Isther
Forum Guru
Topics: 39
Posts: 745
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So... you were absolutelly right. Certainly, is quite useful to knock the door with at least 2 DD, and a system wise approach is better. Today I could finish 6 out of 8 cases with extra time for the PN, that's a heck of a progess in only 1 day (THANKS THANKS THANKS) Another tip that helped me was to use my swatch clock facing down, so while you are writting, you can see the time without letting know the SP. In 5 min the PQRST of the CC and the ROS can be covered in easy cases. A friend used to cover SH while washing hands, and also helped me.
I'm still having problems with the complete neurologic exam (takes too long), but hope to improve that on the days left. If I get another good advice I'll post it to share with your fans...
Since then... All the best!!!
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| kald
Forum Junior
Topics: 4
Posts: 35
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LisaM, your preparation journal is very helpful, its giving me an idea of how to study and i have my exam in month's time so its getting me oriented to CS. thank you Kal
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| naina
Forum Senior
Topics: 15
Posts: 65
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hi isther, ur tips r really helpul, thanq very much,
wish u all the success, also thanqs to lisaM and other frens aswell
naina.
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| Isther
Forum Guru
Topics: 39
Posts: 745
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My CS is in 2 days... just arrived to the US and barely can stay awake... I'm feeling quite anxious so if there is any last minute advice, I really need it. I still can't perform a neurologic exam in less that 5 min...
Thanks and take good care!!
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| LisaM
Forum Guru
Topics: 16
Posts: 319
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Hi Isther, Welcome. Hope you have overcome the jetlag. Please practice CNS exam (or any other physical examination) well enough that you can do the maneuvers without thinking about it. I practiced even in the airplane, by just mentally asking the questions (thereby getting comfortable with the phrases to use) and then mentally going over every detail of the examination. Examination of cranial nevers should really take less than a minute. I would start with counting fingers for vision test, a quick fundus exam, examine extraouclar movements by moving our fingers in X and H patterns, examine sensations on forehead, clench jaw for V, smile, grimace, test hearing by whisper test, test swallowing, sticking tongue out and moving from side to side, shrug shoulders/ turn head- finish! SPs are quite helpful too, and in a CNS case, I think they would actually cooperate to help us complete the examination. But do try to explain quickly and clearly what you are going to do and what you want them to do when testing strength, sensations, reflexes etc.
I think it is a good idea to stop studying/ looking at study materials/ going over stuff mentally- at about 6pm the previous evening and start to relax. You will certainly forget something during exam- even something crucial, and when it is anticipated, it can be dealt with more easily and without panic. The test does take into account the stress factor. So relax, overall. Be attentive to the directions before exams and follow them to the word. Walk in with a smile, and treat the encounter as real. When you do that, you will automatically feel sorry for the person in pain etc. All the best to you, Isther! 
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lisa
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| Isther
Forum Guru
Topics: 39
Posts: 745
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Thank you so much!!! Your words are reassuring. I'll write soon after completed my exam.
Take good care!
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| SilatK
Forum Guru
Topics: 42
Posts: 577
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Thank you Lisa for starting this journal besides the good info you have it helps you relax.
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| icycool
Forum Junior
Topics: 2
Posts: 24
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LisaM ,thanks for this journal
i have just registered for the exam and was thinking how do i tackle it ...your post is really great
i really like the idea of learning d/d before doing anything else.thanks again
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| som
Forum Guru
Topics: 59
Posts: 308
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Hi LisaM,
your journal for CS is very helpful n thnks for sharing ur prep info. In ur earlier posts u said tht ,
LisaM wrote:
I really found some helpful counselling tips too that made counselling quick, easy and positive. For instance, if I were to counsel about smoking, I would do it right after I asked "have you ever smoked"? If the patient is a current smoker, next question would be "have you ever tried to quit smoking"? If yes, I would just counsel about how to improve his chances of quitting. If never tired to quit, then the next question is "are you aware of the harmful effects of smoking"? Then I had a little 3 sentence speech about how smoking causes cancers, stroke etc, how quitting reduces those risks, how the person could get help with quitting smoking. I had these little speeches prepared for counselling for STD, Alcoholism, and ofcourse, standard ones like how to convince mom to bring child to ER etc.
All the best to you!
can u pls give some tips for counselling as I'm finding difficulty in this part esp for STDs, psych cases.
Thanks
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| LisaM
Forum Guru
Topics: 16
Posts: 319
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I got my CS results today and I have passed. I am very happy and thankful to God, my supportive family, all my good friends who have encouraged me relentlessly and my two study partners.
Som, if you go through the conuselling sections, you will get an idea of what you are expected to say and then it is a matter of wording the sentences in a manner that you are comfortable using. For STD counselling, I would the following questions in personal history after appropriate transition sentence- "Are you sexually active". If yes, I would ask "How many sexual partners have you had in the past six months". This I used instead of asking "Do you have multiple sexual partners" which I was not comfortable asking. Also, I found the question "are your sexual partners male or female or both" a little offensive though we may be required to elicit such information. So, I decided to reserve that question only in someone for whom I had high suspicion of STD along with "Have you ever been tested for STD".
If the SP gives history of multiple sexual partners, then I would ask "Do you use condoms". If yes, I decided to leave it at that, especially if the history was that of a stable relationship. If I had to counsel specifically for STD, "There is a risk of infection with sexually transmitted diseases in anyone that is sexually active. The risk is increased when there are multiple sexual partners. Abstinence from sex is the best method to prevent infection with and spreading of sexually transmitted diseases. When this is not possible, the risk is reduced by limiting the number of sexual partners and using condoms which are also a reliable method of contraception."
For psych cases, the counselling would ofcourse depend on the diagnosis which will be quite different for Alzheimers, depression, schizophrenia etc. Hope that helped. All the best for your exam.
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lisa
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| Isther
Forum Guru
Topics: 39
Posts: 745
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Congratulations LisaM... I knew the result since I read your journal for the first time... Now its time to celebrate... All the best!
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| doctor81
Forum Elite
Topics: 34
Posts: 240
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congrats
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| LisaM
Forum Guru
Topics: 16
Posts: 319
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Thank you for your faith in me and your good wishes, Isther. Thank you, doctor81.
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lisa
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| kald
Forum Junior
Topics: 4
Posts: 35
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Lisa
Congratulations!!
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| nithu
Forum Elite
Topics: 15
Posts: 200
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Hi LISAM,
Congratulations.Good luck for ut step3
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| som
Forum Guru
Topics: 59
Posts: 308
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Congratulations LisaM !!!!
Thanks for the info n Gud Luck wih ur fiture endeavours.
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| shyma
Forum Senior
Topics: 1
Posts: 65
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congrats Lisa M
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MAY ALLAH SHOWER HIS BLESSINGS UPON US
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| waqastariq
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CONGRATS LISA..thats great 
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| LisaM
Forum Guru
Topics: 16
Posts: 319
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Thank you everyone!
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lisa
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| djyoti
Forum Newbie
Topics: 0
Posts: 13
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it is better not to miss pamhugs foss soda in any cases
it is not wise idea -- to take orthostatic bp -- just mentioninng is okey -- it kills ur time
tilt test is also not so much necessary -- in my opinion -
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