Secret of passing step 2 CS - a must read!

[blackboxmd]

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The main problem in passing step 2 cs is that i think we don"t know what are the criteria on which we are monitored.

my experience is that i studied for 2 weeks and the last 7 days made me pass when i met a friend who had taken usmlesource.com's coaching. He allowed me to see the cases with him. We also practiced together and found out and corrected our mistakes. so practcing is the key.

there are a few points and sp marks u
bad average good excellent

history of chief complaint (1-5 point for this depending on the cheif complaint)

pamhugsfoos each carry 1 point (so around 7 points for them)

so we have to place a lot of importence on pamhugsfoss. UsmleSource.com uses this approach using PAM HUGS FOSS in all the cases which is very useful

now on ur manners
1 point for knocking on door
1 point for behaviour in general ( was he nice)
1 point for washing hands
1 point for draping
1 point for asking permission before examination
1 point - were u able to understand him

and finally 1-4 points for proper physical examination( which i doubt sp knows a lot abt)

finally there is a q like do u like the doctor and will u like to visit him again

so guys u have to practice according to this. sp has to be happy with u and u should cover his points rather than being an excellent doctor.

this may sound an exagerration but i think even a non medico can pass thsi exam becuz it is not a test of ur medical knowledge but ur behavior. The Mnemonic based approach using LIQOR AAA and PAM HUGS FOSS of usmlesource can really make the difference since most people fail in data gathering! Best of luck for you guys!

 

[dynx]

The main problem in passing step 2 cs is that i think we don"t know what are the criteria on which we are monitored.

my experience is that i studied for 2 weeks and the last 7 days made me pass when i met a friend who had taken usmlesource coaching. He allowed me to see the cases with him. We also practiced together and found out and corrected our mistakes. so practcing is the key.

there are a few points and sp marks u
bad average good excellent

history of chief complaint (1-5 point for this depending on the cheif complaint)

pamhugsfoos each carry 1 point (so around 7 points for them)

so we have to place a lot of importence on pamhugsfoss. Usmle Source uses this approach using PAM HUGS FOSS in all the cases which is very useful

now on ur manners
1 point for knocking on door
1 point for behaviour in general ( was he nice)
1 point for washing hands
1 point for draping
1 point for asking permission before examination
1 point - were u able to understand him

and finally 1-4 points for proper physical examination( which i doubt sp knows a lot abt)

finally there is a q like do u like the doctor and will u like to visit him again

so guys u have to practice according to this. sp has to be happy with u and u should cover his points rather than being an excellent doctor.

this may sound an exagerration but i think even a non medico can pass thsi exam becuz it is not a test of ur medical knowledge but ur behavior. The Mnemonic based approach using LIQOR AAA and PAM HUGS FOSS of usmlesource can really make the difference since most people fail in data gathering! Best of luck for you guys!

Who the F*uck is pam and why is she all over this Foss guy?

 

[blackboxmd]

The main problem in passing step 2 cs is that i think we don"t know what are the criteria on which we are monitored.

my experience is that i studied for 2 weeks and the last 7 days made me pass when i met a friend who had taken usmlesource online coaching. He allowed me to see the cases with him as we studied togther. We also practiced together and found out and corrected our mistakes. so practcing is the key.

there are a few points and sp marks u
bad average good excellent

history of chief complaint (1-5 point for this depending on the cheif complaint)

pamhugsfoos each carry 1 point (so around 7 points for them)

so we have to place a lot of importence on pamhugsfoss. Usmle Source uses this approach using PAM HUGS FOSS in all the cases which is very useful
now on ur manners
1 point for knocking on door
1 point for behaviour in general ( was he nice)
1 point for washing hands
1 point for draping
1 point for asking permission before examination
1 point - were u able to understand him

and finally 1-4 points for proper physical examination( which i doubt sp knows a lot abt)

finally there is a q like do u like the doctor and will u like to visit him again so guys u have to practice according to this. sp has to be happy with u and u should cover his points rather than being an excellent doctor.
this may sound an exagerration but i think even a non medico can pass thsi exam becuz it is not a test of ur medical knowledge but ur behavior. The Mnemonic based approach at usmlesource or other places can really make the difference since most people fail in data gathering! Best of luck for you guys!

 

[chrisisinnocent]

This is pretty standard for any OSCE you would take in med school. Most people get tripped up when they write the note.

