April-May 2014 Step 2 CS Exam Takers Thread - USMLE Forums
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  #1  
Old 02-09-2014
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Group talk April-May 2014 Step 2 CS Exam Takers Thread

Hi everyone, nice to be on CS forum.

More than any exam this one needs partner, friend, someone by your side.
I have been gone through FA cases once last year, i m generally familiar more or less with everything.

I cannot write PN, so first thing im gonna start with today is reading new updated cs manual + kaplan Core cases general part about how to write notes and by the end of day will post my independent note without looking into anything. And will correct it so i will better remember with my mistakes or what i have omitted.

http://www.usmle.org/pdfs/step-2-cs/cs-info-manual.pdf

I have two dedicated friends with whom i will have live practice, hopefully more and more intense especially from march!!!

Good luck everyone, i know there are lot of friends here planning and preparing for cs. So lets share our mistakes, schedules, our progress. Also we could find each other everyday if somebody has time and try skype practice. Never done it before. It should be also of help because it is impossible to have someone beside studying and practicing with you all the time.

Im not planning any live course so far..

Lets do it!!!!
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Quote:
Originally Posted by tamta View Post
Hi everyone, nice to be on CS forum.

More than any exam this one needs partner, friend, someone by your side.
I have been gone through FA cases once last year, i m generally familiar more or less with everything.

I cannot write PN, so first thing im gonna start with today is reading new updated cs manual + kaplan Core cases general part about how to write notes and by the end of day will post my independent note without looking into anything. And will correct it so i will better remember with my mistakes or what i have omitted.

http://www.usmle.org/pdfs/step-2-cs/cs-info-manual.pdf

I have two dedicated friends with whom i will have live practice, hopefully more and more intense especially from march!!!

Good luck everyone, i know there are lot of friends here planning and preparing for cs. So lets share our mistakes, schedules, our progress. Also we could find each other everyday if somebody has time and try skype practice. Never done it before. It should be also of help because it is impossible to have someone beside studying and practicing with you all the time.

Im not planning any live course so far..

Lets do it!!!!
You started a new thread!!! That's awesome!! Im taking the test in march..But im going to participate in this thread..nice to see you here tamta!!
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You started a new thread!!! That's awesome!! Im taking the test in march..But im going to participate in this thread..nice to see you here tamta!!
lets see how it goes! I my also pass it earlier. cause all this exam need is one month intensive prep.
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The following are examples of actions that would
result in higher scores:
• Using correct medical terminology
• Providing detailed documentation of pertinent history
and physical findings. For example: writing
“pharynx without exudate or erythema” is preferable
to stating that the pharynx is clear.
• Listing only diagnoses supported by the history
and findings (even if this is fewer than three)
• Listing the correct diagnoses in the order of likelihood,
with the most likely diagnosis first
• Supporting diagnoses with pertinent findings
obtained from the history and physical examination
The following are examples of actions that would
result in lower scores:
• Using inexact, nonmedical terminology, such as
pulled muscle
• Listing improbable diagnoses with no supporting
evidence
• Listing an appropriate diagnosis without listing supporting evidence
• Listing diagnoses without regard to the order of
likelihood

if only two diagnosis is likely do not write third

thats it for today

we should not use costly tests just to list something. they would result in lower score.

one thing i would not do is " loosening bra" i probably will ask to move it and listen to mitral. depends on my performance that day. if i see im out of time i will use gloves and shorten everything i can to make good closure. and write good patient note. i don't want to fail ICE
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Default PN

Hi there,
I haven't done CK yet. Just started preparing for CS. Plan to take it on mid-March. Doing FA long cases, haven't done the minicases yet. I feel like I have difficulty thinking about appropriate DDs and workup! Does minicases help much? Or is it because I lack CK knowledge? Another problem is the PN. I don't feel confident about that also. When I am trying to finish in time I miss out information, but when I want to put more info I run out of time.
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Quote:
Originally Posted by drglo View Post
Hi there,
I haven't done CK yet. Just started preparing for CS. Plan to take it on mid-March. Doing FA long cases, haven't done the minicases yet. I feel like I have difficulty thinking about appropriate DDs and workup! Does minicases help much? Or is it because I lack CK knowledge? Another problem is the PN. I don't feel confident about that also. When I am trying to finish in time I miss out information, but when I want to put more info I run out of time.
I think it really helps to do CK first..For the same reason..Differentials become much easier if you do CK first..This is my take on it.
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Originally Posted by drglo View Post
Hi there,
I haven't done CK yet. Just started preparing for CS. Plan to take it on mid-March. Doing FA long cases, haven't done the minicases yet. I feel like I have difficulty thinking about appropriate DDs and workup! Does minicases help much? Or is it because I lack CK knowledge? Another problem is the PN. I don't feel confident about that also. When I am trying to finish in time I miss out information, but when I want to put more info I run out of time.

Do minicases for sure, its only destination is to help with Differential Diagnoses and use Kaplan CORe cases new edition for Patient note for SURE.

