USMLE Forum Archives - USMLE Step 2 CS - case to discus
case to discus
smyomer - 04-03-08 18:55
here case 21yo f c/o RLQ pain start for the first time today morning. crampr non radiating proressively increase 8/10 in severity nothing makes it better ;movement makes it worse accompany with nausea and 2times vomiting of yellew fluid not mixed with blood . she has fever no chills .she denil diarrhea-constipation - chang in stool color or urinay symptome ; current medication ibuprfen pmh; std one month ago her partener refuse to treat him self. psh none.fh not contiputery.sh work as waiter smok 1ppd since 6 y drink 2-3 times in weekend .sxh active un protected sex with multiple partener no hiv test no pap smear.physical exam; abd. soft no distention no organomegaly +BS tender in RLQ with rebound 'guarding + rovseing sign + psoas sign - cva tendernes. any comment about history and what DD.
smyomer - 04-03-08 18:55
here case 21yo f c/o RLQ pain start for the first time today morning. crampr non radiating proressively increase 8/10 in severity nothing makes it better ;movement makes it worse accompany with nausea and 2times vomiting of yellew fluid not mixed with blood . she has fever no chills .she denil diarrhea-constipation - chang in stool color or urinay symptome ; current medication ibuprfen pmh; std one month ago her partener refuse to treat him self. psh none.fh not contiputery.sh work as waiter smok 1ppd since 6 y drink 2-3 times in weekend .sxh active un protected sex with multiple partener no hiv test no pap smear.physical exam; abd. soft no distention no organomegaly +BS tender in RLQ with rebound 'guarding + rovseing sign + psoas sign - cva tendernes. any comment about history and what DD.
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#1
Re: case to discus TheOne - 04-04-08 15:34 DD:
1) Appendicitis.
2) Pregnancy (Tubal).
3) PID.
4) UTI.
#2
Re: case to discus radhamesramos - 04-05-08 13:48 Labs:
-Complete physical exam with rectal exam and vaginal exam
-CBC
-beta HCG
-urine analysis
-Sonogram
#3
Re: case to discus
smyomer - 04-05-08 16:47 good thank u very much same case i read it in FA ;DD 1-PID 2- appendicitis 3- ruptur ovarian cyct 4- rupture ectopic p 5- torsion ovarian cyst how did you see that
#4
Re: case to discus smyomer - 04-05-08 16:49 i have this Q also if the pt women and i want to do chest exam for her i will untie the gownes so the chest will be seen thats ok
#5
Re: case to discus TheOne - 04-05-08 21:12 
posted by smyomer on 04-05-08 16:49
i have this Q also if the pt women and i want to do chest exam for her i will untie the gownes so the chest will be seen thats ok
i have this Q also if the pt women and i want to do chest exam for her i will untie the gownes so the chest will be seen thats ok
Sure it's ok. Remember, once you're done with your heart/chest exam offer the patient your help to re-tie her gown.
#6
Re: case to discus radhamesramos - 04-07-08 13:00 And tell her to hold her breasts to listen the apex. All female patients will be wearing bras, so it is Ok to untri their gowns, and as Theone said, help her to retie it
#7
Re: case to discus sackatdoc - 06-18-08 04:08 i am wondering all this SP interaction involves too much permission taking,eg may i ask few questions,mind you'll repeat this first for history of current illness,past illness,social history,then every little step in physical exam.wont that makeSP sick&irritated.i know we have to do that anyways but i want to know are there some better ideas or format of asking permission.
#8
Re: case to discus radhamesramos - 06-18-08 09:11 just the one that comes in mind first, but trying to be polite, always ask them first and direct contact to the eyes...everybody has their own way of asking thing
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