idea what it is and what to do. That's motivating. All right. That's something you can use. People have often asked me, like, when should I start boards prep? It's not the same for everybody, but we do see kind of two kinds of people. One kind of person is what I would call an early bird. Early birds, they kind of want to start their boards prep in spring of their junior year. That's perfectly good. No problem. The other kind of person, they're the opposite. I call them summer people. They're like, you know, doc, honestly in my heart of hearts, I don't think I'm going to be able to study this in earnest until May or June after junior year. Perfectly oK, all right? But don't wait till September of your senior year to institute your boards prep. Why? You just added an enormous amount of time stress your world, and it's already stressful enough in the clinics. And it's also the clinics are where we want to invest your best time because it's fun. And you just miss this opportunity to tune up. OK?


Got a quick question on a chat board. How many times can you take, NAVLE®? It depends on whether you're in Canada or the U.S.. In Canada, I believe it's twice and then you have to wait a while. I believe the last time I checked in the United States, you can take it up to five times before they make you wait a year before your sixth attempt. OK. Remember, think in terms of first pass and that all important second pass in the final month or more, redo your questions in timed test mode. OK. In Zuku, that means there is a clock ticking. It's 60 questions, 65 minutes per block, just like the real test. Your habituating yourself to what it feels like to answer random topics and you don't get to see the answers as you go. That's what the real test is like. The more you do of that, the better you get at time management, the more comfortable you get with it, and it will reinforce stuff that you've been studying for the last four to six months. Absolutely vital. Hand-in-Hand with that, we review your notes. When you study notes in books, stick those pictures in your books and notes because it's like mental duct tape. OK? You can't help it, your eye goes to the picture first, right? Snotty nose, crusty eyes. If you see the words hyperkeratotic basal plantum, I hope we're thinking distemper. Right? So that becomes your mental duct tape.


This is EIA, equine infectious anemia in the horse. Pretty uncommon nowadays, I've seen only one case in my career. Classic Classic Boards question. You got a coggins positive EIA horse. What do you do? And you say Ship it to Kentucky, right? Nope. You can, You really can't do that. You can't go across state lines with those guys to either isolate or euthanasia.


Let's say you get a chicken question. And there's a picture of a trachea and it's full of petechial hemorrhages and snot and you see yourself, "yikes. I may not be a chicken expert. But that there is a trachea full some kind of pathology. And I do vaguely remember there is that one disease called infectious laryngotracheitis. Yes, I'm going to pick that." OK? That's how you study, that's how you use the pictures.


On boards and in clinical medicine, we often can use clinical cases to highlight underlying physiology that's very functional like acid base, little complicated, but here's a nice example of a case like you would see on NAVLE® and how they'll ask you about acid base. This is actually something I used to see in practice all the time. High producing dairy cow freshened three weeks ago, so she had a calf. On a physical exam her TPR is basically normal. OK, she's just off feed. Rumen motility is down. A urine test for ketone bodies is positive. So she's ketotic. There's no particular evidence of infection going on. On the left side, there's a high pitched musical ping you can hear on the, with your stethoscope during percussion, over the ribs on a line between the elbow and the tuber coxae. Now this is classic, classic, classic for a particular pretty common condition. And the boards, as I said, isn't always going to ask you, what's the condition? They might ask you something about it. So here's your next poll question, or they might ask you about it. Yeah, Shawn, that's exactly right. This is an LDA good job. So here's the question the board's is going to ask you about this cow. And yes, this is an LDA. They say what acid base abnormalities most likely. Now, let's just walk this through, maybe you're not a cow vet. The abomasum, that's the glandular stomach of the cow. It's just like my stomach and your stomach, right? OK? What's my stomach full of? Hydrochloric acid. Hmm. But that Abomasum is displaced and all twisted up, that means all that hydrochloric acid in the abomasum is sequestered and the body cannot see it. The body can't see that acid. Hmm. So what do we think we're looking at here? Is this cow going to be acidotic or alkalotic? It's one or the other. The same time, are we thinking this is like a metabolic problem or a respiratory problem. Once again, if you don't know, narrow it down, take a guess. If you miss it. Just thank your lucky stars that you missed it because you're going to see it again on Zuku and the ones you miss you don't miss them the next time you see it. OK, last few seconds, folks, let's get those answers in. Three, two, one. And close. There'll be more. Don't worry. So the most people said metabolic alkolosis . That's correct. This is classic for the DA cow. Do you said metabolic acidosis. Hey, man. Atleast you got metabolic. You got in the ballpark. Took a guess. Hey, you missed it, but next time you'll get it and you narrowed it down. That's how we play the game. Good job.


