@ethankeller961
Here is a summary of the entire first part of the video (some of this is abbreviated so hopefully it makes sense, but you can watch and read along) CCS Cases Things to look for initially (brief skim of H&P) - write these on scratch sheet 1. Age 2. Gender 3. Allergies 4. Brief skim of hx 5. Screening/vaccines/social hx (smoke, drink, drugs, sexual hx) **skimming hx - buzzwords (they don’t want to trick you, dx is sometimes very very obvious) ex: RUQ pain exacerbated by fatty foods - gallstones They want to see if you can put in orders correctly, in correct order, and rule out other scary things (i.e ACS, pancreatitis etc) VS Exam: 1. If pt stable (i.e. in clinic and HDS) - complete physical (especially hitting the things they present with) 2. If pt unstable - not doing complete PE, wastes “simulated” time, need to “act fast” and do a focused PE Disposition - Where do you want the patient to be? 1. Home 2. ED 3. Admit 4. ICU STAT orders - Do you want to place any emergency orders? Mnemonic - MAVOCC + F (not all needed, but reminder of some HY examples) 1. Morphine 2. ACC (gives you IV access and glucose accuchecks) 3. Vitals check 4. Oxygen/oximeter 5. Cardiac monitor 6. C-spine 7. Fluids (NS) Orders (mnemonic) - tailor these tests to your ddx, don’t order all every time for every patient CCCMP CUAEH LLUSCENT 1. CBC 2. CMP 3. Creatine phosphokinase (CPK/CK) 4. Magnesium 5. Phosphate 1. CXR (or any XR) 2. US 3. ABG 4. ECG (other cardiac tests - echo, troponins) 5. B-HCG (repro age like <45-50 yo) 1. Lactate 2. LFT/PT/PTT/INR 3. UA/cx/UDS (or toxicology) 4. Stool cx/pH/Ova etc 5. Culture (blood, sputum etc) 6. ESR/CRP 7. Neuro checks 8. TSH Ex: 20 minute case (real-world time) - Takes you 10 minutes to complete (real time) - You treat pt perfectly - Case will end early - If you get major big things, haven’t done anything super wrong, and pt is improving —> case will end early and you have 2 minutes at the end to put in extra orders **refer back to scratch paper for quick reference for these below 1. Screening tests - i.e. colonoscopy, Pap smear, mammography 2. Vaccines - shingles, tetanus, pneumococcal 3. Counseling patient - i.e. smoking/drinking/drug cessation, medications, compliance, side effects, safe sex (if STI case), seat belt SITPM CPM ISSSAD SITPM Vax - based on case, age, gender etc 1. Shingles - zoster max - >50 yo, 2 dose series, now then in 2-6 mo 2. Influenza/COVID - fall/winter season (RSV >60 yo) 3. Tetanus - q10years 4. Pneumococcal >65 (or susceptible to encapsulated organisms) 5. Meningococcal - 2-dose at 11-12 yo and 16 yo CPM Screening 1. Colonoscopy - 45-75 yo (q10years if no abn) 2. Pap smear - (21-29 yo) q3yr w/ cervical cyto alone - (30-65) q3yr w/ cervical cyto alone, q5yr w/ high-risk HPV testing alone, or q5yr w/ hrHPV w/ cyto (co-testing) - Chlamydia/gonorrhea - all sexually active women <24 yo and >25 yo at increased risk for infection 3. Mammography - 50-74 yo - biennial screening ISSSAD Instructing patient - when you type “instruct” into order search, gives you lots of options 1. Instruct 2. Smoking 3. Safe sex 4. Seatbelt 5. Alcohol abstention 6. Disease specific instructions
@salamalvi3690
This was a phenomenal video bro. I used all your ccs mnemonics and tips and passed with ease. Thank You !
@sarahhmaidan6754
By far the best video on this content. Thank you so much for taking the time to make this!
@lesc1234
my test is on Monday and this was great!!! you gave me some ideas on how to optimize my time. thanks doc!!
@namratasethi5420
Very helpful. Makes CCS feel less overwhelming. Thank you!
@anmolsaggar9525
Extremely thorough yet succinct. Thank you for this gem.
@AB-xd8ft
one of the most informative videos of my lifetime really really thank you
@alejandrolopez1868
Where are u located? That lemon tree looks stunning !
@VallousseB
This was extremely helpful. Thanks so much for putting this together.
@EdwinSaji
Thank you, found this video the day before my exam, and it helped a ton!
@muhammadhamzashahab1704
You are an absolute legend.
@MalikKhan_925
Wonderful! Really helpful. I can finally open my CCS and start solving the cases with confidence!
@abbeyerwin2097
Wow, this was so incredibly helpful!!
@mb5101
I really needed this video. Thank you so much
@uth-psy
Super Helpful. Instead of trying to memorize those terrible acronyms, I changed a few. Emergent orders : FAV-MOCCA Workup orders: LUNCHMEATS 4CLUE-P Admit/Treatment orders: CICADA FLAB Closing orders: STIMP shots and CP SADISMS The admit/treatment one I made up: Consult, Insulin, Counsel meds, Abx, Diet, Acid, Fever/pain, Laxative, Activity, Blood (T/S/Transfuse)
@leyrezubiri6584
Thank you so much for the video. It's really helpful! I don't think you need prophylactic cefazolin on the cholecystitis case as you already started therapeutic piperacillin-tazobactam. Thanks again!
@samimazizi90
This is amazing, thanks buddy
@GypsyZoya
Amazing, so helpful!! you should be paid by the CCS cases :D
@anishalewis7958
SO helpful! Thank you!
@nataliamullins6919