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Old 04-15-2013
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Hammer and Otoscope Actual Physical Findings in the CS Exam Patients?

Since these patients are actually actors--are we going to find any positive findings?
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Old 04-17-2013
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The Standardized Patients (SPs) in the CS exam are healthy individuals. Very rarely, they might have actual chronic conditions such as hypertension or diabetes but never with actual acute conditions.

They way you might see physical findings in the CS exam is when they "fake them".

Examples of "Faked" physical findings:
  • The SP skin is painted red for inflammation
  • The SP making harsh sounds when you auscultate (crepitations, rales)
  • The SP whistle when you auscultate (wheeze)
  • The SP responding in pain when you palpate (tenderness)
  • The SP exaggerate DTR response (hyper-reflexia)
  • The SP does not feel touch/vibration (sensory exam)
  • The SP gait is abnormal (Neuro or MSK cases)
  • The SP cannot move a joint (arthritis)
  • The SP skin has pin point red dots (petichiae or other rashes)
But you will never see actual swelling of a joint or abnormal pupillary response for example.

One my friends swore that there was a patient with cardiac murmur, but the case was not cardiac, so I told him you should have not mentioned that in your PN, just ignore it, since the patient scenario was abdominal not cardiac.

So whenever the SP tries to tell you "fake" a physical finding, you should take that as positive otherwise it's very rare to see actual physical findings.
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The above post was thanked by:
DrSK (04-17-2013), Ganymede (09-10-2016), nishaa (04-17-2013)



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