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  #1  
Old 10-18-2012
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Wink Random Tips for the CS exam: Q & A

Just starting a thread here to be more organized and help everyone out.
if anyone has any doubts, feel free to post here.
(have some free time on my hands, so will try to help asap. good luck everyone)


1- How to break up ur exam timing

pace urself well over the 15 minutes

1 minute - at the door - right the patients name (you WILL FORGET LATER), age and CC. roughly what Physical exam u think u will do. 2-3 differentials. the mneumonic. any irregular vitals.

knock-- TAKE A DEEP BREATH---go in

(total 14 minutes remaining)

next 5-6 minutes : history taking + first part of CIS stuff - bonding with the patient, validating feelings, reassuring, remaining calm etc.

(total 7-8 minutes remaining)

next 3-4 minutes : wear gloves, do a quick FOCUSED physical exam.

WHEN THE 5 MINUTE WARNING BELL RINGS YOU MUST HAVE ALREADY BEEN IN THE MIDDLE OF UR PHYSICAL EXAM. IF YOU Are still taking the history at this time --- STOP EVERYTHING YOU ARE DOING AND START YOUR PHYSICAL EXAMINATION.

(total 3-4 minutes remaining)
Final 3-4 minutes -- save it for discussion with the patients. YOu MUST DO THIS on atleast 10/12 patients. this counts alot towards the CIS component.

when they say "THIS PATIENT ENCOUNTER IS NOW OVER" -- leave right then. you are not graded for anything once this announcement is made. so even if said something brilliant to the SP you wont be graded for it. besides you will lose time from ur patient note if you stay back to stay stuff.


patient note:10 minutes -- starts IMMEDIATELY after the announcement "this patient encounter is now over" - so walk out fast!!
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  #2  
Old 10-18-2012
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2- LOOKING AT THE CLIP BOARD WHILE WRITING

look at the clipboard... as long as they are just glances.

just make sure u hv enough eye contact with the actual patient... and are not using the clipboard as an escape mechanism.


when the patient is talking --- flip over ur clipboard on ur lap/ hold it close to ur chest or abdomen---- hence consciously making an effort to no divert attention from the patient

when u decide the SP has said something u need to write --- tell him: "I AM PERIODICALLY GOING TO BE TAKING NOTES, BUT THAT IS JUST SO THAT I DON'T MISS ANY IMPORTANT INFO YOU GIVE ME. PLEASE BE ASSURED THAT U HAVE MY UNDIVIDED ATTENTION"
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  #3  
Old 10-18-2012
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3- IN WHAT ORDER DO I WRITE MY PATIENT NOTE

write it in this order:
1- History
2- Names of the differential diagnosis
3- Tests you will order
4- Physical examination
5- now use the copy/paste function to copy sentences from ur history and physical exam and past them into the boxes for justifications below the differential diagnosis


for every point FOR the diagnosis just put (+) and for every point against the diagnosis put (-)

FILL UP ALL THE SPACES BELOW UR FIRST DIFFERENTIAL DIAGNOSIS -- BELOW UR SECOND AND THIRD DIFFERENTIAL YOU CAN JUST PUT 2-3 AND THESE ARE ENOUGH.




while ordering tests on the patient note
never write - LFT, KFT, TFT etc

write in detail
for eg:
LFT = AST, ALT, Bilirubin - total/direct/indirect, prothrombin time etc
TFT - total t3, t4, FT3, FT4, TSH, TBIG, anti thyroidperoxidase ab.
so on and so forth.. will get u extra points.


use medical abbreviations ALOT in the patient note - cos it makes it seem more professional.

for eg :
PERRLA - pupils equal round reactive to light and accomodation (for HEENT)
BS + 4 Q = bowel sounds positive in four quadrants (for abdomen)
(-)m,r,g === NO murmurs, rubs or gallops (for cvs)
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  #4  
Old 10-20-2012
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Quote:
Originally Posted by shree
Hi Can you please tell us what you wrote on your blue paper.. My exam is on the 29th
Thanks
hey!
well i wrote exactly what i advised in the post above.