I agree with you rockstar, being done with CK gives some different attitude to Diseases. although i am neither confident with history taking, patient note writing or anything yet. I will start doinng everything very soon though.
Rockstar please share your experience with Kaplan Live course, especially MOCK exam. i am just registering for CS. planing may
and if it is worth it i may pay for just Sim EXAM its around 800$ as i know.
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Quote:
Originally Posted by tamta View Post
Do minicases for sure, its only destination is to help with Differential Diagnoses and use Kaplan CORe cases new edition for Patient note for SURE.

I agree with you rockstar, being done with CK gives some different attitude to Diseases. although i am neither confident with history taking, patient note writing or anything yet. I will start doinng everything very soon though.
Rockstar please share your experience with Kaplan Live course, especially MOCK exam. i am just registering for CS. planing may
and if it is worth it i may pay for just Sim EXAM its around 800$ as i know.
Tamta, if you want to take the test in april/may, you need to schedule it right now..Bcz its harder to get dates for CS..I will take the live course between 03/10-03/14 and will take the kaplan practice exam on the 15th..Will let you know how it goes..But the reason im taking classes is bcz its been a while since i graduated and i havent really done anything clinical since then..Since you are already practicing as a surgery resident, it shouldn't be hard for you..Besides, you said you have really good study partners...But i think its really important to take the practice exam..Bcz no one wants an attempt on CS...I will let you know more about the course once im done with it..But schedule your test soon.
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Tamta, if you want to take the test in april/may, you need to schedule it right now..Bcz its harder to get dates for CS..I will take the live course between 03/10-03/14 and will take the kaplan practice exam on the 15th..Will let you know how it goes..But the reason im taking classes is bcz its been a while since i graduated and i havent really done anything clinical since then..Since you are already practicing as a surgery resident, it shouldn't be hard for you..Besides, you said you have really good study partners...But i think its really important to take the practice exam..Bcz no one wants an attempt on CS...I will let you know more about the course once im done with it..But schedule your test soon.

yes i already registered today. hope to have permit soon. i have clinical practice i am a doctor but nfortunately our everyday life does not have nothing common on whats going on CS. you are right no ne wnat s attempt on CS. so i will follow your instructions. i may afford just sim exam. if you will tell me its worth it.

will have couples of hours with my live partners tomorrow. and should start seriously working on Notes. thats it. couple of more days and i will be in good shape. working hard as usual
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this is what i needed..have been slacking off for the past couple of weeks...
so i have already scheduled my exam for April 1st...
just read up on the new info available on the ecfmg site and i found out about this new case format that has been mentioned..
"in some cases you may be instructed to perform a physical examination that relates to a specific medical condition,life circumstance or occupation.Synthetic models or mannequins or simulators provide an appropriate format for assessment of sensitive exam skills such as genital or rectal exam and may be used for these cases.In such cases specific instructions regarding the use of devices will be provided."
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this is what i needed..have been slacking off for the past couple of weeks...
so i have already scheduled my exam for April 1st...
just read up on the new info available on the ecfmg site and i found out about this new case format that has been mentioned..
"in some cases you may be instructed to perform a physical examination that relates to a specific medical condition,life circumstance or occupation.Synthetic models or mannequins or simulators provide an appropriate format for assessment of sensitive exam skills such as genital or rectal exam and may be used for these cases.In such cases specific instructions regarding the use of devices will be provided."
well i can do rectal exam for sure heh thats announced somewhere else then cs manual? Okay i will start tpday with closure:
Lets so this guys daily just print here mnemonics and their meanings which we use and do closures counswling and stuff so those phrases stick to our minds

Mr. Drsrb,
Thank you for letting me examine you, ( no rectal exam
I want to give you my impression. You said that y have pain in asss which radiates to your axilla, it started after your preparation for usmle exams is that correct? On physycal exam i found blablabla... I have to order this this this. After we get results of the tests we will meet again to discuss final diagnosis and treatment plan in detail. I want to assure you that i will be available for any support you need.
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Old 02-11-2014
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Quote:
Originally Posted by tamta View Post
Do minicases for sure, its only destination is to help with Differential Diagnoses and use Kaplan CORe cases new edition for Patient note for SURE.

I agree with you rockstar, being done with CK gives some different attitude to Diseases. although i am neither confident with history taking, patient note writing or anything yet. I will start doinng everything very soon though.
Rockstar please share your experience with Kaplan Live course, especially MOCK exam. i am just registering for CS. planing may
and if it is worth it i may pay for just Sim EXAM its around 800$ as i know.
Yeah, ok..will do that. So, next I'm going to work on my PN and minicases. About the Kaplan exam, can't afford the 5 day course. So, I'm taking the 1 day exam only too, at Pasadena next month. Its about $1000 though! Let's see how that goes. Hope to be in good shape by then.
CS results take a lot some of time to get published that's why I'm taking it before CK. The other way round would be better for sure
What about the synthetic model things? Where to learn those from?
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Yeah, ok..will do that. So, next I'm going to work on my PN and minicases. About the Kaplan exam, can't afford the 5 day course. So, I'm taking the 1 day exam only too, at Pasadena next month. Its about $1000 though! Let's see how that goes. Hope to be in good shape by then.
CS results take a lot some of time to get published that's why I'm taking it before CK. The other way round would be better for sure
What about the synthetic model things? Where to learn those from?
It is not in this manual or is it? Have bot read it well yet? @Drsrb please speciofy where did y find that note about tectal exam
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Quote:
Originally Posted by tamta View Post
well i can do rectal exam for sure heh thats announced somewhere else then cs manual? Okay i will start tpday with closure:
Lets so this guys daily just print here mnemonics and their meanings which we use and do closures counswling and stuff so those phrases stick to our minds