I see a few questions in the chat room, I'll get to them in a sec, I just want to wrap up here. If you get the question of the day, you know we have these top 20, top 5, top 10 articles, OK? These are nice ways to do a quick and dirty skim review. I mean, do you need 100 chicken disease, do you need to know 100 chicken diseases? Nah. 10's enough. Ferrets, what can I say? Five is plenty, and they always get endocrine problems. What can I tell you? Cushing's in the ferret. Bald ferrets. Dysautonomia. They collapse. Ferrets get distemper. What's your prognosis? It's going to be a dead ferret, unfortunately. So that's how you that's how you study, triage.


Good news on these multiple choice questions. Correct answer, it's guaranteed to be there. The bad news, you will hit questions you don't know, and the most common mistake we can make is wasting a lot of time freaking out on the ones we don't know when. What we could do is narrow it down, take a guess and move on. So this is just words we practice all day to day. OK. I've already talked about prognosis so I don't want to belabor it, but, you know, people have tried to assign numbers to it like pasquini. If you get a photo in a question, you're not sure what you're looking at. Talking to you, gutteral pouch. Look in the center. But if you get a radiograph, you need history. Here's a radiograph. Here's your history. What do you guys think we're looking at? Well, in that tracheal carina seems pushed down awful low. That doesn't seem normal. Well, that's why it's not normal, what do you guys think we're looking at? Exactly. This is megaesophageus. What if the question isn't, what is it, the question is what do you tell the owner to do, or what do you tell the owner to look out for? Because it's a common sequela of this of eventually. You would say it's megaesophageus, so you want to feed them elevated, right? Elevated feeding. Or you might say feed them a slurry. Or you might say you have to watch out for aspiration pneumonia. But because you got in the ballpark, you're ready to handle whatever they ask of you. That's a great way to prepare for boards.


Where's the problem? It's in the middle. Remember, on the boards, they may ask you stuff that seems easy. And that is because the boards are obligated to evaluate what can be reasonably expected knowledge wise of a first year graduate. What if the question is what tests do I do for this common problem? Anybody can do it my five seconds. Yeah, floracine stain, right? You put a stain on that. So think big. Are you going to see heartworm questions on your NAVLE® Yeah, for sure. Are you going to see colic? Yeah, pretty much. CAE in goats. Yeah, almost guaranteed. Weird monkey parasites? Mm, probably not. And even if you do, don't stress. Guess. All right. Let me wrap this up, and then I'm going to tell you about the worst question we ever heard and why you care because you're going to get one like it. One way or another, especially as we get closer to boards people often will ask me, they'll be all stressed and be like, "Oh my god doc, oh my God, I'm really stressed out. There's two services. What if I picked the wrong one and I fail?" And the answer is, it's not like that, OK? They're both good. The rate, the way to succeed on your boards is pick the service that fits the way you learn the best and then do the work. OK. But the magic ingredient is find a good fit for the way you learn and do the work, right? If anything I've said today makes sense about the images and helping you remember stuff and re-reviewing, it might be the Zuku is a good fit for the way you learn because we work really hard to have the most images and the most NAVLE® format questions in our database. We're the only service that has access to the Merck manual images as part of our questions, we have special permission from them. So it's a big database of useful images.