 

[avicena25]

Dear colleague, I took the frikking exam in September, I have been reviewing your message, and I believe that I followed the OGS, MOGS, HOGS, and LOGS.
In spite of that, I FAILED. Any other explanation ?

 

[guy_incognito]

Your score report should give some sort of breakdown, indicating what part of the exam you failed. What part did you fail on? This would be a good place to start.

 

[blackboxmd]

If that's how you would want to remember the Mnemonic PAM HUGS FOSS, that's fine with me!😎

 

[blackboxmd]

I think many people are failing in data gathering - at least that is what I hear!

As for me, I used the above approach, practiced about 10 Patient notes using the PN generator at usmlesource.com (One is free in the guest section there) and I think the secret is open ended questions. I used to ask - can you tell me more about your pain? Can you describe your symptoms for me and let the SP speak as much as possible.

It is not that difficult exam, just need some good practice. Do not forget to practice the patient note also using some PN generator like the one I mentioned above. I am not sure if there are others out there

 

[nykka3]

what does PAM HUGS FOSS stand for

 

[QuinnB]

I've never heard of these mnemonics...actually nobody I've every talked to has heard of them; what is usmle source?

 

[tkim]

P=past medical history
A= allergies
M= medications
H= hospitalizations
U= urological complaints
G= gastro intestinal complaints (N/V/D)
S= surgical history
F= family history
O= OB/GYN
S= sexual history
S= social history

 

[TY06]

and LIQOR AAA ?????


thanks for all

 

[antihero94]

The main problem in passing step 2 cs is that i think we don"t know what are the criteria on which we are monitored.

my experience is that i studied for 2 weeks and the last 7 days made me pass when i met a friend who had taken usmlesource coaching. He allowed me to see the cases with him. We also practiced together and found out and corrected our mistakes. so practcing is the key.

there are a few points and sp marks u
bad average good excellent

history of chief complaint (1-5 point for this depending on the cheif complaint)

pamhugsfoos each carry 1 point (so around 7 points for them)

so we have to place a lot of importence on pamhugsfoss. Usmle Source uses this approach using PAM HUGS FOSS in all the cases which is very useful

now on ur manners
1 point for knocking on door
1 point for behaviour in general ( was he nice)
1 point for washing hands
1 point for draping
1 point for asking permission before examination
1 point - were u able to understand him

and finally 1-4 points for proper physical examination( which i doubt sp knows a lot abt)

finally there is a q like do u like the doctor and will u like to visit him again

so guys u have to practice according to this. sp has to be happy with u and u should cover his points rather than being an excellent doctor.

this may sound an exagerration but i think even a non medico can pass thsi exam becuz it is not a test of ur medical knowledge but ur behavior. The Mnemonic based approach using LIQOR AAA and PAM HUGS FOSS of usmlesource can really make the difference since most people fail in data gathering! Best of luck for you guys!

Secret to passing Step 2 CS: Go to a US Medical School, Speak English, Have had at least one meaningful inter-personal relationship in your life on which you have learned social skills.

 

[avicena25]

To Guy incognito:
I know, but the breakdown is way TOOOO general to give me a clear idea. That is something that I was thinking. It should be a little more explicative. Otherwise, it would be like an autopsy that tells only that the deceased died due to a hole in the body. PERIOD.
Do you think that would be accepted in a forensic investigation ?

 

[deleted109597]

Personally, throw all of this out the window. If you speak English natively, you have a 97% chance of passing on your first try. Unless you seriously have interpersonal skill issues, it isn't worth worrying about. Remember, the test is on professionalism, not on knowledge.
That being said, I find it a crock that I pay over $1000 to take a test where the damn SP doesn't know what way her elbow should jerk when I perform a triceps reflex.

 

[driedcaribou]

and LIQOR AAA ?????


thanks for all

L Location of the pain/symptoms
I Intensity of the pain/symptoms
Q Quality of the pain/symptoms
O Onset and precipitating factors
R Radiation
A Associated symptoms
A Alleviating factors
A Aggravating factors

 

[avicena25]

I agree that it is a robbery to charge so much money, but I beg to differ. I obtained good results in english, and personally, I don't think to have interpersonal issues. Still, I failed

 

[doc901333]

I failed the first time for data gathering as well. I didn't ask enough social/sexual questions. The best thing about this is, the programs I have interviewed with have lost all faith in the test. In fact, I even had one PD say that if I come to his program he won't force me to ask people what their favorite color is. The test is a joke. The sad thing is that everybody knows this except the NBME.

