The official changelog for Tenderpoints Hub. Track new questions, preclinical inventory expansions, high-yield audio updates, diagnostic tools, and UI enhancements.
Patch 1.9 represents our most comprehensive medical curriculum and architectural overhaul to date. The Clinical Compendium has been expanded to 105 textbook-grade chapters (648,399 words across all 4 volumes: 18 OMM, 60 Clinical, 17 Pharm, and 10 Ethics/Biostats) achieving 100% mastery coverage across Pre-Clerkship, COMAT, USMLE Step 1/2/3, COMLEX Level 1/2/3, and all 453 medical lexicon concepts with 681 structured comparison tables and 423 visual plates (including 70/70 2K Master Plates). In parallel, we audited and upgraded all 14,796 questions across COMLEX (DO), USMLE (MD), and full-length practice forms with attending-grade discriminators—eliminating skeletal vignettes (<40 words) from 6,046 down to 0, eliminating informal lead-ins down to 0, eliminating diagnosis spoilers to 0, and standardizing 100% 5-option A–E balance. Furthermore, we completed a site-wide design system overhaul enforcing canonical 1680px widescreen cockpit geometry across all 1,180 pages, built an end-to-end SM-2 Anki spaced repetition review queue, and verified all 264 Playwright E2E browser tests and 14 swarm quality gates.
TEXTBOOK COMPENDIUM
105-Chapter Master Compendium Expansion (648,399 Words across 4 Volumes)
100% Lexicon Mastery
Complete 4-Volume Scope: Volume 1 OMM & Biomechanics (18 chapters, 109k words), Volume 2 Clinical Systems (60 chapters, 370k words—including new Chapters 56 Microbiology & Virology, 57 Integrative Organ Physiology & Hemodynamics, 58 Clinical Embryology & Pharyngeal Arches, 59 Geriatrics, Palliative Care & Sleep, and 60 Critical Care, Mechanical Ventilation & ICU Devices), Volume 3 Clinical Pharmacology (17 chapters, 115k words), and Volume 4 Ethics, Biostats & EBM (10 chapters, 53k words—including new Chapters 15 Communication & SPIKES Protocol, 16 Clinical Trial Design & Epidemiologic Bias, 17 USPSTF Screening & Geriatric Prevention, 18 Occupational Medicine & Medicolegal DEA, and 19 Clinical Decision Analysis & EBM Nomograms).
Structured Pedagogical Depth: Every core section features dedicated clinical vignettes, step-by-step diagnostic algorithms, 681 comparative decision tables, 423 visual plates (including 70/70 2K Master Plates), and 9 clinical motion video placements.
Semantic Cleanliness: Purged all code tags, monospace styling, and unrendered LaTeX delimiters, replacing them with semantic typography and KaTeX notation.
14,796-Question Pedagogical Depth & NBOME/NBME Item Standard Upgrade
Zero Skeletal Stems
Elimination of Skeletal Vignettes: Upgraded all short stems (<40 words) from 6,046 down to 0 across COMLEX (DO), USMLE (MD), and practice forms, enriching each with realistic clinical presentations, vital signs, physical exam findings, and lab values.
Informal Lead-In & Category Normalization: Resolved all 141 informal or grammatically defective lead-ins down to 0 and aligned 100% of lead-ins with option categories.
Zero Diagnosis Spoilers: Confirmed 0 stems inadvertently reveal the target diagnosis.
Attending-Grade Distractor Rationales: All 7,681 mock exam distractor options across 12 full-length forms upgraded with precise physiological and pharmacological discriminators with 100% 5-option A–E balance.
Widescreen Layout Geometry: Standardized full-screen clinical cockpits and reader workstations to canonical max-w-[1680px] with responsive gutters (px-4 sm:px-6 lg:px-8 xl:px-12), eliminating narrow mobile-only capping and dead black margins on widescreen monitors.
Unified Card Primitives & Ambient Glow: Standardized on obsidian card primitives (.card-cockpit, .card-metric, .card-action, .card-exhibit) with subtle 1px border highlights and 4px ambient glow accents.
Automated CI Design Linter: Enforced tools/lint-design-consistency.mjs across all HTML pages, verifying 100% compliance with zero design errors or warnings.
SPACED RETRIEVAL
End-to-End SM-2 Anki Queue, Due Banners & Competency Heatmaps
Persistent Memory
SuperMemo-2 Memory Algorithm: Integrated client-side SM-2 spaced repetition tracking across question sessions, test creators, and score reports with custom intervals (Again, Hard, Good, Easy).
Dedicated Review Banners: Real-time due card counter banner on the Qbank dashboard with 1-click launch into active recall review sessions.
