Saturday, February 21, 2009

Do I have this _______ (any disease or diagnosis)

During your USMLE Step 2 CS patient encounters, the simulated patients just like real life patients my ask you different challenging questions about their medical conditions based on their previous experiences, diseases in their friends and families, anxieties and fear.

So the simulated patient may ask you like this:

Doc do you think I have this disease?

Tip : Don't tell patient any thing which you don't know. Don't give false reassurances, but that doesnt mean that you dont have to rassure him or her. Just tell what you know and if that specific diagnosis is likely or not and why. Tell what you are planning to do to find out the exact diagnosis.
Reassure that you are ther to help him or her and do everything possible to help and will keep him/her updated.


EXAMPLES

Patient with severe chest pain

Doc Do you thinks I have a Heart Attack?

Response: Based on the information which I just got from you and based on the physical examination findings; Heart Attack is certainly a possibility which cant be ruled out right now. Let me run some test like and EKG, blood test and imaging studies, when I get the results of the test back I will be in a position to tell you for sure.
Dont worry Mr____ , I am right here to help you and will keep you updated.


Patient with Paricarditis or mild GERD type chest pain

Doc Do you think I am having a Heart Attack?

Tip: In contrast to the above situation, it is less likely for the patient to have a heart attack in this scenario, but it is still a remote possibility, so you just have to explain this.

Response: Based on the information which I just got from you and based on the physical examination findings, your pain doesn't seem to be caused by a heart attack, it could be due to inflammation of the membranes covering you heart or a heart burn.Let me run some test like and EKG, blood test and imaging studies, when I get the results of the test back I will be in a position to tell you for sure.
Dont worry Mr____ , I am right here to help you and will keep you updated.

Chronic Smoker with chorinc chest pain and hemoptysis

Doc Do you think I have cancer?

Response: Your smoking history certainly places you at a higer risk for getting a lung cancer. Productive cough, chest pain and blood tinged sputum can be a symptom of lung Cancer. Let me do some tests, like some blood tests , imaging studies and get the results before telling you about it for sure.
I will keep you updated and fell free to contact me for any inquiries.


Diabetic/Hypertensive Patient with weakness/numbness, headache.

Doc do you thinks this is a stroke?

Response: Diabetes/Hypertinesion certainly puts you at higer risk for getting a stroke, but you symptoms could also be due to some other reasons like nerve compression. Let me run some test like some blood test and imaging studeies. I will get back to you as soon as I get the results and we will then disucss you definitvie diagnosis and treatmet options, Does that sound good to you?




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