 

[OB1🤙]

The test is a joke. The sad thing is that everybody knows this including the NBME, which is laughing all the way to the bank.

Fixed your post.

 

[doc901333]

thanks for correcting me.

 

[Rocky2007]

Listen - if you're relying on PAM HUGS or whatever the crap this thing is to pass step 2 cs then you're already screwed from the get-go. It seems straightforward to me...ask everything you need to write a patient note i.e. HPI ROS, ALL, etc, be nice, speak english, and I doubt it will be too hard to pass CS. If you look at the usmle website 96% of US med students pass...so it can't be that bad...at least I hope not.

 

[blackboxmd]

Hi,
In the normal clinical setting, you have a H and P with some of the items printed out to organize the data collection.

I agree that it is not difficult to pass this exam but I think most people would feel comfortable with a Mnemonic so that you do not have to worry about forgetting to ask any important things in the history. PAM HUGS FOSS and LIQOR AAA are such Mnemonics. Which ever method you use, it is OK as long as you get all the details you need to since the SP checks these items.

 

[blackboxmd]

One important part of the step 2 CS exam that is actually evaluated by MD's and not by the SP's is the patient note. However, many people go the CS exam without practicing the concize patient note you are supposed to write. Many end up rushing it and missing important details.

This is partly because none of the courses so far has any software to practice the cases. UsmleSource has a free software available as part of the guest cases which you can use to practice any case free of charge.

You should at least practice 10-11 cases (i.e. one set of cases) before you go for the test. Do not ignore this fact and risk failing. Practice makes perfection!

Please go to this url for free PN practice software

http://www.usmlesource.com/guest/patient_encounter s/case1.html

One other thing that most people may not realize is that they can type this PN in the time given as it makes it more legible. See how you do timing it!

 

[tomatoattack]

Aren't you practicing this thing every time you do an H&P in your clinical years? You guys dont have how to do an H&P memorized? That seems crazy to me, it isnt that complicated, no need for stupid gimmiky pnemonics. I havent dont it yet, but i never thought that it would be something to study for.

 

[mt.everest]

Step 2 CS is difficult for IMGs for the following reasons:
- For many IMGs, Engish is not their mother-tongue. It has been seen that 60% of all the IMG failures is due to language. Language difficulty leads to practical mistakes as well. We have been studying all our life in English but most of us (IMGs) have problems in spoken English. That is why, English speaking people have advantage over non-english speaking folks. Nonetheless, I have no grudges for my language not being the international language or for my country not being as developed as the USA. I love English language and in fact, I am an avid reader of English literature.
- In developing countries (from where most of the IMGs come from), there are hordes of problems every where: governance, sanitation, education....the list can run a mile. Hospitals, including Universitiy hospitals, are overcrowded with patients. A doctor in an OPD is compelled to see 10 or more patients per hour. It's not practical to go through the standard ritual of patient encounter--greeting, taking permission before examination......Even if we ask a patient for permission to examine him/her, he/she will find it absurd. Many of our patients are illiterate and we have to judge and do what is the best for them without asking any questions.
The above scenario is true for at least my country. In our medical school, we read British and American textbooks. Despite that we are deeply influenced by our unsystematic interpersonal interaction. If I want to enter the US GME, I can not afford to not know the culture of that country. Doctor-patient relationship is a part of the culture. I am trying to adapt to the ways of a US medical graduate. To cite an example, I am learning to wash my hands before and after examining a patient. I think PAMHUGSFOO, LIQOR AAA and the clues given in the starting thread will be USEFUL to americanize (or westernize if you like) my interpersonal skills and systematic data collection. Now I hope AMGs will not be surprised to find an IMG beating his brains for an exam that is so ridiculously easy for them.

I have CS after a few months and I am really on edge.

 

[OB1🤙]

Post deleted- my reply turned into another rant against CS. We all know it's dumb for MD and DO students to have to take it, I'll leave it at that.

 

[Tired]

Post deleted- my reply turned into another rant against CS. We all know it's dumb for MD and DO students to have to take it, I'll leave it at that.

Yes, it's stupid that AMGs have to take this test. But obviously it was designed to weed out non-English speaking applicants before they have the chance to wreak havoc in our health system.

