Step II Question about taking BP for Step II CS

[Taurus]

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As I am reading First Aid, it mentions taking BP manually, for orthostatics for example.

Do people manually take BP during their encounters? If you do, do you just go through the motions and pretend, much like the rest of the exam?

 

[jiy76]

Don't do it but include it in your note as a test u want to order. You have no time for that nonsense.

 

[hardyharhar]

As I am reading First Aid, it mentions taking BP manually, for orthostatics for example.

Do people manually take BP during their encounters? If you do, do you just go through the motions and pretend, much like the rest of the exam?

Yes, Kaplan also says do not measure during the exam, however I noticed that the NBME manual mentions "You will not receive credit for listing examination procedures you WOULD have done or questions you WOULD have asked had the encounter been longer. Write ONLY the information you elicited from the patient through either physical examination or history taking" (http://www.usmle.org/Examinations/step2/cs/content/description.html).

Which seems to agree with your First Aid reading.

Anyone else want to weigh in on this?

 

[jiy76]

Yes, Kaplan also says do not measure during the exam, however I noticed that the NBME manual mentions "You will not receive credit for listing examination procedures you WOULD have done or questions you WOULD have asked had the encounter been longer. Write ONLY the information you elicited from the patient through either physical examination or history taking" (http://www.usmle.org/Examinations/step2/cs/content/description.html).

Which seems to agree with your First Aid reading.

Anyone else want to weigh in on this?

They mean that when writing your physical exam findings, i.e don't make up bs for things u should have done. When u list tests you want to order on the bottom u can include orthostatic bp.

 

[SoCuteMD]

i wanted to do orthostatics. The BP cuff was broken. Thus, I'm going to assume no one else wanted to do orthostatics on this patient. So probably not.

 

[pocketknife52]

i didnt even recheck blood pressure on a hypertensive followup....and i passed...but who knows if it counted against me or not

 

[Abram Hoffer]

Don't do it but include it in your note as a test u want to order. You have no time for that nonsense.

This is the best advice. Don't do it. Unless... you don't want to PASS.

I passed first try, but had I kept on the path I started, I would not have. I was trying to be Mr. Nice and recline the tables for comfort of the SP during abd exams. I wasted so much time with that because the handles on the tables stick. There is no need to do anything that isn't fast and efficient. So think to yourself... is this taking too much time? If the answer is yes, stop doing it... fast! I did not waste time with orthostatics, MMSE, full Neuro exams, etc. The SP's have common problems, and for the ones who don't, these are likely practice cases; most importantly, you don't have to figure out what they have, you just have to present a solid plan that would theoretically figure it out later.

 

[Termwean]

Good Advice. I barely did anything other than the most basic exam. You don't have time. I swear I forgot/didn't have time to do soooo much that I was convinced that I failed. I didn't. I made sure that I did all those little "extra" bs things. Made eye contact, introductions, draping, washing hands (but soon switched to gloves to save time) tied gown back up, rehashed HPI before moving to BS exam. "Any other concerns?" although they never let me get to that question because they always spit out the concern at a stupid time. Showed empathy, discussed plan/ sometimes counsel...."see ya when results come back" or "be back with a nurse in a minute to do pelvic/breast/prostate blah, blah, blah......can't believe they make us take this test.

This is the best advice. Don't do it. Unless... you don't want to PASS.

I passed first try, but had I kept on the path I started, I would not have. I was trying to be Mr. Nice and recline the tables for comfort of the SP during abd exams. I wasted so much time with that because the handles on the tables stick. There is no need to do anything that isn't fast and efficient. So think to yourself... is this taking too much time? If the answer is yes, stop doing it... fast! I did not waste time with orthostatics, MMSE, full Neuro exams, etc. The SP's have common problems, and for the ones who don't, these are likely practice cases; most importantly, you don't have to figure out what they have, you just have to present a solid plan that would theoretically figure it out later.