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USMLE Step 2 CS Forum USMLE Step 2 CS Discussion Forum: Let's talk about anything related to USMLE Step 2 CS exam


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  #1  
Old 12-29-2009
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Stethoscope Patient Vitals

I know that they give the vitals on the doorway info.
But is it a possible scenario to recheck them ourselves like for example a patient with hypertension and we have to measure the blood pressure.
Anyone of you faced such an SP?
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  #2  
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Originally Posted by Calymato View Post
I know that they give the vitals on the doorway info.
But is it a possible scenario to recheck them ourselves like for example a patient with hypertension and we have to measure the blood pressure.
Anyone of you faced such an SP?
Gear up and get ready for all kind of things to happen in cs, though 11 would be exactly the ones you will practice, so find a strategy to take care of those 11, and once you have aced them, think of eccentric things, Its just my way of doing things, it works, so I suggested......
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Old 12-29-2009
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Originally Posted by accurate View Post
Gear up and get ready for all kind of things to happen in cs, though 11 would be exactly the ones you will practice, so find a strategy to take care of those 11, and once you have aced them, think of eccentric things, Its just my way of doing things, it works, so I suggested......
Sorry ... I didn't get you. Do you mean that it's possible to have such an SP!
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Originally Posted by Mahir View Post
Sorry ... I didn't get you. Do you mean that it's possible to have such an SP!
yes , some eccentric thing demanded on door way information , or the one whose diagnosis you may not be able to make out with the kind of history he gives..... or little difficult patient, you can have anything.... though i could really get what you are really asking, i am assuming, that you are asking if you can get SP who is not behaving the way you expect him to....
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yes , some eccentric thing demanded on door way information , or the one whose diagnosis you may not be able to make out with the kind of history he gives..... or little difficult patient, you can have anything.... though i could really get what you are really asking, i am assuming, that you are asking if you can get SP who is not behaving the way you expect him to....
My question and I think Calymato question is this,
Can we see a patient in whom rechecking the blood pressure during the encounter is crucial. Like for example they put a sphygmomanometer in the exam room and the SP tells please doctor take my bp.
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Originally Posted by Mahir View Post
My question and I think Calymato question is this,
Can we see a patient in whom rechecking the blood pressure during the encounter is crucial. Like for example they put a sphygmomanometer in the exam room and the SP tells please doctor take my bp.
yes, can happen,,,,
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Old 12-29-2009
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Default vitals in the cs exam

Accurate is 100% correct you will find unexpected scenarios in the cs exam.

Its good to talk to someone before taking the exam so you can go over all the details that you are unsure about,

In the orientation before you take the exam they will tell you, that if the vitals are high or low it is your option to retake them, however the patient note must reflect the vitals on the door.

I think retaking vitals can be time consuming and may not be directly related to the patients chief complaint. Say you have an SP with HTN and his bp is 158/90 but he is there because of poison ivy, what to do? check for the chief complaint.

In my exam at least three SP had questionable vitals, like a fever, low blood pressure, and increased heart rate.

Naturally I did chest and heart exam in every case, however I did not recheck the vitals but I did note the doorway vitals information on my patient note under vitals.

Check out accurate for cs counseling before you take the exam and if you do that csevideo will give you a free week of video or audio and this will be the perfect recipe to ace the CS.

good luck and happy holidays
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In regard to patients vital signs
I have a question, should we write them down in the draft paper so that then we'll write them exactly as they are in the PN?
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HI,

yes you can write them down on the draft paper and write them exactly as you see them on the doorway information in your pn.

you are allowed to check the doorway information once you have exited the room

I suggest spending at least one minuet outside the door before knocking to collect your thoughts, come up with differentials and view the vitals.

good luck
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Quote:
Originally Posted by Sahar View Post
In regard to patients vital signs
I have a question, should we write them down in the draft paper so that then we'll write them exactly as they are in the PN?
As csevideo said, you have the chance to review the doorway info while you are writing your notes.
Download the official orientation video from USMLE.org and view the video carefully and you'll see that they mentioned this point.
The download link is this
http://download.usmle.org/2010/USMLE_Video.zip
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Old 01-05-2010
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Default CS Information is clear about this

Here I quote for you the CS Information booklet that specifically talks about this issue of vital signs;
The examinee instruction sheet gives you specific instructions and indicates the patient's name, age, gender, and reason for visiting the doctor. It also indicates his or her vital signs, including heart rate, blood pressure, temperature (Celsius and Fahrenheit), and respiratory rate, unless instructions indicate otherwise. You can accept the vital signs on the examinee instruction sheet as accurate, and do not necessarily need to repeat them unless you believe the case specifically requires it. For instance, you may encounter patient problems or conditions that suggest the need to confirm or re-check the recorded vital signs and/or perform
specific maneuvers in measuring the vital signs.
However, if you do repeat the vital signs, with or without additional maneuvers, you should consider the vital signs that were originally listed as accurate when developing your differential diagnosis and work-up plan.

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