Download and import the Medical Vignette Differential Tutor preset
Save `medical-vignette-differential-tutor.json` and import it via the Vezz me extension popup.
Medical Vignette Differential Tutor Prompt: dissect USMLE/COMLEX clues and rule-outs.
Download the Medical Vignette Differential Tutor JSON preset for Vezz me. Highlight clinical vignettes or case reports to extract key discriminators and rule-outs.
Best fit
Best for medical, nursing, and PA students studying USMLE Step 1/2/3, COMLEX, NCLEX, and shelf exam clinical vignettes.
On-screen walkthrough
How this looks on a real webpage.
Instead of switching tabs and rebuilding context, highlight the exact passage that slowed you down and press your shortcut (default: Ctrl+Shift+X or Cmd+Shift+X on macOS, fully customizable in settings).
1. Highlighted on page (Ophthalmology / Neurology Practice Vignette — Acute Vision Loss)
A 68-year-old man is brought to the ED due to sudden-onset, painless loss of vision in his right eye 45 minutes ago ('like a curtain coming down'). He has hypertension and atrial fibrillation and has been nonadherent with apixaban. Funduscopic exam shows a pale, opaque retina with a bright red macula. ESR is 12 mm/hr.
Ctrl+Shift+X“Break down the discriminating clues and differential rule-outs in this vignette.”
2. Vezz me on-screen answer overlay
1. **Discriminating Clues**:
- *Sudden, painless monocular vision loss + AFib off anticoagulation* -> acute cardioembolic occlusion.
- *Pale opaque retina + bright red macula ('cherry-red spot')* -> **Central Retinal Artery Occlusion (CRAO)** (macular choroidal supply stays intact while inner retina becomes ischemic).
- *Normal ESR (12 mm/hr) & painless* -> Pertinent negative ruling out Giant Cell Arteritis.
2. **Differential Rule-Outs ('Why Not X?')**:
- **Central Retinal Vein Occlusion (CRVO)**: Would show diffuse retinal hemorrhages and dilated tortuous veins ('blood and thunder' fundus).
- **Giant Cell Arteritis**: Would change stem to include headache, jaw claudication, and ESR >50 mm/hr.
3. **Next Step Pearl**: Ocular massage / IOP reduction + urgent carotid/cardiac embolic workup.
3. Suggested follow-up questions in thread
- “Convert the CRAO vs CRVO vs GCA discriminators into 3 Anki Cloze cards.”
- “Why is the macula spared from pallor in CRAO (which artery supplies it)?”
Importable Prompt Preset
Use this custom prompt in Vezz me.
Copy the system prompt below or download the .json preset file to import it directly into the Vezz me Chrome or Firefox extension.
Vezz me Custom Prompt Preset
Medical Vignette Differential Tutor
Trains the #1 high-scoring board-exam habit: knowing not just why Choice A is right, but what single lab or exam finding would have to change in the stem to make Choice B or C right.
Act as a medical board exam tutor analyzing the selected clinical vignette or case presentation (for educational study only): 1) Key Discriminating Clues: extract the 3–4 critical findings in the stem (timeline, vitals, physical exam, labs, and pertinent negatives) and state what each signals, 2) Pathophysiology & Primary Mechanism: explain the underlying mechanism in 2 concise sentences, 3) Differential Rule-Outs ('Why Not X?'): for the top 2–3 look-alike distractors, state the *exact stem finding* that rules each out AND what single change in the stem would make that distractor correct, and 4) Next Best Step Pearl: state diagnostic confirmation vs immediate management.Step-by-step workflow
How to run this workflow in place.
Highlight a practice question stem or PMC case report
Select the clinical presentation and answer choices after attempting the question.
Focus on Step 3 ('What would change in the stem to make B correct?')
Board exam writers test boundary conditions between look-alike diseases. Step 3 trains that exact pattern recognition.
Key details
Why this approach works better than switching tabs.
Frequently asked questions
Common questions about clinical study preset.
Is this preset intended for real patient care or clinical diagnosis?
No. This preset is strictly an educational study aid for medical, nursing, and PA students reviewing board-style vignettes and published literature.
Can I pair this with the Anki Flashcard Generator preset?
Yes! After reviewing the differential rule-outs, run the Anki Flashcard Generator preset on the same vignette to create a Cloze card for the missed discriminator.
Does it work on PubMed Central (PMC) clinical case reports?
Yes. Highlight the Case Presentation section of any open-access PMC article and press Ctrl+Shift+X.
Related workflows & guides
Explore connected pages.
Ready to try this workflow on your own reading?
Install Vezz me free, highlight text on any webpage, and press your customizable shortcut (default: Ctrl+Shift+X or Cmd+Shift+X on Mac) to get an answer right beside the source.
