2nd ASSESSMENT Flashcards
A body mass index of 31kg/m2 is classified as??
Obesity I
A 55 years old male was brought to the emergency room of SWU-MC. He is hypertensive and diabetic with poor compliance to medications. As you began your physical examination, you noted that he has a demonstrable loss of muscle power in right upper and lower extremities. What does this denote?
Do you smoke cigarrettes?
A 35 year old female patient came with chest pain that is non radiating and sharp associated with fever and shortness of breath. Self - mediated with Paracetamol 500mg single dose, which provided temporary relief. What would be an additional question that will help you in your History of Present Illness?
What are aggravating and relieving factors?
You are making rounds on a stroke patient assigned to your care. The nurse referred to you that the patient has been having a fever and cough. You are thinking that the patient might have aspiration pneumonia. Which part of the lung fields will you most likely hear crackles?
Right mid to basal area
A 29 year old female consulted in the OPD because of anorexia. She noted that her weight last year was 60 kg and now it is only 50 kg. She had no intention of losing weight. The following would be appropriate
questions to ask regarding clinically significant weight loss except?
- Have you been having financial difficulties?
- Do you smoke cigarettes?
- Have you been taking contraceptives?
- Do you have episodes of abdominal pain?
Have you been taking contraceptives?
A 35 year old female patient came with chest pain, non radiating, sharp, associated with fever and shortness
of breath. Self - medicated with Paracetamol 500mg single dose, which provide temporary relief. What are
important questions to ask regarding shortness of breath in your HPI?
How fast did it happen? Have you been hit in the chest?
The following category of blood classification according to the JNC 8 guidelines are correctly paired, except:
Pre-hyper: systolic of 120-139 mmHg
Stage 2 Hyper: diastolic of >100mmHg
Normal: systolic of <120mmHg
Stage 1 hyper: diastolic of 80-99mmHg
Stage 1 hypertension: diastolic of 80-99 mm Hg
The following are components of the 5 As model in assessing readiness to quit smoking except?
- Arrange follow-up
- Acknowledge problem
- Assist in quit attempt
- Advise to quit
Acknowledge problem
The following are components of the 5 As model in assessing readiness to quit smoking except?
Acknowledge problem
This refers to a painless but uncomfortable awareness of breathing that is inappropriate to the level of
exertion.
Dyspnea
A 45 years old male was brought to SWU-MC ER dept due to dyspnea. Physical examination findings noted
dullness to percussion and decreased breath sounds in right middle to basal lung fields. You decide to do a
thoracentesis to evacuate the pleural effusion. Where will you insert the needle?
T7-T8 interspace
A 48 years old male is referred to your clinic because of elevated blood pressure. He has been taking his medications regularly, has increased his physical activity, and changed his diet to a DASH type of diet. What would be the most appropriate intervention?
Let him do home blood pressure monitoring
A 54 year old male was referred to you because of dyspnea. He is a 40 pack year smoker and was admitted last year due to an exacerbation of COPD. He was advised smoking cessation but refused. On inspection of the chest, what ratio would you expect his anteroposterior (AP) diameter to the lateral chest diameter to be?
> 0.9
It is the demonstrable loss of power
Weakness
A 35 year old female patient came with chest pain, non radiating, sharp, associated with fever and shortness
of breath. Self - medicated with Paracetamol 500mg single dose, which provide temporary relief. What other
important questions that you need to ask this patient that is included in your HPI?
Immunization history
• Previous hospitalization
• The onset, timing and duration of chest pain
• Heredofamilial disease
The onset, timing and duration of chest pain
A 21 year old male was brought to the ER because of dizziness. You took his right upper arm BP which read 160/90 mmHg. You asked your co-intern to validate his BP which still read 160/90 mmHg. You then measured the lower extremity BP which read as 100/70 mmHg. What would be the likely explanation for the discrepancy?
Coarctation of the aorta
The following statements about blood pressure taking are correct except:
• The patient should avoid smoking, caffeine, or exercise 60 minutes prior to measurement
• The width of the inflatable bladder of the cuff should be about 40% of upper arm circumference
• The patient should sit quietly for 5 minutes in a chair with feet on the floor
• The length of the inflatable bladder should be about 80% of upper arm circumference
The patient should avoid smoking, caffeine, or exercise 60 minutes prior to measurement
Which must be considered during the insertion of a chest tube?
• Tubes should be placed just at the superior rib margin
• Tubes should be placed just below the inferior rib margin
• Chest tube is ideally inserted at the 2nd intercostal space
• Tubes must not touch any rib margin
Tubes should be placed just at the superior rib margin
It is a blood pressure of >140/90 mm Hg in medical or clinic setting but with a mean awake ambulatory
reading of <135/85 mm Hg
White coat hypertension
What is the mechanism in respiratory expiration during normal breathing?
Normal expiration occurs through elastic recoil of lung parenchyma and chest wall
A 50 years old male consulted in the OPD because he “coughed out” blood. He took a picture of it and you noted the color to be dark brown with food particles. How will you label this in the patient’s chart?
Hematemesis
During health counseling, the patient asked why he needs a yearly flu shot. Which explanation would you give him?
- The influenza virus mutates into new strains in a phenomenon called antigenic shift
- The antibodies to the influenza virus tend to wane and a booster shot would help
- The yearly influenza shot strengthens the immune system against the flu
- The immune system becomes weak one year after being given an influenza vaccine
The influenza virus mutates into new strains in a phenomenon called antigenic shift
This is considered the “gold standard” in blood pressure measuring and diagnosing hypertension
Ambulatory blood pressure monitoring
A 30 years old male consulted in the OPD because of sleeping problems. He was diagnosed with obstructive sleep apnea and was advised weight loss. His current weight is 80 kg and his height is 5 feet. What is the patient’s classification based on his BMI?
Obesity 1