10-System Competency Heatmap: Visual mastery matrix tracking question volume and accuracy across all organ systems with targeted reinforcement drill generation.
New Episode Drops: Cataloged and linked Divine Intervention Episodes 674 through 677 with structured clinical pearls, high-yield audio enclosures, and full-screen reading modal enhancements.
Multi-Hop Knowledge Graph: Bidirectional concept cross-linking connecting 461 medical lexicon definitions with 243 EM protocols, 136 OMM viscerosomatic reflexes, and 441 compendium chapter reverse backlinks.
Topic Uniqueness Audit: Built tools/audit-duplicate-topics.mjs enforcing 0 intra-track duplicates across 243 EM protocols, 28 OMM chapters, 8 COMAT shelves, 105 compendium chapters, and 461 lexicon concepts.
Universal Completeness Inspector: Added continuous convergence inspection (npm run audit:resource and npm run converge) ensuring zero regression across clinical depth, visual assets, and verification suites.
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Patch 1.8 — Authentic POCUS Sonogram Atlas, User Profile Study Engine, OMM Neuroanatomy Overhaul & Weekly Review Hub
Patch 1.8 delivers on our clinical photography and authentic imagery mandate across diagnostic imaging and osteopathic principles. We have completely eliminated synthetic vector mockups from the Emergency Ultrasound (POCUS) atlas, replacing them with authentic, peer-reviewed sonographic clips and scans across all 12 views. Additionally, we overhauled the User Profile system (/profile/) with guest states, personalized exam date countdowns, and daily pacing targets, launched the dedicated Clinical Weekly Review hub (/weekly/) with 5-choice board-style vignette digests, rebuilt the OMM Viscerosomatics vault with authentic neuroanatomical wiring diagrams, and integrated MDCalc-grade weight-based emergency calculators.
POCUS ATLAS
Authentic Clinical Sonograms Across All 12 Ultrasound Views
Zero Placeholders
Gold-Standard Imaging: Sourced authentic clinical ultrasound scans and dynamic loops across eFAST (RUQ Morison pouch, LUQ splenorenal, subxiphoid pericardial, suprapubic), RUSH (parasternal long/short, IVC collapsibility, aorta), and DVT compression views.
Bladder Views: Added dedicated bladder ultrasound views documenting ureteral jets with color Doppler and post-void urinary retention volume estimation.
Personalized Study Pacing, Target Exam Presets & Stage Sync
User Profile
Dynamic Pacing Engine: Configure target COMLEX (Level 1/2/3) or USMLE (Step 1/2/3) exam dates with real-time countdown clocks and calculated daily quotas (questions/day, cards/day, podcasts/day).
Stage-Aware Context Sync: Switching academic stage (Pre-Clerkship, Clerkship, Sub-Internship) or DO/MD track instantly aligns search priorities, question bank recommendations, and curriculum framing.
OMM OVERHAUL
Master Neuroanatomical Wiring & Organ Segment Explorer
Viscerosomatic Vault
Interactive Anatomical Wiring: Replaced plain text blocks with an authentic 1000x1380 master neuroanatomical vector map detailing sympathetic (T1-L2) and parasympathetic pathways (CN X vs S2-S4).
Organ Segment Explorer: Instant click-to-filter osteopathic spinal levels, Chapman reflex locations, and clinical pearls for 18 visceral organ systems.
Weight-Based Calculators: Deployed interactive bedside dosing calculators for pediatric and adult emergency drugs with hard physiological safety ceilings.
Expanded Protocols: Added dedicated clinical order sets for Rhabdomyolysis & CPK monitoring, Maalox GI cocktail pearls, Osteoarthritis knee injection protocols, and Trimalleolar ankle fracture reductions.
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Patch 1.7 — Emergency Medicine 222-Module Expansion, 9-Part Organ Systems Suite & AMBOSS-Style Concept Interlinking
v1.7
222 EM Modules9 Organ SystemsAMBOSS Interlinking1,135 Pages
Clinical Director's Note
Patch 1.7 marks an expansive curriculum and platform milestone for Tenderpoints Hub, growing our curated static medical preparation platform to 1,135 pages. We have achieved complete textbook parity across all 20 clinical domains of Emergency Medicine with 222 comprehensive modules matching Tintinalli and Rosen standards. Concurrently, we launched the 9-part Organ Systems Command Center suite (/organ-systems/), deployed interactive AMBOSS-style in-text concept linking with obsidian popovers across all hubs, added high-yield Wiggers cardiac cycle and nephron transport SVG vectors, expanded gross anatomy and embryology compendiums, and added a keyboard-driven global command palette (Cmd+K).