In my perfect world, CS would be mandatory for all foreign students/residents, and they would set the bar a little higher than they do now. There are certainly residents floating around now who, despite their sterling academic credentials and brilliant minds, have no business in our clinics and hospitals, because no one can understand a damn thing they say.

 

[deleted113029]

Yes, it's stupid that AMGs have to take this test. But obviously it was designed to weed out non-English speaking applicants before they have the chance to wreak havoc in our health system.

In my perfect world, CS would be mandatory for all foreign students/residents, and they would set the bar a little higher than they do now. There are certainly residents floating around now who, despite their sterling academic credentials and brilliant minds, have no business in our clinics and hospitals, because no one can understand a damn thing they say.

😕 There has always been a clinical exam for FMGs. The CS was intended for US seniors in response to complaints by FMGs that US seniors did not have to take a similar exam. Correct me if I'm wrong.

 

[blackboxmd]

Yes, it's stupid that AMGs have to take this test. But obviously it was designed to weed out non-English speaking applicants before they have the chance to wreak havoc in our health system.

In my perfect world, CS would be mandatory for all foreign students/residents, and they would set the bar a little higher than they do now. There are certainly residents floating around now who, despite their sterling academic credentials and brilliant minds, have no business in our clinics and hospitals, because no one can understand a damn thing they say.

Hi, I respectfully disagree with you that English is the only thing CS is for. And also, it is not just FMG's that have problems with history taking or physical exams. In fact, many of the FMG's are better in those skills since they are trained in areas where they do not have access to a lot of testing like in the West. Since starting the CSA, the test has evolved to be much more than a test of English!

 

[blackboxmd]

HI Mt Averest,
I agree with you that IMG's are trained in a different setting where there are more compelling problems than in the West. However, IMG's can adapt to any circumstance and having seen 10 patient's in an hour, you can see 2-3 patients easily here. Just need to learn more about some of the cultural and communication related issues and over time, you will get it. 40% of the US doctors are IMG's and many of them have demonstrated that they can adapt and excel!

 

[blackboxmd]

Dear colleague, I took the frikking exam in September, I have been reviewing your message, and I believe that I followed the OGS, MOGS, HOGS, and LOGS.
In spite of that, I FAILED. Any other explanation ?

Hi,
I think it might help to practice the cases (Either UsmleSource, UW or any other course) with a friend and both of you critic each other. Also, you may want to try a live course to intereact with live SP's. Do not get discouraged, you will make it!

 

[OB1🤙]

Since starting the CSA, the test has evolved to be much more than a test of English!

You're right, it also tests whether or not you can successfully wash your hands, drape a patient, carry a conversation, and complete a medical interview without physically or verbally assaulting someone. I'm so glad it's there!

 

[Pox in a box]

The main problem in passing step 2 cs is that i think we don"t know what are the criteria on which we are monitored.

my experience is that i studied for 2 weeks and the last 7 days made me pass when i met a friend who had taken usmlesource.com's coaching. He allowed me to see the cases with him. We also practiced together and found out and corrected our mistakes. so practcing is the key.

there are a few points and sp marks u
bad average good excellent

history of chief complaint (1-5 point for this depending on the cheif complaint)

pamhugsfoos each carry 1 point (so around 7 points for them)

so we have to place a lot of importence on pamhugsfoss. UsmleSource.com uses this approach using PAM HUGS FOSS in all the cases which is very useful

now on ur manners
1 point for knocking on door
1 point for behaviour in general ( was he nice)
1 point for washing hands
1 point for draping
1 point for asking permission before examination
1 point - were u able to understand him

and finally 1-4 points for proper physical examination( which i doubt sp knows a lot abt)

finally there is a q like do u like the doctor and will u like to visit him again

so guys u have to practice according to this. sp has to be happy with u and u should cover his points rather than being an excellent doctor.

this may sound an exagerration but i think even a non medico can pass thsi exam becuz it is not a test of ur medical knowledge but ur behavior. The Mnemonic based approach using LIQOR AAA and PAM HUGS FOSS of usmlesource can really make the difference since most people fail in data gathering! Best of luck for you guys!

Are you either (a) someone who works for USMLESOURCE.COM or (b) the creator of the site and are trying to get more funds in your bank account? It's fishy that most of your posts are name-dropping this site.

