Easy-K seriesKHALIL’S HIGH YIELD STEP 2 CS MNEMONICS HIGH YIELD USMLE STEP 2 CS THE BEST MNEMONICS EVER • 20+ Mnemonics cover ALL possible cases you may encounter in USMLE step 2 CS exam. • 30+ EXTRA tips for the most common mistakes. • • Suggested dialogue inside the exam room. • Suggested form for Patient notes. 1 “Easy-K series” is concerned to simplify the medical education, so you are going to love learning medicine. Learning through Mnemonics is one of the best learning tools, which has been proven to fix information to your memory, though you are able to remember that bunch of information under stress of exam. With aid of these mnemonics and keeping practice with a colleague, you will find USMLE step 2CS exam such easy as A PIECE OF CAKE ! Author: KHALIL EZEKIEL KHALIL 2nd Edition, 2012 ISBN: 9781625904362
[email protected] KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) practice and practice. I do encourage you to engage with these fruits of labor for long time to come in this smart shape. All what you need is to practice. All the best wishes in your exam…YOU WILL PASS! KHALIL. EZEKIEL
[email protected] KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . All colleagues who used these mnemonics passed the exam first attempt. You will be one of them soon. with assistance of these notes you will feel comfortable and relax while dealing with real cases under pressure of the exam day.2 KHALIL-High Yield Step 2 CS Mnemonics notes’ are collection of creative notes for the most common cases you may face in USMLE STEP 2CS exam. com • • • • • • • • • • • • • • • • • • • • • • • • • History of present illness Past medical/surgical history Social/sexual history Urinary system Headache Pediatric case (any) OBGYN Amenorrhea PremenopauseDomestic abuse Diabetic pt Neuro. KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .case Forgetfulness(Memory Loss / Dementia/ Alzheimer’s) Joint pain Depression Hear loss Thyroid Nausea / vomiting Erectile dysfunction Dizziness/Palpitation Chronic cough Sexual history Cranial Nerves Tests & Signs u need to know Friends for DD Dizziness “vertigo” Headache / Migraine Psychiatry PED.3 Contents Mnemonics Tips drkhalilezekiel@yahoo. you will feel comfort during history taking session. modifications and new creative mnemonics.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .4 Bonus • Suggested history taking Qs for each system • Suggested dialogue inside the exam room • Suggested form for Patient notes In these notes. you will find mnemonics that cover all possible cases you may have in USMLE step 2CS exam.com drkhalilezekiel@yahoo. Kindly send your mnemonic to: drkhalilezekiel@yahoo. But we will be very happy to receive your comments. So. . smoking.5 HPI (history of present illness) ALL CASES: OCD PSF AAA PAIN: OCD PSF LIQR AAA OCD PSF ABCDO FLUIDS: (Vomiting. constipation. 6/10) Q Quality of symptom.pressure like) R Radiation of the symptom ( to left shoulder and arm) A Associated symptoms ( palpitations. cough.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .BCDSPP (burning.. large meals) A Amount B Blood C Color C Consistency C Content D Duration O Odor
[email protected]. vaginal discharge) O Onset of the symptom (sudden/gradual…) C COURSE “Constant /Intermittent” D Duration P Progression + precipitating factors S Settings F Frequency L Location of the symptom (forehead. Diarrhea. wrist.Sharp.) I Intensity of the symptom (scale 1-10.pulsating..Cramping. shortness of breath) A Alleviating factors (sitting with my chest on my knees) A Aggravating factors (effort. med. para. marijuana.. abortions. how much. elderly... Chills.) A Allergies (drugs. chemicals.Kidney prob.) M Medicines (R U taking any prescription medications/any over-the-counter med.Sinusitis...