Mr. Drsrb,
Thank you for letting me examine you, ( no rectal exam
I want to give you my impression. You said that y have pain in asss which radiates to your axilla, it started after your preparation for usmle exams is that correct? On physycal exam i found blablabla... I have to order this this this. After we get results of the tests we will meet again to discuss final diagnosis and treatment plan in detail. I want to assure you that i will be available for any support you need.
Yup taking usmle has been a pain in the butt ..
Yea the statement I posted is directly from the manual... This is stated under other cases format..
Along with pediatric case where u will talk to care giver (will be on the phone)..
U can check it out..
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Here's a screenshot!!
Attached Thumbnails
April-May 2014 Step 2 CS Exam Takers Thread-screenshot_2014-02-11-10-28-33.png  
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Here's a screenshot!!
Hello drsrb.Thank you for useful information.Could you post the link? It will be very helpful.
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http://www.usmle.org/pdfs/step-2-cs/cs-info-manual.pdf
here u go!
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I am already full of joy and happiness.. It would be my pleasure to sweat profusely on CS exam
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Default Patient Note Practice link

http://www.usmle.org/practice-materi...practice2.html
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Old 02-17-2014
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Default sample case for cs.

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An I also join this thread? I'm having my CS on April.

Quote:
Originally Posted by drsrb View Post
Thanks. Which review resource is this from? Looks helpful. The doctor looks like Lisa Kudrow. I could imagine Phoebe acting like a doctor.

Although, there seems to be a mistake in doing the Psoas sign. Shouldn't the patient actively flex the hip? The other alternative is for the examiner to passively extend the hip. In the video, she passively flexed the hip.
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Old 02-17-2014
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Can I also join this thread? I'm having my CS on April.

Thanks for the video. Which review resource is this from? Looks helpful. The doctor looks like Lisa Kudrow. I could imagine Phoebe acting like a doctor.

Although, there seems to be a mistake in doing the Psoas sign. Shouldn't the patient actively flex the hip? The other alternative is for the examiner to passively extend the hip. In the video, she passively flexed the hip.
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Originally Posted by Dr Pepper View Post
Can I also join this thread? I'm having my CS on April.

Thanks for the video. Which review resource is this from? Looks helpful. The doctor looks like Lisa Kudrow. I could imagine Phoebe acting like a doctor.

Although, there seems to be a mistake in doing the Psoas sign. Shouldn't the patient actively flex the hip? The other alternative is for the examiner to passively extend the hip. In the video, she passively flexed the hip.
I think this is official cs video? I remember it from last year. She also doesnot make transitions. You could join for sure more we are happier we get. So far i had one serious full case practice with notewritting once for ghee hours with my partner. It took us one hour to complete each case. But it was very productive. We are doing kaplan book mostly for differential diagnosis, also first aid although i am reluctant to do it as it seams old. I have gap now workin in mountains for this week. Will be back in shape fro sunday 23 feb. Good luck everyone
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I think this is official cs video? I remember it from last year. She also doesnot make transitions. You could join for sure more we are happier we get. So far i had one serious full case practice with notewritting once for ghee hours with my partner. It took us one hour to complete each case. But it was very productive. We are doing kaplan book mostly for differential diagnosis, also first aid although i am reluctant to do it as it seams old. I have gap now workin in mountains for this week. Will be back in shape fro sunday 23 feb. Good luck everyone
This is not official CS video..This is on some website called http://www.usmle-forums.com/usmle-st...tep2cs.net..is a step 2 cs online training website..But i watched one more sample video on the website and didnt like it so much...Writing patient note in 10 mins is something we should really practice..Bcz obviously 10 mins is not enough...Specially bcz now you have to support your diagnosis with 3 history findings and 3 PE findings...If not, it would be easy.
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Oh ok..even I thought this one was official video from d ecfmg..
Yea she doesn't make transitions and is also skipping out on some parts.. But she covered all this in 10 mins (d original length of d video rather than 15 mins which is shown in the timer)... So yea it can all be covered..
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This is not official CS video..This is on some website called http://www.usmle-forums.com/usmle-st...tep2cs.net..is a step 2 cs online training website..But i watched one more sample video on the website and didnt like it so much...Writing patient note in 10 mins is something we should really practice..Bcz obviously 10 mins is not enough...Specially bcz now you have to support your diagnosis with 3 history findings and 3 PE findings...If not, it would be easy.

Im sorry..I dunno how the link got changed..The website is www.step2cs.net.
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One more thing i would like to add is that most of the videos that we see, whether its kaplan or CSE, none of them are perfect...I think we should just pick good points from all of them and retain whatever we think is correct.
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You could join for sure more we are happier we get.
Great! Thanks.

Quote:
Originally Posted by drsrb View Post
Oh ok..even I thought this one was official video from d ecfmg..
Yea she doesn't make transitions and is also skipping out on some parts.. But she covered all this in 10 mins (d original length of d video rather than 15 mins which is shown in the timer)... So yea it can all be covered..
Which transitions do you think are necessary? Should all components have transitions? Would these suffice: HPI --> RoS --> PM/PSH/meds/allergies --> FH --> SH --> wrap up --> PE --> closure?

