for those who passed step 2 cs

[Becky]

hey ladies and gents

Some guidance needed here... for those who actually passed this test....do you routinely do a Cardio and Pulm exam on every patient.

It feels weird for me to just go straight for the abdominal exam for a pt with abdominal pain on the cs, because in real situation I would...please let me know.

how about headache, knee pain, wrist pain....?

thanks, sorry if this is too basic, I really don't want to spend another 1K!

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[ranmyaku]

I haven't gotten my score back yet, but I did a CV and Pulm exam on every patient. Even the ones with MSK complaints. I didn't do a full fledged CV/pulm exam, ie. 99, E-A, percussing and all that nonsense, but I did listen. It takes like 1 min to do.

 

[drguy22]

hey ladies and gents

Some guidance needed here... for those who actually passed this test....do you routinely do a Cardio and Pulm exam on every patient.

It feels weird for me to just go straight for the abdominal exam for a pt with abdominal pain on the cs, because in real situation I would...please let me know.

how about headache, knee pain, wrist pain....?

thanks, sorry if this is too basic, I really don't want to spend another 1K!

I did the basic cardio and resp exam on everyone including ortho cases, ect.

i passed the exam

 

[Tastebuds]

I performed a cardio, pulm, and abdominal exam on everyone and then additional exams if needed. I also passed the exam.

 

[nockamura]

Yeah, limited Cardio and Pulm on everyone. I was so worried about draping with women that I only listened to 1-2 places. Still passed.

 

[RaistlinMajere]

I only listened to the heart and lungs of every patient. Also, I think I performed a basic abdominal exam on nearly everyone.

I found out I passed yesterday.

 

[anesthesiarocks]

hey ladies and gents

Some guidance needed here... for those who actually passed this test....do you routinely do a Cardio and Pulm exam on every patient.

It feels weird for me to just go straight for the abdominal exam for a pt with abdominal pain on the cs, because in real situation I would...please let me know.

how about headache, knee pain, wrist pain....?

thanks, sorry if this is too basic, I really don't want to spend another 1K!

there is no need to do a cardiac or pulm exam on every pt. If you do on some patients its just a complete waste of time. Wont hurt you or help you.

A good example where I wouldnt do a cardiac or pulm exam- obvious msk stuff(ie a sprained ankle). You're just wasting time and not gaining any pts if you pull out your stethoscope here. Concentrate on the focused msk exam and taking as complete a pertinent history as possible.

But for any patients who complain of just generalized symptoms(like fatigue or something), yeah....do a cards and pulm.

 

[anesthesiarocks]

I haven't gotten my score back yet, but I did a CV and Pulm exam on every patient. Even the ones with MSK complaints. I didn't do a full fledged CV/pulm exam, ie. 99, E-A, percussing and all that nonsense, but I did listen. It takes like 1 min to do.

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so what if it takes 1 minute or 5 minutes or 5 seconds? If you have a patient with a sprained ankle on this test and you do a quickie cvs/pulm exam, it didn't hurt you but it sure as hell didnt help.

Likewise, had you spend 65 seconds drying off your hands instead of 5 seconds it would have been equally useless.......no points docked or gained.

 

[irongal]

yup! I did mini CV and Pulmo exam on everyone and then focused on the "problem" area ( abdomen if chief complaint is abd'l pain). you won't have enough time to do a comprehensive PE on anything with anybody anyway so I suggest make the most of your time by concentrating on the problem area. Establish rapport with pt and you'll do fine.

goodluck!

 

[ForeignBody]

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so what if it takes 1 minute or 5 minutes or 5 seconds? If you have a patient with a sprained ankle on this test and you do a quickie cvs/pulm exam, it didn't hurt you but it sure as hell didnt help.

Likewise, had you spend 65 seconds drying off your hands instead of 5 seconds it would have been equally useless.......no points docked or gained.

The problem is you don't know whether or not a CV/Pulm exam is or is not included on those patients with a MSK complaint, unless you have some inside info on the scoring sheet used by the standardized patients. First aid has a CV/pulm exam on every patient for their checklist.

 

[Gibbles]

Forgot to wash my hands before touching the patient in at least three rooms, but I remembered after the exam.

Performed my CV exam by listening through the gown on every single patient I interviewed.

I passed.

 

[rox]

Forgot to wash my hands before touching the patient in at least three rooms, but I remembered after the exam.

Performed my CV exam by listening through the gown on every single patient I interviewed.

I passed.

dude, you were lucky to pass

 

[anesthesiarocks]

The problem is you don't know whether or not a CV/Pulm exam is or is not included on those patients with a MSK complaint, unless you have some inside info on the scoring sheet used by the standardized patients. First aid has a CV/pulm exam on every patient for their checklist.

sure I know. If you paid attention to the little "intro video" you would see that they mentioned the words "focused physical exam" at least twice.

A "focused" physical exam for *most* msk patients doesn't include a pulm or cardio exam.

And Im not even sure where you got the idea to stop at cardio and pulm. If you're going to make the case that we cant know whether there is a scoring sheet for cvs/pulm on any patient, the same thing can equally be said for neuro/adbominal.

Now some patients with msk complaints might also require a cardio exam, but not all do. If your a poor medical student and aren't good enough to guess know which msk complaints have potential cvs complications and which don't....then yeah I'd probably do it if i had time. But if you know the presentation accurately, skip it.......

 

[anesthesiarocks]

yup! I did mini CV and Pulmo exam on everyone and then focused on the "problem" area ( abdomen if chief complaint is abd'l pain). you won't have enough time to do a comprehensive PE on anything with anybody anyway so I suggest make the most of your time by concentrating on the problem area. Establish rapport with pt and you'll do fine.

goodluck!

likewise, instead of doing a "mini" cv and pulm exam on every non-cards/nonpulm/non generalized symptoms patient I used that two minutes to balance my checkbook.......I passed as well and I got the same amt of "credit" on the standardized pt checklist for balancing my checkbook as you did for your cvs exam on a broken ankle.