Step 2 CS question (Orders)

[Jofry]

Hello! I wasn't too clear on how the order section of the CS works. Say that my ddx are

Vascular dementia
Alzheimer
MDD

Would it still be valid to list B12 level and VDRL/RPR on the orders? B12 deficiency and Neurosyphilis weren't on the differential, but I would check these on pt with such ddx in real life...

Or would i just stick to CT Head + Beck Depression inv? Thank you!

---

Members don't see this ad.

 

[studentdocftw]

Nothing official..but in my opinion, the orders should seek to confirm or refute your differential. In the case of CS, we are restricted to 3...so in your case, I wouldn't order the VDRL/RPR unless you suspect neurosyphilis (nonelderly pt with history of STDs, for example). One could argue B12, because a deficiency could manifest as MDD, which is on your differential. Though I'm sure at the end of the day, as long as your orders are reasonable, this section isn't going to make or break you.