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USMLE Step 2 CS Forum USMLE Step 2 CS Discussion Forum: Let's talk about anything related to USMLE Step 2 CS exam


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  #1  
Old 02-09-2011
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Unhappy Data Gathering Step 2 CS

Hi everyone first time post, let's see how this forum works.

I'm sad since I did not pass step 2 CS. I was above average in CIS and SEP. But did poorly in Data gathering, what actually is data gathering, I asked all the questions on the book could the Physical exam affect it? How can I do better in Data gathering? I asked all the questions I am very sure.

Any help you can give I will appreciate it, thanks
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  #2  
Old 02-09-2011
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Stop Data gathering alone does not fail

You can't fail by data gathering only! there must have been other components that failed you.

Upload a scan of your score report and let's see it and then we can tell you how to improve yourself.
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  #3  
Old 02-10-2011
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Default Step 2 results

Thanks veteran for reply here is my result. Thanks for your help

Data Gathering Step 2 CS-cs-score-report.jpg
click image to enlarge
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  #4  
Old 02-10-2011
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So sorry to hear that....
I found something strange, are you AMG ??
What was your center ?
What were your resources ? Did you practice ? how many weeks did you dedicate for studying, more specific, how many hours/day...
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  #5  
Old 02-10-2011
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Yes I'm International, I studied for 1 month 4 hour- 5 days week. used FA and UW. I don't understand about data gathering I am sure I asked all questions, is it bad to ask too many questions? I think my problem was in PE maybe I did too focused. I need to decipher what is data gathering other than ask questions. Center is Houston
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  #6  
Old 02-10-2011
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Quote:
Originally Posted by mary View Post
You can't fail by data gathering only! there must have been other components that failed you.

Upload a scan of your score report and let's see it and then we can tell you how to improve yourself.

I also failed in data gathering.....I knew I did poorly in data gathering and questioning skills even before I got the results because I "finished" each station before the 5 minute warning was called.....I guess that's what happens when you've been out of clinical practice for a year .Here is my report: (sorry about the formatting....but you can get the picture. l l are the borders.


ICE XXXXXXXXXXlXXX l

Data gathering *XXXXXXXXX l l

Patient note XXXlXXXXXXlXXXXXX

CIS XXXXlXXXXX l

Questioning skills XXXXXXXXXlXXXX l

Info. sharing skills l XXXXXlXXXXXX

Prof. man. lXXXXXXlXXXXX

SEP l l XXXXX*
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  #7  
Old 02-10-2011
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Quote:
Originally Posted by juancho View Post
Yes I'm International, I studied for 1 month 4 hour- 5 days week. used FA and UW. I don't understand about data gathering I am sure I asked all questions, is it bad to ask too many questions? I think my problem was in PE maybe I did too focused. I need to decipher what is data gathering other than ask questions. Center is Houston
In Data gathering, "data" refers to any information you obtain from the patient...either through questioning the patient or examining the patient. Since you seemed pretty confident regarding the questioning, I would assume you failed this component based on your Physical examinations.
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  #8  
Old 02-10-2011
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thanks dreamer for comments. I did PE, the question is how deep I have to go in PE? I did to all abdominal and cardio, should i have done to all, Neuro? I just covered the specifics, I did focused PE to all patients.
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Old 02-10-2011
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Quote:
Originally Posted by juancho View Post
thanks dreamer for comments. I did PE, the question is how deep I have to go in PE? I did to all abdominal and cardio, should i have done to all, Neuro? I just covered the specifics, I did focused PE to all patients.

