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

 

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

 

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.

 

mnemonics for various cases.

http://www.usmle-forums.com/usmle-step-2-cs-mnemonics/41705-my-cs-mnemonics.html

 

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

 

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?

 

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...

 

about pe?

so we only do the physical exam points mentioned in first aid for a particular system?

 

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.

 

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?

 

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. :toosad:

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.

 

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!!!

 

Great mnemonics. Thanks Dr Laura!

 

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.

 

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.

 

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?

 

PE

Quick question, Do you palpate thyroid from front or from back?

 

Quick question, Do you palpate thyroid from front or from back?

AFAIK, from back.

 

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.

 

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

 

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

 

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

 

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.

 

Thanks Tamta for making this thread. Hopefully we'll be ready by May to pass this last thing... Happy-2

 

PE

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?

 

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

 

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

 

Does the examination room contain neuro hammers and a tuning fork?

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

 

Does the examination room contain neuro hammers and a tuning fork?

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

yes everything is in there and they let you check everything before exam.

 

Hello guys,
My exam is in April too. I have just started my prep. I hope that we all will pass the exam.

 

Quick question for who took the exam: is it possible to use the copy/paste command in the pn?

 

Are we supposed to counsel on cancer screening for ALL demographics where they're recommended regardless of the case?

Colonoscopy > 50 y/o, every 10 years
Mammography > 40 y/o, every 1-2 years (although there's a recent study saying it doesn't affect mortality rates)
Pap smear > 21 y/o or 3 years after first sexual activity, every 1-2 years


Suppose I have a 51 y/o woman complaining of heel pain who haven't had any of these yet. Do they expect us to counsel her on all three?

 

Are we supposed to counsel on cancer screening for ALL demographics where they're recommended regardless of the case?

Colonoscopy > 50 y/o, every 10 years
Mammography > 40 y/o, every 1-2 years (although there's a recent study saying it doesn't affect mortality rates)
Pap smear > 21 y/o or 3 years after first sexual activity, every 1-2 years

Suppose I have a 51 y/o woman complaining of heel pain who haven't had any of these yet. Do they expect us to counsel her on all three?

I guess in such case u should counsel her on osteoporosis due to menaupause , so u counsel on exercise and ca++ , vit d intake?
Fof colonoscopy I guess h leave it for related cases and high risk pts.