One Stem at a Time: High-Yield Board Review for Medical Students
One Stem at a Time is a high-yield board review podcast for medical students preparing for USMLE Step 1, Step 2 CK, or COMLEX Level 1 & 2. Each episode breaks down board-style clinical vignettes, teaching test-taking strategies and clinical reasoning. The podcast focuses on exam-relevant concepts, classic presentations, and how to eliminate distractors to identify the next best step, diagnosis, or management. It is designed to help students think the way test writers expect.
Episodes
Zebra of the Month: August 2026
A young patient presents with acute chest pain and findings concerning for acute coronary syndrome—but something about the case doesn’t quite fit the usual picture.In this episode of One Stem at a Time: High-Yield Board Review Podcast, we work through a challenging “zebra” presentation step-by-step, using the history, risk factors, ECG, and clinical clues to uncover an uncommon cause of myocardial
Rheumatology Part 3: Vasculitis
Today we covered eight of the most testable vasculitides by recognizing their clinical patterns instead of memorizing isolated facts. If you can distinguish upper airway disease, asthma, hepatitis associations, vessel size, ANCA status, and immune complex deposition, you'll be able to answer the vast majority of vasculitis questions on Step 1, Step 2, COMLEX, and Internal Medicine shelf exams.
Rheumatology Part 2: Systemic Autoimmune Diseases
Autoimmune diseases don't have to be overwhelming. In Episode 2 of the One Stem at a Time Rheumatology Review Series, we work through high-yield board-style clinical vignettes covering systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), systemic sclerosis, CREST syndrome, Sjögren syndrome, granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (E
Rheumatology Part 1: Inflammatory Arthritis & Crystal Arthropathies
Anki Cards: Gout & Crystal Arthropathy: https://drive.google.com/file/d/10DkylDtLfZXnu6gg5cmk5yJYxKCEiJbw/view?usp=drive_linkJoint pain is one of the most common presentations you'll encounter on the USMLE, COMLEX, shelf exams, and clinical rotations. In this episode of One Stem at a Time, we work through high-yield board-style clinical vignettes covering the most commonly tested inflammat
Amyloidosis: Pearls, Pitfalls & Boards
Amyloidosis can seem intimidating—until you know the pattern. In this high-yield board review, we break down the four major systemic amyloidoses (AL, AA, ATTR, and Aβ2M), including their pathophysiology, classic clinical presentations, diagnosis, and treatment. Through board-style clinical vignettes and exam pearls, you'll learn how to recognize the key clues that point to amyloidosis and iden
Grab Bag Part 1: Pressure, Panic, & Plaques
Not every “classic” presentation comes with a single clear answer. In this surprise Grab Bag episode of random, unrelated topics, we work through three high-yield board exam conditions that test very different parts of clinical reasoning.Through practice question stems, we rapidly review how to recognize the key clues, avoid common traps, and choose the next best step for each condition.In this ep
Green ≠ Good: Pediatric Bilious Vomiting
Green isn't always a good thing...In this episode, we go over the classic pediatric vomiting and bowel obstruction conditions that every medical student needs to recognize.Through practice question stems, we rapidly compare the presentations, imaging findings, and management steps for five high-yield conditions: intestinal atresia, malrotation with midgut volvulus, Hirschsprung disease, meconi
Bad Blood Part 2: Secondary Hemostasis Disorders
Not all bleeding disorders are platelet problems! We go over the different conditions that involve abnormalities in secondary hemostasis for the second and final part of this miniseries.Here, through practice question stems, we do a rapid-review of what secondary hemostasis is, and quickly go over many different potential causes for deficiencies in coagulation factors in less than 24 minutes. In t
Shock Talk: Basics of Obstructive Shock
Obstructive shock is one of the most testable—and most misunderstood—shock states on boards and in clinical medicine. In this episode of One Stem at a Time, we break it down from first principles so you can stop memorizing arrows and start understanding them.Through two classic board-style cases—cardiac tamponade and pulmonary embolism—you’ll learn how to recognize obstructive shock, interpret hem
Bad Blood Part 1: Primary Hemostasis Disorders
Not all platelet disorders are created equal. We go over the different conditions that involve abnormalities in primary hemostasis for the first part of this miniseries.Here, through practice question stems, we do a rapid-review of what primary hemostasis is, and quickly go over five different potential causes for platelet deficiency or dysfunction in less than 22 minutes. In this episode, we go o
Everything You Need To Know About Carcinoid Syndrome in Less Than 10 Minutes
In this episode, we break down carcinoid syndrome from the ground up, starting with its underlying pathophysiology—how neuroendocrine tumors produce excess serotonin and other vasoactive substances that drive the disease.We then walk through the key symptoms, including flushing, diarrhea, and bronchospasm, connecting each one back to what’s happening at a biochemical level. From there, we explore
Water Wars: DI vs SIADH
Struggling to tell DI vs SIADH apart on test day? This episode breaks it down step-by-step—starting with a classic USMLE-style question and ending with the high-yield patterns you need to answer fast and confidently.We kick things off with a patient presenting with polyuria, polydipsia, hypernatremia, and dilute urine after starting a mood stabilizer—can you identify the diagnosis and next best st
The Bili Breakdown: Disorders of Heme Metabolism
Jaundice questions don't have to be confusing. In this rapid review, we break down bilirubin metabolism and classic disorders you'll see on exams: Gilbert, Cringler-Najjar, Dubin-Johnson, and Rotor Syndrome. Learn how to quickly distinguish between unconjugated vs conjugated hyperbilirubinemia and lock in the diagnosis in seconds.One stem. One diagnosis. No guesswork.
