Jul 13, 2011
13
0
Status
Hey everyone,

AMG grad with English as first language here.

I'm starting to make my way through the UWorld CCS software but I'm finding it incredibly confusing. For example, the 2nd case with the young Asian female with nausea and vomiting. I realized its pregnancy, did the physical, ordered a Beta-HCG, did the prenatal counseling and vitamins, and ordered the prenatal labs. I ordered her for f/u in 4 weeks.

Along the way I kept getting lab results back and was told that her nausea was still there. I gave her another antiemetic in addition to the original one I prescribed.

I'm confused by the switching from office to home. When the clock advances to 4 weeks, am I supposed to switch back to office?

Also, the top of the case says 18+2 of REAL time allotted but the case ended after like 6 min of real time. Was I doing something right or did I screw up and did something wrong?

Does the "case" (aka not real time) actually matter if you are under the REAL time maximum?

Any general help or tips appreciated. This software is very clunky and confusing.

-Z
 

thehundredthone

7+ Year Member
Aug 20, 2012
802
218
Status
Fellow [Any Field]
1. When you switch from office to home, it lets you schedule the next visit. Use that, and call the patient back after however long you think is necessary.

2. Cases can end at any time once you've done all the right things or the patient is dead/tired of your quackery.

3. Case time matters to the extent that it can result in the second part of the point above, in an acute case.

4. Use phenergan or similar anti-histaminic as your anti-emetic.

5. Always give morphine + phenergan for acute pain unless contraindicated. UWorld patients are addicts, they don't care for NSAIDs and synthetic opioids and will continue to complain.
 
OP
U
Jul 13, 2011
13
0
Status
1. When you switch from office to home, it lets you schedule the next visit. Use that, and call the patient back after however long you think is necessary.

2. Cases can end at any time once you've done all the right things or the patient is dead/tired of your quackery.

3. Case time matters to the extent that it can result in the second part of the point above, in an acute case.

4. Use phenergan or similar anti-histaminic as your anti-emetic.

5. Always give morphine + phenergan for acute pain unless contraindicated. UWorld patients are addicts, they don't care for NSAIDs and synthetic opioids and will continue to complain.
Much appreciated. Hoping someone can clarify some things. Some of my 2o minute cases end in about 7-8 minutes and then it asks me about the orders. Am I supposed to cancel the inpatient or ED orders at that point and put in discharge orders in those last 2 minutes? Software is super confusing. Thanks.
-Z
 

thehundredthone

7+ Year Member
Aug 20, 2012
802
218
Status
Fellow [Any Field]
Depends on whether you think they've run their course. If you just started antibiotics for acute cholecystitis and the case has ended as it well could, you don't need to discontinue them. Only cancel orders that you would actually cancel at that point of time in the case. It is an opportunity for you to add some orders for later as well, e.g. schedule a cholecystectomy for later, etc.
 
OP
U
Jul 13, 2011
13
0
Status
Depends on whether you think they've run their course. If you just started antibiotics for acute cholecystitis and the case has ended as it well could, you don't need to discontinue them. Only cancel orders that you would actually cancel at that point of time in the case. It is an opportunity for you to add some orders for later as well, e.g. schedule a cholecystectomy for later, etc.
Great thanks. I'm not sure if this is a glitch in the UWorld software or if I'm doing something wrong, but a lot of times when I sent a patient home from the Emergency Department and schedule a follow-up appointment I will get a message that says they have arrived for their appointment. After I click the "Interval/Follow-up" button, it changes them back to "Home" for location before I get a chance to examine them. Is there a reason for this? Thanks in advance.
-Z
 

thehundredthone

7+ Year Member
Aug 20, 2012
802
218
Status
Fellow [Any Field]
Check the date of the follow up appointment, sometimes you have to select it twice and make sure it has actually changed to the date you want (this is specific to UWorld software).
 
OP
U
Jul 13, 2011
13
0
Status
Check the date of the follow up appointment, sometimes you have to select it twice and make sure it has actually changed to the date you want (this is specific to UWorld software).
If the case ends early without the message saying the patient's condition improved, does that mean you did something wrong or you didn't cure the person? I had a couple cases where I moved the person to inpatient and then the case ended abruptly without anything stating the person got better. TIA.
-Z
 

thehundredthone

7+ Year Member
Aug 20, 2012
802
218
Status
Fellow [Any Field]
Usually moving the patient is not what causes a case to end. Did it happen right as you moved the patient? Did you possibly miss doing something in the ER before moving the patient? (Check against the UWorld notes). Try doing the case a second time to see if a different approach changes that outcome.
 
OP
U
Jul 13, 2011
13
0
Status
Usually moving the patient is not what causes a case to end. Did it happen right as you moved the patient? Did you possibly miss doing something in the ER before moving the patient? (Check against the UWorld notes). Try doing the case a second time to see if a different approach changes that outcome.
Ok but my question is if a case ends without telling you the patient felt better does that mean you screwed up?
 

thehundredthone

7+ Year Member
Aug 20, 2012
802
218
Status
Fellow [Any Field]
Not really. There is no congratulatory message or trophy at the end of a successfully managed case (although someone conversely reported being told the patient had died in one case). On the actual exams most cases will end as soon as you take the definitive step (i.e. schedule surgery, instate the medical treatment) or a little after that. You will not always see the patient improve completely or get discharged.