I'm not sure what exactly went wrong in your case...The score reports provided are so vague and generalized that we are only left to speculate as to where exactly we went wrong. I know people who claim to have done only focused exams and still passed....and I know people who did every examination possible in 15 minutes but failed anyway..... I even know one person who didn't even do PE's for at least 4 patients because he ran out of time...and guess what...he passed.
What confuses me though, is how can we fail data gathering yet still be able to compile patient notes that have , at the very least,been deemed satisfactory by the physicians who are grading it. That boggles the mind.
I wish the step 2 CS was done like the PLAB exam in the UK, where a physician was in the room with you and the patient the entire time....maybe then it would be a bit more objective.
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  #10  
Old 02-15-2011
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Mary I uploaded my result, have you been able to analyze? thanks for your help
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  #11  
Old 03-02-2011
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hey i got my score report today too and failed in data gathering as well
i dont know what im going to do now
i took my test on Jan 8 in LA and ive done 4 observerships just in the last year each 2 months!
ill upload my score report too
any advice on how to handle this tough situation is much appreciated guys :-/
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  #12  
Old 03-07-2011
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Quote:
Originally Posted by dreamer2011 View Post
I also failed in data gathering.....I knew I did poorly in data gathering and questioning skills even before I got the results because I "finished" each station before the 5 minute warning was called.....I guess that's what happens when you've been out of clinical practice for a year .Here is my report: (sorry about the formatting....but you can get the picture. l l are the borders.


ICE XXXXXXXXXXlXXX l

Data gathering *XXXXXXXXX l l

Patient note XXXlXXXXXXlXXXXXX

CIS XXXXlXXXXX l

Questioning skills XXXXXXXXXlXXXX l

Info. sharing skills l XXXXXlXXXXXX

Prof. man. lXXXXXXlXXXXX

SEP l l XXXXX*


I am in the opposite side ......I failed in ICE.
Data gathering is in intermediate performance and My Patient notes are in a very, very low performance.
I do not know how my and your situation can occur??

I also failed in SEP with a result near intermediate performance..

USMLE must provide a clear view how this assessment is run. I apply again but till now i do not know how to study because i do not know my cause of failing in my last attempt.

They must provide us in details how PNs are marked .How data gathering is assesed .This is our rights we pay 1355 $for an exam and we do not it's method of assesment.
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  #13  
Old 04-18-2011
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I failed in Data too

I read we failed because we did not do a focused exam, this means do not do non essential exams

for most patients you will do
Chest
Heart
Abd

but do not do a Neuro Heent exam on Abd pain

Do do GYN history on Female 13 to 50 with Abd

Do do a DTR and Muscle strength on hip pain and gait

Most important is the History and review of systems, focused on CC.

Focused if you look disorganized you fail.
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  #14  
Old 04-18-2011
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so dont do cardio and pulmonary routine on every case?
some cases will just require one exam like a complete neuro..is there any point of doing the other exams too?
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Old 04-18-2011
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Quote:
Originally Posted by adamshaban1 View Post
so dont do cardio and pulmonary routine on every case?
some cases will just require one exam like a complete neuro..is there any point of doing the other exams too?
just about every case:
Chest = Breathsounds ( do not do fremitus every case)
Heart= Heart sounds all three spots on front, May do carotids but not necessary for every case.

It's clear in First Aid for CS
If you do not have a copy, to me it doesn't seem to matter a lot which year, then get one.
These things are covered 100% in the book

I have studied and now look back to what I did and I should not have passed ( I failed x1) now I think I get it, focused exam.

For example

ABD pain, dont do a HEENT exam focus on Abd assessment, do do a Psoas and obturator exam. Women 13 to 50 ask menses gyn hx

you have time for chest, heart, abd in most cases.

Focus!
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  #16  
Old 04-18-2011
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Quote:
Originally Posted by mary View Post
You can't fail by data gathering only! there must have been other components that failed you.

Upload a scan of your score report and let's see it and then we can tell you how to improve yourself.
I have to disagree:

US student
Sucked on Data gathering hence failed.

Rest was good

If you ,miss on data gathering ( Questions and assessments) your note will be less and not enough.

I see this as essential that you at least perform the focused exams you need to write the note and support DX's


Remember you are being recorded, what you say and do, it is then reviewed and considered for your score, this is why it takes 3 months to get it back.