Here's is a classic board question. Purpura hemorrhagica in the horse. What happened two weeks ago? Probably he had strangles, OK? Or a strep equine vaccine. If you get the question of the day, by the way, that's the link at the bottom. Oh, good job there, Mary. That's correct. You got it right. Strangles. If you get the question of the day, you know, we're the only ones that in our answers, you also have links to other resources online. Now you don't have to read every last link and every last word. But if you need more or a quick tune up, it's there. We're the only ones that do that. We're the only ones that reference our questions. And if you haven't already, you can go sign up for the question of the day. By the way, second year we have a new question of the day, you can get both of them, the other, the new one is called clinical sciences. It's things like clinical anatomy, toxicology, pharmacy, stuff like that. Might as well get them both. If you subscribe to Zuku Premium, you get access to our expert consultants who give talks on topics like top 10 feline neuro, top 10 reportables. If you like the sound of a man with a French accent Dr. Jean Paré is our exotics consultant. He is the wildlife vet for the Bronx Zoo. It's fun to watch his talks. It's like, "aahh zis rabbit, he has zis problem." Also with premium, you can download audio versions of these if you just want to listen to them, but we recommend you watch them because we make, we work hard to make them visual.


I see a few questions in the chat. I'll get to them in just a sec. Why you Zuku? As I said, the missed questions recycle until you get them right. We have timed tests that mimic the feel of the real NAVLE® that reinforce key topics. Help you build your confidence with time management. We also have two 300 question sample exams you can use to test yourself. OK. You also have our guarantee. If you complete Zuku and you don't succeed, you're entitled to a boards prep consultation to help you and your next attempt and a free re-subscription. For you early birds we always have a winter sale that we're actually going to start a little early this year because of COVID. But basically starting in December, if you sign up for a six month Zuku subscription we'll give you access all the way until December 15th of 2021. So if you want to sign up and not worry about your access, it's there. Summer people. Don't worry, we always do a summer sale for you as well. Starts in May. But wait, there's more. If you haven't already, just register for free on VetVance Development, Professional Development site and they'll give you a coupon for $25 off of Zuku. OK, so wait for the sale. Use the coupon. That's the best deal.


All right. 30 seconds. I told you guys I was going to tell you about the worst question we ever heard. You need to know when you walk out of your NAVLE®, you cannot go to your friends and say, "Man, I had these 12 questions, and here's some real specific specific information about what they were about, and you got to watch out for that." People that have been caught doing something like that on a systematic level had their licenses revoked, OK, so don't do that.  But you are allowed to come out and speak in general like you can come out and say, "Oh my goodness, I sure wish I had studied calfhood diahhrea more, to which all your friends will say, "Well, duh, that's on the NAVLE®." So in that vein one year, a guy called us up, this was not even about the NAVLE®, this was a state test, but it's the same concept. He said, "Doc, I don't need you to tell me the answer to this. I just need to me, what should I have done?" I said, "Well, you know, speak in general. Tell you what I would have done." And he's like I don't even remember it very well, but it was something like a hunter is bitten by a bear and what bacteria did they culture from the bear bite wound? And I'm hearing this and I'm like, OK, first of all, I get bitten by a bear. I'm all worried about the absence of my arms. OK, but what I told them was, you know, if I studied for 10 years straight, I wouldn't be studying no bear bite wound isolates and neither should you. Be healthy and correct, pragmatic response to a question like that is, I do not know this, I would not have studied this in a million years. I'm not going to stress. I'm going to guess, OK? But you mark my words. Every single one of you guys on the day you take your NAVLE®, you will have your own personal version of a bear question, and I don't know what it is. It'll be like you're presented with a lame salmon, whatever it is. I hope you remember this day and you say to yourself, "I do not know this. It's a bear question. I'm not going to stress. I'm going to guess."