Hi,
I have some questions about the Step 2 CS exam:
1. If I forget to explain one differential diagnosis for a patient, can I still write it down in the patient note?
2. If I don´t say that I am going to check your eyes and skin now, can I still write in the patient note that the patient did not have jaundice or conjunctivitis based on my observations?
3. When checking for DTRs in an arm, if the reflexes are hard to provoke should I go on and write that the reflex was normal or should I keep trying until I get a reflex?
4. How to do PMI on a female patient? Can I skip PMI?
5. Should I check femoral pulse for DVT?
6. Is it warranted for physician to squat and check the legs for pulse and edema while patient is sitting or will it look awkward?
7. Will the person reading the patient note look through the video of the patient encounter? If no, how will they know that for example I actually did the PE I listed in my patient note?
The USMLE website says that:
8. "Including a diagnosis without supporting information would result in a lower score even if the diagnosis is likely. Including two diagnoses on the same line would result in a lower score." So if there was a case where I suspected but there was not anything indicating it and I had no second differential, should I just write down one diagnosis in patient note and then leave it at that in order to not get a lower score?
9. For a case of sore throat the USMLE website says that:
“Head/neck CT with contrast” is overly aggressive and costly in this clinical scenario, and would result in a lower score." Is that applicable to all case? For example, someone with suspected intracranial tumor, would I lose points if I wrote MRI and CT in the workup? How much work up should I write down in the patient note? Should it just be workup for the ddx I listed or could I write down workup for other possible ddx that were not listed in the patient note?
10. If I finish up the patient encounter faster, will I have more time for the patient note or do I still have to wait for the 15 mins to be up before I can start?
I would be very thankful for help with his.
I have some questions about the Step 2 CS exam:
1. If I forget to explain one differential diagnosis for a patient, can I still write it down in the patient note?
2. If I don´t say that I am going to check your eyes and skin now, can I still write in the patient note that the patient did not have jaundice or conjunctivitis based on my observations?
3. When checking for DTRs in an arm, if the reflexes are hard to provoke should I go on and write that the reflex was normal or should I keep trying until I get a reflex?
4. How to do PMI on a female patient? Can I skip PMI?
5. Should I check femoral pulse for DVT?
6. Is it warranted for physician to squat and check the legs for pulse and edema while patient is sitting or will it look awkward?
7. Will the person reading the patient note look through the video of the patient encounter? If no, how will they know that for example I actually did the PE I listed in my patient note?
The USMLE website says that:
8. "Including a diagnosis without supporting information would result in a lower score even if the diagnosis is likely. Including two diagnoses on the same line would result in a lower score." So if there was a case where I suspected but there was not anything indicating it and I had no second differential, should I just write down one diagnosis in patient note and then leave it at that in order to not get a lower score?
9. For a case of sore throat the USMLE website says that:
“Head/neck CT with contrast” is overly aggressive and costly in this clinical scenario, and would result in a lower score." Is that applicable to all case? For example, someone with suspected intracranial tumor, would I lose points if I wrote MRI and CT in the workup? How much work up should I write down in the patient note? Should it just be workup for the ddx I listed or could I write down workup for other possible ddx that were not listed in the patient note?
10. If I finish up the patient encounter faster, will I have more time for the patient note or do I still have to wait for the 15 mins to be up before I can start?
I would be very thankful for help with his.
