CS Encounter closure when the diagnosis in unknown! - USMLE Forums
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USMLE Step 2 CS Communication Skills Step 2 CS Communication, Spoken English Proficiency, Language and Interpersonal Skills Discussion forum. CIS and SEP components of the USMLE Step 2 CS Exam.


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  #1  
Old 06-15-2011
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Show Teeth CS Encounter closure when the diagnosis in unknown!

Hi There,

I would like to know what should we say to the patient after finishing the PE when we don't know the diagnosis.

Thanks!
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Old 06-15-2011
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Arrow You should have some DDx

You should be able at least to know the differential diagnoses so then you can tell the SP about the possibilities.

But, if you don't have any clue (which is a rare occasion), you can say something like the following:
"Mr. Smith, your history and physical examination were inconclusive. We need to make further diagnostic testing in order we can reach to a possible diagnosis for your illness/symptoms" ... "Do you have any questions for me?" ...

Note) it's not a fatal mistake if you give a wrong diagnosis to the SP (they are not going to mark you on it and they are not trained on the diagnosis). But it's a big mistake if you don't give your conclusion to the SP, you have to say something.

-
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The above post was thanked by:
ellen_dinh (06-15-2011), harlesmd (06-15-2011), hhmortho (04-24-2012), Thrax_usmle (11-07-2014)
  #3  
Old 06-15-2011
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Default I agree

I agree..
its ok on the CS exam to not know the diagnosis,
The Sp doesnt give you a point for telling him/her the correct diagnosis, you are given a point for answering the question..

a good approach would be.. Based on what you have told me and physical i performed i will need to run some tests on you. once i have the results i will be in a better position to identify whats going on

The differential again carries only 6 points.. 2 for the right diagnosis and 1 point each for every correct differential..
Therefore this exam really is not testing your diagnostic capabilities but your approach towards the patient
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  #4  
Old 04-18-2014
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Default

Quote:
Originally Posted by SHICE View Post
I agree..
its ok on the CS exam to not know the diagnosis,
The Sp doesnt give you a point for telling him/her the correct diagnosis, you are given a point for answering the question..

a good approach would be.. Based on what you have told me and physical i performed i will need to run some tests on you. once i have the results i will be in a better position to identify whats going on

The differential again carries only 6 points.. 2 for the right diagnosis and 1 point each for every correct differential..
Therefore this exam really is not testing your diagnostic capabilities but your approach towards the patient

Hi guys i really need your opnion regarding my CS exam

i took a wk ago in chicago and problem was differentials in 5 out of 12 cases
for example

1) case of fatigue i could not come with any definite dx so i put like anemia due to underlying medical condition, fatigue due to stress at work etc

2) in case of Lou Gehrig's disease i put LUGUREIS disease and miss spelled it

EVERYTHING else like counseling case closure eye contact shaking hands answering challenging questions etc was ok BUT D/D were wrong in 5 out of 12 cases...

Will i still pass it??? plz help i am kinda really freaking out...
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