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  #1  
Old 07-09-2013
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Default Disastrous PN

Can anyone give me a rough idea of what a hit my patient note will take if i DID NOT include:

-Vital signs (because 11/12 had normal ones)
-pertinent + or - in 7/12 patients
-for lung exam didn't include rhonchi or rales, only wheezes
-for cvs: didnt just said rrr, s1+, s2+, no murmurs (didnt put gallops)
-for DTR i put intact instead of +2, for motor strength i put intact instead of 5/5.
-my ddx was for 3 patients was pretty awful.

The reason I ask is because I was looking at the sample PN that the usmle posted...and their write up is so brief compared to what FA included.

Thanks!
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  #2  
Old 07-09-2013
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Quote:
Originally Posted by skyline24 View Post
Can anyone give me a rough idea of what a hit my patient note will take if i DID NOT include:

-Vital signs (because 11/12 had normal ones)
-pertinent + or - in 7/12 patients
-for lung exam didn't include rhonchi or rales, only wheezes
-for cvs: didnt just said rrr, s1+, s2+, no murmurs (didnt put gallops)
-for DTR i put intact instead of +2, for motor strength i put intact instead of 5/5.
-my ddx was for 3 patients was pretty awful.

The reason I ask is because I was looking at the sample PN that the usmle posted...and their write up is so brief compared to what FA included.

Thanks!
Not sure what you are asking - is this what you did on your test day and now you want to know if this will be enough?
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Old 07-09-2013
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Sorry I should have been more clear....That is unfortunately what i ended up doing on test day (my nerves got the best of me).

An example of my PE looked like this (basics)

Gen: aaox3, NAD
HEENT: nc/at, perrla, normal conjunctiva
cvs: rrr, s1+, s2+, no mumurs
lungs: CTA bilaterally, no wheezes
abd: +bs, nontender, nondistended, soft
ext: +2 pulses
neuro: CN intact. DTR intact, motor strength intact in upper and lower extremities.

did not include vitals.

Just want to know if it will be enough to pass
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Old 07-09-2013
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Quote:
Originally Posted by skyline24 View Post
Sorry I should have been more clear....That is unfortunately what i ended up doing on test day (my nerves got the best of me).

An example of my PE looked like this (basics)

Gen: aaox3, NAD
HEENT: nc/at, perrla, normal conjunctiva
cvs: rrr, s1+, s2+, no mumurs
lungs: CTA bilaterally, no wheezes
abd: +bs, nontender, nondistended, soft
ext: +2 pulses
neuro: CN intact. DTR intact, motor strength intact in upper and lower extremities.

did not include vitals.

Just want to know if it will be enough to pass

First off, no one will be able to tell you for sure. we are all just guessing here, no one knows how this test is graded. Also, you might remember wrong. The PN does into the ICE subcomponent, so it also depends how your exam was to know how your ICE will be.
In general, everyone freaks out after their exam so I just tried not to think of what I might have done right or wrong (no way to change it...).
Your PE part of the PN is missing some things and you used a lot of unapproved abbreviations, but again, it really depends on the rest of your notes, on your differentials (I think you are fine as long as you are not too far off, but just a guess of mine...).
So, try not to stress out about this during your wait and focus on something else (easier said than done, I know).
Good luck!
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  #5  
Old 07-09-2013
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How much can u mess up
on the history taking
and still pass CS?
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  #6  
Old 07-09-2013
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Quote:
Originally Posted by add1 View Post
How much can u mess up
on the history taking
and still pass CS?
Like val7 said, we dont know for sure because no one knows how this test is graded and because what is screwing people up is the ICE component, what we will say is only a rough estimation without any solid evidence.

I have seen people say that you only need roughly 60 to 70% of what First aid asks in order to be safe.. (no proof about this!)

You would need to really dont ask anything of the History of present illness and start talking nonsense in other to fail... Again we dont know exactly so people should stop asking these questions.

And to the thread creator follow this link; here people have posted their mistakes and the outcome for them

Also why
do you
write
like
this? (its just a doubt)

Last edited by XpaezX; 07-09-2013 at 01:35 PM.
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  #7  
Old 07-09-2013
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That looks like a strong generalized PN. But for the system you have to examine, it is lacking. For example, if it was a cardio case, forget the Neuro stuff and examine JVD, edema, PMI, etc. If it was abdominal case, make sure to talk about organomegaly, pain on palpation, Rovsing sign, McBurney's point, etc.

But then again, Im the guy that didnt have time to do Neuro exams on lightheaded patients.... so what the hell do I know.
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  #8  
Old 07-09-2013
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Also keep in mind that PE is just 25% of the PN.
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hoor (09-05-2013)



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