Quote:
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One more thing i would like to add is that most of the videos that we see, whether its kaplan or CSE, none of them are perfect...I think we should just pick good points from all of them and retain whatever we think is correct.
I'm planning to subscribe to an online video course for two weeks. Which do you think is better, CSE or step2cs.net (the one with the link above)? step2cs.net seems to be the cheapest, though. Which can be more helpful for the CIS part? (I think this is my weakness)
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Old 02-17-2014
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My friend american doctor gave me such advice: notes are what take most of time, so stay with patuient for 10 minutes only and have 20 minuets for notes he said. as lot of my friends have had trouble with ICE component which includes notes in them, as lot of americans come out of patient room early, as there is no more credit for lot of useless questions you ask or not i think this idea is supported and i will try to do like that and do only most relevant things and ask only most relevant questions.

also guys where are y going to take exam? i have to decide between Atlanta and Philly. Philly is close to new york so it will be convenient for me, but my friends are taking exam in same time in Atlanta so i would have practice buddies with me.. dunno what to do will have permit soon. next week hopefully. and i will have kids with me. so its not gonna be a joke.
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Old 02-18-2014
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My friend american doctor gave me such advice: notes are what take most of time, so stay with patuient for 10 minutes only and have 20 minuets for notes he said. as lot of my friends have had trouble with ICE component which includes notes in them, as lot of americans come out of patient room early, as there is no more credit for lot of useless questions you ask or not i think this idea is supported and i will try to do like that and do only most relevant things and ask only most relevant questions.

also guys where are y going to take exam? i have to decide between Atlanta and Philly. Philly is close to new york so it will be convenient for me, but my friends are taking exam in same time in Atlanta so i would have practice buddies with me.. dunno what to do will have permit soon. next week hopefully. and i will have kids with me. so its not gonna be a joke.
You get 15 mins with the patient and 10 mins for the Patient note..Even if you spend 10 mins asking questions and examining the patient, you will still get 15 mins for the patient note..20 mins is not possible...I think about 12 mins should be enough for the patient note..You dont need 20 mins..Im going to take it in Atlanta.
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Old 02-18-2014
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Great! Thanks.



Which transitions do you think are necessary? Should all components have transitions? Would these suffice: HPI --> RoS --> PM/PSH/meds/allergies --> FH --> SH --> wrap up --> PE --> closure?



I'm planning to subscribe to an online video course for two weeks. Which do you think is better, CSE or step2cs.net (the one with the link above)? step2cs.net seems to be the cheapest, though. Which can be more helpful for the CIS part? (I think this is my weakness)
I think CSE is better than the others..Its suggested by most of the other people..But i heard there are a lot of mistakes even in CSE...I would suggest to watch kaplan first, get to know what the dos and donts are..and then do CSE videos.
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Old 02-18-2014
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Originally Posted by rockstar88 View Post
I think CSE is better than the others..Its suggested by most of the other people..But i heard there are a lot of mistakes even in CSE...I would suggest to watch kaplan first, get to know what the dos and donts are..and then do CSE videos.
@rockstar88,

you suggested watching kaplan first, is there a kaplan video for cs, and do you have the link.
thanks.
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Old 02-18-2014
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@rockstar88,

you suggested watching kaplan first, is there a kaplan video for cs, and do you have the link.
thanks.
There are a few videos in the kaplan lecture videos.
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Old 02-18-2014
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where can i find these kaplan videos for cs?
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Old 02-19-2014
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Default PE

Hey guys, where are you learning the focused PE from?
Can anyone suggest which online video course is best to subscribe? CSEvideos/ UWorld/ step2cs????
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Old 02-21-2014
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You get 15 mins with the patient and 10 mins for the Patient note..Even if you spend 10 mins asking questions and examining the patient, you will still get 15 mins for the patient note..20 mins is not possible...I think about 12 mins should be enough for the patient note..You dont need 20 mins..Im going to take it in Atlanta.
I agree. 20 mins is probably too long for the PN anyway. Also, rushing the encounter might compromise your CIS. It might give the patient the impression that you're rushing him or that you are just trying to get it over and done with him.
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Old 02-21-2014
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Hey guys, where are you learning the focused PE from?
Can anyone suggest which online video course is best to subscribe? CSEvideos/ UWorld/ step2cs????
First Aid can guide you which focused exams to do for each case.

For now, I've been searching Youtube videos for individual PE tests. I still haven't decided which online CS review to subscribe to but I'll probably have CSE videos. Most likely, I won't take Kaplan because it seems too expensive.
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Old 02-22-2014
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http://www.drpuma.net/11.html
all pe videos in one place!!
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Originally Posted by drsrb View Post
http://www.drpuma.net/11.html
all pe videos in one place!!
I am in guys!!!!1 lets finish this exam and mind... of never ending exams!!
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Old 02-22-2014
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Default CS in April

Thanks for starting this thread. Lets keep ourselves updated so that we don't lose track and momentum. CS is easy except if you have bad stars following you. The trick is confidence in the exam center, good hold over the language and common sense. Most of the cases are very straight forward. ECFMG doesn't want us to act like Dr. House in the exam center, so there is no need to act super smart, just follow the simple rules and get it done.
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Old 02-23-2014
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Just to give an update, I'm still reading the FA cases. My plan is to finish them by tomorrow (Case 28 now), then find a skype study partner.