CS is never rescored Pass after a fail,

In fact the USMLE as far as I know, has never rescored any of the steps a Pass when someone fails.
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  #17  
Old 04-18-2011
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Dear all

It would be useful if you could post more about your study methods (simulate cases with family members, reading first aid, online courses such as CSEvideo etc) and any special focuses on your study before posting! It would be useful also, if you could post how many years you had from graduation and what mistakes you think you did!

Us, prospective CS takers would really appreciate this!
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Old 04-18-2011
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http://www.usmle-forums.com/usmle-st...-you-fail.html

Please answer the above poll if you have time!
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  #19  
Old 04-19-2011
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Quote:
Originally Posted by DRFP View Post
just about every case:
Chest = Breathsounds ( do not do fremitus every case)
Heart= Heart sounds all three spots on front, May do carotids but not necessary for every case.

It's clear in First Aid for CS
If you do not have a copy, to me it doesn't seem to matter a lot which year, then get one.
These things are covered 100% in the book

I have studied and now look back to what I did and I should not have passed ( I failed x1) now I think I get it, focused exam.

For example

ABD pain, dont do a HEENT exam focus on Abd assessment, do do a Psoas and obturator exam. Women 13 to 50 ask menses gyn hx

you have time for chest, heart, abd in most cases.

Focus!

I failed SEP with high fail because i was irritable and this made me did a lot of grammer mistakes and two patients said : i do not understand (my sound was low) .If you become irritable and anxious you can do like this even with your mother language.


I did a focused exam but in many cases i was disorganized ..i did not examine one case.

PN was the cause of failing in the ICE component ...May be because i wrote some exams : normal despite i forgot to do it .It was unintended...


The Magic word : Be calm...Be calm ....act as a real doctor
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  #20  
Old 08-17-2011
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Thumbs Down I took My 2nd CS attemp

Hi
I took my second Cs attemp in Mid july and have done this:

-Did not do closing or councelling in 4 or at least 3 cases(running out of time)the proctor came and drag me out of the room in all these cases.
-many cases i did not do councelling in about 6-8 cases.
-did not reach to diagnosis in 1 case and i was not sure about my diagnosis in another one.
- My feet hit the examination table with a loud sound and i did not even say sorry.
-Did not ask Menstrual history in one or two female cases.
-2 or 3 cases i took pauses when i was asking the patient.I stopped and thought while I was looking to the patient.
-Give one wrong diagnosis to a mother of child.
- I did not complete PNs in all cases ...about half of them I missed past Histroy,Social history ,allergy surgical history ,Surgical hx,Sex hx.
-I missed many positive data in HPI.
-write wrong first diagnosis in 1 or 2 cases PN.
-I torn two gloves in 2 cases and tell the the patient i changed my mind and washed my hands.
-Did not do auscultation of heart and chest in 4 cases .
-Write wrong chest auscultation data in one case.

May be i have done more ...But i am sure that i did this.
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  #21  
Old 08-17-2011
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Post To all CS takers

