COMLEX PE Questions

[123456123456]

Hello, I have my PE very soon and have a few questions

1. At my school we were taught to have the pt lay left lateral recumbant to listen to the mitral valve which I assumed I would need to do on the PE. However, I have never seen a doctor actually do this in practice and I was watching the Kauffman videos and he listened to the mitral valve with the patient sitting up. Did you have the patients go in lateral recumbant to listen to the mitral valve or did you listen to it with the patient sitting normally?

2. I know you need to accept vitals as normal (like high HR or temp or BP). However, if a patient is listed as tachycardic on the vitals from pain or something but the SP is not tachycardia, do you put tachycardic on the physical exam since you accept the vitals as normal or do you put regular rate because the SP is not tachycardic?

Thank you for your help, I do not think these questions violate the NBOME rules but please let me know if you think it does and I will delete it.

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[MakeLifeHappen13]

If the patient has a cardiac complaint like chest pain or palpitations then you would do the full cardiac exam including listening in the lateral recumbent position. If it's not a cardiac complaint then it's okay to do a quicker exam while sitting. This is what I was told by an upper class men, and it makes sense.

For number two, I was always told by my school and the Kauffman videos to treat the encounter like a real visit, and repeat abnormal vitals. So even though the sheet of paper says HR 110 but the patient's HR on exam is 68, then I would document 68.