CS Coming up whats worst?

[Doc2b82]

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So I have CS coming up and one thing that really bogs me down is the details of ICE.

Seeing as how our time is limited, is it more important to ask questions and get the proper history than physical exam?

Better to only put one DDx if thats all you think is the possibility?

 

[Malyck]

I posted asking the same thing. I just wonder how many other people only left 1-2 DDx as well, is it normal for that to happen?

 

[thehundredthone]

Even if there's clearly only one diagnosis in your mind, you should be able to put down at least one differential. There are very few clinical diagnoses without differentials.

Now for the frustrating answer: the history and physical examination are both equally important. But that is not to say that they require the same time. The history will easily take up 7-8 minutes of your time, and you'll need another 1-2 to close, leaving you with 4-5 minutes for your focussed physical examination. However you might have some cases where the history takes the majority of the focus in which case they don't expect you to have been able to do a thorough examination anyway.

The other important part of the ICE is your note. It needs to be concise and still contain all pertinent positives and negatives. Don't bother with new lines because you'll need all the space you can get (you can pretty it up later if it's a short note), and at the same time, don't bother with points irrelevant to the case.

 

[TOcho118]

Totally ok to have less than 3 possibilities in your DDx. If you cannot justify a diagnosis you should not put it and even may get points taken away if you do. I just took the exam today and I can assure you that there will be few cases where you can confidently come up with 3 possibilities. It is also totally fine to not put any physical exam findings as justification as every patient for the most part has a normal exam!

 

[autumnwoods]

The worst is waiting so long for your result