My problem with FA is that the PN is not patterned to the current PN type. (I'm using the 3rd ed) There are more than 3 diagnoses, and the diagnostics given are sometimes too costly/invasive or not anymore relevant to the top 3 diagnoses. I find it difficult to decide which diagnostics to retain.
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Old 02-23-2014
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Default The answer is obvious

All of the Diagnosis are not relevant and in real exam they would be more less, just keep the ones which make sense.
Quote:
Originally Posted by Dr Pepper View Post
Just to give an update, I'm still reading the FA cases. My plan is to finish them by tomorrow (Case 28 now), then find a skype study partner.

My problem with FA is that the PN is not patterned to the current PN type. (I'm using the 3rd ed) There are more than 3 diagnoses, and the diagnostics given are sometimes too costly/invasive or not anymore relevant to the top 3 diagnoses. I find it difficult to decide which diagnostics to retain.
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Old 02-23-2014
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Originally Posted by Dr Pepper View Post
Just to give an update, I'm still reading the FA cases. My plan is to finish them by tomorrow (Case 28 now), then find a skype study partner.

My problem with FA is that the PN is not patterned to the current PN type. (I'm using the 3rd ed) There are more than 3 diagnoses, and the diagnostics given are sometimes too costly/invasive or not anymore relevant to the top 3 diagnoses. I find it difficult to decide which diagnostics to retain.
Yeah, the patient note is what's troubling me also. Specially when it comes to relevant history and PE findings for each DDx. It takes too much time when I think about what to write while typing PN. I'm thinking about making a note on it, for each case. We can help each other out here too.
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Old 02-24-2014
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http://www.usmleforum.com/files/forum/2013/3/731318.php
i read this post on another forum about cs..liked it..was funny even..you guys should check it..
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Old 02-24-2014
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I am planning to take CS in May too. I am not sure whether i should take the live kaplan course, or online course or no course atall. I live in Richmond Virginia so all the kaplan live courses are quite far away, which is yet another contributing factor in my confusion over live course.
any sort of advise or opinion will be greatly appreciated. thanks
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Old 02-24-2014
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Nice thread. Though I've booked a date for ist week of july I'm reading this thread for orientation. I have gone through some of the material and would like your opinion on premier course/archer/kaplan4day course. Which one should I go with if at all? or FA will suffice.
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Old 02-24-2014
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Hi guys! I need your advise. I am going to buy a book for cs. I would like to study only on a single book so i was wondering which one is the best/ most complete between fa and kaplan core?
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Hi guys! I need your advise. I am going to buy a book for cs. I would like to study only on a single book so i was wondering which one is the best/ most complete between fa and kaplan core?
I would buy FA, and practice as much as posible with a sp. At first you can feel stupid, but the more you practice, the more confidence you will have.
Good luck to all of us!
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Old 02-24-2014
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anyone taking the march goldsusmle course in new york?
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Old 02-24-2014
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Originally Posted by Torm2 View Post
I would buy FA, and practice as much as posible with a sp. At first you can feel stupid, but the more you practice, the more confidence you will have.
Good luck to all of us!
Thank you very much for your reply! What do u think about online uw for cs? Is it crucial as for the other steps or is it just a waste of money/time?
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Thank you very much for your reply! What do u think about online uw for cs? Is it crucial as for the other steps or is it just a waste of money/time?
Your are welcome! I can't opinate about UW for cs bc I don't know much about it.
I've seen comments in the forums saying that those mock exams for CS are very good, but I just couldn't afford it
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Old 02-25-2014
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so far guys, i think passing this exam is doable without any live courses. I don't have that happiness. i did couple of cases. i am working on notes. mostly doing Kaplan Core cases to get better idea how to write differentials with history finding and Physical exam findings.
good luck everyone.

I need to manage Neuro exam today. terrible ****. need to know it well. drsrb i read that nice CS experience. and probably i will do Cs in Philly. it is most convenient for me from New York.
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Quote:
Originally Posted by tamta View Post
so far guys, i think passing this exam is doable without any live courses. I don't have that happiness. i did couple of cases. i am working on notes. mostly doing Kaplan Core cases to get better idea how to write differentials with history finding and Physical exam findings.
good luck everyone.

I need to manage Neuro exam today. terrible ****. need to know it well. drsrb i read that nice CS experience. and probably i will do Cs in Philly. it is most convenient for me from New York.
Hi tamta, yes, neuro is painfull! So many details, I'm worried about neuro cases on my test! I like this video for cranial nerve examination, I hope it helps.
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Originally Posted by tamta View Post
so far guys, i think passing this exam is doable without any live courses. I don't have that happiness. i did couple of cases. i am working on notes. mostly doing Kaplan Core cases to get better idea how to write differentials with history finding and Physical exam findings.
good luck everyone.

I need to manage Neuro exam today. terrible ****. need to know it well. drsrb i read that nice CS experience. and probably i will do Cs in Philly. it is most convenient for me from New York.