↑BS. H Hospitalization for any illness in the past (Trauma.Asthma.) D recreational Drugs (what drug.) LMP RTV CS PAP S Sexual history (active/preferences/STD/no... any IV drug use?) T Travel /Trauma O Occupation (what do you do for living?) E Exercise S Stress drkhalilezekiel@yahoo. bowel movements. of partners/contraception/pregnancy/ last pap smear) S Social Hx (job/house/smoking/alcohol/recreational drugs/. how much .. foods.UTI. to help sleep..com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . how many hour.6 PMH (past medical history) PAM HUGS FOSS P Previous presence of the symptom (same CC) Past Medical problems (↑BP. dust ..snoring.) S Sleep pattern(difficulties falling/maintain asleep. Night sweats Fatigue O OB/GYN history (LMP.). nightmares) F Family history (similar chief complaints/serious illness) Fevers.consider doing CAGE question. how many years) A Alcohol (what type of alcohol..) WAD SAD TOES Social Hx WAD SAD TOES W Weight / who do u live with? A Appetite D Diet S Smoke (cigarettes.. how do you use it.. how often. surgery) U Urinary changes ( esp if diabetic.wake up.) G Gastrointestinal complains (diet changes. Rhinitis. or is there any dribbling after Ux?) Strain (Do u have to strain during Ux) Stone (have u passed stones in the past?) H Hematuria (did u notice any blood) Hesitancy (do u have 2 wait b4 starting Ux) C COLOR U Urgency (do u have 2 rush to BR to Ux?) P Pyuria (was there any pus in ur Ux?) Pain (Burning) HEADACHE OCD PSF LIQR AAA + DIAGRAM Head trauma/Seizure/Weak.7 UG Hx: OCD PSF AAA + FINISH CUP F Frequency (How frequent do u have to pass urine?) I Incontinence (Do u have trouble holding Ux until u get to BR?) N Nocturia ( do u have 2 wake up @ Night to go to BR?) I Incomplete emptying (do u feel fullness even after Ux) S Stream (How is ur flow of urine? is it cont. Numb Tears / visual changes Flu /Nasal congesion Vomit/ Speech Neck stiffness
[email protected] KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . colour of urine Ulcers in mouth B Bowel changes: Diarrhea-frequency. Stress (bet wet. wt. Consistency. Odor/Onset) F Fever & Chills& Night sweats/Headache E Ear pulling Do u feel dip on top of his head? V Vomiting “dehydration” E Ear/eye discharge. milestones SSC-WTD Month smile 1 sit crawl 6 9 walk 12 talk 15 dress 30 D Day care / Difficult swallowing E Eating habits/ feeding of baby/Diet change A Appetite / Appearance “Look of the baby” L Last check-up S Sleep T Travel recently NB: +Oral Rehydration: Pedialyte or Home-made “1L of water<5 cups> +1/2 tsp. Menstruating (female child >10yo) I Ill contacts F family history B Birth Hx I Immunizations G Growth n development. Activities M Medications. salt+6 tsp. effect on child/parents (bet wet. Color. Blood. DM) Smoke @ home School performance P Past medical/Past surgical Hx / Previous Hospitalizations. / Pets @ home A Allergies. any crying during defecation Discharge Q’s (ABCD-O: Amount.SOB CRY“how is ‘cry of ‘baby?” U Urination-increased or decreased urination. mucus/pus/blood in stool. which part of body? Any leakage of urine or stool during fits.8 Ped Hx (ALL cases of ped. Content. Ear hearing. # of diapers. onset. ht.chest pain. DM). sugar” drkhalilezekiel@yahoo. any odour. and postictal irritability or loss of consciousness. Constant/Intermittent.) CUB FEVERS + PAM IF BIG DEALS-T C Colds-runny nose. Eye vision R Rash /Rigidity “Neck” S Seizure-any jerky movements.cough.com +in WU: Scheduled PE “WU= Work Up” KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . fast respirations. Duration. dryness (have u ever had any vag discharge?ABCDO.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .) ur cycles? Did u ever notice any bleeding after intercourse? P Pregnency ( Hx & complications) have u ever been pregnant? How many times? A Abortion/miscarriage (Any miscarriages or abortions?In ⍵ month of ur pregnancy?) P PAP smear(have u been getting regular PAP sm ?when did u have the last PAP sm ) Amenorrhea FLAG HIV WC F Fatigue L Libido A Anorexia nervosa /Anxiety & Depresion G Galactorrhea H Hair & skin changes ( for Hypothyroid/Hirsutism of PCOS) Headaches Hot flushes I Insomnia V Visual disturbance / voice change “Deep” W Wt change & Appetite & Diet C Cold intolerance & Constipation Premenopause : HADOC H Hot flashes A Atrophy of vagina D Dryness of vagina O Osteoporosis (council) “increase wt bearing exercise.9 ObGyn Hx : LMP RTV CS PAP L LMP (when was ur LMP?) M Menarchae (how old were u when u had ur 1st period? P Period (how many days ur period last?) R Reglarity ( R ur periods regular?) T Tampoons (how many pads do u use in a heavy day?) V Vaginal DID: discharge. D & Ca ? 