Random Step 2 CS questions

[BlindWillieMCT]

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Hi, just some quick random questions on CS. Any advice is appreciated.

1. Are we expected to do some of the more time intensive or complex exam procedures like orthostatics, 2 arm BPs, Dix-Hallpike, etc or can we just list them on our note as diagnostic studies

2. In FA they are very exhaustive on suggested studies (bronchoalveolar lavage for simple bronchitis, ceruloplasmin for tremor) but on the USMLE examples they seem much more restricted to evidence based style. Is it good to list several extra studies if they are possible to help but unlikely or should we keep it simple?

3. I've read you're supposed to explain each exam before doing it but keep it in laymen's terms, what do you suggest for conjunctival pallor (exam takes 0.5 seconds, explaining it would take a while without scientific terms)

4. Do we mark negative findings for the diseases in the note, or do they just assume we know that it's negative if we type it in? (ex: no relation of pain to food if cholelithiasis is your #3 differential)

 

[wazim87]

1. Don't do any time intensive manuevers, you won't have enough time. Do focused PE and give more time to summary and counselling and/or thier questions

2. You need to the most relevant tests to your ddx. Think of it as a real clinic after an initial visit we won't be doing all invasive testing.

3. Also keep it simple here "I am just going to have a quick look at your eyes" is what I used.

4. Important negatives as you mentioned above are good to write in the note as well. Shows that you know what you are looking for.