These are the blue sheet, physical exam, diagnostic studies and differential diagnosis needed for a violent assault or sexual assault case in the USMLE Step 2 CS exam:
BLUE SHEET SEXUAL OR VIOLENT ASSAULTS:
PHYSICAL EXAMINATION
1. HEENT:
Inspection for lesions
Palpation for tenderness: face, head, and neck.
Inspection of the mouth
2. Lungs:
Inspection for lesions
Palpation: Tactile fremitus.
Percussion: Look for resonant or else.
Auscultation: Usually patients can move the thorax without inspiration, simulating decreased breath sounds uni or bilaterally.
3. Heart:
Auscultation
4. Abdomen
Inspection
Auscultation
Palpation
5. Skin:
Inspection
6. Neurologic:
Mental status: A/O x 3 (person, time and place)
CN 2-12
Motor: Strength
POSSIBLE DIAGNOSTIC STUDIES:
- Pelvic and rectal exam.
- X-ray skeletal survey.
- CXR.
- Urine hCG.
- Wet mount, KOH preparation.
- Cervical cultures, gonorrhea, and chlamydia testing.
- HIV ELISA, VDRL, Hepatitis B serologies.
DIFFERENTIAL DIAGNOSIS (depends on the physical findings):
- Fractures.
- Hematoma.
- Pregnancy.
- Sexually transmitted diseases.
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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