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The descriptions are meant to serve as examples of actions that would add to, subtract from, or have no effect on an examinee's score for each case.

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She developed generalized aches and morning joint stiffness during the past 8 weeks and, more recently, pain and intermittent swelling of both wrists, and of the proximal metacarpophalangeal joints, as well as bilateral knee swelling.

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First Aid for the USMLE Step 2 CK, Ninth Edition (First Aid USMLE) 9th Edition.

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As soon as the absent breath sounds and exam findings consistent with tension pneumothorax are discovered, optimal treatment would include performing a needle thoracostomy for decompression followed by a chest tube insertion for lung reexpansion.

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Common Presenting Signs and Symptoms (PDF).

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USMLE Step 1, Third Edition 3rd Edition.

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Physical examination shows bilateral swollen, warm, and tender wrist, proximal metacarpophalangeal, and knee joints, and bilateral knee effusions.

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Patient Note Interactive (simulation of program for writing patient notes).

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First Aid for the Family Medicine Boards, Second Edition 2nd Edition.

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Crush Step 2: The Ultimate USMLE Step 2 Review, 4e 4th Edition.

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Master the Boards USMLE Step 2 CK, 2nd Edition 2nd Edition.

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In this acute presentation, timing is critically important.

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These tests serve to assess the severity of the disease and consider the likelihood of SLE, gout, an infectious process, or reactive arthritis.

Crush Step 3: The Ultimate USMLE Step 3 Review 4th Edition.

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Video Board Review of Internal Medicine 1st Edition.

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The patient has experienced increasing fatigue and generalized weakness during the past 4 months.

In this case simulation, when NSAID or corticosteroid treatment is initiated, the patient regularly reports both joint and systemic improvements.

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Up to Emergency Medicine First Edition.

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From the chief complaint, the differential diagnosis is broad; however, the comprehensive history narrows the differential.

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The CCS database contains thousands of possible tests and treatments.

Step 2 Clinical Knowledge (CK).

Therefore, ordering a rheumatology consult or additional monitoring is appropriate but optional during the time frame of this simulation.

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In the absence of other findings, the patient's illness, at this point, seems most consistent with rheumatoid arthritis.

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The following descriptions are meant to serve as examples of actions that would add to, subtract from, or have no effect on an examinee's score for this case.

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The pain began abruptly 45 minutes before the patient came to the emergency department.

Vital signs show tachypnea, tachycardia, and low blood pressure.

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The absence of fever, chills, cough, or pleural rub suggests that the problem is not an infectious pulmonary process.

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She is now short of breath and mildly nauseated.

First Aid for the USMLE Step 2 CS, Fourth Edition (First Aid USMLE) 4th Edition.

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The patient's blood pressure and respiratory rate should be closely monitored until the patient's condition has stabilized.

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These also appear at the end of the practice cases.

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The patient's illness, at this point, seems most consistent with an intrathoracic process.

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USMLE Step 2 Clinical Skills Triage: A Guide to Honing Clinical Skills 1st Edition.

The patient appears pale and in marked respiratory distress.

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While the presence of certain clinical features is helpful in excluding other connective tissue diseases and osteoarthritis, further diagnostic evaluation is appropriate to confirm the presumptive diagnosis and establish the severity of the disease.

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It is extremely important to check headphone volume during the exam day tutorial.

Practice materials updated May 2019.

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If you do not find the answer you need, please fill out our contact form.

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With the availability of effective treatment for rheumatoid arthritis and concerns about opioid addiction, narcotic analgesics should have a limited role in treatment.

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He is moaning and holding his hands over the right side of his chest.

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Therefore, it is not feasible to list every action that might affect an examinee's score.

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CT before lung reexpansion.

Special Note About Tutorials.

These signs and symptoms are highly suggestive of a chronic systemic inflammatory process.

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First Aid for the Medicine Clerkship, Third Edition (First Aid Series) 3rd Edition.

Step 3 tutorial and practice items, which includes practice CCS cases.

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An NSAID or corticosteroid relieves pain and decreases inflammation essential to provide interim symptom relief while the selected DMARD takes effect.

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First Aid for the USMLE Step 1 2015 25th Edition.

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In evaluating case performance, the domains of diagnosis (including physical examination and appropriate diagnostic tests), therapy, monitoring, timing, sequencing, and location are considered.

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First Aid for the USMLE Step 2 CS 5th Edition.

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There is no history of any previous episodes of chest pain either at rest or on exertion.

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Other physical findings are unremarkable.

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From the chief complaint, the differential diagnosis is broad.

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If you have questions or issues, check out the Frequently Asked Questions: Practice Materials.

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Step 2 Clinical Skills (CS).

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Initially the presentation and reason for visit suggest a broad differential diagnosis, but the limited available history narrows the differential.

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Treatment should be initiated immediately before the patient's condition worsens.

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