soujany
Forum Elite
Topics: 19
Posts: 194
|
Hi, I have just got my step 1 score and have started to study seriously for cs which is on June 2nd. I have planned to put a diary myself so that I can see if I am up to the mark in time and subject regarding my preparation. I think I have completed about 15-20 sample cases of UW. But not really seriously. Now I think id's high time I get started seriously. I have FA and UW and also the 40 cases. Now I get started. I think updating myself about my progress keeps me going and if I don't be up to the mark then since I am making my study diary open to all, Maybe I would be cautious in studying also.
So my plan:
May 15(Monday)-complete 15 cases of sample UW cases. Since I don't have any study partner at present, I would practise with my teddy, my Barbie dolls.
May 16(Tuesday)-Complete the next 15-20 sample cases of UW.
May 17(Wednesday)-Complete the total 46 cases.
May 18(Thursday)-Practise cases of UW half of what is given.
May 19(Friday)-The remaining practise cases of UW.
This would complete the preliminary preparation. Then on Saturday and Sunday I would practise with my husband the cases I have done.
May 22(Monday)-First Aid cases complete the minicases.
May 23(Tuesday)-Practise tests the first 20 cases.
May 24(Wednesday)-Practise tests remaining cases.
May 25(Thursday)-Re-revise and practise writing PN.
May 26(Friday)-Re-revise and re-practise the week's reading with my teddy.
Then Saturday and Sunday, I would have my Husband. Actually I don't do much reading at weekends. So only thing I will practise practise all the read cases with my husband.
May 29(Monday)-Re-revise and practise the sample cases of UW
May 30(Tuesday)-Re-revise and practise the practice tests of UW
May 31 (Wednesday)-Re-revise the first aid cases again.
June 1st(Thursday)-Memorise the mneumonics and give fine touches to my weak areas.
June 2nd(Friday)-My exam day.
Okay with time table I am all set to get onto the move. Now the key to success is motivation and determination. I leave all the household work and cooking for my poor husband and stive to practise my best. I wish myself best of luck.
Okay today May 15th my target was the first 15 cases of sample cases of UW.Now it's 2 O'clock in the afternoon and hurray! I could complete 13 of the sample cases. I should re-revise them again in my remaining time.
|
| dr_jazzy
Forum Newbie
Topics: 2
Posts: 8
|
Hi,
I have an exam on june 8th.Im quite impressed with ur Time table.I have also started studying for cs from today.
Can u guide how u r reading sample cases from cs?I mean how r u memorizing the details of sample cases.I studied 1st case (dark urine) but finding difficult to rem. the points i need to ask pt.
Good luck for ur preparation n exam.
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
Hi jazzy,
For that I have tried to memorise the differential diagnosis first. when u know the d/d then questions can be formatted based on them I think. I have started to write only the d/d on small stick-on papers and as I keep completing the cases I keep preparing these and paste it over easily accesible walls. I can revise whenever I am free or my husband planned that he would ask me okay tell me the diffrentials for dark urine or so. The plan is somewhat like this but should see if it works. Anyway I think if one is strongly determined then it's possible. Maybe u can try this way and anyone like ur mum,brother, sister, husband can just throw u a question when most unexpected. Hope this helps u.
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
Okay today I could complete the remaining cases of Sample cases. As my time table is scheduled for completion of the cases even for tomorrow, I would practice them with my teddy and also practise their corresponding Patient notes.
Obesity Case
D/D: Nutritional,Hypothyroidism,Cushing's Syndrome,Medications,Polycystic Ovarian disease.
So questions to ask.
General-since when? Was it gradual or sudden, over what period, central or peripheral distribution
Nutritional-Ask about diet/exercises
Hypothyroidism-any intolerance to cold,constipation,hair loss, skin changes,voice changes,mental changes,menstrual irregularities
Cushing's syndrome-any striae notice over body,mood changes
Medications-any use of steroids,appetite improving drugs
PCOD-Any hirsutism
Then problems associated with obesity-any polyuria/polydipsia, any joint pains, shortness of breath, chest pain, gall stone features, any sleep problems, any stress incontinence
Then ask for PAM HUGS FOSS.
Examination-remember to check for thyroid.
Councel well about diet and exercises.
Investigations:General and Complications-Fasting sugar levels, Lipid profile,CBC.
