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Finally Good news -I passed CSA -TxLord/My Husbund - jovanat
#11
Ok Let see God_blessme ,
One case on doorway it was only written " needs doctor letter to go back to work " , when asked the complaints he spoke so fast i just understood few as pounding of heart, blackouts...... i got bit nervous.......then i ask Qs related to CVS and CNS... but not to the mark and in PN forgot to write Syncopal attack ( Cardiogenic) rather wrote MI,TIA and other.... didnot do gait n motor system n Plantar but did closure in time...
Wait a minute , did you do physical exam on Him or what ???
Tell me what exactelly you ask Him ??
It is ok to get nervous and to ask Him 2 times or to just say -could you clarify it for me bc I remeber that one pt I coudn't undrstund that he was saying antacids and I ask Him 3 time -could you reapet that plz , and what do you mean not to the mark ???
and why you were thinking to check the gait in this pt ?
Do NOT seems nothing to worrry about the one baove ,but answer my questions that I ask you,Ok....

another case was pt with sickle cell with pain......in my whole encounter he never said he was better, i tried to show empathy for 3,4 times but..... even he didnot tell me his past history of Sickle cell anemia????????
It si OK if he didn't say he was better and did you ask Him if anything help or what aggrevat ehis situation and did you ask Him about the PAST H/O ???and if you did and if he didn't answer it-did you ask Him again or maybe he didn't tell you about previous epizodes bc sickle cell when you hav eit you hva eit for life, so please clarify what do you mean that he didn't tell you and don't get panicky about that bc if he didn't tell you something that means it was not on his "script " and you should ask something more relevant...

Another female case of insomnia also spoke so fast i have to say her sorry , can u plz repeat me few times....THAT IS OK....

Another case of man 30 yrs with stomach problems?? was not showing any reactions in his face throughout encounter, seeemed to b IBS.it si OK that He didn't show reaction -HOW ABOUT YOU -WHAT WAS YOUR REACTION TO THIS ?????

forgot to mention pt about Pelvic examination in Stress continence casse. but wrote on Patient note.VERY GOOD IF YOU PUT IT ON THE PT NOTE -that is very, very good-I did even put to reapet abdominal exam in one cas ebc I didn't do it -I forgot

Didnot do forward bending test to LBP case and also forgot to counsel regarding LBP??
Did you do STRAIGH LEG TEST ?? this is mor eimportant and what about the counselling ???
It is important to counsell about smoking, sex and etoh, and about pain if you didn't tell them to either excersize or whatever is not going to be such crime.....
So you will have 1 point less let say if you didn't do SRLeg test

Couldnot do fundoscopy in one case of HTN.-one point less for that bc this was important but as long as you did counsell here on smoking (if he /she was a smoker ) or LDL, Diet and excersize then you will still be fine...minus 1 point here..


otherwise rest was ok. tried to maintain eye contact. and follow CIS steps. few sps asked me 1 or 2 times coz they couldnot understand me????

I hav eone lady ask me 3 times -what you are saying but you see it was OK...
My answer to you is that you hva eosme minuses here and tehre but this is normal...
Tell me how did you feel when you exit the Exam -I want to know your first impression afther the exam -the first 5 min,NOT the hours and days afther days when we think could of , should of....
I am positive that you will PASS on SEP, CIS and I need to know how you were doing with the PN and Data Gathering -so I will try to tell you my final answer...and you hav eto let me know and remeber I am NOT saying just to mak eyou feel better..this is my honest feedback..
Jovanat..
Thank you for your trust
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#12
We have to remember that thos ept are NOT there to GET US, but we need to get the information from them in order to get to the bottom of their problem and if they will really feel that you are honestelly trying ,even "struglling " to get the information they will give you hints such as if they are just saying ye sor no that measn you have to be more specific bc in order to get the rigth answers we have to ask teh rigth questions....
Oki -docki
Jovanat
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#13
congratulations dear jovana I'm really happy for you
yes I'm totally with you..you either take it or leave it.
wish u all the best
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#14
Dear NICEDAY,
First let me pray with you that the dear Lord will give you peace and strength to overcome this CSA and to trust Him that He has a plan for you and all of us to PROSPER YOU,NOT to HARM you, to guide you in the journey of Life , to help you maintain your daily life and to get you there just bc you are His child and to trust that the day will come when you and all of us will see the ligth in the tunel...
May He embrace you with His abundant Love so you can share the knowledge with others and you can heal others people pain..In teh nam eof teh Jesus and the Holy spirit-Amin
Your's in Christ..
Jovana
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#15
Zkadh,
Congratilation to you to my dear --I still remeber those days studying with you at nigth for step -1 and I love your questions..I wish you luck in everything and May God continue to bless you, so you can bless others..
Your Jovana
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#16
1st case is fatigue- i was too tensed and had to rush during the physical examination and when i started giving closure, time is out and i told her i ve got emergency call and came out.

THIS IS OK -HAPPEND TO ME ATLEAST TWICE or 3 times...
2nd case- another fatigue, this time i rushed the Q and came out in 13 min even..you can come out as long as you feel you are done bc it is better to get out then sit there looking like a "foul " don't you think ???


3rd case- i forgot to pull the footrest and i started inspec and then found her legs down and so i said sorry and imme put the footrest.

OK NO PROBLEM After that i made her sit down with the footrest on and didnot know that i need to push that in. I do not think that this is a big deal bc as far as I remeber I never push it back .It was out till i came out of the exam.


Next is pain in shoulder- i forget to ask RAA in LIQORAA. He told me he has exam in 2 days.I showed empathy but didnt ask him how can i help you in this? YOU DO NOT HAV ETO ASK HIM HOW CAN YOU HELP HIM WITH WHAT -EXAMS ????Only then i realized that this is the challenging Q and i didnt answer it.YOU SHOW EMPATHY and THIS IS IMPORTANT and you could of say that I undrstund that and I will try to do the best that I can to help you -what did you tell Him aftherwards ???


