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  #1  
Old 12-27-2011
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Question HPI, ROS, and PE

Hello,
I just spent yesterday watching some videos and today I just saw the sample CSE video posted on their webpage and I have a question, well, a couple.
1. I get the HPI part, but in this video, where this woman comes in because of pain in an ankle after a fall while jogging, the doc asks the complete ROS...., I mean, I get if you have to ask for accomp. injuries, but everything? Is that necessary?
2. Also, they literally ask before EVERY exam, is that ok? is that ok? is that ok? Can we group that together a little bit or better to do it for EVERY single thing we perform?
3. In the sample video, the doc doesn't explore the painful ankle at ALL. I mean, I know we are not supossed to repeat or do any painful maneuver but not explore the principle complaint at all?

Sorry for the confusion here but this just seems so weird to me!
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Old 12-27-2011
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Also, do we test the gag reflex or is that a no?
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Old 12-29-2011
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do not do physical exam on painful joint
if you see pain say I am sorry I will not touch that again and ask to examing other joint. I reviewed this question also many times before cs exam and from most amg and passing img do not do pe on pain
say in pn unable to do pe due to painful join then put finding on other limb

I recommend follow everything you watch, I did this and passed already, to say is this ok over and over is considered empathetic and respectul attitude

sorry for grammar errors I have step one in 2 days so dont have much time
gl
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Old 01-02-2012
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Quote:
Originally Posted by dr_mhm View Post
Also, do we test the gag reflex or is that a no?
UW says gag reflex to be done only on comatose patients, hence I suppose we don't do it.
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Old 01-03-2012
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Quote:
Originally Posted by dr_mhm View Post
Also, do we test the gag reflex or is that a no?
Never do the Gag reflex, it's a fatal mistake.

The official USMLE Step 2 CS website specifically mentioned stuff that you should never do in the exam.
Here's a quote from the official USMLE bulletin
Quote:
it is critical that you apply no more than the amount of pressure that is appropriate during maneuvers such as abdominal examination, examination of the gall bladder and liver, eliciting CVA tenderness, examination of the ears with an otoscope, and examination of the throat with a tongue depressor.

Ref: http://www.usmle.org/pdfs/step-2-cs/content_step2cs.pdf
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Old 01-03-2012
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Quote:
Originally Posted by dr_mhm View Post
the doc asks the complete ROS...., I mean, I get if you have to ask for accomp. injuries, but everything? Is that necessary?
Please read here
Review of Systems (ROS): do we have to ask about it in detail?

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  #7  
Old 01-03-2012
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Quote:
Originally Posted by dr_mhm View Post
2. Also, they literally ask before EVERY exam, is that ok? is that ok? is that ok? Can we group that together a little bit or better to do it for EVERY single thing we perform?
It's better to ask with each and every exam.

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Old 01-03-2012
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Originally Posted by dr_mhm View Post
3. In the sample video, the doc doesn't explore the painful ankle at ALL. I mean, I know we are not supossed to repeat or do any painful maneuver but not explore the principle complaint at all?
Please read these two useful threads:
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