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I've been reading FA CS and I'm just wondering... did anyone perform any of these maneuvers like Dix-Hallpike for nystagmus or orthostatic BP? Thanks.
Step 2 CS - Quick question
- Thread starter pardonnemoi
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Absolutely not! I mean, maybe these things would have been called for, but I refused to do them. To date, I haven't had a patient w/ vertigo (just didn't come up in my 3rd year) and so I haven't learned the Dix-Hallpike maneuver - I tried to look it up, but I wasn't going to have my 1st go at it be during a graded exam! Similarly, I haven't done orthostatics because at the hospitals I worked at they were done by nursing staff. Besides, actual orthostatics are supposed to be something like: lay for 5-10 min, take BP/pulse, sit up for 2-3 min, take BP/pulse, then stand & take BP/pulse right away - that's too much time to be expected to be done by a med student in a timed 15" encounter. That's just my opinion 
Mind you, I haven't gotten my score back yet, so take my opinion w/ a grain of salt!
Mind you, I haven't gotten my score back yet, so take my opinion w/ a grain of salt! Orthostatic BP: you dont have time for it, but tell the patient that you are going to perform it. Also include it in your Work-up for the write up.
Dix-Hallpike: i didnt have any case they made me dizzy.. I was planning on doing it especially for benign Paroxysmal positional vertigo. it is can be diagnosistic and treatment (a modification of the exam).
- if you dont do it. tell the patient you are going to perform it and include it on your work-up write up.
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To clarify, I agree with commander. If you think it's relevant, tell them you'll do it & put it in your plan. If you have extra time & know how to do them, then go for it
I seriously believe the patients will not know what the heck you're doing if you even tried a Dix-Hallpike maneuver.
Orthostatic hypertension seems like it should be fair game, though. I'm not sure I'd want to try, though, since I wouldn't want to risk having to scrape my collapsed patient off the floor. :]
Orthostatic hypertension seems like it should be fair game, though. I'm not sure I'd want to try, though, since I wouldn't want to risk having to scrape my collapsed patient off the floor. :]
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Personally, I say it's probably lower yield than ensuring you finish the interview.
I tried a similar physical exam maneuver as part of one of my exams and ran out of time for that particular patient and was unable to close the interview as a result. I suspect I lost more points by failing to close the interview than I would have by omitting that particular time consuming maneuver.
Still waiting on my score, hopefully it didn't kill me.
I tried a similar physical exam maneuver as part of one of my exams and ran out of time for that particular patient and was unable to close the interview as a result. I suspect I lost more points by failing to close the interview than I would have by omitting that particular time consuming maneuver.
Still waiting on my score, hopefully it didn't kill me.