2-have u ever tried HRT? drkhalilezekiel@yahoo. do u have any vag.vit D-ca” C Coronary artery disease Any Female>50 yr: ask about: 1-R u taking vit. Itching?) C Cramps (Dysmenorrhea) do u have abd cramp with ur period? S Spotting ( intermenstrual / post coital ) have u ever bled (. itching . CHOL. HgA1c) Appetite/Diet / Weight B Blurry vision (retinopathy) E Extremity (foot ulcer/infection) Exercise ( for obese/sedentary life styles) Eye exam (annual routine) T Tingling/numbness (neuropathy) I Infections (Resp/urinary) C Cardio Risk Factors (HTN.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . Ever tried to leave/divorce?Why not? G Guns at home (are there any weapons @ home?) A Afraid of husband . For how long? D Depression (lost wt/appetite/sleep) S Suicidal (idea/plan/attempt) (ever felt like ending it all up?) Diabetic pt. Heart disease) S Sugar Checkup/ last time? Sex drkhalilezekiel@yahoo. monitoring (fast. home.10 Domestic Abuse SAFE GARDS S Safety inquiry (Do you feel safe at home?). “FU/Med Refill” DIABETICS D Duration of disease Diet (Sugar/Salt/Fatty foods) I Insulin regimen/ oral hypoglyemics regimen/ Compliant? Who gives u insulin?where?SE? A A1c hg -> Gluc. Sex ever forced? A Alcohol abuse (does your husband abuse alcohol?) Addict (does husband use recreational drugs) F Friends/Family who are aware (Dose any1 f ur friend/Fam know of this) Fractures (Abuse ever resulted in fractures?) E Emergency plan (u have emergency plan?). Attacked Children?Attacked u with Guns? R Relationships with husband (how is ur relationship with husband? do you feel Threatened when he is around?. I will ask you to repeat them later S Spell: Please spell ‘world’ backwards? I Eye: Please close your eyes.Sounds. You have to tell me their names R Recall: Now tell me what were the three names I told you to remember earlier" [C-A-T] drkhalilezekiel@yahoo.” “Open your eyes” I Identify :Now I'm going to point at 3 different objects. tree” . Weakness S Sleep disturbance Sight “Vision” Speech difficulties Seizure “Shaking.Lights. Please try to remember them.SIR N Name: Please tell me your full name? L Location: Where are we right now? B Birth: What is your date of birth? R Remember: I’m going to tell you 3 different names and you have to repeat after me” C-A-T “cat.duration?” A Aura “b4 problem.duration?” Spinning G Gait B Breathing Difficulty Before LOC: + Aura + Palpitation + Dizzy + Vision + Nausea/vomit + Dif breathing During LOC: + Attending person? + “shaking/something coming from mouth” + Incontinence “urine/stool” + Tongue bitting After LOC: + Confusion + Concentration + Weakness/ting/numb + Gait + Headache NB: in case of MVA. Tingling.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .Smell” P Palpitations H Headache/ Lightheaded /Hearing loss &Tinnitus I Incontinence “urine/Bowel” T Tongue biting/Trauma& fall N Nausea & vomit Numb.11 Neuro cases “LOC” CAP HIT NSGB +MMSE C Confusion “after the event” Consciousness “LOC. apple. ask about last meal Mini-Mental Status Examination “MMSE” NLBR. com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . MENINGITIS] M MOOD “feel sad” ADL .S.Activities of daily living D Dressing E Eating A Ambulation (can you find your way thru home) T Toiletry (do you manage your toiletry unassisted) H Hygiene IADL .Instrumental activities of daily living S Shopping H Housekeeping A Accounting “pay bills” F Food prep (do u do your cooking ) T Transportation (do you drive? How is your sight. drkhalilezekiel@yahoo. hearing?) COUNCELLING: 1-I would like to ask ur permission to speak with ur family 2-i would like u&ur family to meet a social worker to assess home safety&supervision NOTE: -History: ask for paper with