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USMLE Step 2 CS SP Challenges Challenging situations presented by the Standardized Patient (SP) during the the USMLE Step 2 CS Encounter.

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Old 03-12-2012
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Help Lights off please; I have headache

The patient with headache says he prefers the lights to be off in the room while you are talking with him.

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Old 03-12-2012
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Always make the patient comfortable, so if he wants the lights off, you can switch the lights off (if it is daytime), if it's night time (afternoon CS shift) you can just dim the lights, I mean do not make too dark, you still need to see the patient and do the examination.

The idea here, is that they want you to pay attention to the patient needs and be sympathetic, so once you do that, that's it, you will be checked out for sympathy.

The other hint here is "photophobia" so think of Migraine or Meningitis. Meningitis should be on your differential diagnosis even though it's extremely unlikely as the final diagnosis in CS encounters.

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