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 how many q to ask?  



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  #1

so i started preparing for the step 2cs a while ago, I'm doing the first aid cases with a friend and we're simulating the patient encounter

while doing this we really started to wonder how many of the questions we need to ask in order to pass, because it's 1) really hard to think of all the things we're supposed to regarding a specific problem (eg. i always forget asking in depth-questions about menstrual cycle and sexual history and 2) i'm just running out of time, just for the conversation i usually need 12-15 minutes, which is like the whole encounter..

so i don#t really know where to make up for that and not seem in a hurry as that's not what we're supposed to do either
do you guys have any ideas or can anybody tell me from their experience how many of the questions need to be ticked off?
thanks!




  #2

Usmle world recommendS to have correct at least 75% TO ENSURE A PASSING GRADE.
So if from their check list you get about 75% most likely you will should pass.


  #3

1st of all, u should prepare a UNIFIED set of questions that ur gonna ask for ur patients, regardless of what their case was, instead of preparing a set of questions for each individual case, this way u can guarantee remembering all of ur questions, and scoring more than 75% on each case.

Always remember, that u should ONLY ask detailed questions regarding the chief complaint and the involved system, then quick 2-3 questions on every other system when u do the review of systems.

Example, pt complains of chest pain,,,, ur gonna analyse that pain in detail, then analyse the cardivascular system, then start the review of systems as follows:
*constitutional symptoms: Fever, appetite, wt change, night sweats
*CNS: headache, vision abnormalities
*Respiratory: cough, dyspnea, sputum
*GI: Abd pain, chane in bowel habits (diarrhea, constipation)
*Renal: dysuria, change in urinary habits (frequency, color)
*Muskuloskeletal: muscle/bone/joint paint, morning stifness

The point here is to the most important 2-3 symptoms of each individual system when doing the R.O.S
AND THATS IT, the analysis of the chief complaint and the review of systems won't take more than 5 minutes GUARANTEED!

Things u should remember:

Always ask for gynecological hx in every female pateint, regardless of the case,,,, only 4 questions to ask: 1-age of menarche 2-age os menopause (if applicable) 3-cycle irregularities 4-hx of pregnancy and/or deliver abortion.

Always ask for sexual hx: hx of STD, homo vs hetero, single vs multiple partners, protected vs unprotected intercourse + counselling if required

Always ask for chronic illnesses, medications, allergies.

Always ask for family hx, travel hx, diet.

and for the pediatrics remember the immunization & developmental hx

then u'll at least have 7-8 minutes for ur physical, which won't take more than 3-5 minutes

Hope this answers ur concerns for now

Good Luck


  #4

thank you very much you two, i appreciate your answers!





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