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 CS doubt in FA Kap UW you used  
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Author43 Posts
  #1

Hi everyone, I'll start some doubt in pt encounter of FA that I like to be sure it is what it said ..

1. pt will say ... hush hush for mur mur, carotid bruit.. any one done exm alreday or not, pl verify it , thnx .

2. what noise pt will make if wheezing , cracker , bronchial breath sound ?

Thnx,

GL to me, us , all



  #2

Today's doubt ...

If you did not know the medication name pt said.. can you ask pt to spell it out for u or write it on ur blue sheet ?

thnx.

GLnod


  #3

pt encounter almost done , will start mini case today hopefully .nod


  #4

shwe wrote:
...1. pt will say ... hush hush for mur mur, carotid bruit.. any one done exm alreday or not, pl verify it , thnx .

2. what noise pt will make if wheezing , cracker , bronchial breath sound ?
Thnx,
GL to me, us , all


1. I didn't have any patient who did hush, hush nor did I find any murmur but I don't rule it out especially in those cases that I didn't auscultate. In my first attempt I auscultated everybody but I failed the test because I ran out of time.

2. I had patients (standardized ones) with lung disease usually long time smokers who had a lot of sounds (wheezing, bronchial sounds and possibly some crepitations).

'hope it helps. Good luck.


On Jan 03, 2012 - 9:44 AM, shwe responded:
Q .. u mean if try to listen heart , lung ...every cases .. time will run out.
So did u skip both heart, lung auscultation if not related to cc in the test u success ?

FA cases seems long talking, , hx, exm .. I don't think I can do all without fast talking , moving quick ...which they will not like sad

Anyway , so far not do time frame yet, just try to get used to the trend , flow in cases .. Q , exm, summary closing, counselingwink

Happy New Yr all my friends !

GL to me , us, all nod


  #5

Thnx alot nod

I'm reading FA CS , will do kap cs book too , UW may be if time permit .

FA CS

pt encounter done , so many sentence to get used to . So need review .

onto mini case 1st .. headache cases all done.. got correct DDx , tests .. hope this mood, momentum will stay in exm room wink


GL to me, us , all nod


  #6

Hey sis, you are doing great. When are you taking CS?
Happy studies and GL nodsmiling facenodsmiling facecoolnod


On Jan 03, 2012 - 9:26 AM, shwe responded:
Hi sis , nice to hear from you, was trying to get it through since last yr b4 new typing only thing in , but so many red tape, school side, this side , that side so finally all set .. so am thinking better finish it b4 I change my mind, kidding , b4 another new system kick in . I advice you to do so .

Thnx , will do Cs 1st then st 1.
Now reading more CS than st 1 .

Pl check ur pm wink

GL to me, us , all nod


  #7

CS is not easy like ppl said.
It need lots of both medical [ in big picture ways ], clinical, social , way of speaking , body language trends of USA in real medical clinical setting .

After knowing what to do, ask, react , handle etc next is ... practice it again & again to have most basic things , act , speech as fluent as like you can do any time in the day smoothly , without hesitation, thinking like you are seeing the pt at ur clinic, hospital, ER .

So many mnemonics , style , format .. how to do PE , speak , react ... all different books, courses , advices comes in similar or different versions .

Hope , will find the foundation to build & make it as own style & stick with it so will not be confuse .

Anyway .. dear CS takers ... will keep this as my CS journal & also put any doubt if run into .

Dear Journal ... so far had practice " intro ".. just have to keep intro as daily routinenod

" Door way " practice will take for a while... will be after the all system hx, PE clear in mind .. create own style ,format too .

As usual , in medicine , u can not reply on single book . Like Papi said ..the more u read , the better u score .
So keep reading shwe ... the FA , kap ... later the ... uwgrin

GL to me, us , all nod


  #8

Any input re followings ... friends & Cs takers or CS done persons...thnx.
The Qs are also for me to remind that which choice I will do at exm .

Q...1. to use gloves or wash hand ... well ,will see.

Q...2. to sit or not to sit ... will see.

Q...3. summary at the end with counseling or summary b4 PE , no more summary at the end ... will see, I prefer at the end though .

Q...4. to do general PE or not to ... will see.

Q...5. after intro to say or not to say ...
a. Is everything Ok in here ?
b. I'm going to ask you few Qs & perform/do PE.. is that ok with you ?
ie after saying pt last name, my last name, my id .

Q...6. to say or not to say ... nice to meet you , good bye[ if pt has no Q for me at all after summary & counseling]

That's all for today to think about CS unclear concepts in pt's encounter .

Will have Q/doubt re to bring food or not
re how to or not to dress that way including , hair style, shoes , color of tops choice .

GL to me , us , all nod


  #9

Dear Journal CS my self reminder #1
... like any usmle prep......
more notes, books, info u get.........sometimes u confused .

So today is for

At ... DOOR INFO...
will write on blue sheet ......
pt id with cc & +ve VS as follow

Mr/Ms ... 25 Abd pain
101' 90/60 110 24

... INTRO ... I 'll do after knock knock.........

Hello Mr/Ms ...
I am Dr .....
I am your Dr today

Let me cover you with the drape ( to make u comfortable )

All above in
...smile smiling face,
...sweet , gentle , loud enough voice, tone
...with not too fast , not too slow ... clear word by word with
... good eye contact cool&
... ?? hand shake ??... if not pain pt .

How can I help u ?

Say ... as needed ... I am sorry to hear about that sad

Practice with every breath sticking out tongue nod


  #10

Like it smiling facenodnodcool


On Feb 03, 2012 - 7:52 PM, shwe responded:
Thnx Sis , will try to figure out how to ask in every cases but key is what /how to say in every cases as basic lines too .. that I'll like to memories so will try to write little by little more here , hope will be done soon wink

Practice after read all info, FA well .