Hi tamta, check this video for cranial nerves, I hope it helps!
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Old 02-25-2014
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Hi guys count me in .... Planning for the 5th of may.... Im going to be in new york as well for the prep but taking the exam in chicago
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Old 02-25-2014
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Hey guys....nice to see this thread. Please count me in, I took my date on 27th march at Houston. Let's nail this exam
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  #57  
Old 02-25-2014
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All of the Diagnosis are not relevant and in real exam they would be more less, just keep the ones which make sense.
There are cases when there are 4 relevant diagnoses. For example, in case 31 (25 y/o ER case, motor vehicle accident), pneumothorax, hemothorax, pneumonia, and splenic rupture could be very relevant since they are all probable and can be life threatening.

I'll probably list pneumothorax, hemothorax, and pneumonia in the top 3, but that would leave splenic rupture out of the list. Personally, I would still want an abdominal CT to check for splenic rupture since the patient has LUQ pain not explained by the top 3 diagnoses. Can I order a diagnostic that addresses a differential that is not listed in my top 3?

I'd just hope CS won't give a case as complicated as this since they're now limiting the DDx to 3.
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Originally Posted by Dr Pepper View Post
There are cases when there are 4 relevant diagnoses. For example, in case 31 (25 y/o ER case, motor vehicle accident), pneumothorax, hemothorax, pneumonia, and splenic rupture could be very relevant since they are all probable and can be life threatening.

I'll probably list pneumothorax, hemothorax, and pneumonia in the top 3, but that would leave splenic rupture out of the list. Personally, I would still want an abdominal CT to check for splenic rupture since the patient has LUQ pain not explained by the top 3 diagnoses. Can I order a diagnostic that addresses a differential that is not listed in my top 3?

I'd just hope CS won't give a case as complicated as this since they're now limiting the DDx to 3.
That is a good question!! I have the same doubt in my PN, specially bc we are not suppose to ask for over invasive/costly tests.
Any thoughts?!? Help!!
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Old 02-28-2014
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Im very bad for preparation of this Test. probably cause i dont have permit and date yet.

SO at least i am trying to know NEURO EXAM!!!!!! this is a big monster didi case of arm weakness. nd generaly after each case im somehow getting more confident. somehow managing to write patient notes at least now i remember what i have to write like scheme:

HPI
ROS
ALlergies
MEDs
PMH

Sx:
Sh:

then physical
then differential bullsh>t

costly tests invasive and unneccesary should not be involved and one thing that we at least I do forget to mention in counceling also in tests: rectal vaginal etc exams that are appropriate for cases.

also my head is turned around because of two books so i am sticking with Kaplan Core cases for now. once i Finish its cases than will move on to FIRST AID
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Old 02-28-2014
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Default mnemonics for various cases.

My CS Mnemonics
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Old 02-28-2014
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Quote:
Originally Posted by tamta View Post
Im very bad for preparation of this Test. probably cause i dont have permit and date yet.

SO at least i am trying to know NEURO EXAM!!!!!! this is a big monster didi case of arm weakness. nd generaly after each case im somehow getting more confident. somehow managing to write patient notes at least now i remember what i have to write like scheme:

HPI
ROS
ALlergies
MEDs
PMH

Sx:
Sh:

then physical
then differential bullsh>t

costly tests invasive and unneccesary should not be involved and one thing that we at least I do forget to mention in counceling also in tests: rectal vaginal etc exams that are appropriate for cases.

also my head is turned around because of two books so i am sticking with Kaplan Core cases for now. once i Finish its cases than will move on to FIRST AID
Have you applied for CS already? I think you need to do it several months in advance. When I applied, the available schedule is in 4 months the earliest.
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Old 02-28-2014
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Can I join in?
My exam is in April 29th.
Which book is reference book..FA or Kaplan?
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Old 02-28-2014
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Can I join in?
My exam is in April 29th.
Which book is reference book..FA or Kaplan?
I thjnk both books are must do.
Dr pep im waiting for permit i hope willbbe able to schedule somewhere in may
I dont like myself eith regards to this exam. Im not doing anything for it but hopefully end of march april will be enough
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  #64  
Old 02-28-2014
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Default about counseling?

thank u for the nice thread. I have a question?
do we need do counsel the pts if they'r taking sleep aid medications?
or for women on HRT?
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Old 03-01-2014
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Default about pe?

so we only do the physical exam points mentioned in first aid for a particular system?
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Old 03-02-2014
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thank u for the nice thread. I have a question?
do we need do counsel the pts if they'r taking sleep aid medications?
or for women on HRT?
I haven't encountered a case in FA like this.Probably, if they're taking it, a doctor prescribed it. If they're taking sleeping supplements, we can tell them that these often have no approved therapeutic claims...
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Old 03-02-2014
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so we only do the physical exam points mentioned in first aid for a particular system?
Even less, I think. The instruction in CS is to take a focused PE, so our differentials from the hx should guide us which systems to focus on.

