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APPROACH FOR THE CONTENT ON STEP 2 CK

a) Diagnosis: Are you able to make a differential in your head


and establish the answer to the question What is the
most likely diagnosis.
b) Management: Do you follow the protocol (order) in which
things are done: e.g: patient comes in with an MI, what is
the next best step in management a) aspirin b)nitrates
c) oxygen d)digoxin; all of these are right but the one you
give first is aspirin because it reduces mortality.
How will it change the outcome of my patient? And
what is the most cost effective way of doing?
Can you also answer What is the most accurate test In
other words, what is the gold standard of this test that you
are doing (highest specificity and sensitivity). e.g: Same
patient with the MI, the test done to determine the actual
diagnosis is a Percutaneus Coronary Intervention
(catheterization).
Answering What is the best Treatment according to
the setting (Emergency, follow up, ward) Meaning what
is the most efficacious drug for the particular pathology that
the patient has. Continuing with the case above,
thrombolitics is the best treatment if its been less than 3
hours, and if the hospital does not have cath unit.
c) Preventive Medicine: Know when you have to screen and
what tests do you send for the following:
Cancers: Colon, Breast, Cervical
Chronic Conditions: Hypertension, Diabetes etc

Immunizations: Pediatrics and adults (pneumococcal


vaccine)