hi,

i am confused about the patient note, is it necessary , mandatory to write 3 diagnosis with reasons in history and physical exam

it takes time, plus the case is not clear, some points are contributing others are not ...

any ideas , how are candidates doing it these days...

thanks

good question....
any help will be appreciated.

It is not absolutely necessary to write all 3 Dx in all 12 cases but most of the cases, you would not find that hard to put 3 Dx. You can write 2 in some cases, and very rarely only 1 when there's nothing else, for eg, herpes zoster case in Kaplan Core Cases book.
What is important is to write down pertinent positives and negatives in why you give that Dx/Dx-s. The CC can be written down as pertinent positive in all 3 Dx. Sometimes for the 3rd one, that's the only reason available. Roughly, 3 reasons for 1st Dx, 2 reasons for 2nd Dx, one reason for 3rd Dx, but it doesn't means you have to do it strictly.
The SPs helps a lot if you talk to them friendly and show some respect. Always remember to ask "Before I move on with my questions/examination, do you want to add anything to what we've discussed so far?" or "Do you have any question or concern in addition to what we've talked?" Ask them at least 3 times (after CC and HPI, after Past H/O and right before PE) and they will provide you with information you missed out on and that will give you more Differential Dx. Hope this helps.
I took my test at LA center, April 16th and I passed with high performance.

Thank u

thank you

at least 2 or 3 is fine[


quote=spine100]hi,

i am confused about the patient note, is it necessary , mandatory to write 3 diagnosis with reasons in history and physical exam

it takes time, plus the case is not clear, some points are contributing others are not ...

any ideas , how are candidates doing it these days...

thanks[/quote]

As long as you have 2 ddx it is fine