FA does CV and Pulmo auscultation for all cases, which some CS takers in this forums feel unnecessary. I think we can still do this if we have time. If you're out of time, then don't.
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Old 03-02-2014
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Default Neuro examination in passed out patient

Can any one tell me what all components of neuro examination to be done to finish PE in 5 min....its takes 7 min for me to finish complete neuro examination and I will not be left with time to conclude?
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Old 03-03-2014
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Default Massachusetts/Rhode Island Study Partner

Hello,
Anyone in the Boston/Providence area who would like to practice the First Aid cases? I think in person would be the best. I know some people practice via Skype but I am not sure if that works. Please reply at detomm42@virgilio.it Thank you!!!
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Old 03-03-2014
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Can any one tell me what all components of neuro examination to be done to finish PE in 5 min....its takes 7 min for me to finish complete neuro examination and I will not be left with time to conclude?
I'm not sure if this can be done in 5 mins because I haven't practiced yet, but basing on FA, you need to do almost everything.

BTW, how do you report your cranial nerve findings? The updated manual says you get higher credit for being specific. In FA, it only writes "CN 2-12 grossly intact" Do you think it's better to put:

CN's: 2-3: PERRLA; 3,4,6: EOMI; 5: intact facial sensation to soft touch; 7: no facial weakness/asymmetry; 8: grossly normal hearing; 10: uvula midline; 11: good shoulder shrug; 12: tongue midline

Note that I didn't put CN 9 because the gag reflex is a bit uncomfortable to the SP.

Also, when testing for gross upper extremity strength, can I just ask the patient to squeeze my hands and try to resist me as I try to pull back?

Finally, should we also be specific in the PN which DTR's we tested? (rather than just write "symmetric DTRs")

My worry is that being too specific obviously takes longer and the PN might seem less complete.
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Great mnemonics. Thanks Dr Laura!
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Old 03-04-2014
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Got my permit. no dates in may in Atlanta, chicago or Houston.
i wanted atlanta because of my friend having xam there in may. otherwise philly is best for me, so i will book date in philly. i dont think i will fail exam cause i will take it i Philly.. hopefully
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Old 03-05-2014
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in the dizziness case..will u do the dix hallpike maneuver?
coz i think it will b really time consuming and u dint really have that much time for pe.
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Old 03-05-2014
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Originally Posted by drsrb View Post
in the dizziness case..will u do the dix hallpike maneuver?
coz i think it will b really time consuming and u dint really have that much time for pe.
You can write dix hallpike maneuver in the work up..according to FA atleast.
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  #75  
Old 03-05-2014
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Originally Posted by tamta View Post
Got my permit. no dates in may in Atlanta, chicago or Houston.
i wanted atlanta because of my friend having xam there in may. otherwise philly is best for me, so i will book date in philly. i dont think i will fail exam cause i will take it i Philly.. hopefully
That's great...I dont think the test center makes any difference...Philly should be good...But if you really want to take in Atlanta, keep an eye on the available dates..They keep opening up, specially closer to the test date.
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Old 03-05-2014
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Hi again, everyone.

I've finished FA and I was about to subscribe to CSE videos when I came across a lot of negative comments saying it doesn't go well for CIS. I'm not sure how to proceed from here. Maybe I'll just subscribe to step2cs.net, although its PE seem to be overly explained to the patient, or just start making scripts for each FA case and go on with SP practice next week.
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Old 03-05-2014
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Quote:
Originally Posted by Dr Pepper View Post
Hi again, everyone.

I've finished FA and I was about to subscribe to CSE videos when I came across a lot of negative comments saying it doesn't go well for CIS. I'm not sure how to proceed from here. Maybe I'll just subscribe to step2cs.net, although its PE seem to be overly explained to the patient, or just start making scripts for each FA case and go on with SP practice next week.

What about targetusmle.com?
I didn't subscribe , but just saw the free materials and it sounds good to me, does any body have any idea about it?
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  #78  
Old 03-05-2014
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Quick question, Do you palpate thyroid from front or from back?
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Old 03-05-2014
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Quote:
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Quick question, Do you palpate thyroid from front or from back?
AFAIK, from back.
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Old 03-06-2014
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Hello everybody,

I have a quick question: while writing our differentials, and filling up the history and examination part with pertinent positives, what do we do if there were NO findings at all during examination to support our diagnosis? Leave that part blank?
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Old 03-06-2014
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Quote:
Originally Posted by rockstar88 View Post
That's great...I dont think the test center makes any difference...Philly should be good...But if you really want to take in Atlanta, keep an eye on the available dates..They keep opening up, specially closer to the test date.
Just changed date to atlant exactly with my friends date ao we shall practice until final day.
CSE video has woman acting in it you would hate to be a dpctpr. He sais okay all the time with terrible voice and apathy
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Old 03-06-2014
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Hi guys!
Just starting to prepare the exam that will be at the end of April in Philly.
I was wondering if fa is exactly what i need or if there is something else in the real exam that is not covered in fa?
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Old 03-06-2014
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Quote:
Originally Posted by Neuron View Post
Hi guys!
Just starting to prepare the exam that will be at the end of April in Philly.
I was wondering if fa is exactly what i need or if there is something else in the real exam that is not covered in fa?
Check patient notes, differentials and general part of kaplan core cases. I think its must do. Only newest thing that covers notes and subsequently ICE
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Old 03-06-2014
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Quote:
Originally Posted by fat1iscool View Post
Hello everybody,

I have a quick question: while writing our differentials, and filling up the history and examination part with pertinent positives, what do we do if there were NO findings at all during examination to support our diagnosis? Leave that part blank?
If this were my primary diagnosis, I'd try to put as much as I can. If possible, I'll put a negative PE finding that refutes the other DD but not the primary diagnosis. If there's none, then I guess we have no choice but to leave it blank.

