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  1. #1
    BlueDiablo is offline Newbie
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    CCS Cases on my test (past test takers, please eval if I did okay)

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    Just took my test today. I got the following cases.

    BTW, I got the diagnosis right for the most part. I'm really hoping for any replies from people who have already taken the test and if their CCS performance was similar to mine in that I got the diagnosis and initial workup but missed on a few things. I'm really nervous right now and would appreciate any feedback.

    1. PCP pneumonia - 38 y/o male with SOB. Had do get +HIV. I got the sputum gs and culture but forgot to get a bronch wash for diagnosis. Also forgot to get RPR, Hep panel, pneumovax, or influenza

    2. DUB in postmenopausal F - came in with postmenopausal bleed, u/s showed endometrial thickening, but the biopsy was negative. I ran out of time and didn't get to put in the diagnosis

    3. HTN in 18 y/o M - guy was asymptomatic with no findings on P/E, CBC, SMA-7, or u/a. I had him change his diet, lose weight and come back in 1 month then 2 months later. I was wavering on whether or not to do more studies (renin, metanephrines, renal doppler) but given he had no findings on P/E and his bp went down with environmental changes, I backed off. I forgot to get an EKG and lipid panal

    4. Duodenal ulcer - 68 y/o M with COPD comes in SOB and 3-5 lb weight loss, and bloating. CBC showed microcytic anemia with hgb -9.8 +occult blood. Given he was symptomatic I went ahead and transfused him. I initially thought colon CA so I went with the colonoscopy which was negative. Right before my time ran out, I got a UGI series which revealed a duodenal ulcer. In the 5 min left section, I ordered the H. pylori bx, PPI, clarithromycin, and amoxicillin

    5. Hep A - 18 y/o nausea and elevated LFT's. This guy's bp was 110/80 and he was lethargic. The biggest misstep I had on this case was
    admitting him for fluid hydration which looking back probably shouldn't have been the case.

    6. Nephrotic Syndrome - 4 y/o kid with edema and periorbital swelling. I botched up this case in that I waited until the follow up to give him lasix. In addition I blanked out and didn't give him prednisone.

    7. Hypothyroidism - 30 y/o F. Straightforward workup.

    8. Splenic laceration - 28 y/o F s/p MVA. Forgot to get an pregnancy test before the workup but for the most part I think I got it. I dx it with an abdominal u/s before calling a surgery consult. Put in for a pneumovax at the end.

    9. DKA with UTI - 34 y/o F with DKA and UTI. B-HCG was negative so gave bactrim for the UTI and treated the DKA as usual. Forgot to get an amylase or lipase.

    I gave full counseling on all my patients with follow up to specialty clinics (i.e. the HIV guy got a f/u with ID to start HAART therapy). God, I hope this was enough to pass the test.

  2. #2
    Werther is offline Newbie 510 points
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    Thanks for posting! i think you did very good.

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