know.

CookbookStudy and examsNo. 12

Board exam notes for medical schoolyour own high-yield notes, system by system

Recipe No. 12 · Study and exams

For: A second-year medical student preparing for USMLE Step 1

You get: Step 1 notes by organ system, in your words, with select-all quizzes

Time: A weekend per system, then daily

See it in know.sh

Aortic stenosis in the student’s own words, with the murmurs it is confused with set side by side in a table.

Step 1Cardiovascular

7of 24

Aortic stenosis

Observation, key section, 2 highlights, 1 note, 450 words

Mechanism. Older patients: a normal three-leaflet valve calcifies with age. Younger patients: a bicuspid valve calcifies decades earlier. The left ventricle pushes against a fixed obstruction and thickens (concentric hypertrophy).

What you see. Crescendo-decrescendo systolic murmur at the right upper sternal border, radiating to the carotids. Weak, delayed carotid pulse (pulsus parvus et tardus). Symptoms on exertion: syncope, angina, shortness of breath.

Easily confused with. The other systolic murmurs. Hypertrophic cardiomyopathy is the one that catches me; section 9 has the manoeuvres.

Also in. Turner syndrome (bicuspid aortic valve).

Where I went wrong. Picked mitral regurgitation twice. Mitral regurgitation is holosystolic at the apex and radiates to the axilla; aortic stenosis is ejection-shaped and goes to the neck.

The assistant laying out a system from the student’s own lecture notes, and leaving the parts that must be the student’s empty.

Claude, connected to know.sh

You

I have attached my own notes from the cardiovascular block and the USMLE content outline. Using know.sh, make the document “Cardiovascular” on my “Step 1” shelf and draft a section per disease or drug from my notes only, with the headings Mechanism, What you see, Easily confused with, Also in and Where I went wrong (leave that one empty). Where my notes are too thin, file a Question section instead of filling the gap.

Claude

Your notes cover 21 topics well enough to draft, and three only by name. I will create the document and file them in the order of the outline.

document_create Created Cardiovascular on the shelf Step 1

section_add Added “Aortic stenosis” to Cardiovascular, 7

section_add Added 20 more topic sections and 3 Question sections to Cardiovascular

comment_propose Proposed a note on Cardiovascular, 7

Claude

Filed 24 sections. The drafts use your wording where I could, but they are drafts: I have not checked them against a textbook, and I left every “Where I went wrong” empty for you. Section 9 lists the manoeuvres for hypertrophic cardiomyopathy, but section 7 does not say what they do to the aortic stenosis murmur, so I left a proposed note there.

A select-all question written from the student’s own section. The right options are set in bold, and the answer names the section to reread.

QuizzesCardiovascularQuestion 3 of 8

Which of the following are expected in aortic stenosis? Select all that apply.

  1. aA crescendo-decrescendo systolic murmur at the right upper sternal border
  2. bA weak, delayed carotid pulse
  3. cAn opening snap after the second heart sound
  4. dA murmur that radiates to the carotids
  5. eA wide pulse pressure

Right. The answers are (a), (b) and (d). An opening snap belongs to mitral stenosis, and a wide pulse pressure to aortic regurgitation. See Cardiovascular, 7.

How it works

Your lecture notes become Step 1 notes laid out the way the body is: a document per organ system, a section per disease, drug or mechanism, each ending with the mistake you made the first time. The murmurs that pass for aortic stenosis sit side by side in one table, and select-all quizzes make you judge every option.

  1. Give your assistant your own notes

    Give your assistant your lecture notes and the USMLE content outline. Ask it for a Step 1 shelf, a document per system and a section per topic under the same five headings.

  2. Make every section yours

    Rewrite each draft in the editor until it sounds like you. After each block of practice questions, write what you learned under Where I went wrong, and mark repeat misses Key.

  3. Set the look-alikes side by side

    Ask for a table element under Easily confused with: aortic stenosis, HCM and the mitral murmurs as rows, with timing, where each is heard, where it radiates and what Valsalva does.

  4. Drill with select-all quizzes

    Ask for eight select-all questions from a system. Each cites the section it came from; you take the quiz in know.sh or the iOS app, and it comes back under Revisit.

Try this prompt

Your assistant, connected to know.sh (Claude, ChatGPT or a local model):

Using know.sh, add a table element under Easily confused with in “Aortic stenosis” in “Cardiovascular” on my “Step 1” shelf: rows for aortic stenosis, hypertrophic cardiomyopathy, mitral regurgitation and mitral valve prolapse; columns for timing, where it is best heard, where it radiates and what Valsalva does. Take every cell from my own sections, write “not in my notes” where they are silent, and change nothing else.

Your assistant, connected to know.sh (Claude, ChatGPT or a local model):

Using know.sh, make a quiz of eight select-all-that-apply questions from the document “Cardiovascular” on my “Step 1” shelf. Each question should have five options, with two to four correct, and the wrong options should be sections of conditions that are easily confused with the right one. Cite the section for each option.

Made with

Your AI assistantDocumentSectionElementsQuizProposed notes

See also