1- name of the pt. (+/- age of pt if relevant for counseling about vaccinations and preventive screenings)
2- any abnormal vitals
3- first 2 diagnosis that came to my mind with the CC.
4 - the name of the system i thought i would examine
5- the mnemonic.
SIQORA PAM HITS RUGS FOSS.



hope that helps!
good luck
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Old 10-20-2012
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However when you hear the Patient Encounter is now over do not Just walk out. The SP will take this as rude you should say something along the lines of "I am sorry I am being paged, we will continue later" or "I must answer that emergency call I am sorry" that will get graded as empathy towards your communication skills. Not all SP's will mark you down if you say nothing but many will find it rude. Good luck studying!
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Old 10-20-2012
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Quote:
Originally Posted by freebielady View Post
However when you hear the Patient Encounter is now over do not Just walk out. The SP will take this as rude you should say something along the lines of "I am sorry I am being paged, we will continue later" or "I must answer that emergency call I am sorry" that will get graded as empathy towards your communication skills. Not all SP's will mark you down if you say nothing but many will find it rude. Good luck studying!
hey so i didnt mean that you just walk out without saying anything!!
(sorry my bad .. shud hv made that clearer.)


also on the course they sorta advised against saying "im sorry im being paged" etc... cos it implies that the patient u are attending to currently has a lesser priority to you than another one (cos there is no real pt in danger outside).. also what if you have a case of a patient in acute pain/drug withdrawl/abuse etc... how will u justify saying im being paged?

instead say something like " i will just send the nurse in to take the blood to get the required labs done" (cos its a sort of closing)
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Old 10-23-2012
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Quote:
Originally Posted by Lotsahope View Post
Hey guys. A lot of resources (including Kaplan book and CS information booklet on the website) say that we should perfrom FOCUSED physical. And it is generally accepted by forum people that FA and CSE video have very extensive physicals.
Do you guys think that perfroming only focused exam (i.e. only examining joints in knee pain case) is a way to go? Or do we still need to try and at least auscultate heart and lungs in every case in addition to doing the relevant system exam?
I was trying to do a lot of physical in every case when practicing, but now I start thinking that maybe I should avoid it to feel more comfortable with closure and even maybe to leave couple extra minutes for PN? Does anyone know how much value the "not so relevant" system exam has on the SP checklist?

Recent test takers help is greatly appreciated.
you will get the most points on the SP checklist (the checklist that grades you) If you do a focused physical examination of the system you think is involved.


WHY TO DO ONLY A FOCUSED PHYSICAL EXAM?
because it will give u extra time to close and counsel the patient.
the most important thing on the new pattern is the CIS.

yes you can check stuff like -- pulse, pallor (both by examining the hands)

but personally i would advice against wasting time doing any other systems or general stuff -- it will get you maybe 2-3 extra points on the checklist.. but if you spend the time on counseling/summing up ur impression of the patient... you will hit more points on the checklist


save the time for counseling.





WHAT ALL TO COUNSEL ON? WHY DO I NEED EXTRA TIME


counsel on
1- workup - explain tests u will do
2 - explain the diagnosis
3- guide the patient thru smoking cessation/ alcohol cessation/ support groups/ exercise etc etc
4- Hidden concerns

EVERY patient will have something APART from the obvious case that u can counsel on... having time to go about that will get u the stars on the CIS part which is the hardest to pass.



WHAT IF MY PHYSICAL ISNT UPTO THE MARK?
you can still cover up in the patient note -- write a good history, good differentials, fill up all the stuff for the tests you will order etc.

if you lack a few check points in the physical exam.. you can still cover up for it in the Patient note.

however if u for some reason lack check marks in the CIS, there is no way to cover it up... so while with the SP - give it the MOST importance.
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Old 12-28-2012
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Wow. You got 3 stars? Great. Can you tell us more about patient notes. Are they looking for 1)too much history part or 2)they just want brief history in patient notes? What do they emphasize on most in patient notes?
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Old 12-28-2012
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Quote:
Originally Posted by mbbs2010 View Post
Just starting a thread here to be more organized and help everyone out.
if anyone has any doubts, feel free to post here.
(have some free time on my hands, so will try to help asap. good luck everyone)