 

[avicena25]

To all my colleagues, I need your help:
I have taken the frikking CS test three times, one in Philadelphia and two in Atlanta. I failed in both.
Last time, at least I could pass the physical exam and medical notes component, that I had failed so far. Now they flunked me in the Communications subcomponent for a very narrow margin.
Somebody told me to write on the board they give you the mnemonic of the OGS, BOGS, LOGS, MOGS, HOGS, but they stopped me. Not allowed until they give the signal to begin.
My question: Where is the best place to take it ? The easiest ?
Somebody knows any recent news about this ?

 

[RockShox]

I agree that it is a robbery to charge so much money, but I beg to differ. I obtained good results in english, and personally, I don't think to have interpersonal issues. Still, I failed

Most of this post follows no proper grammatical English standard that I recognize.

 

[LAZYGUY]

Most of this post follows no proper grammatical English standard that I recognize.

🙄👎

 

[MeowMix]

Listen - if you're relying on PAM HUGS or whatever the crap this thing is to pass step 2 cs then you're already screwed from the get-go. It seems straightforward to me...ask everything you need to write a patient note i.e. HPI ROS, ALL, etc, be nice, speak english, and I doubt it will be too hard to pass CS. If you look at the usmle website 96% of US med students pass...so it can't be that bad...at least I hope not.

Ah, grasshopper, it's easy to be confident when you haven't taken the stupid thing yet. You haven't had the experience of meeting SPs with vague complaints that get a huge wide ddx...then let's see if you remember to ask and do all the things you're supposed to do, with a total time of only 15 minutes in the room. Let's just say it's easy to forget something that you've done hundreds of times with real patients, and any mnemonic that saves you $1000 for the retake is worth it.

4% is a big number if you're one of those people!

 

[mjl1717]

Most of this post follows no proper grammatical English standard that I recognize.

That was funny as hell..

But in all seriousness, if one is to talk about step 2 csa on this particular thread... He or she should only use proper grammar or be the combined reincarnation of William Shakespeare and William Osler!!!

 

[MacGyver]

In my perfect world, CS would be mandatory for all foreign students/residents, and they would set the bar a little higher than they do now. There are certainly residents floating around now who, despite their sterling academic credentials and brilliant minds, have no business in our clinics and hospitals, because no one can understand a damn thing they say.

Damn straight. Its very easy to come here as an FMG and go thru all the hoops and still speak English so badly that virtually nobody can understand you. Whatever bars they are setting for language requirements, they are not high enough.

 

[MacGyver]

😕 There has always been a clinical exam for FMGs. The CS was intended for US seniors in response to complaints by FMGs that US seniors did not have to take a similar exam. Correct me if I'm wrong.

It had nothign to do with FMGs.

The reason the CS became required for USMGs is because a bunch of ivory tower liberal fools in academic medicine issued a judgement from their throne room that US med students were "not compassionate" enough and didnt communicate as well as they wanted.

The NBME considered this idea, realized they could make a ****load of money from it, and here we are.

 

[poserboarder]

During step 2-cs, who actually grades you? Are the simulated patients the examiners, or are the SPs just actors and there is an actual examiner also in the room to evaluate how well you do??

 

[mideis79]

I am an American born IMG that did clinicals the states. Sadly enough, I failed this test twice. The first time I didnt take it seriously because of my clinical experience. I failed in the ICE component, Passed CIS and SEP easily. Having no direction where I went wrong, I thought it was purely ddx. I was wrong. I failed it again in the same area.

In clinicals, it was a quick h&p and SOAP note. My attendings and residents ok'd my methods. Maybe one or two additions that where not major. Took Kaplan and the only insight I gained from them was "where is the pertinent negatives and you have sloppy hand writing" !!!

You HAVE TO PUT pertinent negatives in your pt notes. I am not use to that. Its a POINT system so write as much as you think. Order every test know to man. DDx make sure the first one is the most likely and then list the rest.

Now I am on the edge of being kicked out of the match because of this test. 😡

 

[71263]

Dear colleague, I took the frikking exam in September, I have been reviewing your message, and I believe that I followed the OGS, MOGS, HOGS, and LOGS.
In spite of that, I FAILED. Any other explanation ?

'

Were any of the below missing?

Secret to passing Step 2 CS: Go to a US Medical School, Speak English, Have had at least one meaningful inter-personal relationship in your life on which you have learned social skills.

