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Old 03-08-2012
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Hammer and Otoscope Tongue Depressors in the CS encounter

are we allowed to use them or are they available during the exam?

I am currently studying and using CSE video, I think it maybe out of date or something, but during a throat problem I dont see them using tongue depressors or testing the gag reflex

I am an IMG, in the US are tongue depressors not routinely used?

thank you
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Old 03-11-2012
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do not use a tongue depressor or do the gag reflex because
a) it might not even be provided in the exam
b) you would be wasting time trying to get depressor.

using a light to inspect the mouth/pharynx is more than enough
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Old 03-11-2012
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Here's a quote from the official CS regulation:
With real patients in a normal clinical setting, it is possible to obtain meaningful information during your physical examination without being unnecessarily forceful in palpating, percussing, or carrying out other maneuvers that involve touching. Your approach to examining standardized patients should be no different. Standardized patients are subjected to repeated physical examinations during the Step 2 CS exam; 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.
You should interact with the standardized patients as you would with any patients you may see with similar problems. The only exception is that certain parts of the physical examination MUST NOT BE DONE: rectal, pelvic, genitourinary, inguinal hernia, female breast, or corneal reflex examinations. If you believe one or more of these examinations are indicated, you should include them in your proposed diagnostic work-up. All other examination maneuvers are completely acceptable, including femoral pulse exam, inguinal node exam, back exam, and axillary exam.
Another exception is that you should not swab the standardized patient’s throat for a throat culture. If you believe that this diagnostic/laboratory test is indicated, include it on your proposed diagnostic workup.
Excluding the restricted physical examination maneuvers, you should assume that you have consent to do a physical examination on all standardized patients, unless you are explicitly told not to do so as part of the examinee instructions for that case.

So it's better not to examine the throat and you can also avoid the ears (if there are not crucial for your diagnosis).

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drgokult (03-15-2012), mitsua (04-05-2012), rozirose (03-11-2012), rulz (03-15-2012)
Old 03-15-2012
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Thanks for the link!
Nothing is Impossible, the Word Itself says "I'm Possible"
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