EM CURRICULUM
222-Module Tintinalli & Rosen Emergency Medicine Expansion
All 20 Domains
Complete Breadth Parity: Expanded from 21 foundational modules to 222 comprehensive clinical guideline chapters across all 20 emergency medicine domains (Resuscitation, Acute CAD/STEMI, Toxicology, Shock, Trauma, Neuro, Peds, OB/GYN, and Orthopedics).
Clinical Command Toolbar: All 243 protocol pages equipped with dynamic sticky navigation, Code Blue rapid-resuscitation strip, dual-view toggle, and dedicated POCUS bedside ultrasound decks.
Complete 9-Part Organ Systems Command Center Suite
Organ Systems Portal
Master Portal Launch: Unified all pre-clerkship and organ-specific physiology under /organ-systems/ with dedicated hubs for Cardiovascular, Renal, Neurology, Gastrointestinal, Endocrine, Reproductive, Hematology-Oncology, Pulmonology, and Musculoskeletal.
Preclinical Continuums: Integrated embryologic timelines ("Young Liver Synthesizes Blood"), fetal hemoglobin switching mechanics, neural tube vs neural crest derivations, and blood-brain barrier microanatomy directly into study workflows.
Instant Concept Previews: Hovering or tapping medical terms in study text renders obsidian-styled definition cards with key high-yield board associations, eliminating context-switching during study blocks.
Bidirectional Practice Bridges: Seamless 1-click drill jumping from clinical concepts directly into targeted Qbank question sets.
Patch 1.6 represents our largest curriculum and engine expansion to date. We've rolled out six interactive flagship hubs with case simulators and active recall flashcard export, expanded the Anatomy & Embryology curriculum to 10 comprehensive tabs with authentic illustrations, achieved full Sketchy alignment across Pharmacology with high-yield ECG tracings, and recalibrated the entire question bank to 6,438 items with verified 100% COMLEX and USMLE parity.
NEW HUBS
6 Flagship Clinical & OMM Hubs with Simulators
Simulators & Quizzes
Interactive Case Simulators: Launched 6 comprehensive clinical centers featuring step-by-step diagnostic workflows, interactive clinical decision trees, and in-session Anki exporter.
OMM & Counterstrain Engine: Integrated rapid search tools for tenderpoints and treatment setups with real-time positional verification.
Hemodynamic Calibration: Added high-yield pressure-volume loops and cardiac output calculators calibrated for HFrEF and cardiogenic shock.
ANATOMY EXPANSION
10-Tab Anatomy & Embryology Curriculum
First Aid & Sketchy Parity
Authentic Clinical Graphics: Replaced placeholder diagrams with high-resolution anatomical illustrations across all 10 organ system tabs.
High-Yield Mnemonics: Integrated Pringle maneuver peritoneal ligament schematics, branchial pouch/arch clinical tables, and full C2–S4 dermatome landmark reference guides.
PHARMACOLOGY
Full Sketchy Parity & ECG Exhibit Tracings
Board Curriculum Modules
Complete Drug Modules: Standardized high-yield tables for anticoagulants, autonomic pharmacology, and psychotropics with hash-based deep linking.
Community feedback is sacred. Following user reports of repetitive question formats and demographic discrepancies, our team performed an exhaustive clinical review across all 15 question modules. We removed redundant question clones, corrected demographic inconsistencies, balanced answer distributions uniformly to 20% across A–E, and recalibrated answer explanations to ensure board-accurate rigor for COMLEX and USMLE examinees.
CLINICAL VETTING
Complete Demographic & Vignette Calibration
15 Modules Audited
Zero Demographic Anomalies: Eliminated all contradictory clinic presentations (e.g. elderly patients brought to pediatric offices, adult patients described as infants, and gender-incompatible pathology vignettes).
Lab & Vital Sign Integrity: Re-verified clinical laboratory reference ranges, ensuring patient vitals, platelet thresholds, and electrolyte abnormalities align with official NBOME & NBME style guides.
Medical Realism: Cleaned all physical examination and osteopathic structural exam findings to reflect authentic patient presentations without nonsensical combinations.
CONTENT QUALITY
Purge of Repetitive Template Clones
6,043 High-Yield Questions
High-Yield Uniqueness: Purged repetitive question clone blocks that duplicated identical vignette stems across random ages. Every remaining question in the 6,043-item bank is clinically unique and high-yield.
Full COMLEX & USMLE Parity: Preserved comprehensive coverage across all major organ systems, basic sciences, ethics, biostatistics, and emergency medicine.
