These are the blue sheet, physical exam, diagnostic studies and differential diagnosis needed for a positive pregnancy test or pregnancy control case in the USMLE Step 2 CS exam:
BLUE SHEET PREGNANCY:
Suspect abuse in all women and elderly females:
SAFEGARDS:
S: Safety inquiry
A: Alcohol use by the abuser
F: Forced sex, fractures due to abuse, family/friends support
E: Emergency plan
G: Guns at home/attacked with weapons
A: Attack to children, afraid of children safety
R: Report to police
D: Depression screening
S: Suicidal ideation, plan, attempts.
PHYSICAL EXAMINATION
1. HEENT:
Inspection, conjunctival pallor assessment
PERRLA
Neck:
Thyroid exam.
Mouth and oropharynx.
2. Lungs:
Auscultation
3. Heart:
Auscultation
4. Abdomen:
Inspection
Auscultation
Palpation
5. Skin:
Inspection
POSSIBLE DIAGNOSTIC STUDIES:
- Breast and pelvic examinations
- Urine hCG (if pregnancy was not confirmed yet)
- UA C/S
- CBC
- TSH-T4
- U/S pelvis
- Blood type, Rh, antibody screening
- RPR, Varicella, Rubella titers
- HIV, HBV testing
DIFFERENTIAL DIAGNOSIS:
- Normal pregnancy.
- Ectopic pregnancy.
- Molar pregnancy.
- Secondary amenorrhea.
Good luck!.
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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