Originally Posted by csevideo
Thank you for your question.
The CS exam is different from what you would do in an actual clinical setting. In an actual clinical setting, you may offer the patient an OTC for their pain. However, the purpose in the exam for the sp to be asking for a pain medication is twofold, one due to actual pain and two simply for the purpose of retrieving pain medication from you. I would recommend the outline you see in the video for the CS exam unless during your closure the sp request's pain medication a second time. Then you would respond by saying "Yes I can give you some pain medication today." It is very common that the sp will demand pain medication at the beginning of the encounter so that you can be tested on your initial response and ability to show empathy. If you have any other questions please let us know we are happy to respond.
I appreciate your response. Thank you. I understand that sometimes management of the SP may differ from an actual setting, but there is one more point that I would like to discuss. One of the possible Diffrentials was "acute appendicitis". Given that this is an acute, painful condition, would we still ask the patient to wait for 2 days until results return, even when we have suspicion of appendicitis? I noticed the doc in the video did not even consider Abdominal U/S. Would that not be relevant though when I suspect appendicitis? And with that suspicion, should I not keep the patient under observation, should she need surgical intervention. With appendicitis, there is the risk of rupture, correct? That's why it seemed unconventional for me to see the doc tell the patient " wait 2 days, we will call you".
I would appreciate it if you would kindly take the time to clarify this for me. Also I would like to add to that the same patient did mention the need for an aanalgesic just prior to physical examination, so it was mentioned twice.
Thank you again. Your input is important.