Personally, throw all of this out the window. If you speak English natively, you have a 97% chance of passing on your first try. Unless you seriously have interpersonal skill issues, it isn't worth worrying about. Remember, the test is on professionalism, not on knowledge.

 

[MacGyver]

I take this bad boy next week. Can I get some verification that on your writeup you need to order every test in the book?

If I have a diagnostic workup thats 15 items long will they take off points?

 

[lord_jeebus]

I take this bad boy next week. Can I get some verification that on your writeup you need to order every test in the book?

If I have a diagnostic workup thats 15 items long will they take off points?

You are limited to 5 items (including such things as "rectal exam") in your plan, and 5 differential diagnoses. Some lab tests like CBC can be consolidated under that title, but "Chem panel" can not.

 

[rhmtascp]

Most of this post follows no proper grammatical English standard that I recognize.

If your grammar would be correct, you would write something like this. "Most of these posts follow no proper grammatical English standard that I recognize"

Also, standard is synonymous to proper, so no need to be redundant here; you might want to say then: "Most of these posts follow no grammatical standard that I recognize" Notice I have duly omitted the word "English" as I do not see any other languages being written here, and indeed the issue at hand is English. Get yourself together before you turn yourself into a hypocrite. Cheers!

 

[bobmarley77]

Is usmlesource still working? I can't access the site!???

 

[Ypo.]

If your grammar would be correct, you would write something like this. "Most of these posts follow no proper grammatical English standard that I recognize"

Also, standard is synonymous to proper, so no need to be redundant here; you might want to say then: "Most of these posts follow no grammatical standard that I recognize" Notice I have duly omitted the word "English" as I do not see any other languages being written here, and indeed the issue at hand is English. Get yourself together before you turn yourself into a hypocrite. Cheers!

This post gets the award for the most dense in the thread.




But seriously, I have a question.

Anyone have a link for which medical abbreviations are OK to use in your PN for the CS exam? I have a book that lists a few, but the list seems pretty short.

Otherwise I have to break myself of a few habitual shorthand notations I have picked up from the hospital I'm based at.

 

[lord_jeebus]

This post gets the award for the most dense in the thread.




But seriously, I have a question.

Anyone have a link for which medical abbreviations are OK to use in your PN for the CS exam? I have a book that lists a few, but the list seems pretty short.

Otherwise I have to break myself of a few habitual shorthand notations I have picked up from the hospital I'm based at.

There's a list of abbreviations at the station where you write the note. In addition, the graders (who are physicians) are supposed to give credit for any abbreviations they know, so obvious ones like PERRL should be fine.

 

[Ypo.]

Found this list of approved abbreviations on the USMLE website (unfortunately, they say it is "not complete".)

yo year-old
m male
f female
b black
w white
L left
R right
hx history
h/o history of
c/o complaining of
NL normal limits
WNL within normal limits
∅ without or no
+ positive
- negative
Abd abdomen
AIDS acquired immune deficiency syndrome
AP anteroposterior
BUN blood urea nitrogen
CABG coronary artery bypass grafting
CBC complete blood count
CCU cardiac care unit
cig cigarettes
CHF congestive heart failure
COPD chronic obstructive pulmonary disease
CPR cardiopulmonary resuscitation
CT computed tomography
CVA cerebrovascular accident
CVP central venous pressure
CXR chest x-ray
DM diabetes mellitus
DTR deep tendon reflexes
ECG electrocardiogram
ED emergency department
EMT emergency medical technician
ENT ears, nose, and throat
EOM extraocular muscles
ETOH alcohol
Ext extremities
FH family history
GI gastrointestinal
GU genitourinary
HEENT head, eyes, ears, nose, and throat
HIV human immunodeficiency virus
HTN hypertension
IM intramuscularly
IV intravenously
JVD jugular venous distention
KUB kidney, ureter, and bladder
LMP last menstrual period
LP lumbar puncture
MI myocardial infarction
MRI magnetic resonance imaging
MVA motor vehicle accident
Neuro neurologic
NIDDM non-insulin-dependent diabetes mellitus
NKA no known allergies
NKDA no known drug allergy
NSR normal sinus rhythm
PA posteroanterior
PERLA pupils equal, react to light
and accommodation
po orally
PT prothrombin time
PTT partial thromboplastin time
RBC red blood cells
SH social history
TIA transient ischemic attack
U/A urinalysis
URI upper respiratory tract infection
WBC white blood cells