memyself:
I personally feel that we should not waste our time in taking any kind of BP
If it is required just convey it to SP that I require to take your BP in sitting,Lying down postures or in both arms(as per the case) and mention it in PN
It is your personal choice or the time constrain according to case which will decide your plan of action.
regarding preg case-do you think that an actually pregnant lady with palpable fundus will become SP and allow 12 examinee to palpate her tummy?
You may have a DD of preg only in a case of Vomiting
reg sex during preg refer:
http://www.kidshealth.org/parent/pregnan...nancy.html
"Also if time runs short and we are unable to finish it is it okay to end the examination earlier and do councilling first?"
it is applicable specifically in neuro cases
CNS cases obviously require precise time management.Try to practice it again and again to manage it accordingly.However,also prepare yourself for an emergency closure-because proper counseling and closure is MUST and you may sacrifice part of PE instead of closure.(Closure alone counts 6 marks out of 20 CIS component).
How to do an emergency closure is well describedin my notes uploaded on this forum.
Why I'm giving importance to counselin:
A few people attended Kaplan and posted their tips on this forum.If you read my notes it is given at page 6 of my notes.
as far as I know there are about 23 points of CIS nad you need to score 20 (courtesy mccallan's post)
1)examinee knocked before entering
2)apeared professional in dress/hygiene
3)introduced self by name
4)comfortable eye contact
5)used patient name
6)Focused attention on patient
7)expressed empathy( reflected pt feeling)
8)conveyed nonjudgmental attitude ( avoid words like good, great,excellent)instead say allright, okay, thank you
9)used appropriate draping techniqe
10)used few open ended questions
11)used non leading quaestions
12)asked one question at a time
13)answered without interrupting the patient
14)paraphrased
15)used lay language ( imaging studies instead of CT MRI, Electrical study instead of ecg
16)used transitional phrases
17)gave explantion during physical
18)appropriate reassurence
19)summerized significant hx
20)diagnostic impression in lay term
21)discussed diagnostic test
22)asked if pt had any questions or concerns
23)paient educations/suggestion
If you see point 18-23 are generally discussed in counseling.
So it means just by doing proper wrap up you secure 6 points out of 20 which you need to pass CIS-The most dreaded component for IMG's!