Next is dry cough- i failed to inspect the mouth.OK , did you ask Him if he had any preceding symptoms before such as runny nose chills , fever ???but did you do a PE on the LUNGS??? And in the end the pt told me its sharp pain in the middle of chest.

Next is calf pain- i didnt tell her to stop taking HRT. She told back pain also. I didnt tell any thing about it in the closure.WHY YOU NEED TO TELL HER TO STOP HRT or DID YOU DISCUSS TEH CONS /PRONS OF HRT-you can never tell -well you need to stope it ,instaid you will say it si proven that dad ada and it is recommended now a days that .....


Next enuresis case- i dint ask for any stress recently. as its a clear cut secondary enuresis.
You could of , BUT what else did you ask ????
Next is heelpain- i asked him travel history 2 times-IT IS OK TO ASK HIM THAT 2 TIMES bc you are trying to figure it out ...

For chest pain- he told some drugs in trade name- i didnt understand them.
Did you ask Him again , so atleast you could of document it on teh PN

For the first two case- i washed in hurry and i didnt use soap. For others i used but i did not get any froth. I washed hurrily...THAT IS OK !!!!!!!!!!!
I think i spoke very fast in the end when time is almost over.OK,BUT DID YOU HAV EANY FEELINGS THAT THEY COULDN'T UNDRSTUND YOU ???
Otherwise i'm satisfied with my PN. Wrote it as per the order in FA.
Plz - tell me in what position i'm.. Am i worth to get pass? I often get nightmares. I very well know that its too expensive exam.. Could not concentrate ion Step2. I know i did atleast 1 mistake in everycase, but plz tell me whether i can pass?Can you plz pray for me?
Expecting your reply.
So answer my questions and we will go from theer ok NICEDAY -PLZ HAVE A NICE GOOD NIGTH SLEEP..
GOD LOVE YA..
Jovanat


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#17
The last info is for niceday to review her "mistakes " and for others t learn from it!!
Jovanat
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#18
hi jonavat thanks!!!!!!

i dont know but just after the exam i was bit relaxed thinking that exam was over and feeling not so bad abt exam.
But later i thought i did all those mistakes !!!!!!!!
so me tensed and also tensed that if my good cases are dummy case then????????
so very confused and just feeling bit down.

as if all dreams are going to shattered!!!!!!!!!!
and i have to still give CK? dont know how will i study??

rest mistakes i told u.

but i dont remember any blunders in CIS portion!!!!!!! had bit of problem at one or two times in communication with almost all SPs ??

so plz give me ur frank opinion?? what percentage of chance i have to pass??
plz i need ur opinion...........


thanks again
with best regards.
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#19
hi again

Regarding first case i told ya i ask all Qs and almost in all i asked PAMHUGSFOSS AND appetite and weight n travel history, but main thing is i forgot to write syncopal attack in D/D in that case. PN i have written all ok. Bit congested and handwriting not so good but i think legible.... ( Pen they provided was not so good )

in LBP case i did SLR and did other counsellng like smoking ... but forgot to counsel abt LBP as take rest, avoid forward bending n lifting heavy things.. calcium etc. rest was fine

and abt sickle cell i asked all questions LIQORAA i mean aggravating factors and so , but he told nothing .. he having contd pain like that and he told some problem in childhood and cold few days ago ..... but i did counsel abt pain and told him i shall tell my nurse to give u pain medication...

abt stomach problems i ask him if he is having any emotional problems?? and tried to make eye contact and smile............

rest as i told u

so plz help me with your frank opinion

and also other put your opinion??
R this Blunders????
why CS terror is so much???
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#20
THANK YOU SO MUCH JOVANAT! I'm soo happy and feeling relieved by your prayer. I really appeciate you that you take so much efforts in answering to our Q..
Let me tell you few more information!

pain in shoulder-...YOU SHOW EMPATHY and THIS IS IMPORTANT and you could of say that I undrstund that and I will try to do the best that I can to help you -what did you tell Him aftherwards ???
I told - i feel so sorry about that. I can understand board exam in 2 days. I will do all the investigations as quickly as possible and give you treatment early.


3rd case- i forgot to pull the footrest ... I know that she was looking at me with vacant look till the end... And dono if i'm in her position i would ve felt bad for the footrest mistake i made. Everything she told was negative history and i could not find even a single positive findings in her. PAMHUGSFOSS are all negative findings.. That scares me..

dry cough- i failed to inspect the mouth.OK , did you ask Him if he had any preceding symptoms before such as runny nose chills , fever ???but did you do a PE on the LUNGS???
Yes i did complete PE lungs.

I think i spoke very fast in the end when time is almost over.OK,BUT DID YOU HAV EANY FEELINGS THAT THEY COULDN'T UNDRSTUND YOU ???
I was speaking during closure and they were looking at my face, then i finished telling is that ok... they still looked at my face as if i was continuing my speech. This happenned in 3 cases i think. Especially one african american women mother of enuresis case-she was keeping her face blank to whatever i said and she didnot node her head.

First of all i never knew that they will ask Q after the history. So in most of the cases after the history i washed the hands and then they asked me Q-
In the first case- after i washed my hand she asked a Q and i had to lean forward, that time i touched my hand with the steth around my neck. I knew she noticed that but i had no time that time so i didnt rewash and i didnot tell her anything.

In the next two cases- after i washed my hand, i touched my specks to correct it. I think they too noticed that.


Plz reply to my doubts.. and once again thanks for sharing your knowledge and opinion regarding our exam experience.








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