Usmle-Step-3-Ccs-In-Short-Usmle-Step-3-Preparation-Resources.pdf

USMLE STEP 3 CCS CASES - STEP BY STEP APPROACH
Dr. Ashish Shrivastava


1. OFFICE CASE

• Physical Examination.
• Routine orders + Specific orders.
• Nothing urgent - Send the patient home and follow up according to result date.
• Results – 1) Normal – Reassure the patient.
2) Abnormal – Further tests or specific treatment if diagnosis clear.
• Interval history if required.
• Counsel the patient + Vaccination(age appropriate).
• Follow up at appropriate duration(mostly 2-3 months).
• Final Diagnosis.

2. EMERGENCY CASES

(a) Acute Emergency

• First stabilize the patient.
• Focussed physical examination.
• Routine orders + Specific orders.
• Specific treatment + symptomatic treatment in Orders only.
• Treatment interventions based on test results.
• Shift to Ward/Inpatient services.
• Post op orders.
• Follow up for a week.
• Shift to Home & follow up.
• Counseling.
• Final diagnosis.

(b) Non-acute emergency

• Stabilize the patient if required.
• Focussed physical examination.
• Routine orders + Specific orders.
• Specific treatment + symptomatic treatment in Orders only.
• Shift to Ward/Inpatient services.
• Treatment interventions based on test results.
• Follow up in ward till patient stabilizes.
• Shift to Home & follow up.
• Counseling.
• Final diagnosis.