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CS STUDY GUIDE > CS 5 > Flashcards

CS 5 Flashcards

1
Q

What are the obesity related complications?

A

Back pain, osteoarthritis, atherosclerosis cardiovascular issues, sleep apnea

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2
Q

What are the laboratory studies done for obese patients?

A

Glucose (HbA1c)
TSH
Lipids
Hepatic enzymes

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3
Q

What is the approach for obese patients?

A

Underlying conditions causes of obesity, complications of obesity, possible comorbidities

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4
Q

What are the non-medical causes of obesity? Common causes? Endocrine disorder causes?

A

Sedentary lifestyle, over eating; menopause, pregnancy, sleep deprivation, smoking cessation, medications (sulfonylurea, TCAs, Oral contraception; Endocrine disorder such as hypothyroidism, Cushing disorder

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5
Q

What terminates palpitations caused by supraventricular tachycardia?

A

Terminate symptoms by vagal maneuvers (coughing and valsalva)

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6
Q

How can premature ventricular contraction present?

A

Isolated forceful beats at rest

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7
Q

Examples of palpitation?

A

Irregular, forceful, weird, fast

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8
Q

What substance can cause palpitations?

A

Caffeine, stimulants, and amphetamine, alcohol abuse or withdrawal

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9
Q

What are the metabolic causes of palpitations?

A

Hyperthyroidism, hypoglycemia, anemia,Pheochromocytoma

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10
Q

What are the medications that can cause palpitations?

A

Anticholinergic, vasodilators, bronchodilators, stimulants

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11
Q

What are the neuropsychiatric causes of palpitations?

A

Insomnia, anxiety disorders

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12
Q

What are the basic markers that are done for patients who have palpitations?

A

ECG, CBC, glucose, electrolytes, TSH

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13
Q

Preemployment medical evaluations fall into that category?

A

Access fitness for workers with strain US occupation. Aggressive preventative care, substance-abuse or mental health disorders, general preventative care/wellness examination.

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14
Q

What should be done for patient gives you a form to fill out?

A

Explain that you were for the format you leave the room and you are mailed to the patient

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15
Q

What should be noted in your patients note for patients with pre-employment visit?

A

Reason for obvious disqualification for patient to perform the job without public risk

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16
Q

What are the Positive physical examination test done for rotator cuff impingement or tendonopathy? Rotator cuff tear?

A

Pain with external rotation of the shoulder and abduction. (Subacromial tenderness, normal range of motion with positive impingement test (Neer); Similar to previous, pain with external rotation, Age >40

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17
Q

What are you differential diagnosis for shoulder pain?

A

Rotator cuff tear or tendonopathy, or impingement, Adhesive Capsulitis, Bicep tendon apathy/rupture, Glenohumeral osteoarthritis

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18
Q

What are the stages of Smoking Cessation?

A

Precontemplation, Contemplation, Preparation, Action, Maintenance

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19
Q

What are the stages in smoking cessation?

A

Precontemplation, contemplation, preparation, action, maintenance, identification.

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20
Q

In the stages of smoking cessation what does precontemplation mean?

A

Not willing to acknowledge negative consequences

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21
Q

What should be the approach to encouraging a patient to quit smoking?

A

Explain the consequences, personalized risk

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22
Q

What should be the approach in recommending a patient to stop smoking?

A

Mentioned counseling and drug therapy and Follow up phone calls to reinforce positive changes

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23
Q

What are some questions you can ask in HPI for smoking cessation patients?

A

Are there any situations that tend to reinforce smoking? Have you tried to quit before? How did it go?

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24
Q

Delineate motivational interviewing for smoker cessation patients?

A

Indications (comorbid problems), Principles (Acknowledge the resistance to change, discuss discrepancies between behavior and long-term goals, personalize, Enhance motivations for quitting), Technique (OARS) open ended questions reflect Affirmation & summarize the main points

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25
Q

Close encounter for smoking patients?

A

Identify factors that made me quitting easier or harder,Express preferences on quitting strategies for treatment. Provide a quit date

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26
Q

How would you characterize shoulder pain?

A

Acute (<2weeks)or chronic, Traumatic or Atraumatic, intrinsic or extrinsic (Including radicular and referred pain), location (anterior, posterior, superior, diffuse)

27
Q

What are the symptoms for adhesive capsulitis, frozen shoulder syndrome?

A

Decreased both passive and active range of motion and shoulder joint. Painful and progressive. More stiffness and pain.

28
Q

Describe the common causes of shoulder pain?

A

Rotator cuff impingement or tendinopathy, rotator cuff tear, biceps tendinopathy/rupture, glenohumeral osteoarthritis, adhesive capsulitis

29
Q

How do patients with rotator cuff impingement or tendinopathy present?

A

Pain with abduction and external rotation shoulder, subacromial tenderness, normal range of motion with positive impingement test (Neer, Hawkins)

30
Q

How does rotator cuff tear presents?

A

Similar to rotator cuff tendinopathy however patient is usually less than 40 and there’s weakness with external rotation

31
Q

How did patience with Adhesive Capsulitis (frozen shoulder) present?