1- How to break up ur exam timing

pace urself well over the 15 minutes

1 minute - at the door - right the patients name (you WILL FORGET LATER), age and CC. roughly what Physical exam u think u will do. 2-3 differentials. the mneumonic. any irregular vitals.

knock-- TAKE A DEEP BREATH---go in

(total 14 minutes remaining)

next 5-6 minutes : history taking + first part of CIS stuff - bonding with the patient, validating feelings, reassuring, remaining calm etc.

(total 7-8 minutes remaining)

next 3-4 minutes : wear gloves, do a quick FOCUSED physical exam.

WHEN THE 5 MINUTE WARNING BELL RINGS YOU MUST HAVE ALREADY BEEN IN THE MIDDLE OF UR PHYSICAL EXAM. IF YOU Are still taking the history at this time --- STOP EVERYTHING YOU ARE DOING AND START YOUR PHYSICAL EXAMINATION.

(total 3-4 minutes remaining)
Final 3-4 minutes -- save it for discussion with the patients. YOu MUST DO THIS on atleast 10/12 patients. this counts alot towards the CIS component.

when they say "THIS PATIENT ENCOUNTER IS NOW OVER" -- leave right then. you are not graded for anything once this announcement is made. so even if said something brilliant to the SP you wont be graded for it. besides you will lose time from ur patient note if you stay back to stay stuff.


patient note:10 minutes -- starts IMMEDIATELY after the announcement "this patient encounter is now over" - so walk out fast!!

Hello mbbs2010..ur posts were really helpful..u said complete hx in 5-6 minutes.Do u think we can complete hx in dat time.Any hints plz ?Do we have to ask very short sentenced and specific questions ?.U also mentioned abt validating feelings ?I did'nt get it..Can u plz explain ?
My exam is in Jan..Wat r ur suggestions Bro ?
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  #10  
Old 12-28-2012
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Quote:
Originally Posted by Sunny_99 View Post
Wow. You got 3 stars? Great. Can you tell us more about patient notes. Are they looking for 1)too much history part or 2)they just want brief history in patient notes? What do they emphasize on most in patient notes?
what i aimed for was a balanced patient note.
individual parts are not graded -- there is no longer a checklist.
it was graded depending on how it looked "on the whole" according to the usmle website when i took the exam

my advice -
1-use alot of medical abbreviations.
2- NEVER LEAVE ANY FIELDS BLANK --even the differential
3-be precise.



for the history for eg u dont need to put in subtitles..

eg: pt had pain
DONT PUT -- onset : gradual, Progress: increasing, Duration: 3 days etc

u'd rather write it as
PAIN : RUQ, 3d, sudden, colicky, intermittent, increasing, 9/10, non radiating, no aggrev/allev factors.

similarly for P/E - WILL ALWAYS BE NORMAL!
(except for maybe tenderness or skin changes)
So learn the format for every system and be very concise.

eg:
CVS:
S1S2 - WNL, non displaced apex,
(-) mrg, no jvd.


Abdomen:
No scars, skin changes. BS + 4 Q.
(-) tenderness, hsm

etc.
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Old 12-28-2012
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Quote:
Originally Posted by observe View Post
Hello mbbs2010..ur posts were really helpful..u said complete hx in 5-6 minutes.Do u think we can complete hx in dat time.Any hints plz ?Do we have to ask very short sentenced and specific questions ?
HEy. thank you.. and i am glad that i could be of help.

yes it is possible to as a complete hx in 5-6 minutes.

there is no longer a history checklist -- (like in the end of the FA cases)
so u can ask the hx only relevant to ur case...
however u will still ask a few related things in addition
for eg: GI/GU complaints, Sleep, Skin, addictions.

i found that with practice u cud really cut short the time by rephrasing ur questions in a more time efficient manner.