medications ☺ -PE: Auscultate carotid bruit/Fundoscopy/MMSE “Recall” -WU: orthostatic V.12 Forgetfulness (Memory Loss / Dementia/ Alzheimer’s) FORGETS HIM + DEATH SHAFT + MMSE F Fall/ FAINTING / Flashes/ FHx of Alzheimer 0 ORTHOSTATIC HYPOTENSION “Lightheadedness” R RUNNING URINE “INCONTINENCE” G GAIT E EYE “VISION” T TRAUMA/TINGLING & Numbness & Weakness S SEIZURES/ Sleep/ Speech/Support H HEADACHE I INFECTION [SYPHILIS. com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . lonely? Memory problems E Energy C Concentration A Appetite.13 Foot/Heel/Knee/Shoulder/Back pain OPD-CSF-LIQRAAA +WET SURF-D . sports” R Rash/ Redness of skin of joint / ROM / Rheumatologic dis. wake up. F Fever & chills& night sweat / Fatigue /Foot wear D Deformity/Disability “affect his work. snoring. Suicide: thoughts. to help sleep. What do you do in your free time? How are you doing in your job? do you enjoy what you do? G Guilty M Mood. changes in your Weight Attitude towards life (positive/negative frame of mind) P Psychomotor agitation/retardation (do you feel easily agitated or angry/do u feel not to do anything?) Psychiatric “Delusions. need help @home” / Dysuria CIS Cancer Hx /IV DRUGS/ Steroids 4 long time Depression: (Psychiatric Hx Checklist) SIGME CAPT +2 (+MMSE) S Sleep (difficulties falling/maintain asleep.CIS W Weakness / Wt. ( anxious. Hallucinations. how many hours. attempts (do u have pills/guns @ home? ) Stress Support I Interest.Walking habits. nightmares). med. hopeless. Hopes” T Thyroid dysfunctions (ABCD HV for HYPOTHYROID) also need to ask : Do u realize that u have problem ? Do u want help? ( if patient was sent or asked by anyone to consult doc ) drkhalilezekiel@yahoo. plan. sad. loss E Eye infection redness / Exposure to COLD “effect” T Trauma /Tender /Tingling& Numbness / Tick bite S Stiffness in other joints/ Swelling /long Standing hours/morning Stiff/sound U Urethral discharge /ulcer / USE “Work . peripheral vascular dis.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .”/ PSH “prostate” Pyrenoi’s dis. stool” S Stress/Depression
[email protected] Hearing loss: OPD-CSF-AAA + PDF IN RST P Pain D Discharge F FB I Imbalance / Infection N Noise R Ringing S Spinning T Trauma / Tinnitus THYROID: HV A APPETITE/DIET B BOWEL C COLD INTOLERANCE D DEPRESSION H HAIR/SKIN V VOICE-Hoarseness ABCD Nasuea & Vomiting MANGO-IP M Metabolic( DKA)/Meds A Anorexia N Neurological (BETA) = Bleed/Encephalitis/Tumor/Abscess G Gastroenteritis O Obstruction (pyloric /Intestinal) I Inflammation (Pyelonephr/Cholecyst/Appendic/Pancreat/PID) “-ITIS” P Pregnancy Erectile dysfunction LIM-PENIS L Libido I Injury (back-penis) M Medications (B#) P PMH “HTN. Performance anexiety E Erections at all “morning” N Nocturia I Incontinence “urine. Are your partner male or female or both? “Unless the SP says wife or husband in Q 2” .How Many Partners are you active with? .15 TIPS DIZZYNESS: -ROOM SPINNING>>EAR -LIGHT HEADEDNESS>>HEART/BRAIN DIZZINESS / PALPITATION: ANY CASE OF BOTH. Rx for STD's
[email protected] you use protection during intercourse? .H/ STD's. ASK ABOUT THE OTHER Chronic cough: do not forget.Are you Sexually Active? . -contact with TB -HIV status -drugs: ACEI Sexual history: .com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .Ask about anal intercourse in male homosexuals .What kind of protection do you use? . -shrug shoulders up -move face to side against resistance Ask patient to protrude tongue (assess for fasciculation. 7 facial -smile -wrinkle forehead. atrophy & Deviations) -stick your tongue up -move it side to side KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .bite down and palpate masseter Ask patient to. -blow out cheeks -close eyes 8 Vestibulocochlear -whisper.com Assess strength of trapezius & sternocleidomastoid muscles.16 Cranial Nerves: 2 optic 3 4 6 5 Oculomotor Trochlear Abducent -Test visual acuity / Visual field -Test pupillary reflexes (direct&consensual) -Test accommodation reflexes -Assess pupillary reactions to light -Assess corneal reflection -Perform H-test for EOM -Sensory: close eyes.touch face&ask where? -Motor: Assess strength of muscles of mastication. 