These are the blue sheet, physical exam, diagnostic studies and differential diagnosis needed for a diabetes case in the USMLE Step 2 CS exam:
BLUE SHEET DIABETES:
PHYSICAL EXAMINATION
1. HEENT:
PERRLA, fundoscopy.
Neck:
Auscultation for carotid pulses, bruits. JVD.
2. Lungs:
Auscultation.
3. Heart:
Auscultation, PMI.
4. Extremities:
Inspection: Feet lesions or ulcers.
Palpation: Edema, peripheral pulses.
5. Neurologic:
Motor: Strength.
Sensory.
DTR’s – Babinsky.
POSSIBLE DIAGNOSTIC STUDIES:
- Genital exam
- CBC, BUN/Cr, electrolytes
- ESR
- Serum glucose, HbA1C
- Cholesterol, triglycerides
- UA C/S, urine microalbumin.
- TSH
- Nerve conduction studies (diabetic neuropathy)
- Doppler US penis (erectile dysfunction)
DIFFERENTIAL DIAGNOSIS (Probably associated diagnosis with diabetes ):
- Diabetes mellitus type 1 or 2.
- Insulin-induced hypoglycemia.
- Diabetic peripheral neuropathy.
- Diabetic nephropathy.
- Diabetic retinopathy.
- Erectile dysfunction.
- Hypothyroidism.
- Vasculitides.
The diagnosis here may be broad, it depends on the clinical presentation but it is helpful to think about what complications diabetics may develop.
Founder & Autor at Ecuadoctors.com
Hematology/Oncology Fellow at BUSM | Former Internal Medicine Residency/Chief Resident at UCONN | Website Developer & Author at Ecuadoctors.com
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