Hello everyone,
I am sorry to hear about the bad experiences that you have had in regards to CS exam. I took my exam and just got my results last week. I wanted to share some ideas that will perhaps help. Because I was worried about my results too and I often read others advice hear, I thought I should give back.
Just to let you know, I think I had great preparation; I did score very well on all aspects and in fact data gathering I had only 4 xxxx and a star above on the right side which implies well above average and only had 2 areas in which I had some x on the grey zone all else was above.
Here are what I can advice:
1) do not memorize questions on any video or first Aid, you don't have the time nor should you ask all and there will be no logic to your question flow.
2) make a flow diagnostic of major things encountered on cs exam, for example: Shoulder pain, differential, and the path of questions you should ask to get to your diagnosis.
3) It is helpful to have the basic mnemonic "PAM HITS FOSS" written on your blue scrap sheet before you enter.
4) I added some short mnemonic for gyn/ob hx, social hx and wrote that in form of alphabets with spaces in between ex: A B C, make your own and practice with it. but this will allow you to remember all questions and space allows you to just place check mark or how long smoker, etc, which will give you more time to communicate and keep eye contact with the patient. If you practice with it, should not take more tan 45sec to do before entering the room, but it will boost your score.
5) once you ask questions based on your flow diagnostics do the PAM HITS FOSS and go on to physical exam, DO NOT WASTE TIME THINKING OF EXTRA IRRELEVANT STUFF LIKE PARROTS! We are future doctors and the questions should have purpose or no reason to ask!
+++side note: when asking hx like PMH; do not say bunch of stuff together, SPs are instructed not to answer, I knew this and forgot and guess what both times I said : like diabetes, high blood pressure, cancer, the SP was like wow now I am confused and I have to think...so mention one by one and give them 2sec and they say yes or no. it will save u time at the end.
6) Physical exam, make sure ask permission, position blanket accordingly, foot place etc. and also when you do
-joints; make sure you do at least one joint above and one below, for DTR, Sensory and motor. Also you need to just inspect all other major joint. Please make sure you tell the SP that what you are about to do and have transitions.
-Cardiac exam should be done sitting and lying down if you have a cardiac related case.
-Respiratory for resp problem should be done front and back.
-Make sure you mention all scars and skin findings. I had most patients with surgical scars, which I asked about and documented, I had spider angiomas, and etc.
- Dizzy case, please determine is it vertigo or pre syncope and do the questioning and physical in accordance, because even then there is alot to do, and if you dont do that first, you will miss on alot.
-In Acute cases, Acute abdomen and emergency of any kind make sure you still do all questioning and convey your concerns about the situation to SP.
- Now for closing: NEVER advise patient on smoking after you ask them if they smoke, why??? Because that shows that you are not understanding and judgmental and in real world means patient wont share the truth with you after. So if you must and want to do it then, do it after all your social history is done. Make sure you Cage if Men > 3 drinks/ week women>2
Make sure you Pack years even if patient is no longer smokes. offer help and the 5A. also sexual protection and etc.
- Well this was my lowest performance of all and given I had about 2min in each case and did not do it in 2cases, I understand why!! Information sharing, which is when you explain everything. Well do your best given the time you have. Make sure no use of medical terms, and quick brief explanation of the next steps and at least 2-3 dx you are thinking of.

other points:
-wear gloves, washing hands will take too much time to dry properly and etc.
-special questions, I asked them if they had any questions or concerns? when I put on my gloves and some will not ask you then and keep it to the end and some will ask at the end, if they did not ask me then I made sure I finished things quicker to have more time at the end.
-Make sure you are friendly and sympathetic as you would be too a real patient, I even laughed and giggled at some comments SPs made, don't try to memorize a script. plus trust me you wont be able to hold on to it, and it will all go down!
-Patient note start with your diagnosis and test, physical exam and then history.

My mistakes:
- I was so stressed on my first case, I forgot to write one joint test even though I did it.
-I did not have time to tell patients what I was going to do and my thoughts on Dx in 2 cases
-In one patient note, I rushed social Hx and just wrote ETOH + and nothing about how long, time ran out
-My patient note kinda got messy (I wrote, big mistake..but now it is just typing) and this was my second area I got a little grey zone but it was fair since I only got like 3 or 4 x in grey and rest was in white.

Ok that is what I can think of at this point, hope this will help. Be more than glad to answer questions and hope you all benefit from this post. I am sure you will all do well, persistence is the key.
Good luck
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  #22  
Old 10-16-2011
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Smile ICE in CS

Quote:
Originally Posted by dreamer2011 View Post
I also failed in data gathering.....I knew I did poorly in data gathering and questioning skills even before I got the results because I "finished" each station before the 5 minute warning was called.....I guess that's what happens when you've been out of clinical practice for a year .Here is my report: (sorry about the formatting....but you can get the picture. l l are the borders.