Elimination of Choice-A Bias: Deterministically shuffled all options using a cryptographically seeded algorithm, creating an exact ~20% uniform distribution across all positions (A, B, C, D, E).
Dynamic Explanation Cross-References: Automatically mapped and updated all explanation references ("Option A", "Choice C", etc.) to match the newly shuffled option positions, ensuring 100% explanatory accuracy.
Late-night studying requires high-contrast typography without blistering retina glare. This update re-engineers our visual physics with soft atmospheric background glows and elevated card surfaces, while finishing the Preclinical Basic Sciences inventory with deep molecular genetics and metabolic solvers.
Ambient Glow Engine: Implemented hardware-accelerated radial mesh glow (--ambient-glow) behind page headers sitewide across all 850+ pages. Eliminates pitch-black eye strain in Dark Mode while providing soft clinical slate skylight in Light Mode.
Elevated Card Surfaces: Updated all dashboard, question, and module cards with multi-stage elevation drop shadows (0 4px 20px -2px rgba(0,0,0,0.5)) and smooth -2px hover lifts with illuminated violet ambient halos.
Adaptive Frosted Glass: Upgraded category filter bars and sticky headers with backdrop-filter: blur(16px) saturate(180%), eliminating light-mode grey flashes in dark mode.
Tab 3 Added: Complete coverage of DNA repair mechanisms (NER in Xeroderma Pigmentosum, BER in deamination, MMR in Lynch Syndrome, NHEJ in Ataxia-Telangiectasia), RNA snRNP splicing, 30S/50S ribosomal antibiotic targets, and organelle diseases (I-cell M6P, Zellweger peroxisomes, Kartagener ciliary dyskinesia).
Diagnostic Lab Techniques: Added high-yield molecular diagnostic breakdowns covering SNOW DROP blotting, RT-PCR, Karyotyping, FISH, Chromosomal Microarray, and Next-Gen Sequencing.
Metabolic Defect Solver: Expanded with 10 new high-yield conditions including Essential Fructosuria, Classic Galactosemia, Sorbitol polyol cataract pathway, and MCAD deficiency.
Qbank Quick Preset: Added dedicated 1-click Biochemistry & Genetics filter preset (preset=biochem) to the Qbank launch wizard.
BUG FIXES & STABILITY
Service Worker Cache Invalidation & Asset Versioning (v65)
Cache Flush to v65: Upgraded CACHE_VERSION to v65 in the offline service worker and restamped all 903 HTML page heads to ensure all returning students instantly receive fresh CSS without stale disk cache delays.
Qbank Light Mode Contrast: Corrected submitted question option buttons in Light Mode to use high-contrast deep emerald (#064E3B) and rich crimson (#7F1D1D) instead of washed-out white text.
Divine Intervention Podcasts represent the gold standard of audio board prep. This patch ingests the newest 11 episodes through Episode 673, introduces instant clutch preset filters, and connects every episode directly to relevant Qbank practice blocks.
11 Brand New Episodes: Ingested comprehensive structured notes, comparison tables, and buzzword drills for Ep 663 (Localize The Oxygen), Ep 664 (5 Vital Statistics), Ep 665 (HY USMLE Associations), Ep 666 (Stop Studying Wrong), Ep 667 (The 90s Read), Ep 668 (Follow The Arrows), Ep 669 (Electrolytes & Acid-Base), and the 4-Part USMLE Pharm Crash Course (Ep 670–673).
Universal Count Sync: Updated all navigation dropdowns, search indices, and sitemaps sitewide to accurately reflect the full 673-episode library.
Clutch Filter Pills: Instant 1-click filters for Rapid Review Series, Risk Factors (HY), Next Best Step, Screening & Safety, Biostats & Ethics, Military Medicine, and COMLEX Focus.
Practice in Qbank Buttons: Every episode note automatically links directly to question drills matching its medical discipline.
DO / MD Mode Sync: In DO Mode, an alert banner highlights 380+ episodes containing osteopathic viscerosomatics and clinical reasoning.
LEGAL & COMPLIANCE
Copyright Protection & Audio Links
Removed third-party conversational transcripts across all 673 episodes to ensure strict compliance with educational copyright guidelines, while preserving 100% of original summary notes, comparison tables, and OMM integrations. Outbound audio links safely direct students to official recordings.
6,438+ Authentic Questions per Track: Covering all organ systems, pharmacotherapy, pathology, ethics, biostats, and high-yield clinical decision making.
COMSAE Score Deficit Predictor: Automated weakness weighting and passing confidence calibration against NBOME score curves.
Keyboard Shortcut Engine: 1-5 keys for options, Space to submit, Enter for next, and M to mark questions.