Hypothyroidism-serum TSH
Cushing's syndrome-urinary cortisol levels.
|
| 3535
Forum Guru
Topics: 19
Posts: 297
|
 very inspiring post.
I shall too have 18days in hand to prepare after i am done w/ my 2ck.your confidence inspires me. i have helped some friends by acting as s.p. and so i have a little idea about exam. otherwise i am totally blank about cs.
can you pl tell me if u have taken any course for cs. Thanx.All the best.
___________________
"It takes one hour to cut a tree ,but a thousand hours to sharpen the axe."
|
| SilatK
Forum Guru
Topics: 42
Posts: 587
|
soujany,
Try to memorize the neumonics as early as possible not at the end. It will make a world of difference in your learning if you do so.
Also find another partner that is preparing for this test. Practice live or over the phone. it will help you a lot too. You will be able to pin-point small mistakes that either one makes. And also he or she can take the time while you do the cases.
That is good that you are practicing all of the D/D's. Practice writing your note but after practicing cases with someone it will be a lot easier to write it.
Good Luck to You!
___________________
To know is to not know..
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
Silatk,
Thanks folks for the advise. Yeah! I take ur advise and try to find any partner. My pace with my timetable is pretty good but I really don't know how I am doing, there is no one to judge except the weekend when I practise with my husband.The mneumonics, I am reading and noting them as I read.I would pay more attention on memorising them from now itself. Thanks a lot for the help.
3535,
No I am not going to any course nor am I planning to take any. I have heard that we can do thru the exam if we practise well even without any courses.
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
Hey I happened to go to a medical bookstore where I found Blueprints for CS. I read the book there itself, didn't purchase. The book is not very significant but there is a mneumonic to remember the various D/Ds. It goes something like VINDICATE. But I forgot the some of them.
V-Vascular
I-Infections
N-Neoplastic
D-Degenerative
T-Traumatic
I-Immunologic
C-Congenital
A-?
T-Toxic/piosons
E-?Environmental/Metabolic.
Is this correct. I think it's easy to memorise the d/ds based on these. If anyone is using blue prints plz help me give for what A and E stand for? Thanks.
|
| batchiara
Forum Newbie
Topics: 4
Posts: 7
|
Hi everyone,
I am preparing for USMLE 2 CS for June 8th, your posted are very useful, thank you all. I finally found a friend willing to be "guinea pig", but I feel like I am not studying in an efficient way!!!!
I am way behind....it took me a while only to figure out what all this was about. Should I reaview each case on my own after I practice in the day?
In the D/D I get not more then 3 hits same for tests....any advice.
I do not practice the PE I just pretend and tell at loud voice the different manouver..
Any advice is very welcome!!!!
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
Case:
Mother complaining of 5 yo male child with Temper Tantrums
D/D
Normal Childhood Disobedience/Rebelliousness
Oppositional defiant disorder
Conduct disorder
ADHD
R/o drug or alcohol abuse
Questions to ask:
Since when the problem started?
How often do tantrums occur?
When do tantrums occur?
Where do they happen?
What dose he do?
How bad are they?
Does the child do anything else at that time?
Any precipitating factors?
What makes it better?
Anything that makes it worse?
How do u deal with them?
How much the tantrums are affecting them and the family?
Does he listen to parents?
How does he communicate with peers? with adults, teachers, etc?
How do complain about school?
How are his grades?
Has he gotten into trouble in school or with the law?
Being abused/ abusive?
Tried drugs?
Alcohol?
Sex?
Any extracurricular activities? what?
Any mood swings?
Hallucinations?
Threats?
Others- how was his health till now?
Any prevoius medical problems?
Any allergies?
Appetite and any weight changes?
Birth details.
Any perinatal/natal/postnatal problems?
Immunisation status.
Developmental history.
Toilet training-attained and at what age?
Eating and sleeping habits. Any enuresis?
Workup:
1. Physical examination
2. Contact teachers/ school
3. ADHD testing.
4. MMPI testing
5. toxicology screening for drugs/ alcohol.
Councelling:
Mrs. XYZ. based on the information u gave me, ur child may have -- or --. But I need to thoroughly exam him physically and order a few tests upon him as needed. And only after the complete evaluation I will be in a better position to discuss his diagnosis and treatment options.
Do u have any questions or concerns?