10 vagus swallow and palpate neck Trigeminal 11 accessory 12 hypoglossal drkhalilezekiel@yahoo. -Weber -Rinne tests Assess movements of the soft palate. 17 Tests & Signs u need to know Meningeal irritation -kernig’s sign:flex knee&hip. eyes closed (support pt. stands up. -GE -URI -UTI -Meningitis -OM -Scarlet fever -Measles -Varicella KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . feet close.)>>if sway:+ve Whispering “words” Hospital / Doctor Pulses LL Popliteal/ Dorsalis Pedis/ Posterior tibial Cerebellar -Finger to Nose (both sides) (1 is enough) -Rapid alternating movements (both sides) -Heel to Knee (both sides) Dizziness “vertigo” -BPPV -Labrynthitis -vestibular Neuritis -Meneire’s dis Psychiatry -schizoaffective disorder -schizophrenia -schizophreniform disorder -psychotic disorder due to GMC
[email protected] extend knee>>if pain:+ve signs -Brudzinski’s sign:flex neck>>if knee/hip flexes:+ve Straight Leg Test Hold leg and raise it straight>>if pain in leg or shooting sensation below knee : +ve Romberg test Pt.com Friends for DD Headache / Migraine -Migraine -Cluster headache -Tension headache PED. . you will appreciate it on the day of exam!) drkhalilezekiel@yahoo. SYMP “SAME SYSTEM” 3-ROS “HEAD TO TOE” ……………………………… CC: “OCD.Av/Ag” -WHEN DID IT START? -HOW OFTEN DO U HAVE IT? -SINCE IT STARTED.18 If you stuck with any case.com 1-CC 2-ASSOC. HAVE U NOTICED ANY CHANGE IN IT? -WHAT DO U THINK THE CAUSE FOR IT? -HAVE U NOTICED ANY THING THAT MAKE IT BETER? -HAVE U NOTICED ANY THING THAT MAKE IT WORSE? KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .PRECIP. THEN there is is here: You will ask about 3 things: and ANY C/O: Analyze CC in 6 Qs: -Onset/Course/Duration -PRECIPitating/ALLEViating/AGGravating factors In this way you will cover more than 80% on a case you do not know! You PASS ! (Learn the table on the margin by heart. very tired or black out during the encounter.feel as if you have no idea about this case /complaint. Do you have any Cough? any blood in it? 2.Do you have any Diarrhea? (Bowel mov. Do you have any Chest pain? 4. Do you feel tired? 8.) 6. Do you have Heartburn? 3.What is the color of the stool? Any blood in it? Neuro. Do you have any sore throat? 6. 1. Do you have any Chest pain? 4.Do you have any difficulty in walking? 5. 1.Do you have any stomach pain? 2.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .Do you have any Weakness? 6. Do you feel your heart is racing rapidly? 5.Do you have any changes in the hearing? 4. Do you have any Cough? any blood in it? 2. Do you have any constipation? 7.Do you have any Headaches? 2. have u been wheezing? 7.Do you feel nauseated? 4. Do you have any swelling in your feet? 7. 1.Do you have any LOC?
[email protected] numbness? Any Tingling? 8. Do you feel dizzy? 6. is there any discharge back into ur mouth? CVS. have u ever felt light headedness? GIT. Do you have any runny nose? 5. Do you feel SOB? 3.Do you have any changes in the vision? 3. Do you feel SOB? 3.Do you feel dizzy? 9.19 Suggested history taking Qs for each system Resp. 1.Do you have any vomiting? 5. Do you have to rush to bathroom for urination? 12.Do you have any stiffness? 4. How is your urinary stream? 6.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . do u lose control of urine? 5. 1.? 8.Any weakness? 7. How often do u pass urine? 2. Do you feel sad? 4. Do you have to wait 4 urine to come out? 9. 1. have u ever passed stones? 7.Any changes in Bowel habits? 5. Do you have pain during urination? 13. Any swelling of the joint? 5.Do you have any difficulty in walking? THYROID.Do you have difficulty adjusting to changes in the weather? 2.20 MsK. Do you have to push hard during urinat.Have you noticed any Changes in your skin? hair? 3.Do you have any joint pain? 2. Do you have any Muscle pain? 3. Have you noticed any Blood in urine? 10. Any numbness? 6. FINISH CUP 1. what is the color of urine? 11. do u have flank pain?
