Exam in a few days... need CCS advice

[cards99]

I went through UW cases x 1 and now reading the supplemental cases. The issue i am having is that, my work up sequencing is never like UW (sometimes i order more tests initially, compared to what UW describes) case always finishes early.... am I doing something wrong?

some of those UW supplementals are off too.. ie pt with hypothyroidism, why not order TSH and FT4 at the same time? they order TSH, then follow up in a week, then order T4?
can we just order Anti-TPO, TSH, FT4 right away and follow up in 3-4 hours while at the office rather than rescheduling?

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[deleted116380]

I took step 3 last week and all of my cases ended early and it was frustrating as I felt I was missing stuff. I did the UWorld CCS cases and never fully worked up patients like they did, but more or less got the gist of it. Ordering anti-TPO initially for hypothyroidism is not they way I think you should be doing it. I would do basic labs and then have patient follow up in a couple days and review labs, then order additional tests (like I would do anti-TPO then if needed). Shotgun approach with initially labs imo shouldn't be done, but I would basically order a cbc and bmp each time minimum plus initial tests for the diagnosis they hint at.