The basic strategy is this: let’s try and use our time effectively instead of going crazy obsessing about every detail. And keep calm while doing it.

1) Glance at (DO NOT READ) the answer choices. Look for patterns or categories (like names of etiologic agents, yes/no + explanation, clinical signs).
1b) If you don’t get a ton of info from glancing at the answers, read the actual question part of the question (the last sentence with the question mark behind it)
2) Read the whole question strategically. The information from step 1 will tell you what you are actually trying to answer - so use that information to actively and strategically read the question. Skim over the stuff that isn’t important for the question, carefully consider the stuff that is.***
3) Predict an answer. When you get to the end of the question, make a prediction about what you think the answer will be instead of reading through every answer choice looking for the right one. Predictions can be specific (e.g., tularemia) or general (e.g., ‘my next diagnostic should tell me something about the heart’) depending on the question.
4) Find your answer. Find your prediction. If you didn’t make a prediction, consider each answer choice - ask yourself what is right and what is wrong about each one. Cross out answer choices you know are wrong (not just ones you think may be wrong).
*** some information may be important, like bloodwork, but is far too detailed to decipher efficiently. Instead, just make a mental note that the bloodwork is there and, when the time comes, reference only the parts of the bloodwork that are relevant to the question (e.g., you don’t need to interpret the leukogram if the question is asking for you to characterize the azotemia).
On marking questions: Only mark questions that you know you could get right if you had more time to spend on it. Make that determination in the first 10-15 seconds. Choose a random answer, mark the question, and move on. Never mark a question that you aren’t sure about. Never ever mark a question you know you don’t know the answer to. For those, choose and answer and move on.
Don’t obsess over the clock. The more time you stare at the clock, the more time you take away from taking the test. Check the clock every 10 minutes to see if you’re on track. Doing it after every question doesn’t tell you anything and it adds stress to the whole day.
Stay calm. Remind yourself that it’s supposed to feel awful - so if you think you’re failing, then you are feeling exactly how you’re supposed to feel. You know more than you think you do.