Step II step 2 CS / step 2 CK question

[drake19]

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Hi everyone: just 2 quick questions for step 2 CS

1) For step 2 CS - is it necessary to do the cardiovascular exam with patient lying down and sitting up - I saw this on USMLEWORD for step 2 CS

2) For step 2 CS - did you ask the patient to lower their entire gown (i.e. woman) exposing her bra for the cardiovascular exam or do you ask her to lift up her gown and left breast so you can auscultate - they did this in USMLEWORLD (dropped the entire gown to waist for cardiovascular exam but for a guy)

 

[jakeislove]

I didn't expose more than necessary for the physical exam. Sitting with nothing but a bra or topless would be uncomfortable for most patients.

If there was a reason to listen to their tricuspid valve (for example): I'd ask permission to untie the gown, untie it but keep a grip on the gown so it didn't fall too far, listen to the valve, and re-tie the gown afterwards. Generally, I'd say "let me tie this back up so you don't get cold".

We probably underestimate the importance of draping, and how sitting around exposed affects the patient.