Step 2CS questions...whoohoo

[failureatlife]

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Taking it soon, just some logistical questions.

1. Introduce self as medical student or as a doctor?
2. Patient is in pain, lying on exam table as you walk in and says she's most comfortable in that position. Is it ok to just do the history there? I'm guessing yes since it's part of being empathetic.
3. Is it necessary to ask the full history for every patient? (asking about family history and occupation/home situation is a little irritating for a simple cold)
4. Is it necessary to counsel on smoking cessation and ask CAGE questions for every patient who smokes or drinks? And counsel during the history portion or during the closing?
5. When writing the note, you now need to specify the pertinent positives and negatives for the differential. If it's a 60y/o male with HTN, HLP, diabetes, CAD coming in with chest pain and you're suspecting an MI, can you write "older age" and "multiple risk factors" as pertinent positives?
6. Did you feel rushed with the 15 min time limit?
7. Is there any mini-break between patients? Like...5 minutes?
8. What's the extent of acronyms can we use on the note?
9. Can you use the CC as one of your pertinent positives (lol)? (e.g. 42 y/o F with RUQ pain, suspicious for pancreatitis vs. cholecystitis, can you put down RUQ pain down as a reason for your ddx?)

Lots of questions, sorry! Don't want to drop another grand for this test.

 

[EaglesAllDay]

Taking it soon, just some logistical questions.

1. Introduce self as medical student or as a doctor?
2. Patient is in pain, lying on exam table as you walk in and says she's most comfortable in that position. Is it ok to just do the history there? I'm guessing yes since it's part of being empathetic.
3. Is it necessary to ask the full history for every patient? (asking about family history and occupation/home situation is a little irritating for a simple cold)
4. Is it necessary to counsel on smoking cessation and ask CAGE questions for every patient who smokes or drinks? And counsel during the history portion or during the closing?
5. When writing the note, you now need to specify the pertinent positives and negatives for the differential. If it's a 60y/o male with HTN, HLP, diabetes, CAD coming in with chest pain and you're suspecting an MI, can you write "older age" and "multiple risk factors" as pertinent positives?
6. Did you feel rushed with the 15 min time limit?
7. Is there any mini-break between patients? Like...5 minutes?
8. What's the extent of acronyms can we use on the note?
9. Can you use the CC as one of your pertinent positives (lol)? (e.g. 42 y/o F with RUQ pain, suspicious for pancreatitis vs. cholecystitis, can you put down RUQ pain down as a reason for your ddx?)

Lots of questions, sorry! Don't want to drop another grand for this test.

Ill try to help you out...took my exam last month so still waiting for results...this should be some good karma ( )

1. Introduce yourself however you want....doctor is better imo....im dr. blahahah, the physician on duty today

2. Yeah, if the patient is lying down, take the history to the right or left of them whichever way the table is lined up....be empathic with your facial expressions and dont shake a patients hand who is having severe pain

3. Yes...you should ask everything for the most part...for ROS ask only things which are pertinent, but you should do PAMHUGSFOSS completely

4. You should counsel everyone who smokes. For drinking, you should only ask CAGE if they are drinking a significant amount.(think its more then 2/day for males and more then 1/day for females). Counsel whenver you'd like, I did mine at that same exact time because sometimes you may forget at the end.

5. Yes...but make sure you write out those multiple risk factors (HTN, DM, etc)

6. I didnt feel rush per say, I was able to get out before the time hit most tiems....but I also made some mistakes like Forgot to do this and that in select cases....you have suffcient time but it flies.....just make sure you do a focused exam....and always leave 2 minutes for closure no matter what, if you want to cut anything down it should be the Physical exam.

7. Its like a minute break...they tell you to press submit on your computer, and then move to your next station.

8. Use any many as you can....

9. Yes you can