Red Eye Rapid Review
Not all red eyes are created equal. On exam day, missing the diagnosis can cost you easy points. In this rapid-fire episode of One Stem at a Time, we break down the most high-yield causes of red eye through classical vignettes you'll actually see on STEP and COMLEX. From the highly contagious "pink eye" to the vision-threatening emergencies like acute angle-closure glaucoma, we'll help you disting
Hyperkalemia Basics Every Student MUST Know: EKG changes, Treatment, and the DKA Trap
In this high-yield episode of One Stem at a Time, we break down hyperkalemia the way board exams (and real patients) demand you understand it.We walk step-by-step through the physiology of potassium, the classic EKG progression from peaked T waves to sine wave arrest, and the exact treatment algorithm you need to know for exams and the wards. Then we tackle one of the most commonly tested (and mos
Zebra of the Month: January 2026
Every clinician has encountered a case that doesn’t quite fit—where the usual explanations fall short and the clues refuse to line up. In this Zebra of the Month episode, we invite you into a diagnostic puzzle that challenges assumptions and rewards careful, deliberate thinking.With no spoilers and no shortcuts, we unravel the case step by step, highlighting the moments of uncertainty, the subtle
Hyponatremia Simplified
Hyponatremia is one of the most tested — and most misunderstood — electrolyte disorders. This episode breaks it down into a clear algorithm using volume status, osmolality, and urine studies so you can solve hyponatremia questions with confidence on exams and on the wards.You’ll learn how to:Distinguish real vs “fake” hyponatremia in under a minuteUse volume status and urine studies to pinpoint th
Shock Talk: Diving Into Sepsis
Sepsis is one of the most common and deadly emergencies you’ll encounter on boards and in clinical practice. In this episode of One Stem at a Time, we break down sepsis from start to finish: what it is, how the body responds, and when it turns into septic shock. Learn the key mechanisms behind systemic inflammation, the classic clinical clues that signal organ dysfunction, and the stepwise managem
Paraneoplastic Syndromes & Associated Cancers
Sometimes cancer announces itself in unexpected ways—through weakness, electrolyte abnormalities, rashes, or blood clots rather than a visible tumor. In this episode of One Stem at a Time, we break down the high-yield paraneoplastic syndromes you need to recognize on exams, from Lambert-Eaton and myasthenia gravis to SIADH, ectopic ACTH, dermatomyositis, Trousseau syndrome, and hypercalcemia of ma
Zebra of the Month: December 2025
Every clinician has encountered a case that doesn’t quite fit—where the usual explanations fall short and the clues refuse to line up. In this Zebra of the Month episode, we invite you into a diagnostic puzzle that challenges assumptions and rewards careful, deliberate thinking.With no spoilers and no shortcuts, we unravel the case step by step, highlighting the moments of uncertainty, the subtle
Shedding Light on Pleural Effusions: Light's Criteria for Exudates
Pleural effusions are common, but working through them systematically can be challenging. In this episode, we take a deep dive into pleural fluid analysis, starting with a clear and practical breakdown of Light’s criteria and how it’s used to differentiate transudative from exudative effusions. We review the key laboratory values, common pitfalls, and why these criteria remain so central to clinic
Non-Anion Gap Metabolic Acidosis (NAGMA) Made Easy: High-Yield Causes & Treatment Options
In this episode, we take a deep dive into non–anion gap metabolic acidosis (NAGMA) and renal tubular acidosis (RTA)—topics that are high-yield for exams and essential for clinical reasoning. We break down the different types of RTA (Type I, II, and IV), walk through the full differential diagnosis for NAGMA, and explain how to distinguish these entities using labs you’re likely to see on test day.
Chest Pain on USMLE: The Can’t-Miss Diagnoses
Chest pain can range from benign to immediately life-threatening, and missing the dangerous causes can be fatal. In this episode, we break down the 6 deadly causes of chest pain every clinician must recognize: acute coronary syndrome (ACS), pulmonary embolism (PE), esophageal perforation, aortic dissection, pericardial tamponade, and tension pneumothorax.We walk through how each condition presents
Lung Disease & the Physiology of Breathing
Join us for an in-depth discussion on key respiratory physiology and pathology topics. In this episode, we break down the mechanisms behind COPD, the physiology of airway obstruction in asthma exacerbations, and how acid-base balance is affected in respiratory disease. We also explore the pathophysiology of ARDS and its impact on lung compliance, review how to calculate and interpret the A–a gradi
IBD & Autoimmune Conditions of the GI Tract
In this episode, we dive into inflammatory bowel disease (IBD) and autoimmune conditions affecting the gastrointestinal tract. We break down the key differences and overlaps between Crohn’s disease and ulcerative colitis (UC), and explore how chronic inflammation can impact nutrient absorption (especially vitamin B12 deficiency). We also discuss primary sclerosing cholangitis (PSC), a serious auto
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