for eg:
while practicing out of habit i always asked -- any diarrhea? any constipation? etc etc
more efficient way to ask -- any change in ur bowel habits?
(saves the time for one more question and 1 more response)



also for the CAGE questions --u dont need to ask every single question.
just ask the eye opener question.. if the answer to that is YES.. then the answer to all the CAGE questions is yes.

if the answer is NO.. just ask for the "C" question.


in general ask atleast 2-3 open ended questions..
for eg: "tell me more about your ....." (whatever the chief complaint is)
or "how has your sleep been lately"
and for the rest of the questions be more focused/close ended.


but dont be JUDGEMENTAL.
for eg: never say --- "you dont smoke do you?" or "you dont drink, do you?"
never say "does ur pain radiate to your shoulder?" etc
(you get what i mean.)

be neutral.

" have u ever tried tobacco in any form?" "have u ever tried any form of alcohol"

"is your pain radiating?"
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  #12  
Old 12-28-2012
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Quote:
Originally Posted by observe View Post
.U also mentioned abt validating feelings ?I did'nt get it..Can u plz explain ?
validating the patients feelings and being empathic:

1-- saying simple things such as "ah-haan" "hmm" or just nodding ur head as the SP is talking.
(but dont say "OK" or "alright" .. cos its not OK most times and the SP might get offended)

remain engaged with the SP by repeating back to the SP all the points u have on ur blue sheet every 5-6 questions.. to show that u are attentive and interested in having all the right facts.
say "im just going to quickly repeat to you all the facts that i hv written down.. just to make sure that i didnt miss any important info u gave me. i want to be able to serve u to the best of my capabilities"

and after u say it back : eg " so uv had RUQ Pain, colicky, sudden , intermittent........... for 5 hours"
also ask "is there anything that i missed out or that u would like to add to this info"
----> here ur giving the SP a chance to open up and give u info saving u alot of time on asking other follow up questions. IF by this time u hv a good rapport with the SP - he will usually open up to you about questions u might hv forgotten to ask that might be relevant to the case!




2-- making sure the SP knows he/she is not alone.
"we find alot of patients under similar situations hv a similar response."
" but rest assured we at this facility are highly equipped to deal with cases such as yours. "
"As your doctor you and i are in this together and i will help you to the best of my abilities to get out of your current situation"


notice in the first sentence you are avoiding getting personal
u are avoiding saying "its ok" "its NORMAL" "its going to be alright" cos u dont know if any of that is true. but without saying anything much u are reassuring the SP that he is not alone and that there are alot of other people that might be going thru the same thing.

Last edited by mbbs2010; 12-28-2012 at 12:57 PM.
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  #13  
Old 12-28-2012
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Thanks mbbs2010.
Could you explain about this as i found it little confusing.
1)You said, " for every point FOR the diagnosis just put (+) and for every point against the diagnosis put (-)

USMLE website says, "Then, enter the positive or negative findings from the history and the physical examination (if present) that support each diagnosis.

They don't mention point against diagnosis.



2)Also what is the best way to show empathy?
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Old 12-29-2012
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Quote:
Originally Posted by Sunny_99 View Post
Thanks mbbs2010.
Could you explain about this as i found it little confusing.
1)You said, " for every point FOR the diagnosis just put (+) and for every point against the diagnosis put (-)

USMLE website says, "Then, enter the positive or negative findings from the history and the physical examination (if present) that support each diagnosis.

They don't mention point against diagnosis.

eg: if a differential is acute appendicitis but the patient doesnt hv fever u will write

(+) LLQ pain, acute, non radiating, 7/10, a/w Nausea and vomitting
(-) afebrile.

so the fact that the patient is afebrile might go against ur diagnosis.
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Quote:
Originally Posted by mbbs2010 View Post
eg: if a differential is acute appendicitis but the patient doesnt hv fever u will write

(+) LLQ pain, acute, non radiating, 7/10, a/w Nausea and vomitting
(-) afebrile.

so the fact that the patient is afebrile might go against ur diagnosis.

