These are the blue sheet, physical exam, diagnostic studies and differential diagnosis needed for a hoarseness case in the USMLE Step 2 CS exam:
BLUE SHEET HOARSENESS:
PHYSICAL EXAMINATION
1. HEENT:
Inspection conjunctiva, mouth and throat
Neck: thyroid exam
2. Lungs:
Auscultation
3. Heart:
Auscultation
4. Abdomen:
Inspection
Auscultation
Palpation
Percussion
5. Extremities:
Inspection, tremors
6. Neurologic:
DTR’s for thyroid disease
POSSIBLE DIAGNOSTIC STUDIES:
- CBC.
- TSH, T4.
- ESR.
- U/S Neck.
- CT chest and abdomen (look for tumors).
- EKG/echocardiogram (mitral stenosis, atrial enlargement).
- Laryngoscopy.
- Esophageal PH monitoring (GERD).
DIFFERENTIAL DIAGNOSIS:
- Laryngitis (viral, voice overuse, etc).
- Laryngeal cancer.
- Laryngeal polyps or nodules.
- Hypothyroidism.
- GERD.
- Stroke.
- Goiter.
- Mitral valve stenosis.
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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