Derm/HEENT Review Flashcards
SUBJECTIVE vs OBJECTIVE INFORMATION
Subjective: Everything the patient tells you about their health history
HPI, PMH, patient reported info etc.
Objective: Your observation or assessment. It is usually demonstrated, reproducible and reliable information
VS, physical assessment, labs/diagnostic studies
Implicit bias:
unconscious belief that leads to negative opinion about a person or group of people
Explicit Bias:
conscious and deliberate negative belief about a person or group of people
Sensitivity
* Good ability to detect a disease
* High sensitivity means high _____ ___ rate
true positive;
Screening tests should have high _________
sensitivity
Diagnostic tests should have high _____
specificity
Specificity
* Better ability to confirm a disease is present
* Lower number of false negatives
* More likely to confirm a true negative
* High specificity means a high ______ ________ rate
true negative
Acute vs Chronic
Acute < ___ weeks
Chronic > ___ weeks
12 weeks
OLD CHARTS
- Onset- When did it start?
- Location- Where is it located
- Duration- How long does it last?
- Characteristics- What does it feel like? Sharp, dull, pressure, etc
- History- have you ever had this before?
- Associated/Alleviating/Aggravating- what makes it better?
Worse? - Radiation- Does it radiate
- Timing- When does it occur as related to an association with
something else? - Severity- Scale of 1-10
PROS/CONS of OPEN QUESTIONS
PROs: Provides baseline to start forming differential diagnosis; Helps build rapport
**CONS: **Patient decides what information to give; Patient takes control of the conversation- Time limits; Hard to get direct answers; Avoid “leading the witness”
PROS/CONS of CLOSED QUESTIONS
** PROs**:Direct answers to help develop diagnosis; Time efficient; Best only used with ROS
**CONs: **Easy to leave out information; Must ask the right questions; Too many can destroy rapport; avoid rapid fire;
USING TANNING BED:
Increases risk for:
Squamous cell carcinoma by** 58% **
basal cell carcinoma by **24%. **
Using tanning beds before age 20 can increase your chances of developing melanoma by 47%
Atopic dermatitis (eczema):
- Located in bending areas
- Exacerbated by heat and environmental factors
- Associated with allergies
- Often can co-exist with Asthma
- Presents when children around 6 months
Charting Lesions:
- Identify primary lesion
- Size
- . Specify the number or qualify by surface area (i.e. R forearm)
- Demarcation (linear, annular, discoid, serpiginous, well/poor demarcation, bull’s eye)
- Color (test for blanching if RED)
- Secondary characteristics: crusting, fissure, erosion, cellulitis, necrosis
- Texture: smooth, hard, scaly, fleshy, coarse, fine
Superior or cranial
toward the head end of the body; upper (example, the hand is part of the superior extremity).
Inferior or caudal
away from the head; lower (example, the foot is part of the inferior extremity).
Anterior or ventral
front (example, the kneecap is located on the anterior side of the leg).
Posterior or dorsal
back (example, the shoulder blades are located on the posterior side of the body).
Medial -
toward the midline of the body (example, the middle toe is located at the medial side of the foot).
Lateral -
away from the midline of the body (example, the little toe is located at the lateral side of the foot).
Proximal -
toward or nearest the trunk or the point of origin of a part (example, the proximal end of the femur joins with the pelvic bone).
Distal -
away from or farthest from the trunk or the point or origin of a part
Coronal Plane (Frontal Plane) -
A vertical plane running from side to side; divides the body or any of its parts into anterior and posterior portions.
Sagittal Plane (Lateral Plane) -
A vertical plane running from front to back; divides the body or any of its parts into right and left sides.
