CCS..ordering biopsy? Other procedures?

[NRAI2001]

Example: 60yo male with suspected lung cancer. To biopsy the lesion what would you do?

Would you consult pulmonary and they know to preform it? Do you place an order for broncoscopy? Do you place an order for biopsy?

Also do you place an order for cytology, culture.. etc if you do a bronch?

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[NRAI2001]

Same question for other procedures.. like tPA, catherization, other biopsy locations, pericentesis..

 

[Ismet]

You are the PCP, the ED doc, the internist, the consultant, etc. You order the procedure that needs to be done.

 

[NRAI2001]

So would you order the bronchoscope and then the biopsy or would you consult for the bronch and then order biopsy?

 

[Ismet]

So would you order the bronchoscope and then the biopsy or would you consult for the bronch and then order biopsy?

Order the consult first. I should clarify my above statement as technically you're not "the consultant" as there are consultants, but you still have to place the actual order for the procedure, not just assume it gets done. You'd place the order for the bronchoscopy and whatever else you want.

I.e. if you think the patient has appendicitis and you consult surgery, surgery says yes we'll take him to surgery. You still have to place the order for the appy and all the pre-op labs and stuff.

 

[xffan624]

Example: 60yo male with suspected lung cancer. To biopsy the lesion what would you do?

Would you consult pulmonary and they know to preform it? Do you place an order for broncoscopy? Do you place an order for biopsy?

Also do you place an order for cytology, culture.. etc if you do a bronch?

If you just order the procedure (say for an appy..), the system will automatically add the consult. The cytology will be done automatically. The only key is you need to make sure to consult the right service. Had a case on my real CCS where I was consulting the wrong service and it slowed management, but I figured it out in the end. Usually if the consulting service gives you the generic "we have nothing to add, do what you think is indicated", they're not the right folks to consult.

 

[NRAI2001]

Did the CCS cases tend to be bread and butter/common diseases? Or were there some rare, less frequent diseases (genetic diseases, rare infections..etc)?

 

[xffan624]

Did the CCS cases tend to be bread and butter/common diseases? Or were there some rare, less frequent diseases (genetic diseases, rare infections..etc)?

All of the actual ones I did on CCS were bread and butter cases from various specialties. On the UWORLD CCS there are some genetic cases that you can practice (mostly pediatrics), but I guess it varies what you're going to get on the real thing.