CS question

[sequela]

is it true that for the PN you don't have to mention treatment of any kind (ie htn meds, etc), just diagnostic tests?

thanks.

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[manning18]

Yes, the notes ask for a differential (up to 5 ocnditions) as well as a DIAGNOSTIC work-up (also up to 5). There maybe a template of the patient note on the NBME website, but they certainly have them in First Aid for Step 2-CS, which is an excellent resource.

 

[sequela]

okay...last question i hope.

did you guys actually perform orthostatic BPs or did you just list it on the diagnostic workup plan?

i'm just wondering if there is enough time for this given that FA suggests 3-5 min for the entire PE.

thanks so much.

i take this stupid test this coming week.

 

[vwhan]

okay...last question i hope.

did you guys actually perform orthostatic BPs or did you just list it on the diagnostic workup plan?

i'm just wondering if there is enough time for this given that FA suggests 3-5 min for the entire PE.

thanks so much.

i take this stupid test this coming week.

I just wrote it down under diagnostic workup, like First Aid. I didn't really have time to do orthostatics. Plus, they tell you in orientation that you are to assume that the vitals given are accurate. If someone had an abnormal BP I asked them about it during the interview.

 

[samyjay]

I dont know if anyone will respond, but i have the test today at 3pm. In normal encounters, i usually like to make small talk (while performing the physical exam) such as "hey, did you watch that bears game, what an amazing game?" Or talking about things like favorite foods, somethings to make the patient "comfortable" and not treat them only like a disease. Or, should we just focus on the main hx, and during the physical exam, just ask politely to examen the patient. Any input in the next 5 hours will be greatly appreciated!

 

[Adam_K]

I dont know if anyone will respond, but i have the test today at 3pm. In normal encounters, i usually like to make small talk (while performing the physical exam) such as "hey, did you watch that bears game, what an amazing game?" Or talking about things like favorite foods, somethings to make the patient "comfortable" and not treat them only like a disease. Or, should we just focus on the main hx, and during the physical exam, just ask politely to examen the patient. Any input in the next 5 hours will be greatly appreciated!

If your SPs are anything like mine were, that kind of stuff is completely wasted on them. They were like robots in that respect. You also won't have time to do small talk as you need a focused history and physical. But you need to be super polite throughout. Knock, introduce yourself, drape, do whatever else makes them comfortable.

 

[manning18]

I agree, that the small talk is a waste of time in the sense that engaging in this form of chatter does NOT generate any points for you. That's your sole purpose, is to do whatever you need to do to generate points. As mentioned, knock before you enter, extend your hand, introduce yourself, drape the pt, ask for permission before starting the physical, counsel every pt re smoking cessation/safe sex/alcohol cessation, offer social work, wrap up with some diagnostic possibilities, etc.

 

[Dwite]

is it true that for the PN you don't have to mention treatment of any kind (ie htn meds, etc), just diagnostic tests?

thanks.

In the online tutorial, the screen which described what you write for "plan" included things like CXR, blood tests, and "diagnostic tests"".

Can you really be so vague as to put "diagnostic tests" as one of your answers?!

 

[48 hours]

In the online tutorial, the screen which described what you write for "plan" included things like CXR, blood tests, and "diagnostic tests"".

Can you really be so vague as to put "diagnostic tests" as one of your answers?!

ha ha. That'd be sweet if you could, but you can't just write blood tests or diagnostic tests, you have to write which tests you want. They are just giving you examples of the type of information you should list in the work-up portion. Hell, we were told we couldn't even write BMP or LFTs. We had to specifically write out what we wanted.

 

[lattimer13]

I agree, that the small talk is a waste of time in the sense that engaging in this form of chatter does NOT generate any points for you. That's your sole purpose, is to do whatever you need to do to generate points. As mentioned, knock before you enter, extend your hand, introduce yourself, drape the pt, ask for permission before starting the physical, counsel every pt re smoking cessation/safe sex/alcohol cessation, offer social work, wrap up with some diagnostic possibilities, etc.

i don't know about CS, but at our school our OSCE's also had a component for handwashing before and after patient contact of the physical exam. just a thought.

i remember during one of my standardized patients i starting performing the physical and i heard the sink in the room next door go on and off. i stopped my exam, washed my hands, and then continued the exam...still got knocked off points for it in the end. live and learn.