Originally Posted by Bobby Medicine
I'm a complete idiot. I just took Step 2 CS and realized that I misdiagnosed a diabetic. It was obvious in hindsight, and the SP was practically telling me to go down that route. I did not do the proper PE for him (no fundoscopy or sensory in feet), I missed the diagnosis completely, and I missed the workup also. I obviously didn't counsel him about it, as I didn't realize he had it. I completely bombed this case. Im terrified because it was such as easy case.
I also made huge errors in other cases. There was a case where I didn't have time to do the required Neuro exam, so I probably misdiagnosed the patient. I think I ended up being unsure of the diagnosis in about 3-4 cases.....
As long as you do Cardio, Respiratory, and a focused exam for the chief complaint you should be good for the physical examination points.
When I did my CS, I did a very brief neuro exam for the MAIN symptom and never did the whole neuro exam - takes far too long. I would simply put it in the procedure/orders section afterwards. For example a patient with neurological problems I would order a full Neurological Exam, Head CT, etc
I've also heard that they discount 2 cases. In my exam I totally forgot to wash my hands/wear gloves for one case; didn't counsel for smoking and safe sex for a few cases and a few other mistakes here and there and I still did well. I'm sure you'll be fine.