As for the 2nd and 3rd DD, I probably won't sweat it that much unless there's extra time.
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Old 03-06-2014
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Quote:
Originally Posted by Dr Pepper View Post
AFAIK, from back.
Forgive my ignorance, what is AFAIK,Dr Pepper?
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  #86  
Old 03-06-2014
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Quote:
Originally Posted by drglo View Post
Forgive my ignorance, what is AFAIK,Dr Pepper?
A Far As I Know.
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Old 03-06-2014
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Quote:
Originally Posted by Dr Pepper View Post
A Far As I Know.
Oh! I thought may be some mnemonic for PE
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Old 03-08-2014
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Quick question: is "(+) jugular venous distention" based on observing obvious engorgement of the external jugular vein or by measuring CVP through internal jugular venous pulsations?
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Old 03-08-2014
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Quote:
Originally Posted by Dr Pepper View Post
Quick question: is "(+) jugular venous distention" based on observing obvious engorgement of the external jugular vein or by measuring CVP through internal jugular venous pulsations?

We look for JVP by asking the pt to lie down and fixing the table 45 degrees and then telling him that I am looking for any distention of blood channels in your neck.
It is a must-to-do in CV case
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Old 03-08-2014
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I havd a question?
If we have a minor ( i.e.<18 yo)and they don't refer to the parent consent on the door way information, then how to ask the pt about the p consent?
I mean what exactly should We say?
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Old 03-08-2014
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Quote:
Originally Posted by Kawthar View Post
We look for JVP by asking the pt to lie down and fixing the table 45 degrees and then telling him that I am looking for any distention of blood channels in your neck.
It is a must-to-do in CV case
Thanks. Are we looking for external jugular distention, or internal jugular pulsations? Should we use a ruler and place it on the sternal angle?
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Old 03-08-2014
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Quote:
Originally Posted by Dr Pepper View Post
Thanks. Are we looking for external jugular distention, or internal jugular pulsations? Should we use a ruler and place it on the sternal angle?
We r looking for common jugular vein distension, we dont have to use a ruler, just looking and telling the patient that we are looking.
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Old 03-08-2014
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Quote:
Originally Posted by Kawthar View Post
I havd a question?
If we have a minor ( i.e.<18 yo)and they don't refer to the parent consent on the door way information, then how to ask the pt about the p consent?
I mean what exactly should We say?
I have read somewhere cant tell for sure. It is provided that we have consent on everything. Why do you think only about minor's consent. Same is for other pts. So consider that we have consent
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Old 03-08-2014
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Quote:
Originally Posted by tamta View Post
I have read somewhere cant tell for sure. It is provided that we have consent on everything. Why do you think only about minor's consent. Same is for other pts. So consider that we have consent
Of course other patients u start be telling them that I am going to ask u some qs and do PE, it that ok with u?
But for minors u have to get parents consent.
Unless thd minor is married or not dependent on parents. Or has stds, pregnant, addiction of drugs.
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Old 03-10-2014
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Less than a month to go before my exam.

So far, I've studied Dr Laura's blue sheet mnemonics and the general framework of the history.

Plan for this week: I intend to review the FA big cases as part of the mini-cases and try to develop/look for mnemonics for each case as I go along. I'm planning to look at videos from step2cs.net just to have a general feel of how an encounter looks like, especially for the PE's.

Quick question: Is the history in the mini-cases supposed to describe the classic presentation of the first differential highlighted in bold?

I plan to start SP practice next week once I'm more confident enough for practice.
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Old 03-11-2014
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Thanks Tamta for making this thread. Hopefully we'll be ready by May to pass this last thing...
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Old 03-11-2014
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Hey guys, I have a few questions-

1. When we have to do a complete neuro exam, do we have to check for the muscle strength in each muscle group in UE/LE? Can we do 1 muscle group in each limb only? Same for sensation, do you check in 3 areas in UE and LE? I was thinking of starting with the hands/feet, if it was ok I won't do any further (given there no obvious c/o loss of sensation elsewhere). What is your opinion?

2. For auscultation from back, how many areas do we have to check? 6 or 8 (includes the sides)?

3. When we examine a joint (say, patient has pain) and check for ROM, do we ask the patient to move in directions (active), or do we hold the limb and try to move it ourselves (passive)?
Is there any video on MSK exams?
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Old 03-11-2014
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Is there any video on MSK exams?[/QUOTE]
check out geeky medics on youtube..from what i have seen they have the best videos for all the clinical encounters.
http://www.youtube.com/user/geekymedics123
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Old 03-11-2014
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Quote:
Originally Posted by drsrb View Post
Is there any video on MSK exams?
check out geeky medics on youtube..from what i have seen they have the best videos for all the clinical encounters.
http://www.youtube.com/user/geekymedics123[/QUOTE]
Cool! thanks drsrb
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Old 03-14-2014
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Does the examination room contain neuro hammers and a tuning fork?

PS. Congratulations to this thread for its 100th post.
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