ICE XXXXXXXXXXlXXX l

Data gathering *XXXXXXXXX l l

Patient note XXXlXXXXXXlXXXXXX

CIS XXXXlXXXXX l

Questioning skills XXXXXXXXXlXXXX l

Info. sharing skills l XXXXXlXXXXXX

Prof. man. lXXXXXXlXXXXX

SEP l l XXXXX*
I failed ICE, data gathering and patient's notes, but CIS is above average, and questioning skills also did well.
I donot understand why very low performance on ICE.

Please anyone suggest me .
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  #23  
Old 10-18-2011
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Sorry

I fogort to mention that I passed CS in my second attempt.

I passed with a very high performance in Data gathering (Star toward the end).This is opposite to my first attempt result.

you can search my posts about how to pass ICE and PN.

I posted them in many threads in this forum.

The most concise advice...Practice alot in timed manner

DO not neglect clinical examination.

Search for physical findings in SPs.You will find a lot..and accept as a real.

Do not fake examination..

Ask Millions of Questions(Related to the case even with minimal relation)....

Do what you do in your medical career when you encounter a patient to reach the diagnosis).

(This is not an exam of acting ...This an exam of medicine).

Best wishes to all members.
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  #24  
Old 12-07-2011
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Default Data gathering

Quote:
Originally Posted by mary View Post
You can't fail by data gathering only! there must have been other components that failed you.

Upload a scan of your score report and let's see it and then we can tell you how to improve yourself.

Are you certain of this. I received an asterisk for data gathering and my scores for patient note were in the "higher performance" area and I received a score of Fail for ICE. I find this strange because the patient note is simply the data you gathered in a written format. It seems that it would be impossible to have a higher performance score in patient note and asterisk for data gathering.
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  #25  
Old 12-11-2011
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Default failed cs and need your help

hello everyone
i recently got my result...............................i failed in sep.........................................i also failed in ice due to pn but i got high score in data gathering...............i passed cis....................
so i want to know that
1. should i apply for recheck?
2. is there any negative image (impact) of rechecking on next repeat exam or other exam?
please help me
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  #26  
Old 12-14-2011
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I agree data gathering low star but good pn !

Hii
As it can be seen , I have done well in PN and done so well that it OVERTOOK the low performance STAR on my Data gathering skills bar .

How can we fill the PN so well without gathering data and doing focussed PE Sir anyone can pls tell me IS THIS POSSIBlE...

1. With low star on data gathering (hx and PE)..how can I fill the CC, hx of cc, ros , pe , and then arrive at possible diagnosis..

2 Then the Physcian evaluating my PN must be Dumb or the SP have to be Dumb . Or ,sorry for being frustrated I must be dumb for choosing usmle !

3. If say I really didnt gather data or do appropriate PE , then the information I shared about their possible Diagnosis should also be wrong ! But I got higher performance on Info Sharing skills and questioning skills !!

Last edited by drsv; 12-14-2011 at 09:29 PM. Reason: add more
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  #27  
Old 02-01-2012
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Quote:
Originally Posted by damien316 View Post
Are you certain of this. I received an asterisk for data gathering and my scores for patient note were in the "higher performance" area and I received a score of Fail for ICE. I find this strange because the patient note is simply the data you gathered in a written format. It seems that it would be impossible to have a higher performance score in patient note and asterisk for data gathering.
The same happened to me.all scores where above the borderline but not dats gathering which was with an asterisk...and i failed...how it's possible?
When and where did you take your exam?
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  #28  
Old 02-03-2012
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hi
i had a similar problem , had higher performance except poor in data gathering.I asked everything.....is asking too many questions not considered good?
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  #29  
Old 02-03-2012
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I don't know...i think i asked a decent number of questions..like i asked to every patient about etho,drugs etc and i counceled a lot...but i didn't ask about sexual life to a 80yo patient!maybe it was that...so ridiculous...
Anyway where and when did u take it?are u going to take it agsin?
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  #30  
Old 02-03-2012
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I don't know...i think i asked a decent number of questions..like i asked to every patient about etho,drugs etc and i counceled a lot...but i didn't ask about sexual life to a 80yo patient!maybe it was that...so ridiculous...
Anyway where and when did u take it?are u going to take it agsin?
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