Do not forget to practice typing too , lots of cases in a day in typing, in parctice , especially live, timed nod

GL to me, us nod


  #11

hey there,

can i join in your prep?...i m giving exam in a month as well.
For a mini mental status exam- do we do it for all cases?
thanks and goodluck to us smiling face


On Feb 03, 2012 - 7:55 PM, shwe responded:
Hi welcome to my CS prep .

Go ahead, post ur doubts, Q, concern, plus ur style .. the way u'll like to say in sp's rm .


I will not do mini mental to every cases, will only do for related case, will even do shorter or longer depends on the cases.
It's just me .
Do ask around, esp who pass CS already .

Thnx , GL to me, us , all nod


  #12

My biggest challenge is typing .
So should type daily to get it on time .

Keep typing ..

re FA Qs .. u can never done asking all in FA so , starting trimming FA Q after all cases done .. ie later project.

Now keep doing FA , & typing nod

re neuro cases, better done Hx earlier than any other cases to have time for neuro exm , hope will not compromise the Hx.


  #13

i read in one of the forums that practice with a keyboard.nod

Thanks shwe


On Feb 03, 2012 - 9:45 PM, shwe responded:
Do u mean using desk top , with standard key board?? ,not lap top key board ?

Any way , u r welcome, c u here daily wink

GL to me, us, all nod


  #14

yeah the desktop keyboard. coz exams dont have laptop keyboard- i knw they seem much faster.nod


On Feb 04, 2012 - 8:01 AM, shwe responded:
Thnx, never type much on desk top so have to change all posts even this to type on desk top next time till CS done , I guess.

K, keep studying, practicing , lots to cover , memorize & sink in to that trend, mood, modewink
grin

Nice to have u here , do post ur daily CS prep, concern , doubts ... more brain is better , have more idea, see more do .. don't , mistake than one brain in term of CS encounter , sp notes .

GL to me , us , all nod


  #15

I have anthr doubt...might sound silly...but in a case of hallucination- do we need to say"im sorry to hear that....." ? and do all the empathy part like any other case?


On Feb 04, 2012 - 1:34 PM, shwe responded:
For me I will said so since it's annoying or disturbing or in confusion cause no one except pt see , hear things ... for pt point of view so , say ..
... I'm sorry for that/about that .
but u can say more like ... it must be a very difficult time for u [being hearing voices , or seeing things that others could not . ] not sure about [ ] should add in or not .

What do u think??


  #16

My doubts...

I. which is better to say ...

1. can u / can u pl ... open ur mouth

or

2. pl open ur mouth ie pl do this , pl do that instead of have saying ... can u pl do this, that ...


II. Do u need to say, ask permission after intro, drape ... saying ...

3. I'll like to ask few Qs , [ and do PE on you ], is that ok with u ?

or

4. I'll like to ask few Qs ? [ without asking q as ... is that ok with u ?]
If no score for that ... I will skip the asking permission part
BUT
in FA when PE comes .. it said ...
have to ask permission to do PE ie in check list so ie in score system I guess .

Any input from ppl who had done or not done CS yet , thnx wink


  #17

K, easy for real PE, but as for CS.. do, don't like ........do not expose too much .

So let say male or female...

u need to do heart front , chest exm front ,back ..
back is ok .. while pt sitting, untie gown... listen , exm chest from back .
then what ... now confusion, doubt is in .. which way is acceptable
1. without tie up the gown , come to front for heart exm ... ask pt lower the gown on front
then ask pt to put the gown up then help ...tie up the gown b4 pt need to lie down or do next test sitting up
or
2. ... let pt lie down without tie up the gown ...
pull gown down to expose area enough for heart exm
then let pt or help to pull up gown up back onto shoulder ..
2.a .
gown still not tie up yet
or
2.b .
ask pt to roll a bit to side to help tie up gown
or
3. instead of exm back of the chest ...
can be
...untie gown then
...lower the gown at ...front , listen/exm front for... heart
then
...go to back, exm ...back of the chest
... then help tie up gown
...then pt can lie down on the back

so now pt is lie on the back ...

then rest r easy for abd expose ..
pull gown up, move drape up , leave room enough for abd exm .


  #18

Did I already ask.. to be or not to be .. re HAND SHAKING ... yes or no as a must or optional .. raised eyebrow

Now am focusing kap notes I wrote , plus soon PN .. better do at least 2, but frd said 4 , so let see .. 5 or 6, or 2 a daygrin


  #19

http://targetusmle.com/ Go try out .

Really good,organized , solid CS skype, if u r in India can even go for mock with real life sp timed , pn check by target .

Great teacher, great American English that makes us talk in same flow .
Compare with others price wise is also we can reach .

After ages of kap 3 day I attended & FA reading, practicing, am glad I got to finish target CS that organize, round up , give solid foundation in system wise hx to PE , thank you thank you thank you targetusmle.

Time to review them , dissect them so all will come out smoothly on the day nod


  #20

shwe..i dont know if i am going to be ready ...by May ...

i have heard it takes just a month or so for cs 

how much ck knowledge is needed...not done with any steps...

cs would be the first ...so what material should i be looking at..and how to approach...


On Feb 12, 2012 - 11:26 PM, shwe responded:
How sorry to reply late , will pm u my e mail so can tell u more re everything . FT Cs study you may need 1.5 mo or 2 mo depends on your confidence level & having live & skype "GOOD " partner is the key .





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