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Old 10-06-2012
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Question Repeat Symptoms in Differentials

Im currently studying for CS.Now, with a new format, said to list 3 differentials and to each of them have to add 3 history signs and 3 physical. Ive got into a problem, they might repeat each other! For example, case 4 from FA says about pt with Inf.Mononucleosis (diff. with HIV and Pharyngitis).What Ive got looks like that:
IM- history- sore throat, discomfort in LUQ, fatigue
physical-cervical lymphoadenopathy, tenderness in LUQ and fever

HIV-history-multiple sex partners, hx of STD and....? sore throat for 2 weeks? again?
physical-fever again?.., cervical lymphoadenopathy ? again?and weight loss(if you know weight from previous visit)

Pharyngitis- history-sore throat, discomfort in the neck, fatigue
physical-fever,cervical lymphoadenopathy,possibly redness of pharynx

What do you guys think? Any suggestions? Does it look right to you?
My exam in Jan 2013, Im thinking about SP via Skype
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Old 10-07-2012
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According to sample note on the USMLE website and sample notes that CSE video has, it is perfectly fine to repeat some Hx points in each of three DDx.
You can write "Sore throat for 2 weeks" to support Viral pharyngitis, acute HIV and mono. Other findings will vary though, like you will add Hx of LUQ pain for mono, or weight loss and fever for HIV.
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marina99 (10-07-2012)
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Old 10-07-2012
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Of course you can repeat
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Old 10-21-2012
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Default Definitely

Quote:
Originally Posted by marina99 View Post
Im currently studying for CS.Now, with a new format, said to list 3 differentials and to each of them have to add 3 history signs and 3 physical. Ive got into a problem, they might repeat each other! For example, case 4 from FA says about pt with Inf.Mononucleosis (diff. with HIV and Pharyngitis).What Ive got looks like that:
IM- history- sore throat, discomfort in LUQ, fatigue
physical-cervical lymphoadenopathy, tenderness in LUQ and fever

HIV-history-multiple sex partners, hx of STD and....? sore throat for 2 weeks? again?
physical-fever again?.., cervical lymphoadenopathy ? again?and weight loss(if you know weight from previous visit)

Pharyngitis- history-sore throat, discomfort in the neck, fatigue
physical-fever,cervical lymphoadenopathy,possibly redness of pharynx

What do you guys think? Any suggestions? Does it look right to you?
My exam in Jan 2013, Im thinking about SP via Skype

Yes you can repeat and SHOULD repeat to make your pt note more complete. You should write all the History and Physical findings that can match your differential. For some of my cases the Differentials had ALL the same physical and history findings and I passed with no problems. Just make sure you DO NOT add something that would NOT support your differential.
Good Luck!
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