Workup on Step 2 CS

[BillrothI]

Hey Everybody,

Two quick questions regarding Step 2 CS:

(1) I'm using First Aid to study for Step 2 CS and noticed that the workup provided for the minicases often involves redundant testing. For example, it will include both a head CT and brain MRI for evaluation of syncope, or D-dimer, CTA, and V/Q scan for a suspected PE.

Is that the approach that the examiners prefer, or would it be better to choose one or two tests for each possible diagnosis (eg - just an ABG and CTA for a suspected PE)?

(2) Is there any need to include a plan as part of the workup, or do we just order tests?

Thanks!

-Bill

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[Dr. Opout]

Yeah, definitely do NOT put multiple redundant tests. That is not the way to take the exam. Pick one or the other for CT and MRI in cases like that. I think you should refer to the USMLE Step 2 CS handbook. Aside from exam rules, they give you a few examples of how to write the note which isn't explained as well in FA.

For the workup, you're just ordering tests and physical exams you couldn't do in person (breast, genital, etc). The section is just literally a list of things you'd order.

 

[BillrothI]

Thank you! I will absolutely take a look at the handbook.

The practice cases in First Aid seem much more reasonable. The minicases, however, seemed to list every conceivable test for a given condition.

Thanks again.

-Bill