Hello mbbs2010..Can u plz tell me where can i find the abbreviations that can b used on the PN...If u have yours can u plz share them?....
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Old 12-30-2012
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Quote:
Originally Posted by observe View Post
Hello mbbs2010..Can u plz tell me where can i find the abbreviations that can b used on the PN...If u have yours can u plz share them?....
check the usmle website for accepted abbreviations on the CS exam
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  #17  
Old 04-23-2013
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Quote:
Originally Posted by mbbs2010 View Post
eg: if a differential is acute appendicitis but the patient doesnt hv fever u will write

(+) LLQ pain, acute, non radiating, 7/10, a/w Nausea and vomitting
(-) afebrile.

so the fact that the patient is afebrile might go against ur diagnosis.
Hi! your post has been very helpful to me I must tell you, thanks.
this issue of positive and negative findings, i find particularly confusing. and this example u used kind of confused me more. can u use another one? for instance if a differential is PUD and the murphy's sign is negative, can u put (-)murphy's as a supporting finding for the PUD?
also if it's a case like depression for eg, and there's nothing on phys exam to write, can u say "patient not in acute distress"? I'll appreciate ur quick response cos my exam is tmr and I still haven't resolved this in my head. thanks!
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Old 04-25-2013
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Following r very basic things to do in CS....it will help u pass even if u make few mistakes here n there.
-Be confidant (make sure not over confidant)
-SMILE, be very pleasant, make small talk while washing hands unless the pt is in severe pain.
-tell pt in severe pain that ur nurse will come and give him pain meds at the end
-be very attentive, maintain eye contact
-say sorry about their pain, loss or other discomfort. say "thats really good" when pt says he/she doesn't smoke, drink or drug. Say "glad to know" when pt says his family has no health problems
-READ door info carefully. whether pt has come to ED, routine clinic visit or phone! tell pt about disposition ( he needs to be monitored / admitted for further management / follow up)
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Old 04-27-2013
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Quote:
Originally Posted by mbbs2010 View Post
5- the mnemonic.
SIQORA PAM HITS RUGS FOSS.



hope that helps!
good luck
Can you please tell me what this mnemonic stands for??
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Old 04-28-2013
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Quote:
Originally Posted by mbbs2010 View Post
you will get the most points on the SP checklist (the checklist that grades you) If you do a focused physical examination of the system you think is involved.


WHY TO DO ONLY A FOCUSED PHYSICAL EXAM?
because it will give u extra time to close and counsel the patient.
the most important thing on the new pattern is the CIS.

yes you can check stuff like -- pulse, pallor (both by examining the hands)

but personally i would advice against wasting time doing any other systems or general stuff -- it will get you maybe 2-3 extra points on the checklist.. but if you spend the time on counseling/summing up ur impression of the patient... you will hit more points on the checklist


save the time for counseling.





WHAT ALL TO COUNSEL ON? WHY DO I NEED EXTRA TIME


counsel on
1- workup - explain tests u will do
2 - explain the diagnosis
3- guide the patient thru smoking cessation/ alcohol cessation/ support groups/ exercise etc etc
4- Hidden concerns

EVERY patient will have something APART from the obvious case that u can counsel on... having time to go about that will get u the stars on the CIS part which is the hardest to pass.



WHAT IF MY PHYSICAL ISNT UPTO THE MARK?
you can still cover up in the patient note -- write a good history, good differentials, fill up all the stuff for the tests you will order etc.

if you lack a few check points in the physical exam.. you can still cover up for it in the Patient note.

however if u for some reason lack check marks in the CIS, there is no way to cover it up... so while with the SP - give it the MOST importance.


so we dont need a HEENT and GEN exam and hear and lung in each case as is it rumored ????
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  #21  
Old 04-28-2013
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Quote:
Originally Posted by palindrome View Post
Can you please tell me what this mnemonic stands for??
I'm guessing:

(Pain history...)
Site
Intensity
Quality
Onset, Frequency, Duration, Progression
Radiation
Alleviating/Aggravating factors, Associated symptoms

Past medical history
Allergies
Medications

(I'd put an S here for Surgical History)

Don't know what HITS RUGS stands for. Probably the review of systems.

