Having trouble remembering all the important questions to ask during your patient encounter? Then try this Assault Rape Mnemonic for USMLE Step 2 CS.
- Loss of consciousness, Dizziness
- Vaginal bleeding
- Changes in vision
- Blood in urine/stool
- Head & Neck exam: Inspection, Palpitation (Look for signs of head trauma)
- Mouth exam: Inspection
- Cardiovascular exam: Inspection, Auscultation, Palpation, Percussion
- Pulmonary exam: Inspection, Auscultation, Palpation, Percussion, Tactile Fremitus. (Especially in a patient with SOB & Chest pain)
- Abdominal exam: Inspection, Auscultation, Palpation, spleen,
- Neurologic exam: Mini Mental Status Exam, Cranial nerves (2-12), Gross Motor & Sensory
- Musculoskeletal exam: Inspection, Palpitation (look for bruises and trauma)
- This section depends on patient’s Chief Complaint. For example; Chest pain, Abdominal pain, Headache, Loss of consciousness…
ALWAYS include the following in your Differential Diagnosis:
- Sexually Transmitted Infection
- Pelvic exam
- Urine Beta-hCG
- Wet mount, KOH prep, Cervical Culture, Vaginal pH
- XR-Skeletal survey
- HIV 1&2 antibody, VDRL, Hepatitis B surface antigen, Urine gonorrhea/chlamydia PCR
- Chest X-ray
- Make sure to show empathy.
- If patient is crying offer her tissue & water and let her finish crying.
- Support the patient by letting her know that you are here for her and that what happened to her was not her fault and could have happened to anyone.
- Encourage her to report the incident to the police if she/he hasn’t already done so.
- Offer her emergency contraceptives.
- Let her know that you are going to let the social worker come and talk to her and provide her with phone numbers for support groups and other resources.
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Assault Rape Mnemonic.