A

Decreased active and passive range of motion. More stiffness and pain

32
Q

How Do you patience with bicep tendon apathy/rupture present?

A

Anterior shoulder pain, pain with lifting carrying or overhead reaching. Weakness is less common.

33
Q

What two can be damaged and a patient who has a humeral fracture? What can be the results?

A

Axillary nerve can be injured in proximal humerus fracture, causing sensory loss alongthe lateral aspect of the deltoid region.
Radial nerve can be injured in a fracture of the mid shaft/distal third of the humerus causing wrist drop

34
Q

What are the bio metric measurements for patients who are obese?

A

Blood pressure and pulse, weight, BMI, waist circumference

35
Q

What are the laboratory studies that should be done for obese patients or patients who experience excessive weight gain?

A

Glucose or hemoglobin A-1 C, TSH, lipids, hepatic enzymes

36
Q

What are the three parts in evaluating patients with obesity?

A

Ruling out any underlying disorder’s, complications, comorbid conditions

37
Q

How is BMI measured?

A

Weight in kilograms divided by height in meters squared

38
Q

What is considered severe obesity?

A

BMI greater than 40 or greater than 35 with weight related complications

39
Q

What are the differential diagnosis for obesity or weight gain?

A

Nonmedical causes include sedentary lifestyle or over-eating. Medical causes include pregnancy, menopause, smoking cessation, sleep deprivation, and medications ( oral contraception, sulfonylurea, tricyclic) and endocrine disorder (hypothyroidism Cushing’s syndrome)

40
Q

What should you say with patients who inquires about weight loss treatment?

A

I will follow up to address appropriate options for your case

41
Q

What are the differential diagnosis for palpitations?

A

Structural heart disease, cardiac conduction disease, medications, other, metabolic disorders, neuropsychiatric disorder’s

42
Q

What are the structural heart disease that can cause palpitations?

A

Valvular heart disease, cardio myopathy

43
Q

What are the Cardiac conduction disease that can cause palpitations?

A

Atria fibrillion, super ventricular arrhythmia/ectopy , ventricular arrhythmia/ectopy

44
Q

What are the metabolic disorders that can cause palpitations?

A

Hyper thyroidism, pheochromocytoma, Hyperglycemia, anemia

45
Q

Neuropsychiatric disorders that can cause palpitations include?

A

Anxiety disorders, insomnia

46
Q

Medication that can cause palpitations include?

A

Stimulants, vasodilators, bronchodilators, anti-cholinergics

47
Q

Other substances that can cause palpitations include?

A

Caffeine, cocaine, amphetamines, alcohol abuse or withdrawal

48
Q

What are some of the things I look for to support a cardiac source for palpitations?

A

Irregular heartbeat, prolonged symptoms greater than five minutes, underlying heart disease

49
Q

How may patients terminate the palpation sensation?

A

Vagal maneuvers like coughing or Valsalva which suggest supraventricular tachycardia

50
Q

What question should be asked in family history as a relates to obese patients?

A

Is there obesity in your family? Do any of your close family members have heart disease diabetes or thyroid disorder?

51
Q

Questions that should be asked to obesity patients as it pertains to medication?

A

Do you take any medications? Have you taken steroid medication recently?

52
Q

What should be discussed during the closing encounter for obesity patients?

A

Clarify patient’s concerns. Review any complications or comorbidities and additional findings.

53
Q

What should we do response in a obese patient requires about weight loss treatment to?

A

Acknowledge their concern and expressed that they will be follow up like to address the appropriate options

54
Q

When are x-rays necessary for obese patients?

A

If patient expressed symptoms of osteoarthritis as a pertains to weight-bearing joints

55
Q

What is benign ectopy?

A

Occasional skip beats that occur rest and disappears with activity in an otherwise healthy well conditioned patient

56
Q

What are family history questions should be asked for patients who had palpitations?

A

Any heart conditions that run in the immediate family? And when your family died unexpectedly at a young age?

57
Q

What should be done if the pre-employment form ask you to measure blood pressure?

A

Measure blood pressure

58
Q

What diagnostic test are very common for preemployment patient?

A

Fasting glucose, lipid panel, urine toxicology, tuberculin skin test

59
Q

What test should be ran for preemployment patients who experience high risk exposure?

A

Chest x-ray and pulmonary function test for patients with inhalation exposure to hazardous particulates

60
Q

How does the glenohumeral Osteoarthritis present?

A

Gradual onset of anterior or deep shoulder pain usually caused by trauma.
Decreased active and passive abduction and external rotation

61
Q

How does Biceps tendinopathy/rupture?

A

Anterior shoulder pain. Pain with lifting caring or overhead reaching. Weakness is less common

62
Q

Adhesive capsulitis (frozen shoulder) how does it present?

A

Decrease passive and active range of motion. More stiffness than pain

63
Q

What should be done in pre-employment encounter in which there has been and how Laois and exposure to hazardous particulates?

A

Chest x-ray and pulmonary function test

CS STUDY GUIDE (6 decks)

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