Family
Obstetric
Social
Sexual

Please confirm.

Last edited by greater_infinity; 04-28-2013 at 08:22 PM.
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  #22  
Old 04-28-2013
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thank you, helpful tips
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  #23  
Old 04-29-2013
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sorry for the delayed replies guys.

was a little caught up with stuff but Will be online more now on.

as for the questions -
S - site
I - Intensity
Q - quality
O - Origin/duration/progress
R - radiation
A - aggrev factors
A - allev factors
P - Past Med Hx
A - Allergies
M - Current Medications
H - H/O hospitalizations
I - H/O Immunizations
T - H/O trauma
S - Past Surgical History
R - ROS
U - GU complaints
G - GI complaints
S - SLee[
F - Family hx
O - OBGYN hx
S - Social hx
S - Sexual Hx
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  #24  
Old 04-29-2013
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Quote:
Originally Posted by hamzarayes View Post
so we dont need a HEENT and GEN exam and hear and lung in each case as is it rumored ????
Not unless the case requires it - OR you have extra time at the end and want to go back to it to just increase stuff in your Patient Note.
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  #25  
Old 05-03-2013
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Quote:
Originally Posted by mbbs2010 View Post
sorry for the delayed replies guys.

was a little caught up with stuff but Will be online more now on.

as for the questions -
S - site
I - Intensity
Q - quality
O - Origin/duration/progress
R - radiation
A - aggrev factors
A - allev factors
P - Past Med Hx
A - Allergies
M - Current Medications
H - H/O hospitalizations
I - H/O Immunizations
T - H/O trauma
S - Past Surgical History
R - ROS
U - GU complaints
G - GI complaints
S - SLee[
F - Family hx
O - OBGYN hx
S - Social hx
S - Sexual Hx
On reviewing the PN in FA, I realized that some female patients don't have an obstetric or menstrual history. DOes it mean that it can be scrapped if probably unrelated to the chief complaint?
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  #26  
Old 05-03-2013
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Quote:
Originally Posted by greater_infinity View Post
On reviewing the PN in FA, I realized that some female patients don't have an obstetric or menstrual history. DOes it mean that it can be scrapped if probably unrelated to the chief complaint?
I think if the female is post-menopausal age then you can skip it. Also, if her symptoms (Cough, CP, SOB) are unrelated to any OB history then you can skip it. I usually make it a point of at least asking about her LMP and skipping the rest if the complaint is unrelated. IF her LMP was more than four weeks ago then you can probe more into OB history.
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  #27  
Old 06-23-2013
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Very useful post.
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  #28  
Old 06-23-2013
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Quote:
Originally Posted by hamzarayes View Post
so we dont need a heent and gen exam and hear and lung in each case as is it rumored ????
thank god did the exam and passed

did not do heart, lung, heent and gen exam in all cases actullay may be only in two cases

of course did it if indicated form sx
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  #29  
Old 06-25-2013
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Default vicky

to mbbs2010
thank u so much.. ur posts r really helpful.
i need to ask that can any1 prep 4 cs alone? w/o partner?
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  #30  
Old 08-15-2013
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i'm now preparing alone...
my study partner got tired
so last few days have to prepare alone
so it is doable i guess
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  #31  
Old 08-15-2013
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Default hello mbbs 2010

hey mbbs2010 waiting for my results...can anyone please guide me about my mistakes i mean to say are they just minor mistakes ,blunders or big blunders
1..i forget to do leg rest in my 4 abdominal examination cases
2..after doing my counselling at the closure of my all cases i forget to remove my gloves i all 12 cases and hand shake with all sp e my gloves
3....in 2 cases i found the name of my sp a bit difficult and just during the knock i used to kall my sp e name and after that i used to kall him e YOU or MR

