Do CS patients have actual findings?

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Do the SP's for Step 2 CS actually have clinical findings? I'm guessing not in most cases since you can't really use an actual patient with pneumothorax?

But I guess if they are actual patients themselves with a weird murmur or something, would you be docked points for not saying that? What if some other person got a person without that murmur?

 

[drizzt3117]

sometimes. My intern from last year said he had a patient with HCM.

 

[Green Grass]

I don't think most of them do. You might have the occasional patient who has an actual finding.

However, keep in mind these people are ACTORS and paid to ACT. I had a patient basically lift his chest up and down when I listened to one side of his lungs, but took breaths on the other side. They can be pretty sneaky when they want to be.

 

[Domenech]

sometimes. My intern from last year said he had a patient with HCM.

He must be carrying a portable echo in his pocket.

 

[DrBowtie]

He must be carrying a portable echo in his pocket.

You could suspect HCM with squatting/standing/hand grip maneuvers that they harp on for physical diagnosis. Definitely a possible differential.

 

[Domenech]

You could suspect HCM with squatting/standing/hand grip maneuvers that they harp on for physical diagnosis. Definitely a possible differential.

I don't imagine anyone actually listening to any "incidental" murmurs, not to mention subjecting the murmurs to all physical maneuvers, during the exam.

 

[drizzt3117]

I don't imagine anyone actually listening to any "incidental" murmurs, not to mention subjecting the murmurs to all physical maneuvers, during the exam.

have you ever seen HCM? It's not particularly subtle.

 

[cabinbuilder]

Do the SP's for Step 2 CS actually have clinical findings? I'm guessing not in most cases since you can't really use an actual patient with pneumothorax?

But I guess if they are actual patients themselves with a weird murmur or something, would you be docked points for not saying that? What if some other person got a person without that murmur?

Step II CS was VERY straightforward. Just remember to wash your hands before each patient. Ask the med hx, surg hx, CC, HPI, meds, and allergies. Everything is pretty obvious. They are not out to get you or fail you. Talk to the patient, touch the patient, get your info, do your exam, exit and write your note. If you are DO, the patient will ask you if you can do some manipuation on them. You are not allowed to use the thrusting technique but set them up and then say you would thrust at that time. Or do ME or Counterstrain, etc.

 

[deleted103644]

I could've sworn I felt a neck mass on a fake patient with a history suggestive of laryngeal/esophageal SCC, but I'm sure it was all in my head.

Wrote it in my note for the hell of it though.