Last minute Step 2 CS question - ASAP please

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radoncadonc

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1.) Do they collect the scrap paper after each encounter?

The point of this question is I planned on writing down a skeleton on one piece of paper and then using that same piece of paper for every encounter. Is this possible, or do they collect all the notes/paper after each patient?


2.) Are the patients as complicated as the First aid cases? It seems every patient has a primary concern ex: chf, but as you progress in your questioning they are also depressed with ED, possible chest pain and blood in their stool.
Are the patients more of a single complaint or are they like real patients with pan positive ROS?

Thanks
 
1.) Do they collect the scrap paper after each encounter?

The point of this question is I planned on writing down a skeleton on one piece of paper and then using that same piece of paper for every encounter. Is this possible, or do they collect all the notes/paper after each patient?


2.) Are the patients as complicated as the First aid cases? It seems every patient has a primary concern ex: chf, but as you progress in your questioning they are also depressed with ED, possible chest pain and blood in their stool.
Are the patients more of a single complaint or are they like real patients with pan positive ROS?

Thanks

1) YES

2) NO, not as complicated..all the patients have one complaint, and they dont have a pan positive ROS. read FA x2 and ull be fine...of course i dont know if i passed yet.......
 
1.) Do they collect the scrap paper after each encounter?

The point of this question is I planned on writing down a skeleton on one piece of paper and then using that same piece of paper for every encounter. Is this possible, or do they collect all the notes/paper after each patient?


2.) Are the patients as complicated as the First aid cases? It seems every patient has a primary concern ex: chf, but as you progress in your questioning they are also depressed with ED, possible chest pain and blood in their stool.
Are the patients more of a single complaint or are they like real patients with pan positive ROS?

Thanks

1. Yes, I'd suggest memorizing a brief algorithm.

2. No, simpler cases. A very brief ROS. That being said, the cases are usually ambiguous and leaves multiple options when writing up the A/P on your note.
 
Another question for those who have taken it.


Are the patients pretty forthcoming with information (ie one question gets the patient going and goes a long way)?
Or is getting information out of them like pulling te
eth?
 
Do you counsel every smoker/alcohol drinker about smoking/alcohol? When do you do that, while taking social history or in the closure?
 
Do you counsel every smoker/alcohol drinker about smoking/alcohol? When do you do that, while taking social history or in the closure?


i usually did that during the closure, that is IF they said they had a smoking /drinking history. I mean dont do it if they said they quit. I would just offer counseling during the closure. Like asking them if they wanted to quit and if they did we have programs that could help them or I can set them up with a social worker . it worked for me apparently. 🙂 good luck!
 
Thanks. What about the CAGE for alcohol? Do you ask these questions to all patients who drink regardless of the amount and when do you do that - social vs closure? Thanks
 
I think they make it obvious for you if you need to ask the CAGE questions. Usually it will be someone who says they drink like 4-5 beers a day or something like that. If the SP says they only drink socially or 1-2 drinks a week, I dont think CAGE is necessary, and is prob a waste of time for that case. Hope this helps.
 
The patients are not like real patients. They have a script to questions and they stick to it. They will only give you the info you ask for. And if you ask them something different from their script it will confuse them. For example, a standarized patient told me she had "chest discomfort" and when I asked her how long she had "chest pain", she was very adamant that it she did not have chest pain. Very frustrating to talk to these patients. Also you can counsel anytime you want, and long as you do it. Also I've noticed that the patients medical and past history was much simplier than those of real life patients. Please dont stress about this exam. If you've ever seen patients on a day to day basis and know how to take a pertinent history and physical I believe you should be fine. Just remember to wash your hands and keep good eye contact.
 
bottome line, CAGE only for heavy drinkers during social histrory and counseling smokers and heavy drinkers during closure? sounds nice to me 🙂 Thanks.
 
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