can u people give ur valuable feedbacks..can i pass my cs exam e these mistakes??everything else was ok i think but these mistakes bother me a lot.plx need ur advise,its a real torture for me,,thanks
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  #32  
Old 08-16-2013
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Quote:
Originally Posted by dana187 View Post
hey mbbs2010 waiting for my results...can anyone please guide me about my mistakes i mean to say are they just minor mistakes ,blunders or big blunders
1..i forget to do leg rest in my 4 abdominal examination cases
2..after doing my counselling at the closure of my all cases i forget to remove my gloves i all 12 cases and hand shake with all sp e my gloves
3....in 2 cases i found the name of my sp a bit difficult and just during the knock i used to kall my sp e name and after that i used to kall him e YOU or MR

can u people give ur valuable feedbacks..can i pass my cs exam e these mistakes??everything else was ok i think but these mistakes bother me a lot.plx need ur advise,its a real torture for me,,thanks
I cannot tell you if you will pass or not.
Why not? Because I don't work for ECFMG. I don't know how this exam is scored. no one in this forum does!
I don't know what you are hoping to get by posting this in pretty much every thread in the CS forum, I know some people will tell you "you passed dude, 100%". Well, I am not one of these people and you should not be someone to listen to a stranger in a forum online.
You will find out if you passed in your reporting period. Wish you all the best and I really hope you will get that "pass"!!
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  #33  
Old 08-17-2013
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Quote:
Originally Posted by val7 View Post
I cannot tell you if you will pass or not.
Why not? Because I don't work for ECFMG. I don't know how this exam is scored. no one in this forum does!
I don't know what you are hoping to get by posting this in pretty much every thread in the CS forum, I know some people will tell you "you passed dude, 100%". Well, I am not one of these people and you should not be someone to listen to a stranger in a forum online.
You will find out if you passed in your reporting period. Wish you all the best and I really hope you will get that "pass"!!
ok thanks and sorry if u mind my words..actually there is so much tension that i m forced to do this on each forum thread...bcx i cnt do anything except keep thinking about my cs results despite each and every effort to stop thinking..anywaz thanku for ur comment
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  #34  
Old 12-15-2013
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Quote:
Originally Posted by mbbs2010 View Post
what i aimed for was a balanced patient note.
individual parts are not graded -- there is no longer a checklist.
it was graded depending on how it looked "on the whole" according to the usmle website when i took the exam

my advice -
1-use alot of medical abbreviations.
2- NEVER LEAVE ANY FIELDS BLANK --even the differential
3-be precise.



for the history for eg u dont need to put in subtitles..

eg: pt had pain
DONT PUT -- onset : gradual, Progress: increasing, Duration: 3 days etc

u'd rather write it as
PAIN : RUQ, 3d, sudden, colicky, intermittent, increasing, 9/10, non radiating, no aggrev/allev factors.

similarly for P/E - WILL ALWAYS BE NORMAL!
(except for maybe tenderness or skin changes)
So learn the format for every system and be very concise.

eg:
CVS:
S1S2 - WNL, non displaced apex,
(-) mrg, no jvd.


Abdomen:
No scars, skin changes. BS + 4 Q.
(-) tenderness, hsm

etc.


I found these on the different website. http://meded.ucsd.edu/clinicalmed/abbreviation.htm

Are they good to use on the exam???

Also, can we use day, week, and month as D, wk, and Mo? I really appreciated if someone let's me know
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  #35  
Old 12-15-2013
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Quote:
Originally Posted by Doctor Ali View Post
http://meded.ucsd.edu/clinicalmed/abbreviation.htm
Are they good to use on the exam???
I would not use these. Stick to the official abbreviations. If one is not in there, I would rather write out the word than risk losing points on anything!

check out the Step 2 CS information bulletin here: http://usmle.org/pdfs/step-2-cs/cs-info-manual.pdf and check the "common abbreviations" list. To be safe, I would use these but no other abbreviations.

Quote:
Also, can we use day, week, and month as D, wk, and Mo?
NO!! definitely not.
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  #36  
Old 05-02-2014
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thanx for the helpful tips
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