Step 2 CS: Pertinent positive and negative findings for DDX?

[wazim87]

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Hi all,

Ive got my CS coming up soon, and this pertinent postitive and negative findings in the DDx portion is driving me nuts.

In the example patient note on usmle.org, it only writes the positives that we picked out during the HX and possible PE, that makes sense. But what are these negatives I am supposed to write?

Any clarification on the matter would be highly appreciated.

 

[username456789]

Part of being a good clinician and physician (and not simply a data collector) is identifying what is significantly present and significantly absent. In a patient who presents with, say, shortness of breath of new onset, a pertinent negative may be "no lower extremity edema." This presupposes you know enough to consider CHF as one cause of dyspnea in an elderly person who may or may not have a cardiac history.

This is the kind of thing you should have been developing all along during medical school.

 

[wazim87]

Part of being a good clinician and physician (and not simply a data collector) is identifying what is significantly present and significantly absent. In a patient who presents with, say, shortness of breath of new onset, a pertinent negative may be "no lower extremity edema." This presupposes you know enough to consider CHF as one cause of dyspnea in an elderly person who may or may not have a cardiac history.

This is the kind of thing you should have been developing all along during medical school.

Yes, I understand that, but for the purposes of this exam would I be writing that as a pertinent negative for CHF as one of my DDs?

 

[username456789]

Yes, I understand that, but for the purposes of this exam would I be writing that as a pertinent negative for CHF as one of my DDs?

Oh sorry, I guess I wasn't clear what you were asking.

I took CS before they apparently required you to write down pertinent positives/negatives, so I'm not much help here. Ignore my above post.

 

[swamprat]

I recently took CS and it doesn't rlly say pertinent positives or negatives its like supporting history and supporting physical findings. I think I wrote a pertinent negative once in the physical exam findings for something but most of the stuff was pertenent positives and mostly history because there r few physical exam findings they simulate in the actual test.

 

[tco]

Since most of the patients don't actually have whatever the disease is that they are portraying, I doubt that it's necessary to put "pertininent negatives." Unless you don't want to actually make a diagnosis, that is.