Hey! I think the councelling part I bombed. Any better councelling for temper tantrum case?
Plz let me know what / how to do.
Thanks in advance.
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
A 45 yo f for prepregnancy councelling
Questions to ask:
First Gynecological/Obstetric history:
Mrs. XYZ. I am happy to hear that u have come for a prepregnancy councelling. Can u tell me about ur cycles.
When was ur LMP?
How often do you get ur menstrual period?
How long does it last?
How many pads/ tampons do u use per day?
Have u noticed any change in ur periods?
Have u ever been pregnant?
How many times?
Have u ever had a miscarriage?
In what trimester?
Do u have any vaginal discharge?
Do u have any pain during intercourse?
Have u had a Pap smear before?
Immunisation status about Rubella. And when?
What made u decide for getting pregnant now?
Do u have any specific plans for getting pregnant like artificial insemination/ IVF?
Then Sexual History:
Are u sexually active?
Are u in a stable relationship?
Do u have any other sexual partners?
Are u using any type of contraception.
Did u ever have any previous sexually transmitted disease?
How old is ur partner?
Then Medical History:
Questions to rule out fever/cough,cold/lung conditions/heart conditions/etc.
Appetite and weight changes.
Exercise and diet.
Do u have any past medical probelms like high blood pressure, diabetes, heart or lung problems?
Any allergies?
Remaining of MA HUGS FOS.
Is there anything u want to tell me.
Physical Examination:
General, thyroid, cvs & lung ausculatation, abdomen examination. Tell the need for breast and pelvic examination.
D/D:
----------
Workup:
1.Pelvic examination.
2.CBC with differential.
3.Basic metabolic screen.
4. Blood glucose and HbA1c.
5.Lipid profile.
6.Chest X-ray and EKG.
Councelling:
Mrs. XYZ, Pregnancy at such an ur age is not a difficult issue these days, however late pregnangies may be associated with some risk when compared to that at the usual age. So What we can do now is do a good pelvic examination and rule out any local infections or other issues that may prevent u getting pregnant. Then order some blood work and some imaging studies. Once the results are out, I will be in a better position to discuss ur condition and the further treatment options. Do u have any questions for me?
Is there anything bothering u?
|
| soujany
Forum Elite
Topics: 19
Posts: 194
|
If the answer in the above case for rubella status is NO. Then advise to be given is- I would like ur titerts for rubella. And based on those results, umay need to be given a vaccine if the levels are inadequate. Any following the vaccination, u should avoid becoming pregnant for 3 to 4 months. Is that okay.Then continue remaining of the councelli ng.
|
| Researchsurvivor
Forum Junior
Topics: 3
Posts: 39
|
batchiara wrote:
Should I reaview each case on my own after I practice in the day?
In the D/D I get not more then 3 hits same for tests....any advice.
I do not practice the PE I just pretend and tell at loud voice the different manouver..
Any advice is very welcome!!!!
Hi Batchiara
Where are taking your CSA on June 8th?
My two cents is that maybe you should try to physically perform your PE maneuvers even if this is only moving your hands in the air. I thought I am ok with using an ophthalmoscope, but make sure you really shine the light 1st on your hand. I was practicing w/ a friend who has one and was trying to be on time w/ the PE - as a result I shined the light of the ophthalmoscope in my own eye. I hope I don't do this on the exam - the SP will definetely notice a stupid mistake like this.
For the DD - I am using the Kaplan book and there are quite well organized over there - I'll also do sticky notes - great idea of Saujau.
I have a question, still can not find the answer. If we hand write during the SP encounter, can we choose to type when we write the Patient Note? I mean - do I always have to type even during the SP ecounter (which would be difficult if you're talking to the pt). If the answer is listed on a weblink and I've missed it, please, send me the link.
|
| Researchsurvivor
Forum Junior
Topics: 3
Posts: 39
|
[quote=soujany]
Hi Soujany
I don't know the mnemonic for VINDICATE, but I know one for VITAMIN:
V- vascular
I- Infection
T- toxic/trauma
A- autoimmune
M-metabolic
I- idiopathic/iatrogenic
N- neoplastic
or sort of a short version of VITAMIN is MINIT:
M-metabolic
I-infetion
N-neoplasia
I-inflamatory
T-trauma
|
|
| |
| | | | | | | | | | | | | | |
