asha kamat
Forum Senior
Topics: 12
Posts: 101
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jesussaves,
there are 2 papers
1. scrap paper
2. patient note template
you take the scrap paper with you inside during the patient encounter, write important points in short while you take the history on it, then finish the physical exam and other things you are supposed to do and come out.
Now you have patient note template waiting for you on the table outside, you sit down, look at your scrap paper what you have written and write it with a little more detail in your patient note template(this is your patient note ).
next you submit both your scrap paper and patient note to the proctor.
scrap paper is shredded by the proctors(not you) and patient note is used for assesing your performance.
good luck to you
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| Tintin
Forum Junior
Topics: 7
Posts: 52
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Well Jesussaves,
Asha has explained very well. One point though - she says "Now you have patient note template waiting for you on the table outside, you sit down, look at your scrap paper what you have written and write it with a little more detail in your patient note template(this is your patient note )"
Here, "write it with a little more detail" is not exactly what it is ... well you won't have time to make enough notes on the scrap paper...well, all you will have time to write on it is a few mnemonics just to aid the encounter process. So, in the patient note you will be writing a lot more than what is on the scrap paper.
Cheers.
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| Tintin
Forum Junior
Topics: 7
Posts: 52
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A few more queries being answered...
1)is the patient's gown easy to untie? (is the back part a strap to untie or a velcro) (some kindda silly question but i'm just anxious that the examinee before me could possibly tightly tie the gown unintentionally)
Ans: Very easy to untie ... its a knot (not velcro)
2) is it ok if i check the patient's carotid and PMI while he's sitting? (hoping that it would save me time)
Ans: Yes, its Ok. But tell him, rather, explain to him what you intend to do - crisply. Frankly speaking you will not need to go after the carotid. One more thing - as a matter of protocol and safety ---- don't do carotids both sides at the same time (risk of hypoxia to the brain) - Yes!
3)when i examine a male patient's chest when lying down, do i have to let him take off his gown or is it ok if i lift the gown up from his abdomen all the way to the top of his chest?
Ans: No. You get two for one! This approach makes sense in business - not in medicine :-) Don't listen to his chest when he is lying down. If you need to ... cover the abdomen (after the abdominal exam) ... then make him get up from the supine position - tell him you need to examine the chest and then lower the gown.
4) what if an examinee unmindfully perform a breast exam? (it's a big no-no right!) what could possibly be the consequence? (hope it doesn't happen to anyone)
Ans: In the first plave, nobody will do it. If somebody does embark upon such an idea, then most probably the patient will refuse or if it is a female doctor - she may just stay silent and finally, the doctor will end up losing marks.
Hope this helps.
Cheers!
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| Jesussaves
Forum Junior
Topics: 7
Posts: 99
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wow Tintin
Thanks for the clear answer to my question.I understand now very well as I also watched the step 2 cs CD.Thanks a lot
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| Jesussaves
Forum Junior
Topics: 7
Posts: 99
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Thank you so much Asha for your timely help and support.You are great.
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| Tintin
Forum Junior
Topics: 7
Posts: 52
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You are welcome Jesussaves.
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| Musharraf Shah
Forum Newbie
Topics: 1
Posts: 5
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THANKYOU for your time and support.
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| Tintin
Forum Junior
Topics: 7
Posts: 52
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Somebody posted this question:
"can u plz tell me if we r supposed to do any test on a painful hand?if
the SP moans in pain while touching it,should we go ahead and try doing
any test-strength,sensory,reflexes or joint movement related to the
muscle group?"
I personally feel ... one can go ahead and check for local tenderness, and cause of pain very superficially ... no fancy tests, DTRs etc . please!
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| weijiandong
Forum Newbie
Topics: 1
Posts: 6
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Dear Tintin:
You have been giving us very practical information. Thanks a lot. One more question for you if it is OK with you. Shall we measure blood pressure with different postures or on different arms in the real test? That will take a few minutes. Or can we just write this under the work-up plan as USMLEWorld recommended? Thanks for your help.
Jian
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| Tintin
Forum Junior
Topics: 7
Posts: 52
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Jian,
Routinely - no need! But if the case demands it - go ahead.
Few minutes are a lot!!! Save your time.
Cheers!
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