[email protected] you have to go to bathroom at night? 4. Do you feel like ur bladder is not fully empty? 3.Any tingling? 8. any changes in weight/appetite? Urinary. Based on ur Hx & my PE.I. As u mentioned. u have …. ok? (SxH) Now. ☺ ? ……. . I am done é history. ☺ Now I need to examine u.” Mr.. SHAKE HANDS I am here to take care of you.oh! Mr ☺ we have an emergency and I have to leave. I am Dr.Mr.How can I help you today Mr.. it seems that u might have…. Exam let me give my impression. I assure u that all info. about ur health in ‘past. about ur habits.Do u have any Qs. can u tell me more about ……. ☺ now I’d like to ask u few Qs.Good morning Mr. I ‘ll run some tests & order imaging studies such as …. . ok?(FH) Does any body in ur family have any med.I will see u as soon as I get free.21 Suggested dialogue inside the exam room . feel free to ask me. for me? Mr. is that ok?…THANK U. ☺ I’d like to ask u few Qs.com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . is that ok? (SH) Now I’d like to ask u few personal Qs.c.I’ll be sitting & writing some notes while we’re talking. is that ok? (PMH) Mr.(short of time) . ☺ thank u... ☺ ? . but it could be something else/ …or…. ☺ Thank u for ur cooperation. for me? SHAKE HANDS & LEAVE ROOM drkhalilezekiel@yahoo.. “c. may I proceed? But 1st let me wash my hands. and do brief physical exam. about health of your family members. let me ask u few Qs.Let me make u more comfortable DRAPE PT. C. I am done é phys. Will be kept confed. First I’ll ask u few Qs. Conditions? Mr. let me summarize for it. an attending physician in this . options. Meanwhile if u have any Qs.. hospital. . Do u have any Qs. so to arrive at right Đ. ☺ . Ok? Mr. . ok? .once I’ve results we’ll meet again & discuss various ttt. -month/year-old female/male c/o her child having …. spells backward.22 Suggested form for Patient notes HISTORY HPI: OB/GYN: LMP…. . non-distended.No fundoscopic abnormalities. regular periods every….com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) . no hepatosplenomegally + Extremities: no edema. PERRLA.lasting….. …) ( The source of information is the patient’s mother. No spinous process or paraspinous tenderness.. tired. non-tender. Menarche at age… Uncomplicated NSVD at full term.Weeks . thyroid normal. + Heart: RRR. Motor: strength 5/5 throughout -sensory: intact to soft touch and pinprick.Days. normal DTR in lower extremities + Skin: no rash + Neuro: MMSE: AOx3. +BS. Allergies: NKDA Medications: none PMH: PSH: SH: smoke /alcohol / illicit drugs/sex / job /exercise FH: noncontributory PHYSICAL EXAM Patient is in no acute distress OR looks . clear breath sounds bilaterally. normal S1/S2.. rapid alternating movement and heel to chin test normal and symmetric + Back: No obvious deformities or signs of trauma. Cerebellar: . Years ago. + Chest: no tenderness. Nose. no conjunctival pallor.mouth and pharynx WNL + Neck: Supple. drkhalilezekiel@yahoo. Gait: normal. no carotid bruits. no murmurs.Babinski bilateral. Of …) + HEENT: NC/AT.. rubs or gallops + Abdomen: soft. DTR: symmetric 2+ in all extremities (or lower extremities).(anxious. No LAD. no guarding. recalls 3 objects. Cranial nerves: 2-12 grossly intact.) + VS: WNL (except for temp. Range of motion normal anteriorly. ROS: negative except as above..Romberg. the mother of a …. drkhalilezekiel@yahoo. Practice live or through Skype/Google+/Telephone On day of the exam. then Practice with a colleague..com KHALIL’S HIGH YIELD STEP 2 CS MNEMONICS (2nd Ed) .23 Easy-K series Success key for USMLE step 2 CS exam is : PRACTICE Read First Aid book from page to page FIRST. eat light. never panic even you faced a strange case. You have THE MAGIC BULLET! Learn mnemonics in this booklet by heart! Practice it. family member or even Teddy bear if no one available.